Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

Science.gov (United States)

2013-01-01

Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR (AUC 0.791; 95% CI 0.702, 0.880; P<0.001). Less than two positive clinical features resulted in 96% sensitivity (95% CI 0.78, 0.99) and a LR- 0.09 (95% CI 0.02, 0

Leadership for Primary Schools: An Examination of Innovation within an Austrian Educational Context

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Petra Heißenberger

2016-02-01

Full Text Available This study examined relationships between the work of innovative school principals and innovative primary schools determined by defining eight areas of school leadership: Instructional Development, Classroom Management, School Organization, Social Interaction, Personnel Development, Cooperation, Infrastructure and School Marketing. A questionnaire was sent out to 658 primary school principals in Lower Austria. Data were analyzed using Lime Survey, SPSS (Statistical Package for the Social Sciences, and PASW (Predictive Analysis Soft Ware. To determine to what extent the self-assessment of principals supported the existence of respective areas of innovation, their self-assessment (independent variable was correlated with the outcomes from the item grouping (i.e., innovation themes. In addition, a correlation calculation with correlation parameters by Pearson and Spearman was executed. In summary, it must be pointed out that between the self-assessment of the principals and the subsequent self-assessment of school innovation themes no statistically significant correlations were verifiable. The study supports the need for further education and training that can support principals in their role as designers of their schools.

Chaperone use during intimate examinations in primary care: postal survey of family physicians

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Upshur Ross EG

2005-12-01

Full Text Available Abstract Background Physicians have long been advised to have a third party present during certain parts of a physical examination; however, little is known about the frequency of chaperone use for those specific intimate examinations regularly performed in primary care. We aimed to determine the frequency of chaperone use among family physicians across a variety of intimate physical examinations for both male and female patients, and also to identify the factors associated with chaperone use. Methods Questionnaires were mailed to a randomly selected sample of 500 Ontario members of the College of Family Physicians of Canada. Participants were asked about their use of chaperones when performing a variety of intimate examinations, namely female pelvic, breast, and rectal exams and male genital and rectal exams. Results 276 of 500 were returned (56%, of which 257 were useable. Chaperones were more commonly used with female patients than with males (t = 9.09 [df = 249], p Conclusion Clinical practice concerning the use of chaperones during intimate exams continues to be discordant with the recommendations of medical associations and medico-legal societies. Chaperones are used by only a minority of Ontario family physicians. Chaperone use is higher for examinations of female patients than of male patients and is highest for female pelvic exams. The availability of a nurse in the clinic to act as a chaperone is associated with more frequent use of chaperones.

Examination of Attitudes to Learning and Educational Stress in Prospective Primary School Teachers: Izmir-Buca Sample

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Hamurcu, Hülya

2018-01-01

Many factors interact with each other in learning and internalizing a subject along with performing a new task. Attitudes and stress are the two of these factors. The aim of this study was to examine attitudes to learning and educational stress in third and fourth year students as prospective primary school teachers. The relational model was used…

Examination of Primary and Secondary School Teachers' Aspects towards Educational Use of Video Sharing Websites

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Usta, Ertugrul; Atun, Handan

2017-01-01

Daily use of video has increased by televisions, but lately people have been using video sharing websites most frequently. This extended use of video sharing websites has emerged a new era for education; teachers and learners can use them to enhance learning in education. Hence, the purpose of this study is to examine primary and secondary school…

Examining Primary Schools' Physical Education Coordinators' Pedagogical Content Knowledge of Games: Are We Just Playing as This?

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Ward, Gavin

2013-01-01

A detailed insight into how the current educational climate influences the pedagogical decisions made by primary school teachers when teaching games is limited. Studies examining the pedagogical content knowledge (PCK) of teachers within physical education have revealed its close relationship with specific forms of subject knowledge. In…

Die belewenis van ouers met ’n siek premature baba

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M. E. van der Heyde

1993-03-01

Full Text Available The purpose of this study was to identify and describe the experiences of the parents of an ill premature infant in order to identify the needs of the parents going through this potential crisis. As a result of the constant medical and technological progress the percentage of premature infants is continually increasing. It is therefore of vital importance that the nursing and other medical staff are made aware of the trauma that these parents experience. This will enable them in giving adequate support and accompaniment in the prevention of social pathology.

Technology and Early Science Education: Examining Generalist Primary School Teachers' Views on Tacit Knowledge Assessment Tools

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Hast, Michael

2017-01-01

For some time a central issue has occupied early science education discussions--primary student classroom experiences and the resulting attitudes towards science. This has in part been linked to generalist teachers' own knowledge of science topics and pedagogical confidence. Recent research in cognitive development has examined the role of…

Examining the Seven-Flag "Chieu Hoi" Pass: A Primary Document from the American War in Viet Nam

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Engelmann, Ted

2006-01-01

During the Viet Nam war, U.S. military helicopters dropped "Chieu Hoi" (safe conduct) passes over suspected enemy locations to encourage enemy soldiers to surrender. This article presents a classroom activity that encourages students to examine a "Chieu Hoi" pass as a primary historical document, identify its various elements,…

Measuring Progress toward Universal Primary Education: An Examination of Indicators

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Langsten, Ray

2014-01-01

The Education Millennium Development Goal of universal primary education (UPE) states that "by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling." The 2008 midterm Global Monitoring Report claims that "A country's distance from UPE appears most clearly in terms of the net…

An Examination of Democratic Attitudes of Primary School Teachers

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S. Gulec

2009-12-01

Full Text Available As democracy can develop better in a society of democratic people, democracy education can also get its intended goals better in a democratic school environment. As the most influential people in a school environment were teachers, this study, too, aimed to determine their levels of democratic attitudes. In the present study, 60 primary school teachers working in the schools attached to the Bursa Metropolitan Municipality were surveyed. The relationships between their attitudes and some variables were studied. These variables included school they work, age, gender, marital status, number of children they have, education level, teaching experience and number of broth-ers or sisters. The questionnaire used for this study was validated by Aydogan & Kukul (2003 based on previous studies made by Gomleksiz (1988, Yildirim (1994 and Atasoy (1997. For the validity of the questionnaire, Cronbach Alpha coefficient (0.829 was calculated. The results suggest that teachers show very positive attitude with a score of 103. When the items were examined individually, some significant relationships were found with the variables. Teachers should have positive democratic attitudes in order to give lessons of democracy to their students. An appropriate and encouraging environment should be prepared in order for students to gain desired democratic outcomes. In a democratic environment, teachers’ positive attitudes will help their students to gain critical thinking skills, effective discussion skills, capability for fighting against inequity, cooperation and collaboration skills, and showing empathy and respect for diversity.

Potentiality of the existence of plea bargaining in the criminal process of Lithuania

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Janušaitytė, Gintarė

2016-01-01

Kontinentinės teisės tradicijos valstybėse pradėtas taikyti bendrosios teisės sistemos valstybėms būdingas derybų dėl kaltės (angl. plea bargaining) institutas sudarė prielaidas diskusijoms apie naujos baudžiamosios procesinės formos taikymo galimybes Lietuvos Respublikos baudžiamajame procese. Atsižvelgiant į siekį tobulinti baudžiamojo proceso optimizavimo galimybes, yra tikslinga svarstyti derybų dėl kaltės instituto egzistavimo prielaidas Lietuvos Respublikos baudžiamajame procese. Straip...

Extensive screening for primary tumor is redundant in melanoma of unknown primary

DEFF Research Database (Denmark)

Tos, Tina; Klyver, Helle; Drzewiecki, Krzysztof T

2011-01-01

For decades, patients in our institution with metastastic melanoma of unknown primary have been subjected to extensive examinations in search of the primary tumor. This retrospective study questions the results, and thus the feasibility of these examinations. Of 103 patients diagnosed with unknow......, for patients referred with metastastic melanoma of unknown primary, we recommend that a detailed history is obtained, and a standard physical examination performed, in addition to a histopathological review and CT/PET for staging....

Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care

NARCIS (Netherlands)

Wagemakers, H.P.; Luijsterburg, P.A.; Boks, S.S.; Heintjes, E.M.; Berger, M.Y.; Verhaar, J.A.; Koes, B.W.; Bierma-Zeinstra, S.M.

2010-01-01

Wagemakers HP, Luijsterburg PA, Boks SS, Heintjes EM, Berger MY, Verhaar JA, Koes BK, Bierma-Zeinstra SM. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care. Arch Phys Med Rehabil 2010;91:1452-9. Objective: To

Application of Addenbrooke's cognitive examination to diagnosis and monitoring of progressive primary aphasia.

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Leyton, Cristian E; Hornberger, Michael; Mioshi, Eneida; Hodges, John R

2010-01-01

Primary progressive aphasia (PPA) comprises 2 main variants: semantic dementia (SD) and progressive nonfluent aphasia (PNFA). Addenbrooke's Cognitive Examination (ACE) has become widely used for the diagnosis of dementias. Less information, however, is available about its ability to detect and monitor changes in cognition in PPA. We aimed to analyse the sensitivity and longitudinal changes of ACE scores in 2 subforms of PPA. We included 63 SD and 45 PNFA cases, all of whom had at least 2 assessments. Sensitivity levels, annualised rates of change and difference in scores over time on repeated ACE measurements were calculated. A cut-off of 88 points detected 95% of the PNFA and SD cases. Longitudinal analysis showed an average annual decline of 10 points per year, with no significant difference between groups. The ACE is a useful tool for detecting and tracking the evolution of PPA. Copyright 2010 S. Karger AG, Basel.

Examining School Culture in Flemish and Chinese Primary Schools

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Zhu, Chang; Devos, Geert; Tondeur, Jo

2014-01-01

The aim of this research is to gain understanding about school culture characteristics of primary schools in the Flemish and Chinese context. The study was carried out in Flanders (Belgium) and China, involving a total of 44 Flemish schools and 40 Chinese schools. The School Culture Scales were used to measure five school culture dimensions with…

Body mass index and depressive symptoms in primary care settings: examining the moderating roles of smoking status, alcohol consumption and vigorous exercise.

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Hooker, S A; MacGregor, K L; Funderburk, J S; Maisto, S A

2014-02-01

Depressive symptoms and obesity are highly prevalent in primary care settings. Depressive symptoms and obesity are positively related; as body weight increases, individuals are more likely to display depressive symptoms. This study examines the moderating roles of health behaviours (alcohol use, smoking status and vigorous exercise) on the relationship between body mass index and depressive symptoms. Exercise attenuates the relationship between depressive symptoms and obesity. Primary care patients often report multiple health risk behaviours and symptoms, including obesity and depressive symptomatology. This study examined the relationship between body mass index (BMI) and depressive symptomatology among primary care patients and tested its moderation by health behaviours. Primary care patients (n = 497) completed self-report questionnaires. Using three multilevel models, we tested the moderation of health behaviours on the BMI-depressive symptoms relationship. After controlling for relevant covariates, BMI was positively related to depressive symptoms. Smokers reported more depressive symptoms (P exercisers reported fewer (P  0.05). Only vigorous exercise significantly moderated the BMI-depression relationship (P < 0.05). BMI is positively related to depressive symptoms among patients who do not participate in vigorous activity, suggesting that vigorous activity reduces the risk for depressive symptoms among patients with higher BMI. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

[Correlation of intraocular pressure variation after visual field examination with 24-hour intraocular pressure variations in primary open-angle glaucoma].

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Noro, Takahiko; Nakamoto, Kenji; Sato, Makoto; Yasuda, Noriko; Ito, Yoshinori; Ogawa, Shumpei; Nakano, Tadashi; Tsuneoka, Hiroshi

2014-10-01

We retrospectively examined intraocular pressure variations after visual field examination in primary open angle glaucoma (POAG), together with its influencing factors and its association with 24-hour intraocular pressure variations. Subjects were 94 eyes (52 POAG patients) subjected to measurements of 24-hour intraocular pressure and of changes in intraocular pressure after visual field examination using a Humphrey Visual Field Analyzer. Subjects were classified into three groups according to the magnitude of variation (large, intermediate and small), and 24-hour intraocular pressure variations were compared among the three groups. Factors influencing intraocular pressure variations after visual field examination and those associated with the large variation group were investigated. Average intraocular pressure variation after visual field examination was -0.28 ± 1.90 (range - 6.0(-) + 5.0) mmHg. No significant influencing factors were identified. The intraocular pressure at 3 a.m. was significantly higher in the large variation group than other two groups (p field examination. Increases in intraocular pressure during the night might be associated with large intraocular pressure variations after visual field examination.

From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database.

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Coleman, Nathan; Halas, Gayle; Peeler, William; Casaclang, Natalie; Williamson, Tyler; Katz, Alan

2015-02-05

Electronic Medical Records (EMRs) are increasingly used in the provision of primary care and have been compiled into databases which can be utilized for surveillance, research and informing practice. The primary purpose of these records is for the provision of individual patient care; validation and examination of underlying limitations is crucial for use for research and data quality improvement. This study examines and describes the validity of chronic disease case definition algorithms and factors affecting data quality in a primary care EMR database. A retrospective chart audit of an age stratified random sample was used to validate and examine diagnostic algorithms applied to EMR data from the Manitoba Primary Care Research Network (MaPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The presence of diabetes, hypertension, depression, osteoarthritis and chronic obstructive pulmonary disease (COPD) was determined by review of the medical record and compared to algorithm identified cases to identify discrepancies and describe the underlying contributing factors. The algorithm for diabetes had high sensitivity, specificity and positive predictive value (PPV) with all scores being over 90%. Specificities of the algorithms were greater than 90% for all conditions except for hypertension at 79.2%. The largest deficits in algorithm performance included poor PPV for COPD at 36.7% and limited sensitivity for COPD, depression and osteoarthritis at 72.0%, 73.3% and 63.2% respectively. Main sources of discrepancy included missing coding, alternative coding, inappropriate diagnosis detection based on medications used for alternate indications, inappropriate exclusion due to comorbidity and loss of data. Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its

Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

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Rajmohan Panda

2013-03-01

Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

Attitudes, subjective norms, and intention to perform routine oral examination for oropharyngeal candidiasis as perceived by primary health-care providers in Nairobi Province

NARCIS (Netherlands)

Koyio, L.N.; Kikwilu, E.N.; Mulder, J.; Frencken, J.E.F.M.

2013-01-01

Objectives: To assess attitudes, subjective norms, and intentions of primary health-care (PHC) providers in performing routine oral examination for oropharyngeal candidiasis (OPC) during outpatient consultations. Methods: A 47-item Theory of Planned Behaviour-based questionnaire was developed and

Computed tomography as the primary radiological examination of lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Ilkko, E.; Laehde, S.

1988-10-01

A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8,5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed.

Computed tomography as the primary radiological examination of lumbar spine

International Nuclear Information System (INIS)

Ilkko, E.; Laehde, S.

1988-01-01

A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8,5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed. (orig.) [de

Examination of Stress-Coping Methods of Primary School Teachers in Terms of Different Variables

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Bayraktar, Hatice Vatansever; Yilmaz, Kamile Özge

2016-01-01

This research is a study that aims to reveal whether there is a significant difference between primary school teachers' stress-coping methods and their demographic features, and if any, whether it is negative or positive. The study consists of 191 primary school teachers working in 14 primary schools in seven geographical regions. The…

Non destructive examination of primary wall small scale mock-up DS-1F

International Nuclear Information System (INIS)

Jeskanen, H.; Lahdenperae, K.; Kauppinen, P.; Taehtinen, S.

1998-06-01

Ultrasonic examination of primary wall small scale mock up DS-1F before thermal testing showed no major defects on studied interfaces. However, some small indications were found on copper to copper and copper to steel interfaces and surface roughness of the outer surface of copper layer gave clear indications on ultrasonic images. After thermal test a curved 50 mm long crack along the Y- direction in the middle of the heated surface of the mock up and a 220 mm long crack along the copper to copper interface on the side surface of the mock up were detected. Small cracks, less than 60-80 μm in depth, were observed on copper surface. After thermal test the corresponding ultrasonic examination showed a strong effect on ultrasonic attenuation properties and on leaky Rayleigh waves on outer surface of copper layer. A major indication was found on copper to copper interface. About 50% of the copper to copper interface was delaminated. However, some small indications found already before thermal test were also found after thermal test and they were not grown in size. No indications were observed on copper to stainless steel interfaces. Additionally, major indications were found on stainless steel tube to copper interfaces. Tubes No. 1 and 2 were almost completely whereas tube No. 3 only partly separated from copper. No indications were found on stainless steel tube to copper interface on tube No. 4. Eddy current measurements showed no volumetric or crack like flaws in the stainless steel tubes, however, delamination of the copper to copper interface along the tubes No. 1, 2 and 3 was observed. (orig.)

Using Social Network Analysis to Examine the Effect of Care Management Structure on Chronic Disease Management Communication Within Primary Care.

Science.gov (United States)

Holtrop, Jodi Summers; Ruland, Sandra; Diaz, Stephanie; Morrato, Elaine H; Jones, Eric

2018-05-01

Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Individual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care management activities, and communication regarding chronic disease care. Using social network analysis and other statistical methods, we analyzed the communication dynamics related to chronic disease care for each practice. The structure of chronic disease communication varies greatly from practice to practice. Care managers who were embedded in the practice or co-located were more likely to be in the core of the communication network than were off-site care managers. These care managers also had higher in-degree centrality, indicating that they acted as a hub for communication with team members in many other roles. Social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. Structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.

Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.

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Loresto, Figaro L; Jupiter, Daniel; Kuo, Yong-Fang

2017-06-01

Few studies have examined differences in functional, cognitive, and psychological factors between patients utilizing only nurse practitioners (NPs) and those utilizing only primary care medical doctors (PCMDs) for primary care. Patients utilizing NP-only or PCMD-only models for primary care will be characterized and compared in terms of functional, cognitive, and psychological factors. Cohorts were obtained from the Medicare Current Beneficiary Survey linked to Medicare claims data. Weighted analysis was conducted to compare the patients within the two care models in terms of functional, cognitive, and psychological factors. From 2007 to 2013, there was a 170% increase in patients utilizing only NPs for primary care. In terms of health status, patients utilizing only NPs in their primary care were not statistically different from patients utilizing only PCMDs. There is a perception that NPs, as compared with PCMDs, tend to provide care to healthier patients. Our results are contrary to this perception. In terms of health status, NP-only patients are similar to PCMD-only patients. Results of this study may inform research comparing NP-only care and PCMD-only care using Medicare and the utilization of NPs in primary care. ©2017 American Association of Nurse Practitioners.

Screening for Cognitive Impairments in Primary Blepharospasm.

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Yang, Jing; Song, Wei; Wei, Qianqian; Ou, Ruwei; Cao, Bei; Liu, Wanglin; Shao, Na; Shang, Hui-Fang

2016-01-01

Studies have reported that non-motor symptoms are an important component of primary dystonia. However, evidence supporting cognitive impairment in primary dystonia is limited and contradictory. We applied the Chinese version of the Addenbrooke's Cognitive Examination-Revised and the Mini-Mental State Examination (MMSE) to screen for cognitive impairment in patients with primary blepharospasm. In addition, we investigated the relationship between performance on the Addenbrooke's Cognitive Examination-Revised and quality of life as measured by the Medical Outcomes Study 36-item Short-Form (SF36). The study included 68 primary blepharospasm patients and 68 controls matched by age, sex and education. The prevalence of cognitive deficits was 22.0% and 32.3% in primary blepharospasm patients group, as measured by the MMSE and the Addenbrooke's Cognitive Examination-Revised, respectively. Primary blepharospasm patents had a broad range of cognitive deficits, with the most frequently affected domains being visuospatial function (30.9%) and language (30.9%), followed by memory (27.9%), orientation/attention (26.4%) and verbal fluency (22.0%). Patients with cognitive deficits had lower total SF36 scores, especially in the subdomains of physical functioning, role-physical and social functioning, compared to those without cognitive deficits. Scores on the Addenbrooke's Cognitive Examination-Revised were significantly correlated with both the SF36 scores and the scores on the subdomains of physical functioning and social functioning. Some patients with primary blepharospasm have cognitive deficits. Poor performance on the Addenbrooke's Cognitive Examination-Revised is related to poorer quality of life.

A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan

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Abdullah Alkhawaldeh

2014-01-01

Full Text Available Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR=13.32, (OR=19.63, and (OR=17.91, respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

The Examination of the Views of Primary School Teachers and Pre-Service Primary Teachers on European Union Citizenship from the Point of Different Variables

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Üner, Sadik Selman; Yesil, Rüstü

2016-01-01

The aim of this study is to determine the view of primary school teachers and pre-service primary teachers on European Union citizenship. This study is a descriptive and quantitative research in survey methodology. The data of the research was collected from 207 primary school teachers teaching in 22 primary school in the city center of Kirsehir…

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations

OpenAIRE

Creavin, Sam T; Wisniewski, Susanna; Noel-Storr, Anna H; Trevelyan, Clare M; Hampton, Thomas; Rayment, Dane; Thom, Victoria M; Nash, Kirsty J E; Elhamoui, Hosam; Milligan, Rowena; Patel, Anish S; Tsivos, Demitra V; Wing, Tracey; Phillips, Emma; Kellman, Sophie M

2016-01-01

BACKGROUND: The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia.OBJECTIVES: To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia.SEARCH METHODS: We searched the specialised register of the Cochrane Dementia and Cognitive Improvement G...

Three treatments for bilingual children with primary language impairment: Examining cross-linguistic and cross-domain effects

Science.gov (United States)

Ebert, Kerry Danahy; Kohnert, Kathryn; Pham, Giang; Disher, Jill Rentmeester; Payesteh, Bita

2014-01-01

Purpose This study examines the absolute and relative effects of three different treatment programs for school-aged bilingual children with primary or specific language impairment (PLI). It serves to expand the evidence base on which service providers can base treatment decisions. It also explores hypothesized relations between languages and cognition in bilinguals with PLI. Method Fifty-nine school-aged Spanish-English bilingual children with PLI were assigned to receive nonlinguistic cognitive processing, English, bilingual (Spanish-English), or deferred treatment. Participants in each of the three active treatments received treatment administered by nationally certified speech-language pathologists. Pre- and post-treatment assessments measured change in nonlinguistic cognitive processing, English, and Spanish skills, and analyses examined change within and across both treatment groups and skill domains. Results All active treatment groups made significant pre- to post-treatment improvement on multiple outcome measures. There were fewer significant changes in Spanish than in English across groups. Between group comparisons indicate that the active treatment groups generally outperformed the deferred treatment control, reaching statistical significance for two tasks. Conclusions Results provide insight into cross-language transfer in bilingual children and advance understanding of the general PLI profile with respect to relationships between basic cognitive processing and higher level language skills. PMID:23900032

An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender

Science.gov (United States)

Bowhay, Andrew R; Watmough, Simon D

2009-01-01

Background There has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ) section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. Methods Data from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender. Results There were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7), p < 0.001; pharmacology, mean difference = 1.7% (95% CI 1.0, 2.3), p < 0.001; physics with clinical measurement, mean difference = 3.5% (95% CI 2.8, 4.1), p < 0.001; overall mark, mean difference = 2.7% (95% CI 2.1, 3.3), p < 0.001; and standardised overall mark minus the pass mark, mean difference = 2.5% (95% CI 1.9, 3.1), p < 0.001. Graduates from three medical schools that have undergone the change from Traditional to Problem Based Learning curricula did not show any change in performance in any aspects of the MCQ pre and post curriculum change. Conclusion Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males. PMID:19563655

The promotion of olanzapine in primary care: an examination of internal industry documents.

Science.gov (United States)

Spielmans, Glen I

2009-07-01

Media reports have discussed how olanzapine was marketed off-label for dementia and subsyndromal bipolar disorder. Much of this marketing occurred in primary care settings. However, these reports have provided few details. In legal proceedings, Lilly disclosed internal documents that detail the strategies utilized to market olanzapine. The current paper addresses the marketing of olanzapine in detail based upon a review of these documents. All 358 documents released by Lilly are publicly available online. Documents were utilized for this review if they were relevant to the marketing of olanzapine in primary care settings in the United States. It was found that olanzapine was marketed off-label in primary care settings for relatively mild symptoms that were framed as bipolar disorder and schizophrenia. A key strategy in this campaign was the use of hypothetical patient profiles in detailing visits, most of which clearly failed to meet diagnostic criteria for any recognized mental disorder. Evidence emerged that olanzapine was also marketed off-label as a treatment for dementia.

Ovarian metastasis in a transposed ovary 10 years after primary cervical cancer: the importance of histologic examination and review of literature.

Science.gov (United States)

Janse, Julienne A; Sie-Go, Daisy M D S; Schreuder, Henk W R

2011-06-17

Cases of cervical carcinoma metastasing to the transposed ovary are rarely reported in the literature. In this report, the authors present the case of a 53-year-old woman with a persisting, unsuspected cyst in the right transposed ovary, 10 years after treatment for adenosquamous carcinoma of the cervix. It is the first report describing a secondary ovarian malignancy originating from a cervical adenosquamous carcinoma in a transposed ovary. In addition, this is the first account of an ovarian metastasis 10 years after primary treatment for cervical cancer. Furthermore, pathologic examination with immunohistochemistry and human papillomavirus genotyping played a key role in the diagnostic process, as the case did not raise suspicion by ultrasound findings neither by cytological examination after cytological aspiration or by appearance during surgery.

Examining the Mathematical Modeling Processes of Primary School 4th-Grade Students: Shopping Problem

Science.gov (United States)

Ulu, Mustafa

2017-01-01

The purpose of this study is to identify primary school students' thinking processes within the mathematical modeling process and the challenges they encounter, if any. This is a basic qualitative research study conducted in a primary school in the city of Kütahya in the academic year of 2015-2016. The study group of the research was composed of…

Ultrasonic Examination of Double-Shell Tank 241-AP-104. Examination Completed August 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-AP-104. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AP-104 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-SY-103. Examination completed February 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-SY-103. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-SY-103 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-AZ-102 Examination Completed August 2003

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2003-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-AZ-102. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AZ-102 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plat (ETP), RPP-11832 (Jensen 2002) and summarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA ultrasonic examinations

Conversion between Addenbrooke's Cognitive Examination III and Mini-Mental State Examination.

Science.gov (United States)

Matías-Guiu, Jordi A; Pytel, Vanesa; Cortés-Martínez, Ana; Valles-Salgado, María; Rognoni, Teresa; Moreno-Ramos, Teresa; Matías-Guiu, Jorge

2017-12-10

We aim to provide a conversion between Addenbrooke's Cognitive Examination III (ACE-III) and Mini-Mental State Examination (MMSE) scores, to predict the MMSE result based on ACE-III, thus avoiding the need for both tests, and improving their comparability. Equipercentile equating method was used to elaborate a conversion table using a group of 400 participants comprising healthy controls and Alzheimer's disease (AD) patients. Then, reliability was assessed in a group of 100 healthy controls and patients with AD, 52 with primary progressive aphasia and 22 with behavioral variant frontotemporal dementia. The conversion table between ACE-III and MMSE denoted a high reliability, with intra-class correlation coefficients of 0.940, 0.922, and 0.902 in the groups of healthy controls and AD, behavioral variant frontotemporal dementia, and primary progressive aphasia, respectively. Our conversion table between ACE-III and MMSE suggests that MMSE may be estimated based on the ACE-III score, which could be useful for clinical and research purposes.

[Transient elevation of intraocular pressure in primary open-angle glaucoma patients after automated visual field examination in the winter].

Science.gov (United States)

Nishino, Kazuaki; Yoshida, Fujiko; Nitta, Akari; Saito, Mieko; Saito, Kazuuchi

2013-12-01

To evaluate retrospectively seasonal fluctuations of transient intraocular pressure (IOP) elevation after automated visual field examination in patients with primary open-angle glaucoma (POAG). We reviewed 53 consecutive patients with POAG who visited Kaimeido Ophthalmic and Dental Clinic from January 2011 to March 2013, 21 men and 32 women aged 67.7 +/- 11.2 years. The patients were divided into 4 groups, spring, summer, autumn, and winter according to the month of automated visual field examination and both eyes of each patient were enrolled. IOP was measured immediately after automated visual field examination (vf IOP) and compared with the average IOP from the previous 3 months (pre IOP) and with the average IOP from the following 3 months (post IOP) in each season. IOP elevation rate was defined as (vf IOP- pre IOP)/pre IOP x 100% and calculated for each season (paired t test). Additionally, the correlation between mean deviation (MD) and IOP elevation rate was evaluated (single regression analysis). Exclusion criteria were patients who received cataract surgery during this study or had a history of any previous glaucoma surgery. The automated visual field test was performed with a Humphrey field analyzer and the Central 30-2 FASTPAC threshold program. The average vf IOP was 14.5 +/- 2.5 mmHg, higher than pre IOP 13.8 +/- 2.4 mmHg (p field examination, especially in the winter but not in the summer.

The Whiteley Index-6: An Examination of Measurement Invariance Among Self-Identifying Black, Latino, and White Respondents in Primary Care.

Science.gov (United States)

Fergus, Thomas A; Kelley, Lance P; Griggs, Jackson O

2018-03-01

Brief measures that are comparable across disparate groups are particularly likely to be useful in primary care settings. Prior research has supported a six-item short form of the Whiteley Index (WI), a commonly used measure of health anxiety, among English-speaking respondents. This study examined the measurement invariance of the WI-6 among Black ( n = 183), Latino ( n = 173), and White ( n = 177) respondents seeking treatment at a U.S. community health center. Results supported a bifactor model of the WI-6 among the composite sample ( N = 533), suggesting the presence of a general factor and two domain-specific factors. Results supported the incremental validity of one of the domain-specific factors in accounting for unique variance in somatic symptom severity scores beyond the general factor. Multiple-groups confirmatory factor analysis supported the configural, metric, ands scalar invariance of the bifactor WI-6 model across the three groups of respondents. Results provide support for the measurement invariance of the WI-6 among Black, Latino, and White respondents. The potential use of the WI-6 in primary care, and broader, settings is discussed.

Problem Solving Strategies among Primary School Teachers

Science.gov (United States)

Yew, Wun Thiam; Lian, Lim Hooi; Meng, Chew Cheng

2017-01-01

The purpose of this article was to examine problem solving strategies among primary school teachers. The researchers employed survey research design to examine their problem solving strategies. The participants of this study consisted of 120 primary school teachers from a public university in Peninsula Malaysia who enrolled in a 4-year Graduating…

Ultrasonic Examination of Double-Shell Tank 214-AW-102 Knuckle Region. Examination completed February 2003

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2003-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic examination of the knuckle region of Double-Shell Tank 241-AW-102 utilizing the Remotely Operated Nondestructive Examination (RONDE) system. The purpose of this examination was to provide information that could be used to evaluate the integrity of the knuckle region of the primary tank. The requirements for the ultrasonic examination of Tank 241-AW-102 were to detect, characterize (identify, size, and locate), and record measurements made of any circumferentially oriented cracks that might be present in the knuckle area of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-7869, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided t o PNNL for third-party evaluation. PNNL is responsible for preparing a report(s) that describes the results of the COGEMA ultrasonic examinations

Ultrasonic Examination of Double-Shell Tank 241-AY-101. Examination completed October 2007

International Nuclear Information System (INIS)

Pardini, Allan F.; Weier, Dennis R.

2008-01-01

AREVA NC Inc., under contract from CH2M Hill Hanford Group, has performed an ultrasonic examination of selected portions of Double-Shell Tank 241-AY-101. PNNL is responsible for preparing a report(s) that describes the results of the AREVA ultrasonic examinations. This report is Revision 1 - more data has been added to the original report. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-AY-101 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan, RPP-Plan-27202 (Jensen 2005) and summarized on page 1 of this document, are to be reported to CH2M Hill Hanford Group and the Pacific Northwest National Laboratory for further evaluation. Under the contract with CH2M Hill Hanford Group, all data is to be recorded on electronic media and paper copies of all measurements are provided to Pacific Northwest National Laboratory for third-party evaluation. Pacific Northwest National Laboratory is responsible for preparing a report(s) that describes the results of the AREVA NC Inc. ultrasonic examinations.

Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention.

Science.gov (United States)

Cournot, Maxime; Taraszkiewicz, Dorota; Cambou, Jean-Pierre; Galinier, Michel; Boccalon, Henri; Hanaire-Broutin, Hélène; Chamontin, Bernard; Carrié, Didier; Ferrières, Jean

2009-11-01

The choice of noninvasive tests used in primary prevention of cardiovascular diseases must be based on medical evidence. The aim of this study was to assess the additional prognostic value, over conventional risk factors, of physical examination, exercise testing, and arterial ultrasonography, in predicting a first coronary event. A prospective cohort study was conducted between 1996 and 2004 (n = 2,709), with follow-up in 2006 (response rate 96.6%). Participants had no history or symptoms of cardiovascular disease and had a standardized physical examination, a cardiac exercise testing, and carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during follow-up. Over the Framingham risk score, femoral bruit, positive exercise test, intima-media thickness >0.63 mm, and a femoral plaque provided significant additional information to the prediction model. The addition of the exercise test to the traditional risk factors, then the intima-media thickness and lastly the presence of femoral plaques, produces incremental increases in the area under the receiver operating characteristic curve (0.73-0.78, P = .02) and about a 50% increase in the positive predictive value (15.8%-31.4%), with no effect on the negative predictive value (96.4%-96.9%). Physical examination, exercise testing, and arterial ultrasonography provide incremental information on the risk of coronary event in asymptomatic adults. Exercise testing and femoral ultrasonography also improve the accuracy of the risk stratification.

The Sensitivity of Primary School Enrollment to the Cost of Post-Primary Schooling in Rural Pakistan: A Gender Perspective.

Science.gov (United States)

Hazarika, Gautam

2001-01-01

Examines gender differences in the sensitivity of primary-school enrollment to the costs of postprimary schooling in rural Pakistan. Finds that distance from primary school is a significant determinant of female primary-school enrollment and distance from middle school is a significant determinant of male primary-school enrollment. Suggests…

The role of MRI of the brain and spinal cord, and CSF examination for the diagnosis of primary progressive multiple sclerosis

DEFF Research Database (Denmark)

Nilsson, P; Sandberg-Wollheim, M; Norrving, B

2007-01-01

The clinical applicability of the revised McDonald diagnostic criteria of primary progressive multiple sclerosis (PPMS) was assessed in 17 patients with a longstanding PPMS diagnosis (mean 15 years). All patients were re-evaluated with clinical examinations, magnetic resonance imaging (MRI...... the revised McDonald criteria for positive scans. No contrast-enhancing lesion was observed despite administration of triple doses of gadolinium. In total, 12 patients fulfilled the revised McDonald MRI criteria for PPMS. Of the remaining five patients who incompletely fulfilled the revised MRI criteria, all...

TMI-2 core examination plan

International Nuclear Information System (INIS)

Owen, D.E.; MacDonald, P.E.; Hobbins, R.R.; Ploggr, S.A.

1982-01-01

The Three Mile Island (TMI-2) core examination is divided into four stages: (1) before removing the head; (2) before removing the plenum; (3) during defueling; and (4) offsite examinations. Core examinations recommended during the first three stages are primarily devoted to documenting the post-accident condition of the core. The detailed analysis of core damage structures will be performed during offsite examinations at government and commercial hot cell facilities. The primary objectives of these examinations are to enhance the understanding of the degraded core accident sequence, to develop the technical bases for reactor regulations, and to improve LWR design and operation

A Very Historical Mode of Understanding: Examining Editorial and Ethnographic Relations in "The Primary" (2008)

Science.gov (United States)

Warmington, Paul; Grosvenor, Ian

2011-01-01

This article offers an analysis of "The Primary," a television documentary broadcast in the UK in 2008 as part of a BBC series exploring multicultural Britain. The film documents a term at an inner-city primary school. It depicts school leadership, cultural diversity, relationships between the school and the local community, pupils'…

42 CFR 32.88 - Examinations and treatment.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Examinations and treatment. 32.88 Section 32.88... Hansen's Disease § 32.88 Examinations and treatment. Patients will be provided necessary clinical examinations which may be required for the diagnosis of primary or secondary conditions, and such treatment as...

Primary Teacher Educators' Perception of Desired and Achieved Pedagogical Content Knowledge in Geography Education in Primary Teacher Training

Science.gov (United States)

Blankman, Marian; van der Schee, Joop; Volman, Monique; Boogaard, Marianne

2015-01-01

This paper presents the findings of a study conducted among primary geography teacher educators. The research examines the perceptions of educators of primary teacher students' desired and achieved levels of substantial knowledge, syntactic knowledge, and beliefs about the subject of geography. The findings indicate that primary teacher educators…

[The importance of systematic examination of preschool children in new organization of primary health care in B&H and RS].

Science.gov (United States)

Cajić, Dragan; Cirić, Dara; Cajić, Milijana; Sokolac, Dom zdravlja

2007-01-01

A systematic examination of 391 children at school age was performed, at age from 1st to 4th grade of grammar school, among which there was 183 boys and 208 girls. Examination was done by the responsible pediatric service of the Primary health care Center Sokolac with help of the humanitarian organization World Vision from Taiwan. The goal of the examination was to get an insight in the general health state of this population, including the risk factor for development of cardiovascular disease (CVD), to suggest appropriate preventive measures, and determine further justification of these examinations within the new organization of health care in RS and B&H. Satisfactory hygiene status of these children, eradication of lousiness and scabies, high percentage of vaccinated children (95%) according to current national program, evaluation of most common congenital anomalies speaks in favor of adequate pediatric care at early age. Higher percent of weak vision (10.23%), "flat feet" (36.57%) and chronic tonsillitis (34.52%), as well as occasional cases of herniations, criptochrism, spine and thorax deformities, and one hearth anomaly indicates on insufficient systematic examination "within critical period" from 3 to 7 years of age. Most often pathological substrate during the examination was caries (69.30%) which indicated the poor prevention of this illness. Percentage of 10.74% obese children and 8.95% children with systolic blood pressure above 95 for this age justify the attitude of WHO on early prevention of CVD. The necessity of pediatric care is indicated at age up to 7 years and regular systematic examinations of the school children according to the program of Health Care Fund by the consultancy pediatric service, as well importance of cooperation with the teams of family medicine. Urgent prevention and treatment of caries is recommended at the referral health care centers and more strict control by the responsible Health Care Fund of RS for the signed contracts

Final Assessment of Manual Ultrasonic Examinations Applied to Detect Flaws in Primary System Dissimilar Metal Welds at North Anna Power Station

Energy Technology Data Exchange (ETDEWEB)

Anderson, Michael T.; Diaz, Aaron A.; Cinson, Anthony D.; Crawford, Susan L.; Prowant, Matthew S.; Doctor, Steven R.

2014-03-24

PNNL conducted a technical assessment of the NDE issues and protocols that led to missed detections of several axially oriented flaws in a steam generator primary inlet dissimilar metal weld at North Anna Power Station, Unit 1 (NAPS-1). This particular component design exhibits a significant outside-diameter (OD) taper that is not included as a blind performance demonstration mock-up within the industry’s Performance Demonstration Initiative, administered by EPRI. For this reason, the licensee engaged EPRI to assist in the development of a technical justification to support the basis for a site-specific qualification. The service-induced flaws at NAPS-1 were eventually detected as a result of OD surface machining in preparation for a full structural weld overlay. The machining operation uncovered the existence of two through-wall flaws, based on the observance of primary water leaking from the dissimilar metal weld. A total of five axially oriented flaws were detected in varied locations around the weld circumference. The field volumetric examination that was conducted at NAPS-1 was a non-encoded, real-time manual ultrasonic examination. PNNL conducted both an initial assessment, and subsequently, a more rigorous technical evaluation (reported here), which has identified an array of NDE issues that may have led to the subject missed detections. These evaluations were performed through technical reviews and discussions with NRC staff, EPRI NDE Center personnel, industry and ISI vendor personnel, and ultrasonic transducer manufacturers, and laboratory tests, to better understand the underlying issues at North Anna.

Detection of dementia in primary care: comparison of the original and a modified Mini-Cog Assessment with the Mini-Mental State Examination.

Science.gov (United States)

Kamenski, Gustav; Dorner, Thomas; Lawrence, Kitty; Psota, Georg; Rieder, Anita; Schwarz, Franz; Sepandj, Asita; Spiegel, Wolfgang; Strotzka, Stefan

2009-12-01

Background Dementia is considered widely under-detected in primary care, and general practitioners (GPs) frequently ask for easy to use tools to assist in its early detection.Aim To determine the degree of correlation between the Mini-Cog Assessment (Mini-Cog) as performed by GPs and the Mini-Mental State Examination (MMSE).Design of study This was a prospective study (2005, 2006) comparing two cognitive screening instruments.Setting Ten general practices in Austria, with patients with a hitherto undiagnosed suspicion of dementia seen consecutively.Method Sensitivity, specificity and positive and negative predictive values (PPVs and NPVs) of the Mini-Cog (applying both a colour-coded and the original rating method) were assessed for degree of correlation with the MMSE. In phase one GPs examined patients suspected of having dementia using the Mini-Cog; in phase two a neurologist retested them applying the MMSE, a clock-drawing test (CDT) and a routine clinical examination. A questionnaire on the practicability of the Mini-Cog was answered by GPs.Results Of the 107 patients who participated 86 completed the whole study protocol. The Mini-Cog, as performed by the ten GPs, displayed a sensitivity of 0.85 (95% CI: 0.71, 0.98), a specificity of 0.58 (95% CI: 0.46, 0.71), a PPV of 0.47 (95% CI: 0.33, 0.61) and an NPV of 0.90 (95% CI: 0.80, 0.99) as against the MMSE carried out by neurologists. The GPs judged the Mini-Cog useful and time saving.Conclusion The Mini-Cog has a high sensitivity and acceptable specificity in the general practice setting and has proved to be a practicable tool for the diagnosis of dementia in primary care.

Ultrasonic Examination of Double-Shell Tank 241-SY-102. Examination Completed June 2004

International Nuclear Information System (INIS)

Pardini, Allan F.; Posakony, Gerald J.

2004-01-01

COGEMA Engineering Corporation (COGEMA), under a contract from CH2M Hill Hanford Group (CH2M Hill), has performed an ultrasonic nondestructive examination of selected portions of Double-Shell Tank 241-SY-102. The purpose of this examination was to provide information that could be used to evaluate the integrity of the wall of the primary tank. The requirements for the ultrasonic examination of Tank 241-SY-102 were to detect, characterize (identify, size, and locate), and record measurements made of any wall thinning, pitting, or cracks that might be present in the wall of the primary tank. Any measurements that exceed the requirements set forth in the Engineering Task Plan (ETP), RPP-17750 (Jensen 2003) and/SUMmarized on page 1 of this document, are reported to CH2M Hill and the Pacific Northwest National Laboratory (PNNL) for further evaluation. Under the contract with CH2M Hill, all data is to be recorded on disk and paper copies of all measurements are provided to PNNL for third-party evaluation. PNNL is responsible for preparing a report that describes the results of the COGEMA

The prevention of the primary lymphedema

International Nuclear Information System (INIS)

Benda, K.; Lebloch, D.; Bendova, M.

1998-01-01

The endangered familiar members of the ailing with the primary lymphedema are clinically examined (anamnesis, physical examination of the extremities and biochemical examination) and by radionuclide lymphography of the extremities. For the proved latent stadium of the lymphedema the complex of preventive therapy is recommended. (authors)

Suicidal ideation in German primary care

NARCIS (Netherlands)

Wiborg, J.F.; Gieseler, D.; Lowe, B.

2013-01-01

OBJECTIVE: To examine suicidal ideation in a sample of German primary care patients. METHODS: We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were

Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study

Directory of Open Access Journals (Sweden)

Jones-Harris Amanda R

2010-10-01

Full Text Available Abstract Background One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK. Methods A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK. Results There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting. Conclusions The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare

An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

Science.gov (United States)

Tu, Shih-Kai; Liao, Hung-En

2014-01-01

Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p intentions (γ = .66, p intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

Bilateral supernumerary primary maxillary canines

Directory of Open Access Journals (Sweden)

Santanu Mukhopadhyay

2018-01-01

Full Text Available Supernumerary teeth are more common in the permanent than in primary dentition. In the primary dentition, the anomaly is most frequently observed in the maxillary lateral incisor region, followed by the maxillary midline where they are termed as mesiodens. Supernumerary teeth in the primary canine region are rare. This paper describes a rare case of nonsyndromic supernumerary primary maxillary canine distributed bilaterally in a 4-year-old boy. Both the supernumeraries resembled size and shape of normal primary canine. The right supplemental canine is high labially placed, whereas the left one is seen normally aligned in the dental arch distal to lateral incisor. One of the most significant sequelae of primary supernumerary teeth is their duplication in the permanent series. Radiographic examination of supernumerary primary canine did not indicate any such anomaly in the permanent dentition. The patient was kept under observation.

Safeguarding Primary Healthcare: A Case Study of Barbados

Directory of Open Access Journals (Sweden)

Patricia Rodney

2009-11-01

Full Text Available The concept of primary health care has regained prominence as many countries around the globe face rising health costs and failed health systems. This study examines Barbados, a developing country in the eastern Caribbean, which has consistently included the concept of primary health care in all of its development plans. Based on the government's stated commitment to Health for All, this review was conducted to examine whether this focus has prevailed. The purpose of this paper was to identify some of the advancements or reversals of primary health care policy in Barbados.

Modes of failures: primary and secondary stresses

International Nuclear Information System (INIS)

Roche, R.L.

1987-07-01

The paper begins with a reminder that the purpose of stress classification is to ensure suitable margins with respect to failure modes. The distinction between primary stresses and secondary stresses is then examined and a method is given for assessing the degree of elastic follow up in the elastic plastic field. The importance of elastic follow up is then highlighted by an examination of the effect of primary and secondary stresses on crack behavior

Examining Primary Pre-Service Teachers' Perspectives on Teaching Practice Courses

Science.gov (United States)

Basturk, Savas

2016-01-01

The courses "school experience" and "teaching practice" are undoubtedly among the central courses to be received by pre-service teachers who will be future teachers. Through them, pre-service teachers obtain the realistic information about their profession. Therefore, the aim of this study was to examine pre-service teachers'…

Primary Intraorbital Ectopic Meningioma

Science.gov (United States)

Yokoyama, Tetsuo; Nishizawa, Shigeru; Sugiyama, Kenji; Yokota, Noki; Ohta, Seiji; Uemura, Kenichi; Hinokuma, Kaoru; Inenaga, Chikanori

1999-01-01

We report a case of intraorbital meningioma. Operative findings and histopathological examination revealed the tumoc to be meningothelial meningloma and to be located entirely outside the optic dura. This case demonstrates the occurrence of primary intraorbital ectopic meningioma, and the tumor was removed through a modified Dolenc approach. The primary intraorbital ectopic meningioma is discussed and the surgical approach to the orbital apex region is reviewed. ImagesFigure 1Figure 2Figure 4Figure 5 PMID:17171081

Multiple primary syphilis on the lip, nipple-areola and penis: An immunohistochemical examination of Treponema pallidum localization using an anti-T. pallidum antibody.

Science.gov (United States)

Fukuda, Hidetsugu; Takahashi, Misaki; Kato, Keiichi; Oharaseki, Toshiaki; Mukai, Hideki

2015-05-01

Primary syphilis caused by Treponema pallidum usually develops after sexual contact as an initial solitary sclerosis or hard chancre in the genital region. We describe a case of primary syphilis at three sites in genital and extragenital regions of a man who had sex with men. A 29-year-old man visited our hospital for skin lesions on his lower lip, nipple-areola and penis. A positive syphilis serological test for rapid plasma reagin had a titer of 1:16; the patient also tested positive for specific antibodies against T. pallidum, with a cut-off index of 39.0. Histopathological examination of a nipple-areola biopsy specimen revealed a thickened epidermis and dense infiltration of inflammatory cells extending from the upper dermal layers to the deep dermis. The inflammatory cells were composed of abundant lymphocytes, plasma cells, histiocytes and neutrophils. Immunohistochemical staining for T. pallidum using an anti-T. pallidum antibody showed numerous spirochetes in the lower portion of the epidermis, scattered inside inflammatory cell infiltrate and perivascular sites throughout the dermis. Based on these findings, the patient was diagnosed with primary syphilis. Treatment with oral amoxicillin hydrate was started. Five days after starting treatment, a diffuse maculopapular rash (syphilitic roseola) occurred on his trunk and extremities. Perivascular cuffing due to T. pallidum was present throughout the dermis in the biopsy specimen of a localized lesion of primary syphilis. Moreover, syphilitic roseola, which indicates generalized dissemination of T. pallidum, developed during the course of treatment for primary syphilis. Therefore, we considered perivascular cuffing to be indicative of the dissemination phase. © 2015 Japanese Dermatological Association.

Primary vertebral tumours in children

Energy Technology Data Exchange (ETDEWEB)

Kozlowski, K.; Beluffi, G.; Masel, J.; Diard, F.; Ferrari-Ciboldi, F.; Le Dosseur, P.; Labatut, J.

1984-03-01

20 cases of primary benign and malignant bone tumours in children were reported. The most common tumours were Ewing's sarcoma, aneurismal bone cyst, benign osteoblastoma and osteoid osteoma. Some rare primary bone tumours in children (osteochondroma, chondroblastoma 6F, primary lymphoma of bone and neurofibromatosis with unusual cervical spinal changes) were also reported. The authors believe that radiographic findings together with clinical history and clinical examination may yield a high percentage of accurate diagnoses. Although microscopy is essential in the final diagnosis, the microscopic report should be also accepted with caution.

Primary care research in Denmark

DEFF Research Database (Denmark)

Vedsted, Peter; Kallestrup, Per

2016-01-01

International Perspectives on Primary Care Research examines how the evidence base from primary care research can strengthen health care services and delivery, tackle the growing burden of disease, improve quality and safety, and increase a person-centred focus to health care. Demonstrating...... the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

Free Primary Education Policy: Coping Strategies in Public Primary Schools in Kakamega South District, Kakamega County, Kenya

Science.gov (United States)

Mulinya, Lidoro Charles; Orodho, John Aluko

2015-01-01

This study examined the challenges of implementing free primary education and copping strategies in public primary schools in Kakamega South District, Kakamega County, Kenya. The study was premised on the demand and supply theory. A descriptive survey research design was adopted. The sample comprised 23 headteachers, 92 teachers and one Ministry…

Primary School Leadership Today and Tomorrow

Science.gov (United States)

Southworth, Geoff

2008-01-01

The article provides a retrospective and prospective view of primary school leadership. It begins with an analytic description of primary school leadership in the recent past. The second part looks at school leadership today, identifies contemporary issues and examines role continuities and changes. The third part looks at what the future might…

Reducing duplex examinations in patients with iatrogenic pseudoaneurysms.

Science.gov (United States)

Stone, Patrick A; Aburahma, Ali F; Flaherty, Sarah K

2006-06-01

Ultrasound-guided thrombin injection has become the initial treatment of choice for femoral access-related pseudoaneurysms. Patients typically undergo serial duplex examinations to assess for spontaneous resolution of small iatrogenic pseudoaneurysms (IPSAs) (IPSAs (>2.5 cm). We evaluated the impact of a revised treatment algorithm that includes primary treatment of both small (2.5 cm), rather than observation of smaller ones, and attempts to establish a single duplex examination via a point-of-care treatment strategy. We reviewed 105 consecutive patients treated with ultrasound-guided thrombin injection from July 2001 through September 2004. Patient, IPSAs, characteristics, and treatment methods were examined. The number of duplex examinations per patient was evaluated over the treatment interval. Also, published cost data were used to compare primary treatment of small ISPAs vs observation with serial duplex examinations. Successful thrombosis occurred in 103 (98.1%) of 105 treated pseudoaneurysms. No minor or major complications occurred after thrombin injection in either small or large ISPAs, and both failures requiring operation were in the large aneurysm group. The recurrence rate for the series was 1.9% (2/105), and both recurrences were successfully treated with an additional thrombin injection. A single injection was successful in treating 43 (97.7%) of 44 small (IPSAs, and one required a second injection. Patients had an average of 3.3 duplex examinations in our first year of treatment experience, which declined to 1.5 by our third year with the institution of a point-of-care service model for all pseudoaneurysms. Based on this decreased use of duplex examination and an average treatment cohort of 35 IPSA patients per year our institution, we determined this results in a reduction of 35 hours of laboratory time and nearly 70 ultrasounds per year. Similarly for small pseudoaneurysms, a point-of-service primary treatment program rather than observation

Rationale and design of a pilot study examining Acceptance and Commitment Therapy for persistent pain in an integrated primary care clinic.

Science.gov (United States)

Kanzler, Kathryn E; Robinson, Patricia J; McGeary, Donald D; Mintz, Jim; Potter, Jennifer Sharpe; Muñante, Mariana; Lopez, Eliot J; Dougherty, Donald M; Hale, Willie J; Velligan, Dawn I

2018-03-01

Most of the 100 million Americans with persistent pain are treated in primary care clinics, but evidence-based psychosocial approaches targeting pain-related disability are not usually provided in these settings. This manuscript describes the rationale and methods for a protocol to pilot test the feasibility and effectiveness of Acceptance and Commitment Therapy (ACT), an evidence-based psychological treatment for persistent pain, delivered by a Behavioral Health Consultant in primary care. Eligible patients are identified through electronic health record registries and invited to participate via secure messaging, letters and a follow-up phone call. Participants are also recruited with advertising and clinician referral. Patients agreeing to participate are consented and complete initial assessments, with a target of 60 participants. Randomization is stratified based on pain severity with participants assigned to either ACT or Enhanced Treatment as Usual (E-TAU). ACT participants receive one standardized Behavioral Health Consultation visit followed by three ACT-based group visits and one group booster visit. All patients attend six assessment visits, during which the E-TAU patients are provided with educational pain management handouts based on standard cognitive behavioral treatment of pain. The study aims to determine feasibility and effectiveness of brief ACT for persistent pain delivered by an integrated behavioral health clinician in primary care from pre- to post-treatment, and to examine mechanisms of change in ACT participants. This study, in a "real-world" setting, will lay groundwork for a larger trial. If effective, it could improve treatment methods and quality of life for patients with persistent pain using a scalable approach. Copyright © 2018 Elsevier Inc. All rights reserved.

Correlation between posterior vaginal wall defects assessed by clinical examination and by defecography

NARCIS (Netherlands)

Groenendijk, Annette G.; van der Hulst, Victor P.; Birnie, Erwin; Bonsel, Gouke J.

2008-01-01

To estimate the accuracy of clinical examination and the indications for defecography in patients with primary posterior wall prolapse. Fifty-nine patients with primary pelvic organ prolapse were evaluated with a questionnaire, clinical examination and defecography. Defecography was used as

Australian Primary In-Service Teachers' Conceptions of Geography

Science.gov (United States)

Preston, Lou

2015-01-01

This paper reports on the second part of a two pronged qualitative investigation that examines the ways in which Australian primary teachers conceptualise geography and geography teaching. In the first part of the project, 47 pre-service primary teachers were surveyed. In this paper, I draw on interviews with six in-service primary teachers to…

Contribution of computerized tomography to diagnosis of primary hyperaldosteronism

International Nuclear Information System (INIS)

Hrabaneova, J.; Stribrna, J.; Bultasova, H.; Karasova, L.; Placer, Z.; Pinsker, P.

1987-01-01

Two cases are reported of computerized tomography (CT) examination for proof of suspect primary hyperaldosteronism caused by adenoma of the adrenals. The findings were then confirmed surgically and histologically. CT was again found to be an invaluable tool for differential diagnosis of this condition, which spared the patients demanding invasive examinations and clearly differentiated primary hyperaldosteronism from adrenal cortex hyperplasia. This is mainly important for the fact that adenoma or more rarely carcinoma causing primary hyperaldosteronism can surgically be removed. (L.O.). 2 figs., 2 tabs., 6 refs

Clinical effect of Resina Draconis capsules on primary dysmenorrhoea

African Journals Online (AJOL)

Clinical effect of Resina Draconis capsules on primary dysmenorrhoea. Li Sun, Jia Wang. Abstract. Purpose: To examine the effectiveness of Resina Draconis capsules in the treatment of primary dysmenorrhoea. Methods: In total, 324 patients with primary dysmenorrhoea were randomly allocated to three groups based on ...

Examining teachers’ views on the implementation of English as L3 into primary schools: A case of Kazakhstan

Directory of Open Access Journals (Sweden)

Bakhytgul A Zhetpisbayeva

2016-06-01

Full Text Available The Ministry of Education and Science of the Republic of Kazakhstan changed the State Educational Program for primary education and the curriculum for teaching English as a third language (L3 to grades 1-4in 2013. As with many changes in the curriculum, English language teaching has also been changed and the starting age for learning of English language has been lowered to 6-7 years of age (Grade 1. However, implementation of the curriculum requires readiness on the part of the teachers and teachers' views about teaching English in primary school is important for successful implementation of English language policy. Thus, this research aims to investigate the teachers’ views about the starting age for L3 learning, teachers' professional development, teaching materials and problems of implementation of a language policy in primary schools in Kazakhstan. The data for the study was gathered from 105 English teachers working in different primary schools. The study revealed that most have not yet made a transition to the organized system of teaching English languages in primary school.

Investigation of the Work Motivation Levels of Primary School Teachers

Science.gov (United States)

Ates, Hatice Kadioglu; Yilmaz, Perihan

2018-01-01

This study was conducted to examine the work motivation levels of primary school teachers working in primary school institutions located in Istanbul province, Kucukcekmece district. The descriptive survey model was used in this study. The population of the study consists of primary school teachers and primary school administrators working in state…

Informed consent: attitudes, knowledge and information concerning prenatal examination

DEFF Research Database (Denmark)

Dahl, Katja; Kesmodel, Ulrik; hvidman, lone

2006-01-01

Background: Providing women with information enabling an informed consent to prenatal examinations has been widely recommended. Objective: The primary purpose of this review is to summarise current knowledge of the pregnant woman's expectations and attitudes concerning prenatal examinations, as w...

An objective and cross-sectional examination of sun-safe behaviours in New South Wales primary schools

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Dean A. Dudley

2017-01-01

Full Text Available Abstract Background Previous evaluations have supported the link between sun protection policies and improved sun protection behaviours. However these evaluations have relied on self-reported data. Methods A cross-sectional design as part of an ongoing 18-month cluster-controlled trial in primary schools (n = 20 was used. Researchers conducted direct observations to record students’ hat use and teachers’ use of sun protective measures during recess and lunch. Researchers also recorded the volume of sunscreen consumed in each school. Results Only 60% of primary school children wear a sun-safe hat during their breaks when observed using objective measures. Weak correlations were observed between the wearing of a sun-safe hat and a school’s socio-economic status (r = 0.26. All other independent variables measured had only very weak correlations (r < 0.19 with sun-safe hat wearing behaviour of students. Sunscreen consumption by school students during the school day is negligible. Conclusions A large percentage of NSW primary schools in this study wear sun-safe hats during the school day but this is well below what has been reported in previous national surveys. Given the finite resources of schools and the correlation, though small, with SES status for these behaviours, it behoves researchers to investigate low-cost solutions to these problems. Further qualitative data will also be needed to inform the enablers and barriers for sun-safe behaviour interventions to be adopted in NSW primary schools.

DO GENERAL MEDICAL PRACTITIONERS EXAMINE INJURED RUNNERS?

DEFF Research Database (Denmark)

Videbæk, Solvej; Jensen, A V; Rasmussen, S

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

Decentralization and Distribution Primary Education Access in Indonesia 2014

OpenAIRE

Benita, Novinaz

2016-01-01

This paper examines decentralisation and distribution of access to primary school in Indonesia. Data come from Indonesia National Socio Economic Survey 2014, and statistic reports from Ministry of education, Ministry Of Finance, and General Election Commision. Descriptive statistic is used to describe spatial distribution of decentralization in primary education system and distribution of primary education access. The results show there are districts disparities in decentralization of primary...

Standardization of Primary Education in Great Britain

Science.gov (United States)

Yarovaya, Yelena B.

2015-01-01

The article examines the standardization of primary education as one of the development trends of the British school at the present moment in the context of improving its efficiency and quality. It analyses the positive results of the standard-based reforms (modernization of primary education content, improvement of younger students' outcomes,…

Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

Science.gov (United States)

Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

2007-08-01

Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

Development of Educational Management System in Small Primary School

Science.gov (United States)

Alsammarry, Yupayao; Sirisuthi, Chaiyuth; Duangcharthom, Surat

2016-01-01

The purposes of the research were: (1) to study the factors of Educational Management System in Small Primary School; (2) to investigate current situations problems and guidelines of developing educational management in small primary school; (3) to develop Educational Management System in Small Primary School; and (4) to examine the results of…

Nondestructive examination of DOE high-level waste storage tanks

International Nuclear Information System (INIS)

Bush, S.; Bandyopadhyay, K.; Kassir, M.; Mather, B.; Shewmon, P.; Streicher, M.; Thompson, B.; van Rooyen, D.; Weeks, J.

1995-01-01

A number of DOE sites have buried tanks containing high-level waste. Tanks of particular interest am double-shell inside concrete cylinders. A program has been developed for the inservice inspection of the primary tank containing high-level waste (HLW), for testing of transfer lines and for the inspection of the concrete containment where possible. Emphasis is placed on the ultrasonic examination of selected areas of the primary tank, coupled with a leak-detection system capable of detecting small leaks through the wall of the primary tank. The NDE program is modelled after ASME Section XI in many respects, particularly with respects to the sampling protocol. Selected testing of concrete is planned to determine if there has been any significant degradation. The most probable failure mechanisms are corrosion-related so that the examination program gives major emphasis to possible locations for corrosion attack

Primary optic nerve sheath meningioma

Energy Technology Data Exchange (ETDEWEB)

Jeremic, Branislav [International Atomic Energy Agency, Vienna (Austria); Pitz, Susanne (eds.) [University Eye Hospital, Mainz (Germany)

2008-07-01

Optic nerve sheath meningioma (ONSM) is a rare tumour. Cases are usually separated into primary ONSM, which arises either intraorbitally or, less commonly, intracanalicularly, and secondary ONSM, which arises intracranially and subsequently invades the optic canal and orbit. This is the first book to cover all important aspects of the diagnosis and treatment of primary ONSM. After a general introduction, individual chapters discuss the clinical presentation, clinical examination and diagnosis, imaging, and histology. Treatment options are then addressed in detail, with special emphasis on external beam radiation therapy, and in particular stereotactic fractionated radiation therapy. The latter has recently produced consistently good results and is now considered the emerging treatment of choice for the vast majority of patients with primary ONSM. This well-illustrated book will prove invaluable to all practitioners who encounter primary ONSM in their clinical work. (orig.)

Suicidality in primary care patients with somatoform disorders

NARCIS (Netherlands)

Wiborg, J.F.; Gieseler, D.; Fabisch, A.B.; Voigt, K.; Lautenbach, A.; Lowe, B.

2013-01-01

Objective To examine rates of suicidality in primary care patients with somatoform disorders and to identify factors that might help to understand and manage active suicidal ideation in these patients. Methods We conducted a cross-sectional study screening 1645 primary care patients. In total, 142

Scintigraphic examination of the sympathicoadrenal system

International Nuclear Information System (INIS)

Dabasi, Gabriella; Duffek, Laszlo

1989-01-01

Experiences with 100 131 I-metaiodo-benzylguanidine (MIGB) scintigraphy are described. The importance of the examination is stressed in the diagnostics of neuroblastoma in childhood and in the determination of the clinical stage and follow-up of the disease. MIGB scintigraphy plays a primary role in the imaging examination procedures aimed at the localization of pheochromocytoma, especially in the extraadrenal, multiplex and malignant diseases. The disturbance of adrenergic innervation in Shy-Drager syndrome can be demonstrated with radiopharmacon. (author) 19 refs.; 5 figs

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

Science.gov (United States)

Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

2007-01-01

Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

The image of mathematics held by Irish post-primary students

Science.gov (United States)

Lane, Ciara; Stynes, Martin; O'Donoghue, John

2014-08-01

The image of mathematics held by Irish post-primary students was examined and a model for the image found was constructed. Initially, a definition for 'image of mathematics' was adopted with image of mathematics hypothesized as comprising attitudes, beliefs, self-concept, motivation, emotions and past experiences of mathematics. Research focused on students studying ordinary level mathematics for the Irish Leaving Certificate examination - the final examination for students in second-level or post-primary education. Students were aged between 15 and 18 years. A questionnaire was constructed with both quantitative and qualitative aspects. The questionnaire survey was completed by 356 post-primary students. Responses were analysed quantitatively using Statistical Package for the Social Sciences (SPSS) and qualitatively using the constant comparative method of analysis and by reviewing individual responses. Findings provide an insight into Irish post-primary students' images of mathematics and offer a means for constructing a theoretical model of image of mathematics which could be beneficial for future research.

Radiologic examination

International Nuclear Information System (INIS)

Thoeni, R.F.

1989-01-01

The radiographic examination of the upper and lower gastrointestinal tract has been changed drastically by the introduction of endoscopic procedures that are now widely available. However, the diagnostic approach to the small bowel remains largely unchanged. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are occasionally employed but are not primary imaging modalities for small bowel disease. Even though small bowel endoscopes are available, they are infrequently used, and no scientific paper on their employment has been published. Barium studies are still the mainstay for evaluating patients with suspected small bowel abnormalities. This paper discusses the anatomy and physiology of the small bowel and lists the various types of barium and pharmacologic aids used for examining it. The different radiographic methods for examining the small bowel with barium, including SBFT, dedicated SBFT, enteroclysis, peroral pneumocolon (PPC), and retrograde small bowel examination, are described and put into perspective. To some degree such an undertaking must be a personal opinion, but certain conclusions can be made based on the available literature and practical experience. This analysis is based on the assumption that all the various barium techniques are performed with equal expertise by the individual radiologist, thus excluding bias from unfamiliarity with certain aspects of a procedure, such as intubation or skilled compression during fluoroscopy. Also, the use of water-soluble contrast material, CT, and MRI for evaluating suspected small bowel abnormalities is outlined

Frequency of primary amenorrhea due to chromosomal aberration

International Nuclear Information System (INIS)

Jabbar, S.

2004-01-01

Objective: To find out the frequency of primary amenorrhea due to chromosomal aberration and the different options available for management. Subjects and Methods: All patients with primary amenorrhea due to chromosomal aberrations were included in study. Patient's detailed history, general physical examination, presence or absence of secondary sexual characteristics, abdominal and pelvic examination finding were noted. Targeted investigations, including ultrasound, hormonal assay, buccal smear and karyotyping results were recorded. The management options were individually tailored with focus n psychological management. Results: Eighteen patients out of 30,000 patients were diagnosed as having primary amenorrhea. Six had primary amenorrhea due to chromosomal aberrations with the frequency of 0.02%. The age at presentation was 20 years and above in 50%. The most common cause was Turner's syndrome seen in 4 out of 6. The presenting symptoms were delay in onset of menstruation in 05 patients and primary infertility in 01 patient. Conclusion: Primary amenorrhea due to chromosomal aberration is an uncommon condition requiring an early and accurate diagnosis. Turner's syndrome is a relatively common cause of this condition. Management should be multi-disciplinary and individualized according to the patient's age and symptom at presentation. Psychological management is very important and counselling throughout treatment is recommended. (author)

Carcinomatous Meningitis from Unknown Primary Carcinoma

Directory of Open Access Journals (Sweden)

L. Favier

2009-10-01

Full Text Available Carcinomatous meningitis (CM occurs in 3 to 8% of cancer patients. Patients present with a focal symptom, and multifocal signs are often found following neurological examination. The gold standard for diagnosis remains the demonstration of carcinomatous cells in the cerebrospinal fluid on cytopathological examination. Despite the poor prognosis, palliative treatment could improve quality of life and, in some cases, overall survival. We report on a patient who presented with vertigo, tinnitus and left-sided hearing loss followed by progressive diffuse facial nerve paralysis. Lumbar cerebrospinal fluid confirmed the diagnosis of CM. However, no primary tumor was discovered, even after multiple invasive investigations. This is the first reported case in the English-language medical literature of CM resulting from a carcinoma of unknown primary origin.

Primary headaches in children

Directory of Open Access Journals (Sweden)

Ajay Kumar Pan

2015-01-01

Full Text Available Headache is a widespread clinical problem; the prevalence is high in all age groups, from which children and teenagers are not spared. It has been reported that, as many as 75% of school-age children may experience headache infrequently, among them 10% have recurrent headaches. [1],[2] The vast majority of headaches are primary and classified as migraine, tension-type headache (TTH, cluster headache, and other trigeminal autonomic cephalgias. The type of primary headaches could usually be diagnosed by a thorough and careful history taking, and physical examination. Once the diagnosis of migraine is established and appropriate reassurance provided, a balanced and individually tailored treatment plan can be instituted. The goal of treatment includes abortive or acute pain treatment, preventive long-term treatment, and biobehavioral therapy. Knowledge of precise impact of primary headaches on child′s quality of life helps to design a proper comprehensive treatment plan.

Examining First Grade Teachers' Handwriting Instruction

Science.gov (United States)

Arslan, Derya

2012-01-01

The purpose of this study is to examine the first grade teachers' practices of handwriting instructions in terms of teaching, evaluation and handwriting difficulties. From qualitative research patterns, phenomenology was used. The study was applied to the 54 First grade teachers who work at central Burdur and Burdur county centre primary education…

College Students' Reasons for Depression Nondisclosure in Primary Care

Science.gov (United States)

Meyer, William J.; Morrison, Patrick; Lombardero, Anayansi; Swingle, Kelsey; Campbell, Duncan G.

2016-01-01

Unwillingness to share depression experiences with primary care physicians contributes to the undertreatment of depression. This project examined college students' reasons for depression nondisclosure to primary care providers (PCPs). Undergraduate participants read a vignette describing someone with depression and completed measures of disclosure…

Primary Teacher Education in England: 40 Years On

Science.gov (United States)

Murray, Jean; Passy, Rowena

2014-01-01

This article examines the relationship between pre-service teacher education (ITE) for primary schooling and primary teaching in England between 1974 and 2014, and explores the "fitness of purpose" of the current system of preparing teachers for the classrooms of the twenty-first century. Our historical analysis suggests that, despite 40…

Bilateral primary malignant lymphoma of the breast.

Science.gov (United States)

Shpitz, B; Witz, M; Kaufman, Z; Griffel, B; Manor, Y; Dinbar, A

1985-08-01

A rare case of bilateral primary malignant lymphoma of breast in a 76 year old woman is presented. The lesion was examined by electron microscopy and immunochemistry. The diagnosis of primary malignant lymphoma remains a diagnosis by exclusion and requires extensive work-up to exclude widespread malignant process. The behaviour of this malignancy tends to be an aggressive one and the prognosis is generally poor.

Development of ASME Code Section 11 visual examination requirements

International Nuclear Information System (INIS)

Cook, J.F.

1990-01-01

Section XI of the American Society for Mechanical Engineers Boiler and Pressure Vessel Code (ASME Code) defines three types of nondestructive examinations, visual, surface, and volumetric. Visual examination is important since it is the primary examination method for many safety-related components and systems and is also used as a backup examination for the components and systems which receive surface or volumetric examinations. Recent activity in the Section XI Code organization to improve the rules for visual examinations is reviewed and the technical basis for the new rules, which cover illumination, vision acuity, and performance demonstration, is explained

Moral accounts and membership categorization in primary care medical interviews.

Science.gov (United States)

Dillon, Patrick J

2011-01-01

Although the link between health and morality has been well established, few studies have examined how issues of morality emerge and are addressed in primary care medical encounters. This paper addresses the need to examine morality as it is (re) constructed in everyday health care interactions. A Membership Categorization Analysis of 96 medical interviews reveals how patients orient to particular membership categories and distance themselves from others as a means of accounting (Buttny 1993; Scott and Lyman 1968) for morally questionable health behaviours. More specifically, this paper examines how patients use membership categorizations in order to achieve specific social identity(ies) (Schubert et al. 2009) through two primary strategies: defensive detailing and prioritizing alternative membership categories. Thus, this analysis tracks the emergence of cultural and moral knowledge about social life as it takes place in primary care medical encounters.

Space changes after premature loss of the mandibular primary first molar: a longitudinal study.

Science.gov (United States)

Lin, Y T; Chang, L C

1998-01-01

The purpose of this study was to evaluate the space changes after premature loss of the primary mandibular first molar. Twenty-one children (12 boys and 9 girls), with premature loss of the primary mandibular first molar, were selected from the children's dental clinic for this study. The age ranged from 5.1 to 7.2 years with an average of 6 years and 11 months. Mandibular study casts were made from alginate impression for each initial examination and a follow-up examination eight months later. Four measurements including D+E (first and second primary molars) space, arch width, arch length and arch perimeter were tested for comparisons between the initial examination and the follow-up examination eight months later. The D+E space of intact primary molars served as a control. The results showed that the D+E space on the extraction side after the follow-up examination eight months later was significantly shorter than the control side (p = 0.025) and less than the initial D+E space (p 0.05). It is concluded that the space change after the eruption of the first permanent molar in the mandible is mostly distal movement of the primary cuspid during the early stage of premature loss of the primary first molar.

Microleakage of different adhesive systems in primary molars ...

African Journals Online (AJOL)

Background and aim: This study aimed to examine the microleakage of class V cavities of primary molars prepared by either a conventional dental bur or Er:YAG laser and one of two different adhesive systems. Methods: A total of 50 tooth samples from primary molars were used in this study. They were randomly assigned ...

Musicality Development Among Primary School Pupils in Music Studies

OpenAIRE

Vilde, Ilze

2013-01-01

Abstract Research goal. To explore the structure of musicality, to examine components that characterize musicality among primary school pupils and the pedagogic logic of its development during music lessons in primary school. As a result of the theoretical study, characterizing components and criteria of musicality among primary school pupils were researched and described and the description of musicality was broadened. The created model for music studies for facilitating the developme...

Parental Influence on Academic Achievement among the Primary School Students in Trinidad

Science.gov (United States)

Johnson, Emmanuel Janagan; Descartes, Christine H.

2017-01-01

The present study examined the level of parental influence on academic achievement in primary school students who prepare for the National-level test at standard five (grade 6), Secondary Entrance Examinations in Trinidad. A sample of 128 students studying standard five from primary schools was randomly selected. The data were analysed using SPSS.…

Primary breast tuberculosis. A case report

International Nuclear Information System (INIS)

Filippou, D.C.; Rizos, S.; Nissiotis, A.

2003-01-01

Background. The differential diagnosis of primary breast tuberculosis with other benign or malignant conditions can be difficult with the current imaging techniques that used to recognize breast pathologies. In many cases mammographic and ultrasound characteristics of breast tuberculosis are similar to those of breast cancer. Case report. We present a case of primary breast tuberculosis, with no previous history of the disease, which was diagnosed during the operation. Conclusions. Primary breast tuberculosis can be misdiagnosed. In these cases a tuberculosis infection history is negative, the mammographic and radiological findings obscure and the mass can be misdiagnosed as carcinoma. The diagnosis is achieved after the surgical removal of the mass and histological examination of the specimen. (author)

The MCQ in the primary FRCS(Eng).

OpenAIRE

Lumley, J. S.; Browne, P. D.; Elcock, N. J.

1984-01-01

Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all examinations is emphasised.

The MCQ in the primary FRCS(Eng).

Science.gov (United States)

Lumley, J S; Browne, P D; Elcock, N J

1984-11-01

Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all examinations is emphasised.

Applying organizational behavior theory to primary care.

Science.gov (United States)

Mullangi, Samyukta; Saint, Sanjay

2017-03-01

Addressing the mounting primary care shortage in the United States has been a focus of educators and policy makers, especially with the passage of the Affordable Care Act in 2010 and the Medicare Access and CHIP Reauthorization Act in 2015, placing increased pressure on the system. The Association of American Medical Colleges recently projected a shortage of as many as 65,000 primary care physicians by 2025, in part because fewer than 20% of medical students are picking primary care for a career. We examined the issue of attracting medical students to primary care through the lens of organizational behavior theory. Assuming there are reasons other than lower income potential for why students are inclined against primary care, we applied various principles of the Herzberg 2-factor theory to reimagine the operational flow and design of primary care. We conclude by proposing several solutions to enrich the job, such as decreasing documentation requirements, reducing the emphasis on specialty consultations, and elevating physicians to a supervisory role.

Primary Student Teachers' Ideas about Teaching a Physics Topic

Science.gov (United States)

Ahtee, Maija; Johnston, Jane

2006-01-01

This study examines Finnish and English primary student teachers' ideas when planning to teach a physics topic during their science education studies. Many primary student teachers lack sufficient subject knowledge, which prevents them from constructing the scientific pedagogical content knowledge that enables them to concentrate on pupils'…

Career Preparation: A Longitudinal, Process-Oriented Examination

Science.gov (United States)

Stringer, Kate; Jennifer Kerpelman; Vladimir Skorikov

2011-01-01

Preparing for an adult career through careful planning, choosing a career, and gaining confidence to achieve career goals is a primary task during adolescence and early adulthood. The current study bridged identity process literature and career construction theory (Savickas, 2005) by examining the commitment component of career adaptability,…

Improving Primary Education in Pakistan: An Examination of the Association between School Autonomy and Children's Learning Outcomes

Science.gov (United States)

Rahim, Bushra

2017-01-01

The purpose of this study is to explore the impact of the delegation of financial authority to public primary schools through Parent-Teacher Councils (PTCs) on learning outcomes of primary school children in the Khyber Pakhtunkhwa (KP) province, Pakistan. The learning outcomes were measured in three subject areas (Urdu, English, and Mathematics).…

Exploring the Values of Chaplains in Government Primary Schools

Science.gov (United States)

Isaacs, Amy Kate; Mergler, Amanda

2018-01-01

Minimal prior research has examined the school chaplaincy programme in Australia. This exploratory study sought to identify the values primary school chaplains feel are the most important to them personally, and in their role as chaplain. Eight chaplains working in government primary schools were interviewed. Inductive thematic analysis was used…

Primary and Secondary Labor Markets: Implications for Vocational Rehabilitation.

Science.gov (United States)

Hagner, David

2000-01-01

Reviews theoretical and empirical work in labor economics and the sociology of work relating to the segmentation of the labor market into a primary and a secondary sector and examines the implications for vocational rehabilitation. Transition into primary sector employment is explored as an important aspect of career development for individuals…

Distributed Leadership: Key to Improving Primary Students' Mathematical Knowledge

Science.gov (United States)

Larson, Matthew R.; Smith, Wendy M.

2013-01-01

The purpose of this article is to present the findings of a quantitative study focused on primary mathematics teachers who participated in an intensive professional development program and then had leadership responsibility for the implementation of a new primary mathematics curriculum in their district. The study examines the effect of the…

Initiatives to Enhance Primary Care Delivery

Directory of Open Access Journals (Sweden)

Jan L. Losby

2015-01-01

Full Text Available Objectives: Increasing demands on primary care providers have created a need for systems-level initiatives to improve primary care delivery. The purpose of this article is to describe and present outcomes for 2 such initiatives: the Pennsylvania Academy of Family Physicians’ Residency Program Collaborative (RPC and the St Johnsbury Vermont Community Health Team (CHT. Methods: Researchers conducted case studies of the initiatives using mixed methods, including secondary analysis of program and electronic health record data, systematic document review, and interviews. Results: The RPC is a learning collaborative that teaches quality improvement and patient centeredness to primary care providers, residents, clinical support staff, and administrative staff in residency programs. Results show that participation in a higher number of live learning sessions resulted in a significant increase in patient-centered medical home recognition attainment and significant improvements in performance in diabetic process measures including eye examinations (14.3%, P = .004, eye referrals (13.82%, P = .013, foot examinations (15.73%, P = .003, smoking cessation (15.83%, P = .012, and self-management goals (25.45%, P = .001. As a community-clinical linkages model, CHT involves primary care practices, community health workers (CHWs, and community partners. Results suggest that CHT members successfully work together to coordinate comprehensive care for the individuals they serve. Further, individuals exposed to CHWs experienced increased stability in access to health insurance ( P = .001 and prescription drugs ( P = .000 and the need for health education counseling ( P = .000. Conclusion: Findings from this study indicate that these 2 system-level strategies have the promise to improve primary care delivery. Additional research can determine the extent to which these strategies can improve other health outcomes.

Examining the Impact of Technology on Primary Students' Revision of Written Work

Science.gov (United States)

Lisy, Jennifer Garrette

2015-01-01

Few studies have examined the revision processes of second grade students and even fewer have explored the impact of digital writing on young students' revisions. This study utilized a within subject crossover trial using randomized block assignment (AB | BA) for counterbalancing. This study sought to determine (1) whether revising on paper versus…

Leadership in primary health care: an international perspective.

Science.gov (United States)

McMurray, Anne

2007-08-01

A primary health care approach is essential to contemporary nursing roles such as practice nursing. This paper examines the evolution of primary health care as a global strategy for responding to the social determinants of health. Primary health care roles require knowledge of, and a focus on social determinants of health, particularly the societal factors that allow and perpetuate inequities and disadvantage. They also require a depth and breadth of leadership skills that are responsive to health needs, appropriate in the social and regulatory context, and visionary in balancing both workforce and client needs. The key to succeeding in working with communities and groups under a primary health care umbrella is to balance the big picture of comprehensive primary health care with operational strategies for selective primary health care. The other essential element involves using leadership skills to promote inclusiveness, empowerment and health literacy, and ultimately, better health.

Primary Geography Education in China: Past, Current and Future

Science.gov (United States)

Xuan, Xiaowei; Duan, Yushan; Sun, Yue

2015-01-01

In China, geography education in primary schools (grades 1 to 6) has not been emphasized, although some scholars have done research in this area. In order to deepen the understanding of primary geography education in China, this paper examines its history, current situation, and future trends. The authors used the method of document analysis and…

Radiologic examination of the small bowel: 1987

International Nuclear Information System (INIS)

Carlson, H.C.; Maglinte, D.D.T.

1987-01-01

Effective clinical imaging of the small intestine is accomplished only with methods capable of accurately demonstrating bowel morphology. The two major approaches to barium enema examination of this segment of gut - orally and enteroclysis - will be described and illustrated with short videotape presentations. Pursued vigorously and with interest, both methods can yield excellent results in an efficient manner. Careful execution of the examination rather than use of a particular methodology is probably the most important factor in realizing such results. However, each method has its advantages and disadvantages, and these will be presented and discussed. A cursory small bowel examination has no role in modern medicine. Radiologists assume primary responsibility for the diagnostic evaluation of the small bowel and should strive to refine and advance the accuracy of the examination

Environmental Factors Associated with Primary Care Access Among Urban Older Adults

OpenAIRE

Ryvicker, Miriam; Gallo, William T.; Fahs, Marianne C.

2012-01-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors – in particular, the primary care infrastructure – inform older adults’ primary care use. Using geographic data on primary care physician supply and surveys from 1,260 senior center attendees in New York City, we examined factors that facilitate and ...

Scintigraphy in primary hypogonadism in testicle transplantation

International Nuclear Information System (INIS)

Glejzer, Yu.Ya.; Marinbakh, A.E.; Vasil'ev, V.I.

1979-01-01

A new method of diagnosis, scintigraphy of the testicles with sup(99m)Tc-pertechnetat is presented. The technique of the study is described, the data are processed. 26 patients with primary hypogonadism (cryptorchism, hypo- and aplasia of the testicles) and adrogenic insufficiency were examined before and after allotransplantation of cadaver testicle on arterial-venous pedicle. The advantages of the method lie in its being highly informative and objective and its low toxicity for a patient. Radionuclide examination makes it possible to determine the disposition, size and type of blood supply as well as the functional ability of testicles of patients with primary hypogonadism. Testicle scintigraphy can be significant while estimating the level of vascular network development and the function of a transplanted testicle, as well as in dynamic observations of a graft

Gonioscopy in primary angle closure glaucoma.

Science.gov (United States)

Bruno, Christina A; Alward, Wallace L M

2002-06-01

Primary angle closure is a condition characterized by obstruction to aqueous humor outflow by the peripheral iris, and results in changes in the iridocorneal angle that are visible through gonioscopic examination. Gonioscopy in these eyes, however, can be difficult. This chapter discusses techniques that might help in the examination. These include beginning the examination with the inferior angle, methods to help in looking over the iris, cycloplegia, locating the corneal wedge, indentation, van Herick estimation, examining the other eye, and topical glycerin. Finally, there is a discussion about the pathology associated with the closed angle, with emphasis on the appearance of iris bombé, plateau iris, and the distinction between iris processes and peripheral anterior synechiae.

Examining Perceptions of Servant Leadership in Administration of Selected Public Schools

Science.gov (United States)

Dunn, Peggy Jane Mattson

2012-01-01

The primary purpose of this study was to examine the impact of "Servant Leadership" in an organization using the following variables: valuing people, developing people, building community, displaying authenticity, providing leadership and sharing leadership. The study also examined whether or not a correlation existed between years of…

Poverty of Primary Education in Nigeria: The Way Forward

Science.gov (United States)

Ige, Akindele Matthew

2014-01-01

Inspite of the fact that primary education forms the foundation on which education at the secondary and tertiary levels rests, the issue of poverty is undermining its roles in Nigeria. In this paper, this issue of poverty of primary education was examined, from the perspectives of its history, scope, indicators, in terms of inadequacy of resource…

Primary health care in Canada: systems in motion.

Science.gov (United States)

Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

2011-06-01

During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

Switch and examine transmit diversity for spectrum sharing systems

KAUST Repository

Abdallah, Mohamed M.; Alouini, Mohamed-Slim; Qaraqe, Khalid A.

2011-01-01

In this paper, we develop a switch and examine transmit diversity algorithm for spectrum sharing cognitive networks. We consider a cognitive network composed of a primary link that employs constant rate and constant power transmission scheme

A rare case of primary amenorrhea

Directory of Open Access Journals (Sweden)

Himadri Bal

2016-01-01

Full Text Available Crytomenorrhea arises usually due to the imperforate hymen, sometimes due to vaginal septum, rarely due to cervical agenesis. Here, we present a case of primary amenorrhea resulting from cervical agenesis in a 38-year-old woman. She presented with primary amenorrhea and cyclic lower abdominal pain. She had undergone some surgery 5 years back, details of which were not available. On examination secondary sexual characters were normal, per abdomen there was an 18 weeks size firm abdominopelvic mass. Local vaginal examination showed a blind vaginal pouch. A clinical diagnosis of hematometra due to transverse vaginal septum was made. However, magnetic resonance imaging pelvis suggested hematometra with cervical stenosis. The patient was taken up for examination under anaesthesia (EUA and exploratory laparotomy. On opening the abdomen uterus found to be enlarged with dense adhesions all around and signs of endometriosis. Extensive adhesiolysis revealed bilateral chocolate cysts of ovaries with hematosalpinges and peritubal adhesions. Hysterotomy and drainage of tarry contents were followed by an exploration of the uterine cavity. The lower pole ended blindly with no evidence of any cervix. Peroperative diagnosis of cervical agenesis leading to hematometra and endometriosis was made. A subtotal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination confirmed ovarian endometriosis and adenomyosis of uterus. Though reconstructive surgery for cervical dysgenesis has been successful in some cases, hysterectomy is generally recommended for cervical agenesis.

Cosmic ray antimatter: Is it primary or secondary?

Science.gov (United States)

Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

1981-01-01

The relative merits and difficulties of the primary and secondary origin hypotheses for the observed cosmic ray antiprotons, including the low energy measurement of Buffington, were examined. It is concluded that the cosmic ray antiproton data may be strong evidence for antimatter galaxies and baryon symmetric cosmology. The present antiproton data are consistent with a primary extragalactic component having antiproton/proton approximately equal to .0032 + or - 0.7.

"I Didn't Always Perceive Myself as a "Science Person"": Examining Efficacy for Primary Science Teaching

Science.gov (United States)

Mansfield, Caroline F.; Woods-McConney, Amanda

2012-01-01

Teacher efficacy has become an important field of research especially in subjects teachers may find challenging, such as science. This study investigates the sources of teachers' efficacy for teaching science in primary schools in the context of authentic teaching situations with a view to better understanding sources of teachers' efficacy…

Primary production in the Kattegat - past and present

DEFF Research Database (Denmark)

Richardson, K.; Heilmann, Jens

1995-01-01

data collected during the period 1984-1993 are calculated using the method employed in the 1950s. It is concluded that primary production in the Kattegat has increased from less than 100 g C m(-2) y(- 1) to about 200 g C m(-2) y(-1) since the 1950s. This increase is not seen during the winter months...... to be responses to increases in primary production. However, for most areas, there are insufficient data to demonstrate whether or not increases in primary production have actually occurred. In this study, the evidence for increased primary production in the Kattegat is examined by comparing primary production...... measurements from the 1950s and measurements made in the period 1984-1993. The methods employed during the two periods differ considerably. These differences and how they may affect the validity of a comparison of the results from the studies carried out in two periods are addressed. The primary production...

Primary intestinal lymphangiectasia in adults - diagnostic and therapeutic challenge

Directory of Open Access Journals (Sweden)

Jocić Tatiana

2018-01-01

Full Text Available Introduction. Primary intestinal lymphangiectasia is a rare disorder, characterized by abnormal dilation of intestinal lymphatic vessels and extensive enteric loss of lymph rich in plasma proteins, lymphocytes and chylomicrons. The main characteristics of the disease are hypoalbuminemia, hypogammaglobulinemia, lymphocytopenia, and more rarely, the deficit of liposoluble vitamins and anemia. Except for primary, there are secondary lymphangiectasia, associated with celiac disease, malignant, infective and inflammatory diseases of the small intestine, fibrosis, liver and cardiovascular diseases. Case report. A male, 33 years of age, presented for his medical examination suffering from diarrhea and edema. The diagnosis was established upon the histological examination of a small intestine biopsy during double balloon enteroscopy, which revealed changes only in one segment of the intestine examined. Such a finding was later confirmed by the video endoscopy capsule. Conclusion. The diagnosis of intestinal lymphangiectasia is usually established before the age of 3, but it can also be diagnosed in adults. The diagnosis is based on the histological analysis of the intestinal mucosa biopsy, obtained by endoscopic procedures. The diagnosis of primary intestinal lymphangiectasia is also made upon the exclusion of secondary causes.

Debris Examination Using Ballistic and Radar Integrated Software

Science.gov (United States)

Griffith, Anthony; Schottel, Matthew; Lee, David; Scully, Robert; Hamilton, Joseph; Kent, Brian; Thomas, Christopher; Benson, Jonathan; Branch, Eric; Hardman, Paul;

Primary Amenorrhea with Bilateral Endometriotic Cysts

International Nuclear Information System (INIS)

Jabeen, S.; Raees, M.

2015-01-01

Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found. (author)

The reliability of blood film examination for malaria at the peripheral ...

African Journals Online (AJOL)

Background: Malaria is a common and serious problem in Ethiopia. Blood film examination is the best tool for diagnosing malaria where feasible. Objective: To assess the reliability of blood film examination at the primary health care level. Method: Two specimens were taken from all suspected patients in five health center ...

Radiation diagnosis of patients with primary sclerosing cholangitis

International Nuclear Information System (INIS)

Sharipov, V.Sh.

2001-01-01

Results of combined examination of patients for the purpose of diagnosis of primary sclerosing cholangitis (PSC) are presented. Combined examination consisted of the following techniques: ultrasonography, routine X-ray contrast study of upper section of digestive system, relaxation duodenography, percutaneous transhepatic cholangiography, computerized tomography, endoscopic retrograde pancreatocholangiography. Peculiarities in X-ray PSC semiotics were revealed. It is shown that the combined examination and X-ray semiotics of the disease is of great significance for PSC preoperational diagnosis [ru

What Teachers Want: Supporting Primary School Teachers in Teaching Science

Science.gov (United States)

Fitzgerald, Angela; Schneider, Katrin

2013-01-01

Impending change can provide us with the opportunity to rethink and renew the things that we do. The first phase of the Australian Curriculum implementation offers primary school teachers the chance to examine their approaches to science learning and teaching. This paper focuses on the perceptions of three primary school teachers regarding what…

The United States Chiropractic Workforce: An alternative or complement to primary care?

Directory of Open Access Journals (Sweden)

Davis Matthew A

2012-11-01

Full Text Available Abstract Background In the United States (US a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians. Methods We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types. Results According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value  Conclusion These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

A case of primary osseous pelvic hydatid disease (echinococcus granulosus)

Energy Technology Data Exchange (ETDEWEB)

Sinner, W.N. von (King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Dept. of Radiology)

1991-07-01

Primary bone involvement in hydatid disease (HD) is rare. Sporadic reports estimate its prevalence to 1%. Only a few cases have been reported where CT has been used. Magnetic resonance imaging (MRI) of primary pelvic skeletal hydatid disease has, to my best knowledge, previously not been published. This report deals with a case of primary hydatid disease of the right ilium and the sacrum examined by plain film radiography. CT and MRI confirmed by pathology. (orig.).

A case of primary osseous pelvic hydatid disease (echinococcus granulosus)

International Nuclear Information System (INIS)

Sinner, W.N. von

1991-01-01

Primary bone involvement in hydatid disease (HD) is rare. Sporadic reports estimate its prevalence to 1%. Only a few cases have been reported where CT has been used. Magnetic resonance imaging (MRI) of primary pelvic skeletal hydatid disease has, to my best knowledge, previously not been published. This report deals with a case of primary hydatid disease of the right ilium and the sacrum examined by plain film radiography. CT and MRI confirmed by pathology. (orig.)

Patterns of cancer screening in primary care from 2005 to 2010.

Science.gov (United States)

Martires, Kathryn J; Kurlander, David E; Minwell, Gregory J; Dahms, Eric B; Bordeaux, Jeremy S

2014-01-15

Cancer screening recommendations vary widely, especially for breast, prostate, and skin cancer screening. Guidelines are provided by the American Cancer Society, the US Preventive Services Task Force, and various professional organizations. The recommendations often differ with regard to age and frequency of screening. The objective of this study was to determine actual rates of screening in the primary care setting. Data from the National Ambulatory Medical Care Survey were used. Only adult visits to non-federally employed, office-based physicians for preventive care from 2005 through 2010 were examined. Prevalence rates for breast, pelvic, and rectal examinations were calculated, along with the rates for mammograms, Papanicolaou smears, and prostate-specific antigen tests. Factors associated with screening, including age, race, smoking status, and insurance type, were examined using t tests and chi-square tests. In total, 8521 visits were examined. The rates of most screening examinations and tests were stable over time. Clinical breast examinations took place significantly more than mammography was ordered (54.8% vs 34.6%; P<.001). White patients received more mammography (P=.031), skin examinations (P<.010), digital rectal examinations (P<.010), and prostate-specific antigen tests (P=.003) than patients of other races. Patients who paid with Medicare or private insurance received more screening than patients who had Medicaid or no insurance (P<.010). Current cancer screening practices in primary care vary significantly. Cancer screening may not follow evidence-based practices and may not be targeting patients considered most at risk. Racial and socioeconomic disparities are present in cancer screening in primary care. © 2013 American Cancer Society.

Predictors of mortality within 1 year after primary ovarian cancer surgery

DEFF Research Database (Denmark)

Sjøland, Mette Ørskov; Iachina, Maria; Sørensen, Rikke Guldberg

2016-01-01

System. PARTICIPANTS: 2654 women who underwent surgery due to a diagnosis of primary ovarian cancer. OUTCOME MEASURES: Overall survival and predictors of mortality within 0-180 and 181-360 days after the primary surgery. Examined predictors were age, preoperative American Society of Anesthesiologists...

DSM-IV hypochondriasis in primary care.

Science.gov (United States)

Escobar, J I; Gara, M; Waitzkin, H; Silver, R C; Holman, A; Compton, W

1998-05-01

The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impaired in their physical functioning than patients without the disorder. Of the various psychopathologies examined, major depressive syndromes were the most frequent among patients with hypochondriasis. Interestingly, unlike somatization disorder, hypochondriasis was not related to any demographic factor. Hypochondriasis is a relatively rare condition in primary care that is largely separable from somatization disorder but seems closely intertwined with the more severe depressive syndromes.

Integration of depression and primary care: barriers to adoption.

Science.gov (United States)

Grazier, Kyle L; Smith, Judith E; Song, Jean; Smiley, Mary L

2014-01-01

Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. A literature search focused on peer-reviewed journal literature in Medline and PsycInfo. The search strategy focused on barriers to integrated mental health care services in primary care, and was based on previously existing searches. The search included: MeSH terms combined with targeted keywords; iterative citation searches in Scopus; searches for grey literature (literature not traditionally indexed by commercial publishers) in Google and organization websites, examination of reference lists, and discussions with researchers. Integration of depression care and primary care faces multiple barriers. Patients and families face numerous barriers, linked inextricably to create challenges not easily remedied by any one party, including the following: vulnerable populations with special needs, patient and family factors, medical and mental health comorbidities, provider supply and culture, financing and costs, and organizational issues. An analysis of barriers impeding integration of depression and primary care presents information for future implementation of services.

Electronic consultation system demonstrates educational benefit for primary care providers.

Science.gov (United States)

Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

2017-01-01

Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

Primary Cardiac Leiomyoma Causing Right Ventricular Obstruction and Tricuspid Regurgitation.

Science.gov (United States)

Careddu, Lucio; Foà, Alberto; Leone, Ornella; Agostini, Valentina; Gargiulo, Gaetano Domenico; Rapezzi, Claudio; Di Bartolomeo, Roberto; Pacini, Davide

2017-09-01

We report the unique case of a primary cardiac leiomyoma originating from the right ventricle and involving the tricuspid valve in a 43-year-old woman. Echocardiography showed a giant mass causing severe pulmonary stenosis and tricuspid valve regurgitation. The patient underwent surgical excision and histologic examination revealed a primary cardiac leiomyoma. To the best of our knowledge only three cases of primary cardiac leiomyoma have so far been reported, and this is the first case of primary cardiac leiomyoma involving the tricuspid valve apparatus. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Addison disease and normocalcemic primary hyperparathyroidism ...

African Journals Online (AJOL)

A 12-year old dog with a 9-year history of primary adrenal insufficiency was referred to the service for hyporexia, muscle weakness, polyuria and polydipsia. Ultrasound examination showed an unresectable mass in the left adrenal gland, with local vascular invasion, which prompted the euthanasia of the animal. Additionally ...

Patient surface doses in computerized tomography examinations

International Nuclear Information System (INIS)

Vekic, B; Kovacevic, S.; Ranogajec-Komor, M.; Duvnjak, N.; Marusic, P.; Anic, P.; Dolencic, P.

1996-01-01

The diagnostic value of computerized tomography has increased due to very rapid technical advances in both equipment and techniques. When the CT scanners were introduced, a significant problem for the specification of the radiation dose imparted to the patient undergoing CT examination has been created. In CT, the conditions of exposure are quite different from those in conventional X-ray imaging. CT procedure involves the continuous tomography of thin layers. Some of these layers touch each other while others overlap. The radiation doses received by patients can vary considerably. In addition to the radiation from the collimated primary beam, patients are exposed to significant scattered doses in unpredictable amounts. Every effort should be made to keep these doses to a reasonable minimum, without sacrificing the image quality. The aims of this work were to determine the surface doses delivered to various organs of patients during various computerized tomography examinations (head, thorax, kidney, abdomen and pelvis). Particular attention was directed to the precise determination of doses received by the eyes (during CT of head) and gonads (during CT of pelvis and lower abdomen) since these organs can be near or even in the primary X-ray beam

Do general medical practitioners examine injured runners?

DEFF Research Database (Denmark)

Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study....... METHODS: An online survey was distributed in October and November 2015 to more than 370 GMPs in Denmark and completed by 27. RESULTS: The median prevalence proportion of consultations caused by running-related injuries in the prior two weeks was 0.80% [25th percentile = 0.00%; 75th percentile = 1...

Evaluating Social Participation of Pupils with Special Needs in Regular Primary Schools Examination of a Teacher Questionnaire

NARCIS (Netherlands)

Koster, Marloes; Timmerman, Marieke E.; Nakken, Han; Pijl, Sip Jan; van Houten, Els J.

2009-01-01

The study addresses the psychometric qualities of a new teacher questionnaire, the Social Participation Questionnaire (SPQ), to assess the social participation of pupils with special needs in regular primary education. The SPQ initially consisted of 34 statements related to four key themes of social

Primary conjunctival amyloidosis

Directory of Open Access Journals (Sweden)

Chandana Chakraborti

2014-01-01

Full Text Available A 19-year-old previously healthy male presented with a 4 year history of painless drooping of right upper eyelid.On eversion of the right upper eyelid, a yellowish pink mass was seen in the tarsal region. Rest of the ocular examination was normal in both the eyes. Initial biopsy showed chronic inflammation. Subsequently, the entire mass was excised and histopathological examination showed the presence of amyloid in the subconjunctival stroma. At 3 months follow-up, similar lesion was detected in the right lower, left upper, and lower lid, which were treated with cryotherapy, with partial resolution. Patient has been followed up for more than 2 years without any complaints. To our knowledge, this is the first case report of an isolated primary conjunctival amyloidosis with involvement of both the upper and lower palpebral conjunctiva of either eye. It was treated successfully by excision and cryotherapy.

Primary Prevention of Sexual Violence in Aotearoa New Zealand.

Science.gov (United States)

Dickson, Sandra; Willis, Gwenda M

2017-03-01

The extensive and sometimes profoundly damaging effects of sexual violence and large numbers of victims necessitate dedicated attention to primary prevention efforts. Few studies have examined the scope of current prevention activities or their fit with empirical research into effective prevention strategies. The current article presents findings from a survey of primary prevention activities in non-Māori and bicultural communities within Aotearoa New Zealand. Forty-four respondents representing 42 agencies responded to a comprehensive survey that canvased types of sexual violence primary prevention activities undertaken, sexual violence primary prevention programs, and barriers and supports to sexual violence prevention work. Consistent with findings from previous international surveys, the focus of primary prevention work in New Zealand was on sexual violence education and increasing awareness. Findings are discussed in the context of the sexual violence prevention literature and what works in prevention more broadly to help identify promising initiatives as well as gaps in current practices. Recommendations for advancing sexual violence primary prevention research are also provided.

Common primary headaches in pregnancy

Directory of Open Access Journals (Sweden)

Anuradha Mitra

2015-01-01

Full Text Available Headache is a very common problem in pregnancy. Evaluation of a complaint of headache requires categorizing it as primary or secondary. Migrainous headaches are known to be influenced by fluctuation of estrogen levels with high levels improving it and low levels deteriorating the symptoms. Tension-type Headaches (TTHs are the most common and usually less severe types of headache with female to male ratio 3:1. Women known to have primary headache before conception who present with a headache that is different from their usual headache, or women not known to have primary headache before conception who present with new-onset of headache during pregnancy need neurologic assessments for potential secondary cause for their headache. In addition to proper history and physical examination, both non-contrast computed tomography (CT and Magnetic Resonance Imaging (MRI are considered safe to be performed in pregnant women when indicated. Treatment of abortive and prophylactic therapy should include non-pharmacologic tools, judicious use of drugs which are safe for mother and fetus.

Dynamic gamma camera scintigraphy in primary hypoovarism

International Nuclear Information System (INIS)

Peshev, N.; Mladenov, B.; Topalov, I.; Tsanev, Ts.

1988-01-01

Twenty-seven patients with primary hypoovarism and 10 controls were examined. After intravenous injection of 111 to 175 MBq 99m Tc pertechnetate, dynamic gamma camera scintigraphy for 15 minutes was carried out. In the patients with primary amenorrhea no functioning ovarial tissue was visualized or the ovaries were diminished in size, strongly reduced and non-homogenous accumulation of the radionuclide with unclear and uneven delineation were observed. In the patients with primary infertility, the gamma camera investigation gave information not only about the presence of ovarial parenchyma, but about the extent of the inflammatory process, too. In the patients after surgical intervention, the dynamic radioisotope investigation gave information about the volume and the site of the surgical intervention, as well as about the conditions of the residual parenchyma

Autism and primary care dentistry: parents' experiences of taking children with autism or working diagnosis of autism for dental examinations.

Science.gov (United States)

Thomas, Nicole; Blake, Sharon; Morris, Christopher; Moles, David R

2018-03-01

Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews. Data were analysed thematically. Key themes identified were flexibility of the dental team and environment, confidence of the parents to advocate for their children's needs, continuity of services and clear referral pathways to specialist services. Cross-cutting all themes was the value of clear communication. The experiences provide greater understanding of issues such as hyper-empathy, the dental chair, challenges of the waiting room, perceived medical authority, and the importance of continuation of care. In line with previous research about the importance of family-centred care, a strong relationship between parents and the whole dental team is essential for children with autism to access dental examinations and have satisfactory experience of care. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness.

Science.gov (United States)

Dreischulte, Tobias; Grant, Aileen; Hapca, Adrian; Guthrie, Bruce

2018-01-05

The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point). Invited practices recruited (n=33) and not recruited (n=32) to the DQIP trial in Scotland, UK. (1) Characteristics of recruited versus non-recruited practices. Associations of (2) practice characteristics and 'adoption' (self-reported implementation work done by practices) with documented review activity and (3) of practice characteristics, DQIP adoption and review activity with effectiveness. (1) Recruited practices had lower performance in the quality and outcomes framework than those declining participation. (2) Not being an approved general practitioner training practice and higher self-reported adoption were significantly associated with higher review activity. (3) Effectiveness ranged from a relative increase in high-risk prescribing of 24.1% to a relative reduction of 77.2%. High-risk prescribing and DQIP adoption (but not documented review activity) were significantly associated with greater effectiveness in the final multivariate model, explaining 64.0% of variation in effectiveness. Intervention implementation and effectiveness of the DQIP intervention varied substantially between practices. Although the DQIP intervention primarily targeted review of ongoing high-risk prescribing, the finding that self-reported DQIP adoption was a stronger predictor of

Assessment of primary care services and perceived barriers to care in persons with disabilities.

Science.gov (United States)

Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L

2009-10-01

To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P brain injury (P use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.

Primary Non-Hodgkin's Malignant Lymphoma of the Sinonasal Tract

Directory of Open Access Journals (Sweden)

Nitin Gupta

2009-09-01

Full Text Available Primary non-Hodgkin’s lymphomas (NHL of the sinonasal tract are rather uncommon entities. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non- neoplastic processes. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and invasive fungal infection respectively. We report a case of primary NHL involving sinonasal tract in elderly female, which was clinically and radiologically mimicking as sinonasal malignany and was proven as NHL on histological examination and confirmed by immunohistochemistry. A high index of suspicion, appropriate histopathological examination and immunohistochemistry is necessary to differentiate sinonasal lymphomas from other possibilities. Failure to do so may miss the diagnosis and delay appropriate treatment

Diagnosis of endometrial tuberculosis: culture versus histopathological examination

International Nuclear Information System (INIS)

Zaman, G.; Karamat, K.A.; Hafeez-ud-Din; Yousaf, A.; Abbasi, S.A.; Rafi, S.

2002-01-01

Objective: To compare the relative efficacy of histopathological examination and culture method in the diagnosis of endometrial tuberculosis. Design: It was a prospective, comparative in-vitro study. Place and Duration of Study: The study was conducted at the Armed Forces Institute of Pathology, Rawalpindi and Department of Obstetrics and Gynecology, Military Hospital, Rawalpindi from August 1998 to April 1999. Materiel and Methods: A total number of 50 cases of primary and secondary infertility were selected. Endometrial biopsies of all patients were subjected to histopathological as well as culture examination on BACTEC. Results: Culture method yielded 10% (n=5) positive results compared with 6% (n=3) positive results obtained by histopathological examination. P value was 0.096 by chi-square test. Conclusion: Culture is a more effective method compared with histopathological examination in the diagnosis of endometrial tuberculosis. (author)

Periodontal disease detection in primary and mixed dentitions.

Science.gov (United States)

Nobre, C M Guimarães; Fernandes-Costa, A N; de Melo Soares, M S; Pugliesi, D M Carvalho; de Vasconcelos Gurgel, B C

2016-10-01

This was to compare the periodontal status of children with primary and mixed dentition at the time of their first consultation. Children (200), aged 0-12 years (156 with mixed and 44 with primary dentition), were examined by assessing their simplified plaque index (PI) and simplified periodontal record (PSR). Statistical analysis (Chi-square test) was performed with appropriate software to find any significant associations between sex, type of dentition and PI with the PSR codes (0, 1, 2, 3 and 4). There was no statistically significant difference with regard to gender (p = 0.82). Generalised PI was associated more significantly with mixed dentition (p = 0.025 and higher PSR scores (p periodontal examination in children to diagnose and prevent future periodontal disease and maintain their dentition as well as to identify any associated systemic conditions.

Examining empathy and its association with aggression in young ...

African Journals Online (AJOL)

Objective: In a context of disturbing rates of violent crime, this pilot study initiated examination of the association between empathy and aggressive behaviour in young Western Cape children. Establishing which empathy measures are appropriate for our context was a primary concern. Method: To capture various aspects of ...

Career Preparation: A Longitudinal, Process-Oriented Examination

OpenAIRE

Stringer, Kate; Kerpelman, Jennifer; Skorikov, Vladimir

2011-01-01

Preparing for an adult career through careful planning, choosing a career, and gaining confidence to achieve career goals is a primary task during adolescence and early adulthood. The current study bridged identity process literature and career construction theory (Savickas, 2005) by examining the commitment component of career adaptability, career preparation (i.e., career planning, career decision-making, and career confidence), from an identity process perspective (Luyckx, Goossens, & Soen...

The Role of the Primary School Head.

Science.gov (United States)

Davies, Lester

1987-01-01

This study uses Henry Mintzberg's structural observation method to examine British primary school head teachers' work patterns and determine the nature of their role. Head teachers' days were characterized by brevity, variety, and fragmentation similar to those discussed in findings of other empirical managerial studies. Leadership roles stressed…

Precise chronology of differentiation of developing human primary dentition.

Science.gov (United States)

Hu, Xuefeng; Xu, Shan; Lin, Chensheng; Zhang, Lishan; Chen, YiPing; Zhang, Yanding

2014-02-01

While correlation of developmental stage with embryonic age of the human primary dentition has been well documented, the available information regarding the differentiation timing of the primary teeth was largely based on the observation of initial mineralization and varies significantly. In this study, we aimed to document precise differentiation timing of the developing human primary dentition. We systematically examined the expression of odontogenic differentiation markers along with the formation of mineralized tissue in each developing maxillary and mandibular teeth from human embryos with well-defined embryonic age. We show that, despite that all primary teeth initiate development at the same time, odontogenic differentiation begins in the maxillary incisors at the 15th week and in the mandibular incisors at the 16th week of gestation, followed by the canine, the first primary premolar, and the second primary premolar at a week interval sequentially. Despite that the mandibular primary incisors erupt earlier than the maxillary incisors, this distal to proximal sequential differentiation of the human primary dentition coincides in general with the sequence of tooth eruption. Our results provide an accurate chronology of odontogenic differentiation of the developing human primary dentition, which could be used as reference for future studies of human tooth development.

Job Satisfaction of Catholic Primary School Staff: A Study of Biographical Differences

Science.gov (United States)

De Nobile, John J.; McCormick, John

2008-01-01

Purpose: This study's purpose is to examine the relationships between the biographical characteristics gender, age, years of experience and employment position, and job satisfaction of staff members in Catholic primary schools. Design/methodology/approach: Survey data were collected from 356 staff members from Catholic primary schools. Research…

Prevalence of primary glaucoma in an urban South Indian population

Directory of Open Access Journals (Sweden)

Jacob Aby

1998-01-01

Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

The Role of Pre-School Education on Learning Achievement at Primary Level in Bangladesh

Science.gov (United States)

Nath, Samir Ranjan

2012-01-01

This paper examines the impact of pre-school education on learning achievement at primary level in Bangladesh. Evidence from learning achievement test and household and school-related data were obtained from 7093 pupils attending 440 primary schools in Bangladesh. Findings suggest that a small proportion (15.3%) of primary school pupils attended…

Primary joint disease in the shoulder of the beagle dog

International Nuclear Information System (INIS)

Morgan, J.P.; Pool, R.R.; Miyabayashi, T.; Soo, S.

1985-01-01

Shoulder joints of 149 beagle dogs, whose ages were over 8 years at the time of death, were examined to document primary joint disease. Clinical histories of the dogs suggested no underlying causes, i.e. no evidence of osteochondrosis, trauma or joint infection. Radiographic examinations revealed normally developing shoulders in the first years of their lives. Radiographic changes were progressive with age. Bilateral involvement was common. The changes consisted of osteophyte formation on the caudal aspect of the humeral head and glenoid. Postmortem findings included: subchondral bone sclerosis (thin-section radiographs), cartilage wearing, joint capsule thickening, and pannus formation. The authors believe that the changes occurring in the shoulder joints are those of primary joint disease. 12 references

A Web-based Examination System Based on PHP+MySQL.

Science.gov (United States)

Wen, Ji; Zhang, Yang; Yan, Yong; Xia, Shunren

2005-01-01

The design and implementation of web-based examination system constructed by PHP and MySQL is presented in this paper. Three primary parts, including students',teachers' and administrators', are introduced and analyzed in detail. Initial application has demonstrated the system's feasibility and reasonability.*

Post-Primary Students' Images of Mathematics: Findings from a Survey of Irish Ordinary Level Mathematics Students

Science.gov (United States)

Lane, Ciara; Stynes, Martin; O'Donoghue, John

2016-01-01

A questionnaire survey was carried out as part of a PhD research study to investigate the image of mathematics held by post-primary students in Ireland. The study focused on students in fifth year of post-primary education studying ordinary level mathematics for the Irish Leaving Certificate examination--the final examination for students in…

Inherited retinal dysplasia and persistent hyperplastic primary vitreous in Miniature Schnauzer dogs.

Science.gov (United States)

Grahn, Bruce H; Storey, Eric S; McMillan, Catherine

2004-01-01

The objectives of this study were to define the clinical syndrome of retinal dysplasia and persistent primary vitreous in Miniature Schnauzer dogs and determine the etiology. We examined 106 Miniature Schnauzers using a biomicroscope and indirect ophthalmoscope. The anterior and posterior segments of affected dogs were photographed. Four enucleated eyes were examined using routine light microscopy and scanning electron microscopy. A pedigree was constructed and related dogs were test-bred to define the mode of inheritance of this syndrome. Congenital retinal dysplasia was confirmed in 24 of 106 related Miniature Schnauzer dogs. Physical and postmortem examinations revealed that congenital abnormalities were limited to the eyes. Biomicroscopic, indirect ophthalmoscopic, and neuro-ophthalmic examinations confirmed that some of these dogs were blind secondary to bilateral retinal dysplasia and detachment (nonattachment) (n = 13), and the remainder had generalized retinal dysplasia (n = 11). Fifteen of these dogs were also diagnosed with unilateral (n = 9) or bilateral (n = 6) persistent hyperplastic primary vitreous. Nutritional, infectious, or toxic etiologies were not evident on physical, postmortem, light microscopic, or transmitting and scanning electron microscopic examination of four affected Miniature Schnauzers. We examined the pedigree and determined that an autosomal recessive mode of inheritance was most likely. Three test-bred litters including those from affected parents, carrier and affected parents, and carrier parents confirmed this mode of inheritance. This study confirms that retinal dysplasia and persistent hyperplastic primary vitreous is a congenital abnormality that is inherited as an autosomal recessive condition in Miniature Schnauzers.

Primary sinonasal tuberculosis in north-west Pakistan

International Nuclear Information System (INIS)

Nawaz, G.; Khan, M.R.

2004-01-01

Objective: To record the frequency of primary involvement of nose and paranasal sinuses with tuberculosis in today's situation in the north-west region of Pakistan. Patients and Methods: A total of ten cases of primary sinonasal tuberculosis were included. The inclusion criteria were biopsy and acid-fast bacilli (AFB) examination after Ziel Neelsen (ZN) staining. Patients were put on anti-tuberculous chemotherapy. Response to the therapy and compliance of the patients were studied through follow up. Patients were admitted and offered surgical treatment wherever needed. Results: The primary sinonasal tuberculosis affected mainly young adults (18-60 years), both genders almost equally. Majority (80%) of the patients belonged to far-flung rural areas and all (100%) were poor. More frequent presenting features were granular lesion and mass in the nose (40%), epistaxis (30%), septal perforation (30%), external deformity (30%), palpable cervical lymph nodes (30%) and others. All the cases were diagnosed microscopically. Compliance to treatment was not good. Conclusion: The incidence of primary tuberculosis of nose and paranasal sinuses has risen in the recent past. The patients manifested no evidence of pulmonary tuberculosis. (author)

Performance feedback: An exploratory study to examine the acceptability and impact for interdisciplinary primary care teams

Science.gov (United States)

2011-01-01

Background This mixed methods study was designed to explore the acceptability and impact of feedback of team performance data to primary care interdisciplinary teams. Methods Seven interdisciplinary teams were offered a one-hour, facilitated performance feedback session presenting data from a comprehensive, previously-conducted evaluation, selecting highlights such as performance on chronic disease management, access, patient satisfaction and team function. Results Several recurrent themes emerged from participants' surveys and two rounds of interviews within three months of the feedback session. Team performance measurement and feedback was welcomed across teams and disciplines. This feedback could build the team, the culture, and the capacity for quality improvement. However, existing performance indicators do not equally reflect the role of different disciplines within an interdisciplinary team. Finally, the effect of team performance feedback on intentions to improve performance was hindered by a poor understanding of how the team could use the data. Conclusions The findings further our understanding of how performance feedback may engage interdisciplinary team members in improving the quality of primary care and the unique challenges specific to these settings. There is a need to develop a shared sense of responsibility and agenda for quality improvement. Therefore, more efforts to develop flexible and interactive performance-reporting structures (that better reflect contributions from all team members) in which teams could specify the information and audience may assist in promoting quality improvement. PMID:21443806

Petechiae and vasculitis in asymptomatic primary biliary cirrhosis

DEFF Research Database (Denmark)

Diederichsen, H; Sørensen, P G; Mickley, H

1985-01-01

Recurrent petechiae of the lower legs and signs of asymptomatic primary biliary cirrhosis have been found in three women. Large immune complexes were identified in the serum of three and cryoglobulin/cryofibrinogen in two. Histological examination of skin biopsies revealed a leukocytoclastic vasc...

Apoptosis in the human periodontal membrane evaluated in primary and permanent teeth

DEFF Research Database (Denmark)

Bille, Marie-Louise Bastholm; Thomsen, Bjarke; Kjær, Inger

2011-01-01

that resorption is connected to apoptosis of the epithelial cells of Malassez. The purpose of this study is to localize cells undergoing apoptosis in the periodontal membrane of human primary and permanent teeth. Materials and methods. Human primary and permanent teeth were examined immunohistochemically...... for apoptosis and epithelial cells of Malassez in the periodontal membrane. All teeth examined were extracted in connection with treatment. Results. Apoptosis was seen in close proximity to the root surface and within the epithelial cells of Malassez. This pattern of apoptotis is similar in the periodontal...... membrane in primary and permanent teeth. Conclusions. The inter-relationship between apoptotis and root resorption cannot be concluded from the present study. Apoptosis seen in close proximity to the root surface presumably corresponds to the highly innervated layer of the periodontal membrane...

A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

Science.gov (United States)

Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

2015-03-15

Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

The Association Between the Physical Environment of Primary Schools and Active School Transport

NARCIS (Netherlands)

Kann, D.H.H. van; Kremers, S.P.J.; Gubbels, J.S.; Bartelink, N.H.M.; Vries, S.I. de; Vries, N.K. de; Jansen, M.W.J.

2015-01-01

This study examined the relationship between the physical environment characteristics of primary schools and active school transport among 3,438 5- to 12-year-old primary school children in the Netherlands. The environmental characteristics were categorized into four theory-based clusters (function,

The primary empty sella in children and its significance

International Nuclear Information System (INIS)

Tokiguchi, Susumu; Tsuchiya, Toshiaki; Ito, Jusuke

1983-01-01

The primary empty sella has been thought to be rare in children; only a few children have been described in the literature. The majority of such cases have been associated with congenital anomalies, optic atrophies, or cerebrospinal fluid rhinorrheas. We now report four cases of the primary empty sella in children. Two of the patients(Case 1 and Case 3) were prepubescent and had primary generalized epilepsy, while Case 2 and Case 4 complained of attacks of vascular headache and peri-orbital pain respectively. None of them showed any clinical evidence of endocrine disturbance. Ophthalmological examination revealed no abnormalities. The association of the primary empty sella with such disorders as primary epilepsy, attacks of vascular headache, and peri-orbital pain were thought to be almost certainly coincidental; the possibility was suggested that the empty sella might be present in children as an anatomical variant or as an acquired process in a certain percentage of them. (author)

Three-dimensional space changes after premature loss of a maxillary primary first molar.

Science.gov (United States)

Park, Kitae; Jung, Da-Woon; Kim, Ji-Yeon

2009-11-01

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars. The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars. Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss. There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side. The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.

Preliminary examination of metabolic syndrome response to motivational interviewing for weight loss as compared to an attentional control and usual care in primary care for individuals with and without binge-eating disorder.

Science.gov (United States)

Barnes, Rachel D; Barber, Jessica A

2017-08-01

Motivational interviewing (MI) treatment for weight loss is being studied in primary care. The effect of such interventions on metabolic syndrome or binge eating disorder (BED), both highly related to excess weight, has not been examined in primary care. This study conducted secondary analyses from a randomized controlled trial to test the impact of MI for weight loss in primary care on metabolic syndrome. 74 adult participants with overweight/obesity recruited through primary care were randomized to 12weeks of either MI, an attentional control, or usual care. Participants completed measurements for metabolic syndrome at pre- and post-treatment. There were no statistically significant differences in metabolic syndrome rates at pre-, X 2 (2)=0.16, p=0.921, or post-, X 2 (2)=0.852, p=0.653 treatment. The rates in metabolic syndrome, however, decreased for MI (10.2%) and attentional control (13.8%) participants, but not for usual care. At baseline, metabolic syndrome rates did not differ significantly between participants with BED or without BED across treatments. At post-treatment, participants with BED were significantly more likely to meet criteria for metabolic syndrome than participants without BED, X 2 (1)=5.145, p=0.023, phi=0.273. Across treatments, metabolic syndrome remitted for almost a quarter of participants without BED (23.1%) but for 0% of those with BED. These preliminary results are based on a small sample and should be interpreted with caution, but they are the first to suggest that relatively low intensity MI weight loss interventions in primary care may decrease metabolic syndrome rates but not for individuals with BED. Copyright © 2017 Elsevier Ltd. All rights reserved.

Divergent primary moult-A rare moult sequence among Western Palaearctic passerines.

Directory of Open Access Journals (Sweden)

Yosef Kiat

Full Text Available Wing morphology strongly affects flight performance which may consequently decline during feather moult due to the creation of feather gaps in the wing. Hence, the size and shape of moult-related wing gap may directly affect flight capacity. Here I examined the rare divergent primary moult sequence compared to the more common descendant moult sequence. In the divergent moult, the focus of primary moult is shifted from P1 (primary feather numbered descendantly to another primary between P2 and P5, and then primaries are moulted in two concurrent waves, one descendant and the other ascendant. The result of this rare moult sequence is the splitting of the wing gap to two smaller gaps. Using a large moult database including 6,763 individuals of 32 Western Palaearctic passerine species, I found evidence of divergent moult only among 27 individuals of 12 species. I examined the speed of wing-feather moult for each individual that moulted divergently compared to a control group of individuals at the same moult stage which moulted following the common descending sequence. The results indicate that the sequence of primary moult and moult speed are correlated. Individuals which moulted divergently moulted their primaries with higher moult speed than descendant moulters. The applicability of this study is weakened by the dearth of moult data, thus making it difficult to draw conclusions for a large range of species. Ornithologists and bird ringers are therefore encouraged to collect more basic moult data during their field study.

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

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Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

Blackboard Bullies: Workplace Bullying in Primary Schools

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Fahie, Declan

2014-01-01

This paper offers a comprehensive examination of the "lived experience" of workplace bullying in primary schools in Ireland. Underpinned by the qualitative analysis of in-depth interviews with a class teacher, a chairperson of a Board of Management and a school principal--all of whom who believe themselves to have been targets of…

Primary School Principals' Experiences with Smartphone Apps

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Çakir, Rahman; Aktay, Sayim

2016-01-01

Smartphones are not just pieces of hardware, they at same time also dip into software features such as communication systems. The aim of this study is to examine primary school principals' experiences with smart phone applications. Shedding light on this subject means that this research is qualitative. Criterion sampling has been intentionally…

Mixed-Age Grouping in Nongraded Primary Classes.

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Pasemko, Judy Guthrie

This study examined teachers' and parents' perceptions of pedagogical successes in, and problems with, the implementation of mixed-age classes in primary education. Questionnaires were completed by 44 teachers in 2 British Columbia school districts, and by 41 parents of children in mixed-age classes in those districts. Some of the teachers were…

Computed tomography in malignant primary bone tumours

International Nuclear Information System (INIS)

Kersjes, W.; Harder, T.; Haeffner, P.

1990-01-01

The importance of computed tomography is examined in malignant primary bone tumours using a strongly defined examination group of 13 Patients (six Ewing's-sarcomas, five osteosarcomas, one chondrosarcoma and one spindle-shaped cell sarcoma). Computed tomography is judged superior compared to plain radiographs in recognition of bone marrow infiltration and presentation of parosteal tumour parts as well as in analysis of tissue components of tumours, CT is especially suitable for therapy planning and evaluating response to therapy. CT does not provide sufficient diagnostic information to determine dignity and exact diagnosis of bone tumours. (orig.) [de

Cancer of unknown primary origin: a case report

Directory of Open Access Journals (Sweden)

Elisa De Carlo

2013-03-01

Full Text Available Carcinoma of unknown primary origin (CUP accounts for 2-10% of all malignancies. The apparent absence of the primary tumour, the development of early, uncommon systemic metastases and the resistance to therapy and poor prognosis are hallmarks of this heterogeneous clinical entity and are a challenge for physicians. The diagnostic workup of patients with CUP includes a large amount of histopathological examination, as well as the use of imaging techniques that often fail to identify the primary tumour. Therefore, the optimal workup and treatment for these patients remains to be determined. Molecular diagnostic tools, such as DNA microarray analysis, could help in the search for "lost" CUP origin and guide the further treatment approach. We report the case of a 66-year-old man, with mediastinal lymph nodes metastasis of carcinoma and neurological syndrome with diplopia and balance disorders, in which many exams have been performed without finding the primary tumour.

Examining the Role of Primary Care Physicians and Challenges Faced When Their Patients Transition to Home Hospice Care.

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Shalev, Ariel; Phongtankuel, Veerawat; Lampa, Katherine; Reid, M C; Eiss, Brian M; Bhatia, Sonica; Adelman, Ronald D

2018-04-01

The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care. Nineteen semi-structured phone interviews with PCPs were conducted. Study data were analyzed using standard qualitative methods. Participants included PCPs from 3 academic group practices in New York City. Measured: Physician recordings were transcribed and analyzed using content analysis. Most PCPs noted that there was a discrepancy between their actual role and ideal role when their patients transitioned to home hospice care. Primary care physicians expressed a desire to maintain continuity, provide psychosocial support, and collaborate actively with the hospice team. Better establishment of roles, more frequent communication with the hospice team, and use of technology to communicate with patients were mentioned as possible ways to help PCPs achieve their ideal role caring for their patients receiving home hospice care. Primary care physicians expressed varying degrees of involvement during a patient's transition to home hospice care, but many desired to be more involved in their patient's care. As with patients, physicians desire to maintain continuity with their patients at the EoL and solutions to improve communication between PCPs, hospice providers, and patients need to be explored.

Classification and clinical features of primary headache in Akaki ...

African Journals Online (AJOL)

Classification and clinical features of primary headache in Akaki Textile Mill workers, ... study wherein data collection and examination of cases using a structured and ... like pressure or tightness with a mild to moderate intensity and anorexia.

Migraine Nurses in Primary Care : Costs and Benefits

NARCIS (Netherlands)

van den Berg, Jan S. P.; Steiner, Timothy J.; Veenstra, Petra J. L.; Kollen, Boudewijn J.

Objective. We examined the costs and benefits of introducing migraine nurses into primary care. Background. Migraine is one of the most costly neurological diseases. Methods. We analyzed data from our earlier nonrandomized cohort study comparing an intervention group of 141 patients, whose care was

Utilization of Routine Primary Care Services Among Dancers.

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Alimena, Stephanie; Air, Mary E; Gribbin, Caitlin; Manejias, Elizabeth

2016-01-01

This study examines the current utilization of primary and preventive health care services among dancers in order to assess their self-reported primary care needs. Participants were 37 dancers from a variety of dance backgrounds who presented for a free dancer health screening in a large US metropolitan area (30 females, 7 males; mean age: 27.5 ± 7.4 years; age range: 19 to 49 years; mean years of professional dancing: 6.4 ± 5.4 years). Dancers were screened for use of primary care, mental health, and women's health resources using the Health Screen for Professional Dancers developed by the Task Force on Dancer Health. Most dancers had health insurance (62.2%), but within the last 2 years, only approximately half of them (54.1%) reported having a physical examination by a physician. Within the last year, 54.1% of dancers had had a dental check-up, and 56.7% of female dancers received gynecologic care. Thirty percent of female participants indicated irregular menstrual cycles, 16.7% had never been to a gynecologist, and 16.7% were taking birth control. Utilization of calcium and vitamin D supplementation was 27.0% and 29.7%, respectively, and 73.0% were interested in nutritional counseling. A high rate of psychological fatigue and sleep deprivation was found (35.1%), along with a concomitant high rate of self-reported need for mental health counseling (29.7%). Cigarette and recreational drug use was low (5.4% and 5.4%); however, 32.4% engaged in binge drinking within the last year (based on the CDC definition). These findings indicate that dancers infrequently access primary care services, despite high self-reported need for nutritional, mental, and menstrual health counseling and treatment. More studies are warranted to understand dancers' primary health care seeking behavior.

Problem-Solving Treatment and Coping Styles in Primary Care for Minor Depression

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Oxman, Thomas E.; Hegel, Mark T.; Hull, Jay G.; Dietrich, Allen J.

2008-01-01

Research was undertaken to compare problem-solving treatment for primary care (PST-PC) with usual care for minor depression and to examine whether treatment effectiveness was moderated by coping style. PST-PC is a 6-session, manual-based, psychosocial skills intervention. A randomized controlled trial was conducted in 2 academic, primary care…

Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

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Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

2007-01-01

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

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Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

2018-04-12

AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

Revisiting Primary School Dropout in Rural Cambodia

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No, Fata; Sam, Chanphirun; Hirakawa, Yukiko

2012-01-01

Previous studies on school dropout in Cambodia often used data from subjects after they already dropped out or statistics from education-related institutions. Using data from children in two rural provinces before they dropped out, this study examines four main factors in order to identify their influence on primary school dropout in Cambodia.…

Primary tonsillar mast cell tumour in a dog.

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Shekell, C C; Thomson, M J; Miller, R I; Mackie, J T

2018-05-01

A 6-year-old speyed female Bull Arab-cross dog was found to have a small tonsillar nodule. Histological examination revealed a well-differentiated mast cell tumour (MCT). At initial staging, no evidence of concurrent cutaneous or visceral MCTs was found on a complete blood count, a single lateral thoracic radiograph, abdominal ultrasound or cytology of the spleen and regional lymph nodes. A diagnosis of primary tonsillar MCT was made. At 40 months postoperatively, the dog is alive with no evidence of gross tumour progression, in contrast to some previous reports of rapid disease progression and metastasis in dogs with primary oral MCTs. To the authors' knowledge, no previous reports of a primary MCT of the tonsil in dogs exist in the veterinary literature. © 2018 Australian Veterinary Association.

Adenylate cyclase regulates elongation of mammalian primary cilia

International Nuclear Information System (INIS)

Ou, Young; Ruan, Yibing; Cheng, Min; Moser, Joanna J.; Rattner, Jerome B.; Hoorn, Frans A. van der

2009-01-01

The primary cilium is a non-motile microtubule-based structure that shares many similarities with the structures of flagella and motile cilia. It is well known that the length of flagella is under stringent control, but it is not known whether this is true for primary cilia. In this study, we found that the length of primary cilia in fibroblast-like synoviocytes, either in log phase culture or in quiescent state, was confined within a range. However, when lithium was added to the culture to a final concentration of 100 mM, primary cilia of synoviocytes grew beyond this range, elongating to a length that was on average approximately 3 times the length of untreated cilia. Lithium is a drug approved for treating bipolar disorder. We dissected the molecular targets of this drug, and observed that inhibition of adenylate cyclase III (ACIII) by specific inhibitors mimicked the effects of lithium on primary cilium elongation. Inhibition of GSK-3β by four different inhibitors did not induce primary cilia elongation. ACIII was found in primary cilia of a variety of cell types, and lithium treatment of these cell types led to their cilium elongation. Further, we demonstrate that different cell types displayed distinct sensitivities to the lithium treatment. However, in all cases examined primary cilia elongated as a result of lithium treatment. In particular, two neuronal cell types, rat PC-12 adrenal medulla cells and human astrocytes, developed long primary cilia when lithium was used at or close to the therapeutic relevant concentration (1-2 mM). These results suggest that the length of primary cilia is controlled, at least in part, by the ACIII-cAMP signaling pathway.

Adenylate cyclase regulates elongation of mammalian primary cilia

Energy Technology Data Exchange (ETDEWEB)

Ou, Young; Ruan, Yibing; Cheng, Min; Moser, Joanna J. [Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1 (Canada); Rattner, Jerome B. [Department of Cell Biology and Anatomy, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1 (Canada); Hoorn, Frans A. van der, E-mail: fvdhoorn@ucalgary.ca [Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1 (Canada)

2009-10-01

The primary cilium is a non-motile microtubule-based structure that shares many similarities with the structures of flagella and motile cilia. It is well known that the length of flagella is under stringent control, but it is not known whether this is true for primary cilia. In this study, we found that the length of primary cilia in fibroblast-like synoviocytes, either in log phase culture or in quiescent state, was confined within a range. However, when lithium was added to the culture to a final concentration of 100 mM, primary cilia of synoviocytes grew beyond this range, elongating to a length that was on average approximately 3 times the length of untreated cilia. Lithium is a drug approved for treating bipolar disorder. We dissected the molecular targets of this drug, and observed that inhibition of adenylate cyclase III (ACIII) by specific inhibitors mimicked the effects of lithium on primary cilium elongation. Inhibition of GSK-3{beta} by four different inhibitors did not induce primary cilia elongation. ACIII was found in primary cilia of a variety of cell types, and lithium treatment of these cell types led to their cilium elongation. Further, we demonstrate that different cell types displayed distinct sensitivities to the lithium treatment. However, in all cases examined primary cilia elongated as a result of lithium treatment. In particular, two neuronal cell types, rat PC-12 adrenal medulla cells and human astrocytes, developed long primary cilia when lithium was used at or close to the therapeutic relevant concentration (1-2 mM). These results suggest that the length of primary cilia is controlled, at least in part, by the ACIII-cAMP signaling pathway.

Tumor Necrosis Factor Inhibitor Primary Failure Predicts Decreased Ustekinumab Efficacy in Psoriasis Patients.

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Sorensen, Eric P; Fanucci, Kristina A; Saraiya, Ami; Volf, Eva; Au, Shiu-chung; Argobi, Yahya; Mansfield, Ryan; Gottlieb, Alice B

2015-08-01

Additional studies are needed to examine the efficacy of ustekinumab in psoriasis patients who have previously been exposed to tumor necrosis factor inhibitors (TNFi). To examine the predictive effect of TNFi primary failure and the number of TNFi exposures on the efficacy of ustekinumab in psoriasis treatment. This retrospective study examined 44 psoriasis patients treated at the Tufts Medical Center Department of Dermatology between January 2008 and July 2014. Patients were selected if they were treated with ustekinumab and had ≥ 1 previous TNFi exposure. The following subgroups were compared: patients with vs without a previous TNFi primary failure, and patients with one vs multiple previous TNFi exposures. The efficacy measure used was the previously validated Simple Measure for Assessing Psoriasis Activity (S-MAPA), which is calculated by the product of the body surface area and physician global assessment. The primary outcome was the percentage improvement S-MAPA from course baseline at week 12 of ustekinumab treatment. Secondary outcomes were the psoriasis clearance, primary failure, and secondary failure rates with ustekinumab treatment. Patients with a previous TNFi primary failure had a significantly lower percentage improvement in S-MAPA score at week 12 of ustekinumab treatment compared with patients without TNFi primary failure (36.2% vs 61.1%, P=.027). Multivariate analysis demonstrated that this relationship was independent of patient demographics and medical comorbidities. Patients with multiple TNFi exposures had a non-statistically significant lower percentage S-MAPA improvement at week 12 (40.5% vs 52.9%, P=.294) of ustekinumab treatment compared with patients with a single TNFi exposure. Among psoriasis patients previously exposed to TNFi, a history of a previous TNFi primary failure predicts a decreased response to ustekinumab independent of patient demographics and medical comorbidities.

On the Complexity of Chinese Sentences in Singapore Primary Textbooks

Directory of Open Access Journals (Sweden)

Goh Saye Wee

2016-12-01

Full Text Available This paper uses the sentences from the Singapore primary school Chinese textbooks as the research material, using sentence as a unit; analyses sentence composition and sentence patterns, from quantity, distribution, characteristic and semantic type aspects to examine the progression of sentence complexity in Chinese language. The paper describes how the sentence develops in a systemic and complexity aspect in textbooks of various levels. The paper suggests 7 types of sentence pattern grading in term of complexity progression, and proposes a formula to examine and calculate the complexity index of a sentence. The findings derive a set of valuable data to expound the complexity of a sentence and discuss the variable factors influencing the complexity of sentences used in primary school Chinese textbooks.

Laparoscopic examination of the reproductive organs in women treated for infertility

International Nuclear Information System (INIS)

Popiela, A.; Kasiak, J.; Heimrath, T.; Cislo, M.

1993-01-01

The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubar inpatency was found (using hysterosalpingographic examination). The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility. (author)

Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study.

Science.gov (United States)

Juma, Jane; Nyothach, Elizabeth; Laserson, Kayla F; Oduor, Clifford; Arita, Lilian; Ouma, Caroline; Oruko, Kelvin; Omoto, Jackton; Mason, Linda; Alexander, Kelly T; Fields, Barry; Onyango, Clayton; Phillips-Howard, Penelope A

2017-05-04

Examine the safety of menstrual cups against sanitary pads and usual practice in Kenyan schoolgirls. Observational studies nested in a cluster randomised controlled feasibility study. 30 primary schools in a health and demographic surveillance system in rural western Kenya. Menstruating primary schoolgirls aged 14-16 years participating in a menstrual feasibility study. Insertable menstrual cup, monthly sanitary pads or 'usual practice' (controls). Staphylococcus aureus vaginal colonization, Escherichia coli growth on sampled used cups, toxic shock syndrome or other adverse health outcomes. Among 604 eligible girls tested, no adverse event or TSS was detected over a median 10.9 months follow-up. S. aureus prevalence was 10.8%, with no significant difference over intervention time or between groups. Of 65  S.aureus positives at first test, 49 girls were retested and 10 (20.4%) remained positive. Of these, two (20%) sample isolates tested positive for toxic shock syndrome toxin-1; both girls were provided pads and were clinically healthy. Seven per cent of cups required replacements for loss, damage, dropping in a latrine or a poor fit. Of 30 used cups processed for E. coli growth, 13 (37.1%, 95% CI 21.1% to 53.1%) had growth. E. coli growth was greatest in newer compared with established users (53%vs22.2%, p=0.12). Among this feasibility sample, no evidence emerged to indicate menstrual cups are hazardous or cause health harms among rural Kenyan schoolgirls, but large-scale trials and post-marketing surveillance should continue to evaluate cup safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Resilience of primary healthcare professionals: a systematic review.

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Robertson, Helen D; Elliott, Alison M; Burton, Christopher; Iversen, Lisa; Murchie, Peter; Porteous, Terry; Matheson, Catriona

2016-06-01

Modern demands and challenges among healthcare professionals can be particularly stressful and resilience is increasingly necessary to maintain an effective, adaptable, and sustainable workforce. However, definitions of, and associations with, resilience have not been examined within the primary care context. To examine definitions and measures of resilience, identify characteristics and components, and synthesise current evidence about resilience in primary healthcare professionals. A systematic review was undertaken to identify studies relating to the primary care setting. Ovid(®), Embase(®), CINAHL, PsycINFO, and Scopus databases were searched in December 2014. Text selections and data extraction were conducted by paired reviewers working independently. Data were extracted on health professional resilience definitions and associated factors. Thirteen studies met the inclusion criteria: eight were quantitative, four qualitative, and one was an intervention study. Resilience, although multifaceted, was commonly defined as involving positive adaptation to adversity. Interactions were identified between personal growth and accomplishment in resilient physicians. Resilience, high persistence, high self-directedness, and low avoidance of challenges were strongly correlated; resilience had significant associations with traits supporting high function levels associated with demanding health professional roles. Current resilience measures do not allow for these different aspects in the primary care context. Health professional resilience is multifaceted, combining discrete personal traits alongside personal, social, and workplace features. A measure for health professional resilience should be developed and validated that may be used in future quantitative research to measure the effect of an intervention to promote it. © British Journal of General Practice 2016.

Resilience of primary healthcare professionals: a systematic review

Science.gov (United States)

Robertson, Helen D; Elliott, Alison M; Burton, Christopher; Iversen, Lisa; Murchie, Peter; Porteous, Terry; Matheson, Catriona

2016-01-01

Background Modern demands and challenges among healthcare professionals can be particularly stressful and resilience is increasingly necessary to maintain an effective, adaptable, and sustainable workforce. However, definitions of, and associations with, resilience have not been examined within the primary care context. Aim To examine definitions and measures of resilience, identify characteristics and components, and synthesise current evidence about resilience in primary healthcare professionals. Design and setting A systematic review was undertaken to identify studies relating to the primary care setting. Method Ovid®, Embase®, CINAHL, PsycINFO, and Scopus databases were searched in December 2014. Text selections and data extraction were conducted by paired reviewers working independently. Data were extracted on health professional resilience definitions and associated factors. Results Thirteen studies met the inclusion criteria: eight were quantitative, four qualitative, and one was an intervention study. Resilience, although multifaceted, was commonly defined as involving positive adaptation to adversity. Interactions were identified between personal growth and accomplishment in resilient physicians. Resilience, high persistence, high self-directedness, and low avoidance of challenges were strongly correlated; resilience had significant associations with traits supporting high function levels associated with demanding health professional roles. Current resilience measures do not allow for these different aspects in the primary care context. Conclusion Health professional resilience is multifaceted, combining discrete personal traits alongside personal, social, and workplace features. A measure for health professional resilience should be developed and validated that may be used in future quantitative research to measure the effect of an intervention to promote it. PMID:27162208

Structural Dynamics of Education Reforms and Quality of Primary Education in Uganda

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Nyenje, Aida

2016-01-01

This paper examines Uganda's recent undertaking to reform her Primary School education System with a focus on the effect of structural dynamics of education reforms and the quality of primary education. Structural dynamics in the context of this study is in reference to the organizational composition of the education system at the government,…

Homework Involvement among Hong Kong Primary School Students

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Tam, Vicky C. W.

2009-01-01

One component of the curriculum reform in Hong Kong focuses on the use of homework in consolidating learning, deepening understanding and constructing knowledge. This study examines the profile of Hong Kong primary school students' homework involvement, and investigates the relationships between time involvement and academic attributes, namely…

Depression Treatment Preferences in Older Primary Care Patients

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Gum, Amber M.; Arean, Patricia A.; Hunkeler, Enid; Tang, Lingqi; Katon, Wayne; Hitchcock, Polly; Steffens, David C.; Dickens, Jeanne; Unutzer, Jurgen

2006-01-01

Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older…

Classroom assessment in Chinese primary school mathematics education

NARCIS (Netherlands)

Zhao, X.

2018-01-01

In mainland China, where there exists a deeply-rooted examination culture, an assessment reform promoting the use of assessment to support teaching and learning has been carried out since 2001. After a decade, however, only a few studies have been done that focus on primary school mathematics

Twin Specific Risk Factors in Primary School Achievements

NARCIS (Netherlands)

de Zeeuw, L.E.J.; van Beijsterveldt, C.E.M.; de Geus, E.J.C.; Boomsma, D.I.

2012-01-01

The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational

Primary Student-Teachers' Conceptual Understanding of the Greenhouse Effect: A mixed method study

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Ratinen, Ilkka Johannes

2013-04-01

The greenhouse effect is a reasonably complex scientific phenomenon which can be used as a model to examine students' conceptual understanding in science. Primary student-teachers' understanding of global environmental problems, such as climate change and ozone depletion, indicates that they have many misconceptions. The present mixed method study examines Finnish primary student-teachers' understanding of the greenhouse effect based on the results obtained via open-ended and closed-form questionnaires. The open-ended questionnaire considers primary student-teachers' spontaneous ideas about the greenhouse effect depicted by concept maps. The present study also uses statistical analysis to reveal respondents' conceptualization of the greenhouse effect. The concept maps and statistical analysis reveal that the primary student-teachers' factual knowledge and their conceptual understanding of the greenhouse effect are incomplete and even misleading. In the light of the results of the present study, proposals for modifying the instruction of climate change in science, especially in geography, are presented.

Assessing primary care data quality.

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Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Primary tuberculosis of the glans penis.

Science.gov (United States)

Jimenez Parra, Jose David; Alvarez Bandres, Silvia; Garcia Garcia, Diego; Torres Varas, Lorena; Sotil Arrieta, Amaia; Jimenez Calvo, Jesus

2014-03-01

Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports.

Classroom observation data and instruction in primary mathematics education: improving design and rigour

Science.gov (United States)

Thompson, Carla J.; Davis, Sandra B.

2014-06-01

The use of formal observation in primary mathematics classrooms is supported in the literature as a viable method of determining effective teaching strategies and appropriate tasks for inclusion in the early years of mathematics learning. The twofold aim of this study was to (a) investigate predictive relationships between primary mathematics classroom observational data and student achievement data, and (b) to examine the impact of providing periodic classroom observational data feedback to teachers using a Relational-Feedback-Intervention (RFI) Database Model. This observational research effort focused on an empirical examination of student engagement levels in time spent on specific learning activities observed in primary mathematics classrooms as predictors of student competency outcomes in mathematics. Data were collected from more than 2,000 primary classroom observations in 17 primary schools during 2009-2011 and from standardised end-of-year tests for mathematics achievement. Results revealed predictive relationships among several types of teaching and learning tasks with student achievement. Specifically, the use of mathematics concepts, technology and hands-on materials in primary mathematics classrooms was found to produce substantive predictors of increased student mathematics achievement. Additional findings supported the use of periodic classroom observation data reporting as a positive influence on teachers' decisions in determining instructional tasks for inclusion in primary mathematics classrooms. Study results indicate classroom observational research involving a RFI Database Model is a productive tool for improving teaching and learning in primary mathematics classrooms.

Primary Biliary Cirrhosis and Primary Sjögren's Syndrome: Insights for the Stomatologist

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Liliane Lins

2014-08-01

Full Text Available Primary biliary cirrhosis (PBC is a chronic progressive autoimmune disease characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Primary Sjögren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands, mainly the lachrymal and salivary glands, in the absence of other definitively diagnosed rheumatologic disease. We report a diagnosed case of primary Sjögren's syndrome associated with PBC. A 59-year-old Caucasian woman went to oral evaluation reporting dry mouth, difficulty in eating associated with burning mouth syndrome, dysgeusia and dysphagia. Intraoral examination revealed extensive cervical caries, gingivitis, gingival retraction, angular cheilitis and atrophic tongue. Hyposalivation was detected by salivary flow and Schirmer's test was positive. Antinuclear and antimitochondrial antibodies were both positive. Anti-Ro/SSA and anti-La/SSB antibodies were negative. A minor salivary gland biopsy of the lower lip was performed. Histopathologic analysis revealed lymphocytic infiltrate with destruction of salivary gland architecture in some areas and replacement of glandular tissues by mononuclear cells. Optimal management of PBC associated with Sjögren's syndrome requires a multidisciplinary approach as the key to optimal patient care. Dental practitioners should be able to recognize the clinical features of this associated condition. Appropriate dental care may prevent tooth decay, periodontal disease and oral infections as well as improve the patient's quality of life.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases.

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Gong, Li; Liu, Xiao-Yan; Zhang, Wen-Dong; Zhu, Shao-Jun; Yao, Li; Han, Xiu-Juan; Lan, Miao; Li, Yan-Hong; Zhang, Wei

2012-09-19

Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases

Directory of Open Access Journals (Sweden)

Gong Li

2012-09-01

Full Text Available Abstract Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

ISOLATED HYDROPERICARDIUM – THE IMPLICATION OF LATE DIAGNOSIS OF PRIMARY HYPOTHYROIDISM

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Snitko V. N.

2018-02-01

Full Text Available Background. In therapeutic practice the diagnostics of hypothyroidism can be difficult due to its non-specific nature and symptoms diversity. Goal. To present the result of successful diagnostics and treatment of primary hypothyroidism, where hydropericardium was defined as the main symptom of the disease. Material and methods. A case of late diagnosis of primary hypothyroidism in a female aged 50 with hydropericardium is described. The tactics of examination of the patient according to the recommendations of the European Society of Cardiology (2015 with the purpose of excluding metabolic causes of pericardial effusion is presented. Results. The ignoring of the most frequent symptoms of hypothyroidism was found to be the reason for late diagnostics of the disease, hydropericardium being considered the primary disease. Conclusions. In order to exclude metabolic causes of pericardial effusion during the examination of patients with the diseases of pericardium, evaluation of the thyroid function is warranted.

Clinical productivity of primary care nurse practitioners in ambulatory settings.

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Xue, Ying; Tuttle, Jane

Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners' productivity in primary care practice. We examined nurse practitioners' clinical productivity in regard to number of patients seen per week, whether they had a patient panel, and patient panel size. We further investigated practice characteristics associated with their clinical productivity. We conducted cross-sectional analysis of the 2012 National Sample Survey of Nurse Practitioners. The sample included full-time primary care nurse practitioners in ambulatory settings. Multivariable survey regression analyses were performed to examine the relationship between practice characteristics and nurse practitioners' clinical productivity. Primary care nurse practitioners in ambulatory settings saw an average of 80 patients per week (95% confidence interval [CI]: 79-82), and 64% of them had their own patient panel. The average patient panel size was 567 (95% CI: 522-612). Nurse practitioners who had their own patient panel spent a similar percent of time on patient care and documentation as those who did not. However, those with a patient panel were more likely to provide a range of clinical services to most patients. Nurse practitioners' clinical productivity was associated with several modifiable practice characteristics such as practice autonomy and billing and payment policies. The estimated number of patients seen in a typical week by nurse practitioners is comparable to that by primary care physicians reported in the literature. However, they had a significantly smaller patient panel. Nurse practitioners' clinical productivity can be further improved. Copyright © 2016 Elsevier Inc. All rights reserved.

English Primary Trainee Teachers' Perceptions of Geography

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Morley, Emma

2012-01-01

This paper summarises the findings of research conducted with one cohort of English undergraduate primary teacher trainees on point of entry to a 4-year course. The research examines the perceptions held of geography as a subject discipline and the purposes of teaching the subject. Two hundred and eleven trainees were asked to define geography and…

Radiation therapy for primary spinal cord tumors in adults

International Nuclear Information System (INIS)

Jeremic, B.; Grujicic, D.; Jovanovic, D.; Djuric, L.; Mijatovic, L.

1990-01-01

This paper evaluates the role of radiation therapy in management of primary spinal cord tumors in adults. Records of 21 patients with primary spinal cord tumors treated with radiation therapy after surgery were retrospectively reviewed. Histologic examination showed two diffuse and 10 localized ependymomas, six low-grade gliomas, and three malignant gliomas. Surgery consisted of gross tumor resection in six patients, subtotal resection in three patients, and biopsy in 12 patients. Three patients also received chemotherapy. Radiation dose range from 45 to 55 Cy

Using the Fennema-Sherman Mathematics Attitude Scales with lower-primary teachers

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Ren, Lixin; Green, Jennifer L.; Smith, Wendy M.

2016-06-01

The Fennema-Sherman Mathematics Attitude Scales (FSMAS) are among the most popular instruments used in studies of attitudes toward mathematics. However, the FSMAS has been mainly used among student populations and rarely used with teachers. In the present study, three scales from the FSMAS— Confidence, Effectance Motivation, and Anxiety—were revised and used with lower-primary (kindergarten to third grade) teachers. This study includes three parts: (1) a pilot study to ensure the modifications made to the FSMAS were appropriate to use with teachers, (2) confirmatory factor analyses to assess the factor structure of the revised FSMAS with 225 lower-primary teachers, and (3) measurement invariance analyses using data from a similar sample of 171 lower-primary teachers to examine whether the revised FSMAS measures each construct in the same way as in the previous sample. The final three-factor model, after removing three problematic items, achieves acceptable model fit, with each construct meeting all conditions for strict measurement invariance. Additionally, repeated measures analyses were performed on data collected from 39 in-service lower-primary teachers who participated in an elementary mathematics specialist program to examine the use of the revised FSMAS in program evaluation. Overall results suggest that researchers and program evaluators may use the revised FSMAS to reliably measure lower-primary teachers' mathematical attitudes, and it can be a valuable tool for evaluating the effectiveness of professional development programs.

Longer wait times affect future use of VHA primary care.

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Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

Mentoring Beginning Teachers in Primary Schools: Research Review

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Spooner-Lane, Rebecca

2017-01-01

While mentoring programmes have proven to be successful in reducing attrition and improving teaching ability in beginning teachers, there remains a lack of research delineating the key components of effective mentoring programmes in primary education. This integrative research review examines empirical studies conducted since 2000 on the nature…

Socioeconomic Determinants of Primary School Drop Out: The ...

African Journals Online (AJOL)

This paper attempts to examine the socioeconomic determinants of primary school dropout in Uganda with the aid of a logistic model analysis using the 2004 National Service Delivery Survey data. The Objectives were to establish the household socioeconomic factors that influence dropout of pupils given free education ...

Psycho-social correlates of stressful experiences among primary ...

African Journals Online (AJOL)

The study was guided by Social Cognitive Theory, employed to examine the psycho-social environments of serving primary school teachers in Olugbo-Less City, Odeda Local Government Area of Ogun State, Nigeria. 100 rural active teachers currently undergoing in-service training in Ogun State Universal Basic Education ...

Primary School Teachers' Views about Supervisional Deviant Behaviours

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Aksu, Ali; Gucer, Halil; Orcan, Asli

2015-01-01

This research examines supervisional deviant behaviours depending on the primary school teachers' view in Izmir, Turkey. Organizational or workplace deviant behaviours have been studied in number of studies and these types of behaviours are determined. It is obvious that solving the problems of orgaizational deviance contribute to meet…

ACL injury: How do the physical examination tests compare?

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Koster, Christiaan H; Harmsen, Annelieke Mk; Lichtenberg, Miranda C; Bloemers, Frank W

2018-03-01

Three physical examination tests are most commonly used to evaluate cruciate ligament injury. The best known and most frequently used technique is the anterior drawer test. The other 2 tests, the Lachman test and the pivot shift test, are more difficult to perform and are used less often, especially by physicians untrained in their use. In addition, there is a relatively new diagnostic test: the lever sign test. The aim of our article is to provide a short, clinically relevant overview of the literature and to assess the diagnostic value of physical examination for the primary care physician.

Expert opinion regarding the preparation of entry-level physiotherapists for primary healthcare practice, examined using Biggs 3P's model of teaching learning.

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McMahon, Sinead; O'Donoghue, Grainne; Doody, Catherine; O'Neill, Geraldine; Cusack, Tara

2016-05-01

The scope of contemporary physiotherapy practice is a critical factor in determining the appropriate educational preparation for physiotherapists now and into the future. The world-wide shift from secondary to primary healthcare has, and is, continuing to result in new and different ways of working. It is crucial that curricular changes reflect these developments. In this study a qualitative approach using Biggs 3P's - Pressage, Process and Product model to discuss curriculum design. The aim of the study was to explore the perspectives of both national and international physiotherapy educators/practitioners in primary healthcare, on the key elements required in physiotherapy education programmes to prepare future primary healthcare practitioners. Snowball sampling was used to identify experts in education and/or primary healthcare practice. Semi-structured interviews were conducted using an interview guide based on the Biggs 3P's model. Twelve participants were recruited from Ireland (n = 2), the UK (n = 4), Canada (n = 3), New Zealand (n = 2) and Australia (n = 1) using snowball sampling. Interviews were analysed using thematic analysis. Themes identified included; understanding the philosophy of physiotherapy practice, cultural competence, inter-disciplinary team working and communication skills. Contextual factors and teaching and learning strategies were discussed. There is an urgent need for physiotherapy education programmes to adopt the concept of primary healthcare as the basis for the physiotherapy curriculum and illuminate key components for consideration.

Identifying Areas of Primary Care Shortage in Urban Ohio

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Hsin-Chung Liao

Full Text Available ABSTRACT: This study considers both spatial and a-spatial variables in examining accessibility to primary healthcare in the three largest urban areas of Ohio (Cleveland, Columbus, and Cincinnati. Spatial access emphasizes the importance of geographic barriers between individuals and primary care physicians, while a-spatial variables include non-geographic barriers or facilitators such as age, sex, race, income, social class, education, living conditions and language skills. Population and socioeconomic data were obtained from the 2000 Census, and primary care physician data for 2008 was provided by the Ohio Medical Board. We first implemented a two-step method based on a floating catchment area using Geographic Information Systems to measure spatial accessibility in terms of 30-minute travel times. We then used principal component analysis to group various socio-demographic variables into three groups: (1 socioeconomic disadvantages, (2 living conditions, and (3 healthcare needs. Finally, spatial and a-spatial variables were integrated to identify areas with poor access to primary care in Cleveland, Columbus, and Cincinnati. KEYWORDS: Geographic information systems, healthcare access, spatial accessibility, primary care shortage areas

Primary Adenocarcinoma of the Vermiform Appendix. A Case Report

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Luis Antonio Revuelta Pérez

2014-11-01

Full Text Available Primary adenocarcinoma of the vermiform appendix is the least common carcinoma of this organ; its exact frequency is unknown. Primary malignant tumors of the appendix are rare; they are generally found in 1 to 2% of all appendices examined. Most appendiceal malignancies arise from a primary tumor in the adjacent organs, and in some cases, may be metastases from distant tumors. The case of a 43-year-old patient with a history of emergency surgery who was presumptively diagnosed with acute appendicitis is presented. The presence of an adenocarcinoma at the base of the appendix was reported by the pathology department. Because of the rarity of the condition, the publication of this case is considered scientifically important.

The Effect of Organizational Citizenship Behaviours of Primary School Teachers on Their Burnout

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Inandi, Yusuf; Buyukozkan, Ayse Sezin

2013-01-01

It was examined in this study whether organizational citizenship behaviours of primary school teachers predict the level of their burnout. Correlation and multi regression analysis were used for this. Survey model was used in this descriptive study. Data were collected from 1699 primary school teachers working in Mersin. Maslach Burnout Inventory…

Development of Program to Enhance Team Building Leadership Skills of Primary School Administrators

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Sairam, Boonchauy; Sirisuthi, Chaiyuth; Wisetrinthong, Kanjana

2017-01-01

Team building leadership skills are important to understandings of how the primary school administrators might work towards creating more effective teamwork in the school. This research aimed 1) to study the components of team building leadership skills needed for primary school administrators, 2) to examine the current states and desirable…

Usefulness of diagnostic imaging in primary hyperparathyroidism

International Nuclear Information System (INIS)

Sekiyama, Kazuya; Akakura, Koichiro; Mikami, Kazuo; Mizoguchi, Ken-ichi; Tobe, Toyofusa; Nakano, Koichi; Numata, Tsutomu; Konno, Akiyoshi; Ito, Haruo

2003-01-01

In patients with primary hyperparathyroidism, prevention of urinary stone recurrence can be achieved by surgical removal of the enlarged parathyroid gland. To ensure the efficacy of surgery for primary hyperparathyroidism, preoperative localization of the enlarged gland is important. In the present study, usefulness of diagnostic imaging for localization of the enlarged gland was investigated in primary hyperparathyroidism. We retrospectively examined the findings of imaging studies and clinical records in 79 patients (97 glands) who underwent surgical treatment for primary hyperparathyroidism at Chiba University Hospital between 1976 and 2000. The detection rates of accurate localization were investigated for imaging techniques, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) thallium-201 and technetium-99m pertechnetate (Tl-Tc) subtraction scintigraphy and 99m Tc-methoxyisobutylisonitrile (MIBI) scintigraphy, and analysed in relation to the size and weight of the gland and pathological diagnosis. The detection rates by US, CT, MRI, Tl-Tc subtraction scintigraphy and MIBI scintigraphy were 70%, 67%, 73%, 38% and 78%, respectively. The overall detection rate changed from 50% to 88% before and after 1987. The detection rate of MIBI scintigraphy was superior to Tl-Tc subtraction scintigraphy. In primary hyperparathyroidism, improvement of accurate localization of an enlarged parathyroid gland was demonstrated along with recent advances in imaging techniques including MIBI scintigraphy. (author)

Extent of Head Teachers' Utilization of Innovative Sources of Funding Primary Schools in Enugu State of Nigeria

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Amogechukwu, Eze Thecla; Unoma, Chidobi Roseline

2017-01-01

The purpose of this study was to examine the extent Head teachers utilize innovative sources of funding primary schools in Enugu State of Nigeria. Descriptive survey design was employed to examine the extent head teachers utilize innovative sources of funding primary schools in Enugu State. Data were collected through a 14-item questionnaire…

Primary feather molt of adult mourning doves in North and South Carolina

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Haas, G.H.; Amend, S.R.

1979-01-01

Examination of 8,141 adult mourning doves (Zenaida macroura) in North and South Carolina revealed that substantial numbers complete primary feather molt in September. Adult mourning doves shed primaries at the rate of 1 per 14 days. No difference was found in this rate between sexes or among years, 1969-74. The initiation of molt differed from year to year, and female molt always preceded male molt. Available data show that southern doves complete primary molt a month earlier than northern doves. Therefore, age based on primary molt can be biased upward if all molt-complete wings from southern hunting samples are considered immature.

Is Team-Based Primary Care Associated with Less Access Problems and Self-Reported Unmet Need in Canada?

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Zygmunt, Austin; Asada, Yukiko; Burge, Frederick

2017-10-01

As in many jurisdictions, the delivery of primary care in Canada is being transformed from solo practice to team-based care. In Canada, team-based primary care involves general practitioners working with nurses or other health care providers, and it is expected to improve equity in access to care. This study examined whether team-based care is associated with fewer access problems and less unmet need and whether socioeconomic gradients in access problems and unmet need are smaller in team-based care than in non-team-based care. Data came from the 2008 Canadian Survey of Experiences with Primary Health Care (sample size: 10,858). We measured primary care type as team-based or non-team-based and socioeconomic status by income and education. We created four access problem variables and four unmet need variables (overall and three specific components). For each, we ran separate logistic regression models to examine their associations with primary care type. We examined socioeconomic gradients in access problems and unmet need stratified by primary care type. Primary care type had no statistically significant, independent associations with access problems or unmet need. Among those with non-team-based care, a statistically significant education gradient for overall access problems existed, whereas among those with team-based care, no statistically significant socioeconomic gradients existed.

Serum heme oxygenase-1 levels in patients with primary dysmenorrhea.

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Aksoy, Ayse Nur; Laloglu, Esra; Ozkaya, Alev Lazoglu; Yilmaz, Emsal Pınar Topdagi

2017-04-01

Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea. A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient's visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis. Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p dysmenorrhea. Antioxidant support might be helpful to reduce pain severity in primary dysmenorrhea.

Spatial-temporal changes in phytoplankton biomass and primary ...

African Journals Online (AJOL)

Spatial-temporal variations in phytoplankton primary production (PP) and biomass (B) were studied for a period of about one year, from July 1999 to July 2000. In addition, changes in corresponding environmental variables were examined. Sampling took place at two stations in Chwaka Bay, one located in mangrove areas, ...

Suicide Attempts among Depressed Adolescents in Primary Care

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Fordwood, Samantha R.; Asarnow, Joan R.; Huizar, Diana P.; Reise, Steven P.

2007-01-01

Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters…

Pre-Service Primary Teachers' Attitudes towards Inclusive Education

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Varcoe, Linda; Boyle, Christopher

2014-01-01

Research has demonstrated that an important factor in the success of inclusive education is dependent upon teachers' attitudes. Based on this evidence, the present study investigated the impact of a range of teacher variables in association with training on primary pre-service teachers' attitudes by examining total inclusion scores, positive…

Primary ureteral carcinoma: MRI diagnosis and comparison with other diagnostic imaging facilities

International Nuclear Information System (INIS)

An Ningyu; Jiang Bo; Cai Youquan; Liang Yan

2004-01-01

Objective: To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods: Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T 2 WI (water imaging) was performed to show the dilated ureter, then axial T 2 WI and T 1 WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results: MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows: ultrasound (94.3%), IVU (59.8%), CT (52.9%), MRI (40.2%), and RUP (35.6%). The accurate diagnostic rate was as follows :MRI (91.4%), RUP (80.6%), CT (63.0%), ultrasound (47.6%), and IVU (11.5%). Conclusion: Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening

The 2010 spring drought reduced primary productivity in southwestern China

International Nuclear Information System (INIS)

Zhang Li; Li Jing; Xiao Jingfeng; Wang Kun; Lei Liping; Guo Huadong

2012-01-01

Many parts of the world experience frequent and severe droughts. Summer drought can significantly reduce primary productivity and carbon sequestration capacity. The impacts of spring droughts, however, have received much less attention. A severe and sustained spring drought occurred in southwestern China in 2010. Here we examine the influence of this spring drought on the primary productivity of terrestrial ecosystems using data on climate, vegetation greenness and productivity. We first assess the spatial extent, duration and severity of the drought using precipitation data and the Palmer drought severity index. We then examine the impacts of the drought on terrestrial ecosystems using satellite data for the period 2000–2010. Our results show that the spring drought substantially reduced the enhanced vegetation index (EVI) and gross primary productivity (GPP) during spring 2010 (March–May). Both EVI and GPP also substantially declined in the summer and did not fully recover from the drought stress until August. The drought reduced regional annual GPP and net primary productivity (NPP) in 2010 by 65 and 46 Tg C yr −1 , respectively. Both annual GPP and NPP in 2010 were the lowest over the period 2000–2010. The negative effects of the drought on annual primary productivity were partly offset by the remarkably high productivity in August and September caused by the exceptionally wet conditions in late summer and early fall and the farming practices adopted to mitigate drought effects. Our results show that, like summer droughts, spring droughts can also have significant impacts on vegetation productivity and terrestrial carbon cycling. (letter)

From Attitudes to Practice: Utilising Inclusive Teaching Strategies in Kenyan Primary Schools

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Elder, Brent C.; Damiani, Michelle L.; Oswago, Benson O.

2016-01-01

The purpose of this paper is to provide evidence of Kenyan primary school teachers using inclusive teaching strategies in a rural setting with many known barriers to the development of a sustainable inclusive education system. This qualitative study examines teachers' uses of inclusive teaching strategies in primary schools following a series of…

Breast US as primary imaging modality for diagnosing gynecomastia.

Science.gov (United States)

Telegrafo, M; Introna, T; Coi, L; Cornacchia, I; Rella, L; Stabile Ianora, A A; Angelelli, G; Moschetta, M

2016-01-01

To assess the role of breast US in diagnosing and classifying gynecomastia as the primary imaging modality and to compare US findings and classification system with the mammographic ones. 48 patients suspected of having gynecomastia underwent mammography and US. Two radiologists in consensus retrospectively evaluated mammograms and sonograms. Both US and mammographic images were evaluated categorizing gynecomastia into non-mass, nodular and flame shaped patterns. The two category assignations were compared in order to find any difference. The reference standard for both the classification systems was represented by the cytological examination in 18 out of 44 cases (41%) and the six-month US follow-up in the remaining cases. The US examination revealed pseudo-gynecomastia in 4/48 (8%) and true gynecomastia in the remaining 44 (92%). Gynecomastia was bilateral in 25/44 cases (57%) and unilateral in the remaining 19 (43%). The cases of true gynecomastia included non mass shape in 26/44 cases (59%), nodular shape in 12 (27%) and flame shape in 6 (14%). The mammographic examination revealed the same results as compared with US findings. 18/44 (41%) patients affected by nodular or dendritic gynecomastia underwent cytological examination confirming the presence of glandular tissue and the benign nature of the clinical condition. US could be proposed as the primary imaging tool for diagnosing and classifying gynecomastia, avoiding unnecessary Xray examinations or invasive procedures in case of diffuse gynecomastia. In case of nodular or dendritic patterns, biopsy remains mandatory for a definitive diagnosis.

Examining Teachers' Views on the Implementation of English as L3 into Primary Schools: A Case of Kazakhstan

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Zhetpisbayeva, Bakhytgul A.; Shelestova, Tatyana Y.; Abildina, Saltanat K.

2016-01-01

The Ministry of Education and Science of the Republic of Kazakhstan changed the State Educational Program for primary education and the curriculum for teaching English as a third language (L3) to grades 1-4 in 2013. As with many changes in the curriculum, English language teaching has also been changed and the starting age for learning of English…

Diagnostic methods in finding out the causes of infertility, results of HSG examination and laparoscopy in infertile women examined at the Gynecological Ward of the City Hospital

International Nuclear Information System (INIS)

Kwasniewski, S.; Kukulski, P.; Szymanski, J.; Kwasniewska, A.

1993-01-01

The paper presents diagnostic methods and the results of hysterosalpingography (HSG) and laparoscopy examination, with special attention being drawn to the usefulness of these methods in finding out the causes of infertility. 51 patients with primary and second infertility were examined. HSG and laparoscopy make it possible to diagnose correctly the cause of infertility. They also enable adequate and early classification of patients for further diagnosis and treatment at highly specialized centers dealing with the problems of infertility. (author)

Electrocardiogram interpretation and arrhythmia management: a primary and secondary care survey.

Science.gov (United States)

Begg, Gordon; Willan, Kathryn; Tyndall, Keith; Pepper, Chris; Tayebjee, Muzahir

2016-05-01

There is increasing desire among service commissioners to treat arrhythmia in primary care. Accurate interpretation of the electrocardiogram (ECG) is fundamental to this. ECG interpretation has previously been shown to vary widely but there is little recent data. To examine the interpretation of ECGs in primary and secondary care. A cross-sectional survey of participants' interpretation of six ECGs and hypothetical management of patients based on those ECGs, at primary care educational events, and a cardiology department in Leeds. A total of 262 primary care clinicians and 20 cardiology clinicians were surveyed via questionnaire. Answers were compared with expert electrophysiologist opinion. In primary care, abnormal ECGs were interpreted as normal by 23% of responders. ST elevation and prolonged QT were incorrectly interpreted as normal by 1% and 22%, respectively. In cardiology, abnormal ECGs were interpreted as normal by 3%. ECG provision and interpretation remains inconsistent in both primary and secondary care. Primary care practitioners are less experienced and less confident with ECG interpretation than cardiologists, and require support in this area. © British Journal of General Practice 2016.

Soil examination for a forensic trace evidence laboratory-Part 3: A proposed protocol for the effective triage and management of soil examinations.

Science.gov (United States)

Woods, Brenda; Lennard, Chris; Kirkbride, K Paul; Robertson, James

2016-05-01

In the past, forensic soil examination was a routine aspect of forensic trace evidence examinations. The apparent need for soil examinations then went through a period of decline and with it the capability of many forensic laboratories to carry out soil examinations. In more recent years, interest in soil examinations has been renewed due-at least in part-to soil examinations contributing to some high profile investigations. However, much of this renewed interest has been in organisations with a primary interest in soil and geology rather than forensic science. We argue the need to reinstate soil examinations as a trace evidence sub-discipline within forensic science laboratories and present a pathway to support this aim. An examination procedure is proposed that includes: (i) appropriate sample collection and storage by qualified crime scene examiners; (ii) exclusionary soil examinations by trace evidence scientists within a forensic science laboratory; (iii) inclusionary soil examinations by trace evidence scientists within a forensic science laboratory; and (iv) higher-level examination of soils by specialist soil scientists and palynologists. Soil examinations conducted by trace evidence scientists will be facilitated if the examinations are conducted using the instrumentation routinely used by these examiners. Hence, the proposed examination protocol incorporates instrumentation in routine use in a forensic trace evidence laboratory. Finally, we report on an Australian soil scene variability study and a blind trial that demonstrate the utility of the proposed protocol for the effective triage and management of soil samples by forensic laboratories. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Adrenal incidentalomas. Primary hyperaldosteronism

International Nuclear Information System (INIS)

Murat, A.; Dupas, B.; Zenatti, M.; Aupetit-Faisant, B.; Tenenbaum, F.; Tabarin, A.; Barrat, J.L.; Gosse, P.; Olivier-Puel, F.; Leprat, F.; Trouette, H.; Laurent, F.; Roger, P.

1993-01-01

Adrenal incidentalomas are masses incidentally discovered at X rays, ultrasound or MRI examination of the abdomen. In 100 CT scans, one can expect to find two incidentalomas on average. The article by Murat and Dupas is dealing with the strategy of biological, morphological and scintigraphic examinations to be performed in such patients, to assess whether the tumor is of a benign or a malignant nature. Zenatti et al propose a detailed exploration of the aldosterone pathways, since adrenal carcinoma may be responsible for a specific profile of the serum concentrations of mineralo-steroids, compatible with a blockade of the last step of the aldosterone synthesis. The exploration of primary hyperaldosteronism requires biological and imaging techniques. Tabarin et al summarize the main biological parameters and tests available for the diagnosis of this condition and delineate the indications of imaging techniques, associated to hormonal tests to distinguish between adenoma and bilateral adrenal hyperplasia. (author). 104 refs

Primary Surgery vs Radiotherapy for Early Stage Oral Cavity Cancer.

Science.gov (United States)

Ellis, Mark A; Graboyes, Evan M; Wahlquist, Amy E; Neskey, David M; Kaczmar, John M; Schopper, Heather K; Sharma, Anand K; Morgan, Patrick F; Nguyen, Shaun A; Day, Terry A

2018-04-01

Objective The goal of this study is to determine the effect of primary surgery vs radiotherapy (RT) on overall survival (OS) in patients with early stage oral cavity squamous cell carcinoma (OCSCC). In addition, this study attempts to identify factors associated with receiving primary RT. Study Design Retrospective cohort study. Setting National Cancer Database (NCDB, 2004-2013). Subjects and Methods Reviewing the NCDB from 2004 to 2013, patients with early stage I to II OCSCC were identified. Kaplan-Meier estimates of survival, Cox regression analysis, and propensity score matching were used to examine differences in OS between primary surgery and primary RT. Multivariable logistic regression analysis was performed to identify factors associated with primary RT. Results Of the 20,779 patients included in the study, 95.4% (19,823 patients) underwent primary surgery and 4.6% (956 patients) underwent primary RT. After adjusting for covariates, primary RT was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.97; 99% confidence interval [CI], 1.74-2.22). On multivariable analysis, factors associated with primary RT included age ≥70 years, black race, Medicaid or Medicare insurance, no insurance, oral cavity subsite other than tongue, clinical stage II disease, low-volume treatment facilities, and earlier treatment year. Conclusion Primary RT for early stage OCSCC is associated with increased mortality. Approximately 5% of patients receive primary RT; however, this percentage is decreasing. Patients at highest risk for receiving primary RT include those who are elderly, black, with public insurance, and treated at low-volume facilities.

Evaluation of Manual Ultrasonic Examinations Applied to Detect Flaws in Primary System Dissimilar Metal Welds at North Anna Power Station

International Nuclear Information System (INIS)

Anderson, Michael T.; Diaz, Aaron A.; Doctor, Steven R.

2012-01-01

During a recent inservice inspection (ISI) of a dissimilar metal weld (DMW) in an inlet (hot leg) steam generator nozzle at North Anna Power Station Unit 1, several axially oriented flaws went undetected by the licensee's manual ultrasonic testing (UT) technique. The flaws were subsequently detected as a result of outside diameter (OD) surface machining in preparation for a full structural weld overlay. The machining operation uncovered the existence of two through-wall flaws, based on the observance of primary water leaking from the DMW. Further ultrasonic tests were then performed, and a total of five axially oriented flaws, classified as primary water stress corrosion cracking (PWSCC), were detected in varied locations around the weld circumference.

Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources.

Science.gov (United States)

Abdelaziz, Adel; Hany, Mohamed; Atwa, Hani; Talaat, Wagdy; Hosny, Somaya

2016-01-01

In ordinary circumstances, objective structured clinical examination (OSCE) is a resource-intensive assessment method. In case of developing and implementing multidisciplinary OSCE, there is no doubt that the cost will be greater. Through this study a research project was conducted to develop, implement and evaluate a multidisciplinary OSCE model within limited resources. This research project went through the steps of blueprinting, station writing, resources reallocation, implementation and finally evaluation. The developed model was implemented in the Primary Health Care (PHC) program which is one of the pillars of the Community-Based undergraduate curriculum of the Faculty of Medicine, Suez Canal University (FOM-SCU). Data for evaluation of the implemented OSCE model were derived from two resources. First, feedback of the students and assessors through self-administered questionnaires was obtained. Second, evaluation of the OSCE psychometrics was done. The deliverables of this research project included a set of validated integrated multi-disciplinary and low cost OSCE stations with an estimated reliability index of 0.6. After having this experience, we have a critical mass of faculty members trained on blueprinting and station writing and a group of trained assessors, facilitators and role players. Also there is a state of awareness among students on how to proceed in this type of OSCE which renders future implementation more feasible.

Primary muscular hydatidosis. US, CT and MR findings

Energy Technology Data Exchange (ETDEWEB)

Alexiadis, G.; Deftereos, S.; Manavis, J. [Democritus Univ. of Thrace, Alexandroupolis (Greece). Dept. of Radiology; Lambropoulou, M.; Papadopoulos, N. [Democritus Univ. of Thrace, Alexandroupolis (Greece). Dept. of Pathology

2002-07-01

We present a rare case of primary muscular hydatidosis in the left thigh of a 40-year-old female patient. US, CT and MR imaging showed a typical multilocular hydatid cyst deep in the vastus intermedius and vastus medialis muscles. Histopathological examination, which followed surgical excision, established the diagnosis of echinococcus cyst.

Primary muscular hydatidosis. US, CT and MR findings

International Nuclear Information System (INIS)

Alexiadis, G.; Deftereos, S.; Manavis, J.; Lambropoulou, M.; Papadopoulos, N.

2002-01-01

We present a rare case of primary muscular hydatidosis in the left thigh of a 40-year-old female patient. US, CT and MR imaging showed a typical multilocular hydatid cyst deep in the vastus intermedius and vastus medialis muscles. Histopathological examination, which followed surgical excision, established the diagnosis of echinococcus cyst

Primary cutaneous marginal zone B-cell lymphoma: clinical and histological aspects.

Science.gov (United States)

Khaled, A; Sassi, S; Fazaa, B; Ben Hassouna, J; Ben Romdhane, K; Kamoun, M R

2009-02-01

According to the WHO-EORTC classification of cutaneous lymphomas, primary cutaneous marginal zone B-cell lymphoma are now well characterized. We report here a case of primary cutaneous marginal zone B-cell lymphoma in a 51 year-old man in which the diagnosis was made using both histology and immunopathology. The patient had no remarkable medical history, no history of either acute inflammation or insect bite, and presented with a 5 cm solitary asymptomatic erythematous firm, multinodular and infiltrated plaque on the back for 12 months. Histological examination and immunohistochemical study of a cutaneous biopsy provided a differential diagnosis between B cell lymphoma and lymphocytoma cutis. Full body work up revealed no signs of extracutaneous dissemination. The patient underwent surgical excision of the nodule. Histological examination showed a histological and immunophenotyping profile typical of primary cutaneous marginal zone B-cell lymphoma. The lesion was completely excised with clear margins and no recurrence occurred after a 12 month-follow-up period. Primary cutaneous marginal zone B-cell lymphoma are low-grade lymphomas that have an indolent course and a high tendency to recur. They should be differentiated from lymphocytoma cutis and from the other types of cutaneous B cell lymphomas that have a different course and prognosis.

Primary diffuse leptomeningeal gliomatosis: An autopsy case report

Directory of Open Access Journals (Sweden)

Shaik Afshan Jabeen

2014-01-01

Full Text Available Primary diffuse leptomeningeal gliomatosis (PDLG is a rare condition, characterized by infiltration of the meninges by glial cells without evidence of the primary tumor in the brain or spinal cord parenchyma. Glioma arising primarily from the leptomeninges is extremely rare and often diagnosed only in post mortem examination and the diagnosis may be missed in meningeal biopsy. We describe a young female who presented with symptoms of raised intracranial pressure with imaging evidence of diffuse leptomeningeal enhancement in whom autopsy confirmed the diagnosis of PDLG. Our case illustrates the diagnostic difficulties in making the pre-mortem diagnosis even with multiple cerebrospinal fluid cytologies and leptomeningeal biopsy.

STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

Science.gov (United States)

Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

2013-09-01

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Development and Initial Examination of the School Psychology Multicultural Competence Scale

Science.gov (United States)

Malone, Celeste M.; Briggs, Candyce; Ricks, Elizabeth; Middleton, Kyndra; Fisher, Sycarah; Connell, James

2016-01-01

This study reports on the initial development and examination of the School Psychology Multicultural Competence Scale (SPMCS), a 45-item self-report measure for evaluating school psychologists' multicultural competence in the primary domains of school psychology practice (i.e., assessment, consultation, intervention). A sample of 312 school…

Examining Teachers' Motivation Level According to School Principals' Humor Styles

Science.gov (United States)

Recepoglu, Ergun; Kilinc, Ali Cagatay; Cepni, Osman

2011-01-01

The purpose of this research is to examine the motivation level of teachers according to school principals' humor styles. The humor styles survey and job motivation scale were used to gather data from 305 randomly selected teachers employed in primary schools in Karabuk. Results indicated that 141 of the teachers claimed school principal had…

Multiple somatic symptoms in primary care

DEFF Research Database (Denmark)

Goldberg, D. P.; Reed, G. M.; Robles, R.

2016-01-01

Objective A World Health Organization (WHO) field study conducted in five countries assessed proposals for Bodily Stress Syndrome (BSS) and Health Anxiety (HA) for the Primary Health Care Version of ICD-11. BSS requires multiple somatic symptoms not caused by known physical pathology and associated...... with distress or dysfunction. HA involves persistent, intrusive fears of having an illness or intense preoccupation with and misinterpretation of bodily sensations. This study examined how the proposed descriptions for BSS and HA corresponded to what was observed by working primary care physicians (PCPs......) in participating countries, and the relationship of BSS and HA to depressive and anxiety disorders and to disability. Method PCPs referred patients judged to have BSS or HA, who were then interviewed using a standardized psychiatric interview and a standardized measure of disability. Results Of 587 patients...

Radiologic appearance of primary jaw lesions in children

Energy Technology Data Exchange (ETDEWEB)

Gupta, Malini; Kaste, Sue C. [Department of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Hopkins, Kenneth P. [Department of Surgery, Division of Dentistry, St. Jude Children' s Research Hospital, Memphis, TN (United States)

2002-03-01

Background: The jaw (an unusual site of primary tumors in children and adolescents) has lesions often found incidentally by dentists on routine panoramic radiographs or during examination of a child who has swelling or tooth pain. Objective: This pictorial seeks to familiarize pediatric radiologists with the radiographic appearance of a variety of primary jaw lesions. Materials and methods: We retrospectively searched institutional records for cases of primary jaw lesions in children and adolescents. Jaw lesions were characterized as: I, well-circumscribed radiolucent lesions; II, lesions with mixed or variable appearance; III, poorly circumscribed radiolucent lesions; and IV, radiopaque lesions. Results: Although most oral and maxillofacial lesions in children are benign, a broad spectrum of tumors was identified; lesions may occur in patients with unrelated prior malignancy. Conclusion: Because radiologic studies may identify jaw lesions and direct further care, familiarity with the appearance of these entities is prudent. (orig.)

Factors shaping intersectoral action in primary health care services.

Science.gov (United States)

Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

2014-12-01

To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

Catalogue of test specimens for non-destructive examination

International Nuclear Information System (INIS)

1985-05-01

One of the key elements in assuring the integrity of reactor primary circuits is the availability of trustworthy non-destructive methods for detecting dangerous defects that may be present. Various approaches to making such examinations are being developed, including the use of ultrasonic and radiographic techniques. To demonstrate their capability and reliability, they must be tested on steel specimens reproducing the various types of faults which may arise in real primary circuit vessels and piping. Such specimens are costly to fabricate. It is therefore clearly desirable that existing specimens should be made accessible to as many organisations as possible for testing. This catalogue contains detailed Information on forty-odd deliberately flawed plates, blocks, vessels, etc. which have been produced in OECD countries, along with the name of a contact person to whom inquiries should be directed in each case

The Effects of Servant Leadership on Teachers' Organizational Commitment in Primary Schools in Turkey

Science.gov (United States)

Cerit, Yusuf

2010-01-01

This study examines the effects of servant leadership behaviours of primary school principals on teachers' school commitment. The research data were collected from 563 teachers working in primary schools in Duzce. Servant leadership behaviours of principals were measured with a servent organizational leadership assessment scale, and the teachers'…

Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization

Science.gov (United States)

Negre-Barber, A.; Montiel-Company, J. M.; Boronat-Catalá, M.; Catalá-Pizarro, M.; Almerich-Silla, J. M.

2016-01-01

Molar incisor hypomineralization (MIH) is a developmental defect of dental enamel that shares features with hypomineralized second primary molars (HSPM). Prior to permanent tooth eruption, second primary molars could have predictive value for permanent molar and incisor hypomineralization. To assess this possible relationship, a cross-sectional study was conducted in a sample of 414 children aged 8 and 9 years from the INMA cohort in Valencia (Spain). A calibrated examiner (linear-weighted Kappa 0.83) performed the intraoral examinations at the University of Valencia between November 2013 and 2014, applying the diagnostic criteria for MIH and HSPM adopted by the European Academy of Paediatric Dentistry. 100 children (24.2%) presented MIH and 60 (14.5%) presented HSPM. Co-occurrence of the two defects was observed in 11.1% of the children examined. The positive predictive value was 76.7% (63.9–86.6) and the negative predictive value 84.7% (80.6–88.3). The positive likelihood ratio (S/1-E) was 10.3 (5.9–17.9) and the negative likelihood ratio (1-S/E) 0.57 (0.47–0.68). The odds ratio was 18.2 (9.39–35.48). It was concluded that while the presence of HSPM can be considered a predictor of MIH, indicating the need for monitoring and control, the absence of this defect in primary dentition does not rule out the appearance of MIH. PMID:27558479

Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network

OpenAIRE

Chan, KTY; Wong, SYS; Chiu, BCF; Chin, WY; Lam, TP; Lam, CLK; Fong, DYT; Lo, YCY

2014-01-01

Background This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. Methods A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management. Results 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screeni...

A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 1. Factors influencing detection and the decision to refer.

Science.gov (United States)

Brocklehurst, P R; Baker, S R; Speight, P M

2010-01-23

Many oral squamous cell carcinomas present as late stage disease and so the detection of early and pre-malignancy is considered to be of paramount importance. The majority of research examining primary care dentists' experience of the detection and management of early disease has been undertaken using questionnaires, with the inherent bias this introduces. The aim of this study was to use qualitative methods to develop a richer account of practitioners' views about screening and what factors influence the decision to refer a patient. Semi-structured interviews were undertaken with eighteen dentists in Sheffield, transcribed and analysed using thematic analysis. Ten codes were identified according to the aims of the study and organized into four overarching themes. Although many dentists were screening regularly, some did not appear to be adopting a rigorous and systematic approach. A number of participants also placed more reliance on 'classical' presentations rather than the more varied presentation of potentially malignant lesions and were more influenced by the clinical history of the lesion rather than risk factors. Overall, the present research suggests that for some dentists, more rigour is required when examining for early disease.

Occlusal characteristics and prevalence of associated dental anomalies in the primary dentition.

Science.gov (United States)

Lochib, Seema; Indushekar, K R; Saraf, Bhavna Gupta; Sheoran, Neha; Sardana, Divesh

2015-06-01

Morphological variations in primary dentition are of great concern to a pediatric dentist as it may pose clinical problems like dental caries, delayed exfoliation and also anomalies in the permanent dentition, such as impaction of successors, supernumerary teeth, permanent double teeth or aplasia of teeth. The present study was conducted to investigate the presence of dental anomalies in the primary dentition of 1000 schoolchildren in the 3-5 year-old age group in Faridabad. One-thousand schoolchildren were examined using Type III examination (WHO, 1997) for primary molar relationship, occlusal characteristics, primate spaces, physiological spaces and other anomalies of teeth, including number and morphology. The prevalence of physiological spaces in maxillary and mandibular arches was 50.9% and 46.7%, respectively, whereas primate spaces were found in 61.7% of the children in the maxillary arch and 27.9% in the mandibular arch. The prevalence of unilateral anterior and posterior cross-bite was 0.1% and 0.8%, respectively, in the present study. The prevalence of hypodontia in the primary dentition was found to be 0.4% and the prevalence of fusion and gemination in the present study was 0.5%. Double teeth (fusion and gemination) and hypodontia were the most common dental anomalies found in the primary dentition in the present study. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Primary lung abscess caused by Staphylococcus lugdunensis.

Science.gov (United States)

Chou, Deng-Wei; Lee, Chao-Tai

2017-11-01

Staphylococcus lugdunensis, a strain of coagulase-negative staphylococci, is part of the normal flora of human skin but can cause multiple infections at various sites. This microorganism has emerged as a major human pathogen. However, no study has reported primary lung abscess caused by S. lugdunensis. A 54-year-old alcoholic man without relevant past medical history was admitted because of primary lung abscesses. Empirical amoxicillin/clavulanate therapy was initially administered; however, the patient had persistent pleuritic chest pain and fever. He subsequently underwent resection of the lung abscess and removal of exudative pleural effusion on the fourth hospital day. Histopathologic examination confirmed the diagnosis of lung abscess, and colonies of gram-positive bacteria were identified. The culture specimen from the abscess was positive for S. lugdunensis, which was susceptible to amoxicillin/clavulanate, cefazolin, ciprofloxacin, clindamycin, erythromycin, oxacillin, teicoplanin, tetracycline, and vancomycin. Following resection and 3 weeks of amoxicillin/clavulanate therapy, the patient eventually recovered well without relapse. This case report is the first to describe S. lugdunensis as a cause of primary lung abscess; this microorganism should be considered a potential monomicrobial pathogen in primary lung abscess. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Urethral advancement procedure in the treatment of primary distal ...

African Journals Online (AJOL)

advancement in the repair of primary distal penile hypospadias with regard to feasibility, complication rates .... stones and growth, and any associated congenital anomaly. Meticulous local examination was performed ... with a tourniquet placed on the root of the penis. A submeatal crescent-like incision was performed a few.

Continuous admission to primary school and mental health problems

NARCIS (Netherlands)

S.A. Reijneveld (Sijmen); C.H. Wiefferink (Carin); E. Brugman (Emily); F.C. Verhulst (Frank); S.P. Verloove-Vanhorick; A.D.C. Paulussen (Aimée)

2006-01-01

textabstractBackground: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We

Continuous admission to primary school and mental health problems

NARCIS (Netherlands)

Reijneveld, S.A.; Wiefferink, C.H.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.; Paulussen, T.G.W.

2006-01-01

Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed

Epilepsy in primary intracranial tumors in a neurosurgical hospital in ...

African Journals Online (AJOL)

Background: Seizures may be manifestation of intracranial tumor (IT) and demand thorough neurological evaluation. This paper examines epidemiology, lesion characteristics and outcome of seizures associated with primary IT. Methods: Retrospective analysis of medical records, computed tomography and magnetic ...

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations.

Science.gov (United States)

Creavin, Sam T; Wisniewski, Susanna; Noel-Storr, Anna H; Trevelyan, Clare M; Hampton, Thomas; Rayment, Dane; Thom, Victoria M; Nash, Kirsty J E; Elhamoui, Hosam; Milligan, Rowena; Patel, Anish S; Tsivos, Demitra V; Wing, Tracey; Phillips, Emma; Kellman, Sophie M; Shackleton, Hannah L; Singleton, Georgina F; Neale, Bethany E; Watton, Martha E; Cullum, Sarah

2016-01-13

The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. We included studies that compared the 11-item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all-cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all-cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of

Retail clinics versus traditional primary care: Employee satisfaction guaranteed?

Science.gov (United States)

Lelli, Vanessa R; Hickman, Ronald L; Savrin, Carol L; Peterson, Rachel A

2015-09-01

To examine if differences exist in the levels of autonomy and job satisfaction among primary care nurse practitioners (NPs) employed in retail clinics versus traditional primary care settings. Data were collected from 310 primary care NPs who attended the American Association of NP's 28th Annual Conference in June 2013. Participants completed a demographic form, the Misener NP Job Satisfaction Scale, and the Dempster Practice Behavior Scale. Overall, there were no differences in job satisfaction or autonomy among NPs by practice setting. Retail NPs felt less valued and were less satisfied with social interaction, but more satisfied with benefits compared to NPs in traditional settings. NPs working in retail clinics were less likely to have intentions to leave current position compared to NPs in traditional practice settings. The results of this study enhance our current understanding of the linkages between levels of autonomy, job satisfaction, and practice setting among primary care NPs. The findings of this descriptive study offer valuable insights for stakeholders devoted to the development of the primary care workforce and identify modifiable factors that may influence retention and turnover rates among NPs. ©2015 American Association of Nurse Practitioners.

Assessment and management of suicide risk in primary care.

Science.gov (United States)

Saini, Pooja; While, David; Chantler, Khatidja; Windfuhr, Kirsten; Kapur, Navneet

2014-01-01

Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

Periodic inspections of the primary system

International Nuclear Information System (INIS)

Dufour, L.B.

1978-01-01

An impression is given of the inspection techniques, preparations and background for periodic examinations of the primary system of the Dodewaard Nuclear Reactor over the past 10 years. Unfortunately reliable integral inspection techniques to enable 'listening-in' to developing faults, are not yet available. Until they are, inspections will continue to be executed from a distance using different continuous methods, often under water and with a shortage of space and in the presence of ionising radiations. (C.F.)

Switch and examine transmit diversity for spectrum sharing systems

KAUST Repository

Abdallah, Mohamed M.

2011-06-01

In this paper, we develop a switch and examine transmit diversity algorithm for spectrum sharing cognitive networks. We consider a cognitive network composed of a primary link that employs constant rate and constant power transmission scheme with automatic-and-repeat request (ARQ) protocol, while the secondary link is composed of a fixed power multiple-antenna secondary transmitter and a single antenna receiver. Our objective is to develop a low complex transmit diversity algorithm at the secondary transmitter that maximizes the performance of the secondary link in terms of the effective throughput while maintaining a predetermined maximum loss in the packet rate of the primary link. In achieving this objective, we develop an algorithm that selects the best antenna, which maintains the quality of the secondary link in terms of signal-to-noise ratio above a specific threshold, based on overhearing the acknowledgment (ACK) and negative acknowledgment (NACK) feedback messages transmitted over the primary link. We also develop closed form expressions for the bit error rates and the effective throughput of the secondary link. © 2011 IEEE.

[Primary headache and depression].

Science.gov (United States)

Gesztelyi, Gyöngyi

2004-11-28

Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

Risk of primary biliary cirrhosis in patients with coeliac disease

DEFF Research Database (Denmark)

Sørensen, Henrik Toft; Thulstrup, Ane Marie; Blomqvist, P

1999-01-01

BACKGROUND: Several case reports, but only a few studies, have examined the coexistence of coeliac disease and primary biliary cirrhosis. AIM: To estimate the risk of primary biliary cirrhosis in two national cohorts of patients with coeliac disease in Denmark and Sweden. METHODS: Through record...... linkage all Danish patients hospitalised with coeliac disease were followed for possible occurrence of primary biliary cirrhosis from 1 January 1977 until 31 December 1992. All patients hospitalised with coeliac disease in Sweden from 1987 to 1996 were also followed in a separate analysis. RESULTS......: A total of 896 patients with coeliac disease were identified in Denmark with a median follow up period of 9.1 years for a total of 8040 person-years at risk. Two cases of primary biliary cirrhosis were observed where 0.07 were expected, giving a standardised incidence ratio of 27.6 (95% confidence...

Parental Involvement in Primary Children's Homework in Hong Kong

Science.gov (United States)

Tam, Vicky C.; Chan, Raymond M.

2009-01-01

This study draws upon an ecological perspective to examine parental involvement in homework and its relationship with primary school children's educational outcomes within the Chinese sociocultural context of Hong Kong. Data were collected using homework diaries and questionnaires administered to 1,309 pairs of students and parents spanning all…

Fetal antigen 2 in primary and secondary brain tumors

DEFF Research Database (Denmark)

Rasmussen, H Boje; Teisner, B; Schrøder, H D

1991-01-01

Immunohistochemical deposition and distribution of fetal antigen 2 (FA2) was examined in normal brain tissue and in primary and metastatic tumors of the brain. In normal brain tissue FA2 was exclusively found linearly around the vessels, along pia and in arachnoidea. A similar localization was seen...

Comprehensiveness of care from the patient perspective: comparison of primary healthcare evaluation instruments.

Science.gov (United States)

Haggerty, Jeannie L; Beaulieu, Marie-Dominique; Pineault, Raynald; Burge, Frederick; Lévesque, Jean-Frédéric; Santor, Darcy A; Bouharaoui, Fatima; Beaulieu, Christine

2011-12-01

Comprehensiveness relates both to scope of services offered and to a whole-person clinical approach. Comprehensive services are defined as "the provision, either directly or indirectly, of a full range of services to meet most patients' healthcare needs"; whole-person care is "the extent to which a provider elicits and considers the physical, emotional and social aspects of a patient's health and considers the community context in their care." Among instruments that evaluate primary healthcare, two had subscales that mapped to comprehensive services and to the community component of whole-person care: the Primary Care Assessment Tool - Short Form (PCAT-S) and the Components of Primary Care Index (CPCI, a limited measure of whole-person care). To examine how well comprehensiveness is captured in validated instruments that evaluate primary healthcare from the patient's perspective. 645 adults with at least one healthcare contact in the previous 12 months responded to six instruments that evaluate primary healthcare. Scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation modelling) factor analysis examined fit to operational definition, and item response theory analysis examined item performance on common constructs. Over one-quarter of respondents had missing responses on services offered or doctor's knowledge of the community. The subscales did not load on a single factor; comprehensive services and community orientation were examined separately. The community orientation subscales did not perform satisfactorily. The three comprehensive services subscales fit very modestly onto two factors: (1) most healthcare needs (from one provider) (CPCI Comprehensive Care, PCAT-S First-Contact Utilization) and (2) range of services (PCAT-S Comprehensive Services Available). Individual item performance revealed several problems. Measurement of comprehensiveness is problematic, making this attribute a priority for measure development

Association between fee-for-service expenditures and morbidity burden in primary care

DEFF Research Database (Denmark)

Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik

2014-01-01

BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

Success in Implementation of a Resident In-Service Examination Review Series

Science.gov (United States)

Forcucci, Jessica A.; Hyer, J. Madison; Bruner, Evelyn T.; Lewin, David N.; Batalis, Nicholas I.

2017-01-01

Abstract Objectives: Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Methods: Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Results: Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Conclusions: Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. PMID:28340222

Comparison between Primary Teacher Educators' and Primary School Teachers' Beliefs of Primary Geography Education Quality

Science.gov (United States)

Bent, Gert Jan; Bakx, Anouke; den Brok, Perry

2016-01-01

In this study teacher educators' beliefs concerning primary geography education have been investigated and compared with primary school teachers' beliefs. In this study 45 teacher educators and 489 primary school teachers completed a questionnaire, and nine teacher educators have been interviewed as well. It has been found that teacher educators…

Implementing Cooperative Learning in Australian Primary Schools: Generalist Teachers' Perspectives

Science.gov (United States)

Hennessey, Angela; Dionigi, Rylee A.

2013-01-01

To implement cooperative learning successfully in practice, teachers require knowledge of cooperative learning, its features and terms, and how it functions in classrooms. This qualitative study examined 12 Australian generalist primary teachers', understandings of cooperative learning and perceived factors affecting its implementation. Using…

Primary Metabolic Pathways and Metabolic Flux Analysis

DEFF Research Database (Denmark)

Villadsen, John

2015-01-01

his chapter introduces the metabolic flux analysis (MFA) or stoichiometry-based MFA, and describes the quantitative basis for MFA. It discusses the catabolic pathways in which free energy is produced to drive the cell-building anabolic pathways. An overview of these primary pathways provides...... the reader who is primarily trained in the engineering sciences with atleast a preliminary introduction to biochemistry and also shows how carbon is drained off the catabolic pathways to provide precursors for cell mass building and sometimes for important industrial products. The primary pathways...... to be examined in the following are: glycolysis, primarily by the EMP pathway, but other glycolytic pathways is also mentioned; fermentative pathways in which the redox generated in the glycolytic reactions are consumed; reactions in the tricarboxylic acid (TCA) cycle, which produce biomass precursors and redox...

Primary nasal tuberculosis following blunt trauma nose

Directory of Open Access Journals (Sweden)

Kaushik Saha

2014-01-01

Full Text Available Primary nasal tuberculosis is a rare disease with nearly 40 cases reported. Our patient was a young male presented with left sided nasal obstruction, anosmia and occasional epistaxis for last 7 weeks after 6 months of blunt trauma nose. Contrast enhanced computed tomography of the para nasal sinuses showed increased soft-tissue density with contrast enhancement in the left maxillary antrum with extension through left osteomeatal foramen to the left nasal cavity along with further extension through choana to nasopharynx resulting in partial obliteration of the nasopharyngeal airway. Nasal endoscopy revealed a sessile polypoidal pinkish mass arising from the left osteomeatal foramen. Histopathological examination of excisional biopsy of that area showed caseating granuloma. Our patient diagnosed as primary nasal tuberculosis following trauma and treated with anti-tubercular chemotherapy.

Impact of Instructional Resources on Mathematics Performance of Learners with Dyscalculia in Integrated Primary Schools, Arusha City, Tanzania

Science.gov (United States)

Yusta, Nyudule; Karugu, Geoffrey; Muthee, Jessica; Tekle, Tesfu

2016-01-01

Learners with dyscalculia in the integrated primary schools in Arusha have been performing poorly in the Primary School Leaving Examination (PSLE). Thus, the journal sought to investigate the impact of instructional resources on mathematics performance of learners with dyscalculia in integrated primary schools found in Arusha city, Tanzania. The…

Communication Strategies in Primary Schools in Botswana: Interventions Using Cooks, Teacher Aides and Learners

Science.gov (United States)

Mokibelo, Eureka B.

2016-01-01

This paper examines the micro planning activities that schools engage in to address learners' needs to make education work in rural primary schools of Botswana. The national language plan prescribes the use of English and Setswana only as languages of instruction at the primary school level. However, this plan is not practical in some regions…

Sun protection and skin self-examination in melanoma survivors.

Science.gov (United States)

Mujumdar, Urvi J; Hay, Jennifer L; Monroe-Hinds, Yvette C; Hummer, Amanda J; Begg, Colin B; Wilcox, Homer B; Oliveria, Susan A; Berwick, Marianne

2009-10-01

Patients diagnosed with melanoma are at risk for developing recurrent and second primary disease. Skin self-examination (SSE) and sun protection are standard clinical recommendations to minimize risk. In this study we examined performance of these behaviors in individuals with melanoma drawn from the general population. Potential participants (N=148) with a first primary melanoma diagnosed in 2000 were identified through a population-based cancer registry in New Jersey, USA. One hundred and fifteen individuals participated in a 30 min telephone interview concerning behavioral adherence with SSE and sun protection, self-efficacy for performing these behaviors, and perceived risk of developing another skin cancer. We utilized logistic regression to estimate potential associations of demographic, medical, and psychosocial factors with SSE and sun protection, respectively. Seventeen percent of subjects reported performing comprehensive SSE at least once every two months and 23% engaged in regular sun protection. Utilization of SSE was related to the presence of moles (OR=4.2, 95% CI: 1.1-15) and higher SSE self-efficacy (OR=14.4, 95% CI: 1.9-112). Regular sun protection was related to older age (>60 years; OR=3.3, 95% CI: 1.3-8.7), being female (OR=2.8, 95% CI: 1.1-7.3), and higher sun protection self-efficacy (OR=5.0, 95% CI: 1.4-18). These factors remained significant in multivariate models. In this group of primary melanoma survivors, the rates of SSE and sun protection are comparable to, but do not exceed, general population estimates. This study provides justification for further research to address barriers to prevention and control behaviors in melanoma survivors.

The retinoblastoma gene is frequently altered leading to loss of expression in primary breast tumours.

Science.gov (United States)

Varley, J M; Armour, J; Swallow, J E; Jeffreys, A J; Ponder, B A; T'Ang, A; Fung, Y K; Brammar, W J; Walker, R A

1989-06-01

We have analysed the organisation of the retinoblastoma (RB1) gene in 77 primary breast carcinomas, in metastatic tissue derived from 16 of those primary tumours, and in a variety of benign breast lesions. Expression of RB1 was also assessed in most samples by immunohistochemical detection of the RB1 protein in tissue sections. Structural abnormalities to RB1 were detected in DNA from 15/77 (19%) of primary breast carcinomas examined. Where DNA was available from metastatic tissue derived from such primary tumours, the same aberration could be detected. No alterations were seen in benign breast lesions. 16/56 (29%) of tumours examined for expression by immunohistochemical methods showed a proportion of tumour cells to be completely negative for the RB1 protein. All tumours in which a structural alteration to RB1 was detected had a proportion of negative cells, except for one case where all cells were positive. Several primary tumour samples were identified where there was no detectable structural change to the gene, but there was loss of expression in some tumour cells. The data presented here demonstrate that changes to the RB1 gene leading to loss of expression of both alleles are frequent in primary human breast tumours.

Relationships between Teacher Organizational Commitment, Psychological Hardiness and Some Demographic Variables in Turkish Primary Schools

Science.gov (United States)

Sezgin, Ferudun

2009-01-01

Purpose: The purpose of this paper is to examine the relationships between teachers' organizational commitment perceptions and both their psychological hardiness and some demographic variables in a sample of Turkish primary schools. Design/methodology/approach: A total of 405 randomly selected teachers working at primary schools in Ankara…

Examining the interaction between food outlets and outdoor food advertisements with primary school food environments.

Science.gov (United States)

Walton, Mat; Pearce, Jamie; Day, Peter

2009-09-01

Schools are commonly seen as a site of intervention to improve children's nutrition, and prevent excess weight gain. Schools may have limited influence over children's diets; however, with home and community environments also exerting an influence within schools. This study considered the environment of food outlets and outdoor food advertisements surrounding four case study primary schools in New Zealand, and the impact of that external environment on within-school food environments. The shortest travel route between school and home addresses, and the number of food outlets and advertisements passed on that route, was calculated for each student. Interviews with school management were conducted. The schools with a higher percentage of students passing food outlets and advertisements considered that their presence impacted on efforts within schools to improve the food environment. Limiting students' exposure to food outlets and outdoor food adverts through travel route planning, reducing advertising, or limiting the location of food outlets surrounding schools could be explored as intervention options to support schools in promoting nutrition.

[Videocapsule endoscopy as a useful tool to diagnose primary intestinal lymphangiectasia].

Science.gov (United States)

Vignes, S; Bellanger, J

2007-03-01

Primary intestinal lymphangiectasia (Waldmann's disease) lead to a protein-losing enteropathy due to lymph leak into intestinal tract. A 28-year-old woman presented a bilateral lower limb lymphedema. Laboratory examination showing lymphopenia, hypoalbuminemia, hypogammaglobulinemia suggested the diagnosis of primary intestinal lymphangiectasia. Gastroscopy was normal and second duodenum biopsies were negative. Videocapsule endoscopy gave evidence of intestinal lymphangiectasia of the small bowel. Videocapsule endoscopy may be proposed to confirm intestinal lymphangiectasia and to precise their localization when gastroscopy is not conclusive.

Cultural significance of primary teeth for caregivers in Northeast Brazil.

Science.gov (United States)

Nations, Marilyn K; Calvasina, Paola Gondim; Martin, Michele N; Dias, Hilma Fontenele

2008-04-01

This anthropological study critically evaluates Brazilian caregivers' symbolic production and significance of their malnourished offspring's primary teeth, as well as their own, and describes popular dental practices. From January to June 2004, ethnographic interviews of 27 poor, low-literacy mothers were conducted at a public Malnutrition Treatment Center in Fortaleza, Ceará State. Participant observation of clinical pathways and home environments supplemented the data. Content analysis was performed. Results confirm that primary teeth are imbued with cultural significance in Northeast Brazil. Mothers examine mouths, perceive signs of decay, associate primary with permanent tooth healthiness, identify ethnodental illnesses, seek assistance, and perform rituals with exfoliated teeth. The mother's motivation to care for primary teeth is sparked by her memories of past toothache and attempts to avoid stigma and discrimination. Social determinants, not mothers' beliefs or behaviors, are the most critical obstacles to effective dental care. Legitimizing lay knowledge and empowering caregivers and children can improve oral health in Northeast Brazil.

Women's Political Empowerment and Investments in Primary Schooling in India.

Science.gov (United States)

Halim, Nafisa; Yount, Kathryn M; Cunningham, Solveig A; Pande, Rohini P

2016-02-01

Using a national district-level dataset of India composed of information on investments in primary schooling (data from the District Information Survey for Education [DISE, 2007/8]) and information on demographic characteristics of elected officials (data from the Election Commission of India [ECI, 2000/04]), we examined the relationship between women's representation in State Legislative Assembly (SLA) seats and district-level investments in primary schooling. We used OLS regressions adjusting for confounders and spatial autocorrelation, and estimated separate models for North and South India. Women's representation in general SLA seats typically was negatively associated with investments in primary-school amenities and teachers; women's representation in SLA seats reserved for under-represented minorities, i.e., scheduled castes and scheduled tribes, typically was positively associated with investments in primary schooling, especially in areas addressing the basic needs of poor children. Women legislators' gender and caste identities may shape their decisions about redistributive educational policies.

Regional cerebral blood flow in primary degenerative dementia

International Nuclear Information System (INIS)

Kawakatsu, Shinobu; Totsuka, Shiro; Shinohara, Masao; Koyama, Hideki; Sagawa, Katsuo; Morinobu, Shigeru; Oiji, Arata; Komatani, Akio

1991-01-01

Regional cerebral blood flow (rCBF) was examined, using SPECT by Xe-133 inhalation, in patients with primary degenerative dementia who were subgrouped according to predominant symptoms with respect to amnesia, apraxia, agnosia, aphasia, and personality changes. Also the effect of sex and age at dementia onset on the rCBF patterns was assessed. (author). 26 refs.; 1 fig.; 7 tabs

Progress of primary feather molt of adult mourning doves in Missouri

Science.gov (United States)

Sadler, K.C.; Tomlinson, R.E.; Wight, H.M.

1970-01-01

The examination of 7,892 adult doves in Missouri between 1953 and 1965 showed that less than 2.5% of adult doves completed their molt before October 1. Adult doves of both sexes began molting their primary feathers during early June in Missouri and lost the last (tenth) primary during the latter half of October. Approximately 140-150 days were required to complete the molt. Thus, early-hatched immatures, which begin their primary molt 25-30 days after hatching, contributed the bulk of the wings with completed molts in September. By correctly classifying September samples of dove wings with a completed molt as young-of-the-year a more accurate young:adult ratio is obtained.

Ultrasonographic examination in chest disease

Energy Technology Data Exchange (ETDEWEB)

Choe, K.O.; Lee, J.D.; Yoo, H.S. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1983-12-15

Ultrasonographic examination is not widely applied to chest disease, but is may give useful information when the acoustic window for a lesion exist. We did perform ultrasound examination in 68 cases of chest disease. 1. The cases of pleural diseases was predominant; pleural effusion 35 cases, pleural metastatic tumor 2 case, mesothelioma 2 cases and fibrous thickening 1 case, total 40 cases. It was useful to differentiate pleural effusion and fibrous thickening or parenchymal lesion simulating pleural disease, to localize the optimal aspiration site for a loculated empyema, to detect pleural bumorhidden by effusion such as metastatic tumor or mesothelioma. 2. 15 cases of parenchymal lesion and 2 cases of extra pleural mass was examined. The echo pattern of consolidation and atelectasis shows typical multiple tubular streaks within the echogenic area. The echogenicity of the peripheral mass due to primary bronchogenic carcinoma, parenchymal or extrapleural metastatic tumor and granuloma were compared. 3. In the cases of pleural or parenchymal cystic lesions, such as loculated empyema or lung abscess, because of strong reverberation artifact from posterior border of the lesion, the prediction of cystic and solid lesion is sometimes difficult. 4. In 7 cases of mediastinal lesion, cystic lesion show free echo and posterior enhancement. In contrast, solid or fat component show characteristic echo pattern. 5. In the cases of juxta diaphragmatic lesion, sonogram can confirm the underlying intraabdominal pathology, in this case subphrenic abscess

Ultrasonographic examination in chest disease

International Nuclear Information System (INIS)

Choe, K.O.; Lee, J.D.; Yoo, H.S.

1983-01-01

Ultrasonographic examination is not widely applied to chest disease, but is may give useful information when the acoustic window for a lesion exist. We did perform ultrasound examination in 68 cases of chest disease. 1. The cases of pleural diseases was predominant; pleural effusion 35 cases, pleural metastatic tumor 2 case, mesothelioma 2 cases and fibrous thickening 1 case, total 40 cases. It was useful to differentiate pleural effusion and fibrous thickening or parenchymal lesion simulating pleural disease, to localize the optimal aspiration site for a loculated empyema, to detect pleural bumorhidden by effusion such as metastatic tumor or mesothelioma. 2. 15 cases of parenchymal lesion and 2 cases of extra pleural mass was examined. The echo pattern of consolidation and atelectasis shows typical multiple tubular streaks within the echogenic area. The echogenicity of the peripheral mass due to primary bronchogenic carcinoma, parenchymal or extrapleural metastatic tumor and granuloma were compared. 3. In the cases of pleural or parenchymal cystic lesions, such as loculated empyema or lung abscess, because of strong reverberation artifact from posterior border of the lesion, the prediction of cystic and solid lesion is sometimes difficult. 4. In 7 cases of mediastinal lesion, cystic lesion show free echo and posterior enhancement. In contrast, solid or fat component show characteristic echo pattern. 5. In the cases of juxta diaphragmatic lesion, sonogram can confirm the underlying intraabdominal pathology, in this case subphrenic abscess

The effect of retrieval practice in primary school vocabulary learning

NARCIS (Netherlands)

Goossens, Nicole; Camp, Gino; Verkoeijen, Peter; Tabbers, Huib

2018-01-01

The testing effect refers to the finding that retrieval practice leads to better long-term retention than additional study of course material. In the present study, we examined whether this finding generalizes to primary school vocabulary learning. We also manipulated the word learning context.

Malaria microscopy in primary health care centers in Khartoum State ...

African Journals Online (AJOL)

Background: Adequate diagnosis of Malaria is achieved by detection and identification of malaria parasites through examination of Giemsa's stained blood films by competent personnel. Objective: To identify the competency of laboratory personnel of the clinical laboratories attached to primary health care centres at ...

Primary pelvic hydatic cyst mimicking ovarian carcinoma

Directory of Open Access Journals (Sweden)

Faruk Abike

2011-05-01

Full Text Available Hydatic cyst is an illness that appears in consequence of the cystic form of small strap-shaped worm Echinococcus granulosis. Frequently, cysts exist in the lungs and liver. Peritoneal involvement is rare, and generally occurs as a result of second inoculation from rupture of a liver-located hydatic cyst. Primary ovarian hydatic cyst is very rare. A 56-year-old female patient was admitted to Emergency Service with the complaint of stomachache and swollen abdomen. From ultrasonographic examination, a right ovarian 52 × 45-mm heterogeneous semi-solid cystic mass and right hydronephrosis were detected. As a result of the tomographic examination, the right ovarian growth was judged to be a 60 × 45-mm lobule contoured, septal, heterogeneously cystic mass (ovarian carcinoma. Depending on these indicators and with the diagnosis of ovarian carcinoma, laparotomy was planned. During the observation, a mass that compressed on the right ureter and dilatation in the right ureter were determined. The mass was approximately 6 cm long and smoothly contoured, including widespread adhesions, and also obliteration of the pouch of Douglas. The mass was excised and total abdominal hysterectomy and bilateral salpingo-oopherectomy performed. After a pathological examination, hydatid cyst was diagnosed. Although pointing at the issue of the distinctive diagnosis of pelvic and peritoneal mass, it should be realized that the existence of primary peritoneal and pelvic involvement of the hydatic cyst is generally a result of the second inoculation, and is also more common in regions in which Echinococcus granulosa is endemic and livestock production is prevalent.

Magnetic resonance imaging findings of primary bone lymphoma presenting with pathological fracture

Directory of Open Access Journals (Sweden)

Elif Karadeli

2016-03-01

Full Text Available Malignant bone lymphomas are uncommonly encountered clinically. Men, 77-years-old, was admitted to hospital because of pain in the left shoulder. After imaging and histological examination diagnosed primary bone lymphoma. Primary lymphoma of the bone is an extranodal lymphoma that arises from the medullary cavity and manifests as a localized, solitary lesion, which represents 1% of all malignant lymphomas. [Cukurova Med J 2016; 41(0.100: 103-104

Thinking Styles of Primary School Teachers in Beijing, China

Science.gov (United States)

Wang, Ying; Pang, Nicholas Sun-Keung

2013-01-01

Previous studies on teachers' thinking have usually related to teaching and learning, and concentrated on classroom-level outcomes. In this study, an organizational and administrative perspective was adopted in examining teachers' thinking style. Data collected were from a sample of 268 in-service teachers from 6 primary schools in Beijing, China.…

Examination of VVER-1000 Reactor Pressure Vessel

International Nuclear Information System (INIS)

Matokovic, A.; Picek, E.; Markulin, K.

2008-01-01

The increasing demand of a higher level of safety in the operation of the nuclear power plants requires the utilisation of more precise automated equipment to perform in-service inspections. That has been achieved by technological advances in computer technology, in robotics, in examination probe technology with the development of the advanced inspection technique and has also been due to the considerable and varied experience gained in the performance of such inspections. In-service inspection of reactor pressure vessel, especially Russian-designed WWER-1000 presents one of the most important and extensive examination of nuclear power plants primary circuit components. Such examination demand high standards of inspection technology, quality and continual innovation in the field of non-destructive testing advanced technology. A remote underwater contact ultrasonic technique is employed for the examination of the base metal of vessel and reactor welds, whence eddy current method is applied for clad surface examinations. Visual testing is used for examination of the vessel interior. The movement of inspection probes and data positioning are assured by using new reactor pressure vessel tool concept that is fully integrated with inspection systems. The successful performance of reactor pressure vessel is attributed thorough pre-outage planning, training and successful performance demonstration qualification of chosen non-destructive techniques on the specimens with artificial and/or real defects. Furthermore, use of advanced approach of inspection through implementation the state-of-the-art examination equipment significantly reduced the inspection time, radiation exposure to examination personnel, shortening nuclear power plant outage and cutting the total inspection costs. This paper presents advanced approach in the reactor pressure vessel in-service inspections and it is especially developed for WWER-1000 nuclear power plants.(author)

Achieving Value in Primary Care: The Primary Care Value Model.

Science.gov (United States)

Rollow, William; Cucchiara, Peter

2016-03-01

The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation. © 2016 Annals of Family Medicine, Inc.

Environmental factors associated with primary care access among urban older adults.

Science.gov (United States)

Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

2012-09-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits.

Science.gov (United States)

Baker, Jessica H; Sisk, Cheryl L; Thornton, Laura M; Brandt, Harry; Crawford, Steven; Fichter, Manfred M; Halmi, Katherine A; Johnson, Craig; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Strober, Michael; Treasure, Janet; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M; Klump, Kelly L

2014-01-01

Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

The primary protection system software

International Nuclear Information System (INIS)

Tooley, P.A.

1992-01-01

This paper continues the detailed description of the Primary Protection System for Sizewell-B by providing an overview of design and implementation of the software, including the features of the design process which ensure that quality is delivered by the contractor. The Nuclear Electric software assessment activities are also described. The argument for the excellence of the software is made on the basis of a quality product delivered by the equipment supplier's design process, and the confirmation of this provided by the Nuclear Electric assessment process, which is as searching and complete an examination as is reasonably practicable to achieve. (author)

Children Literature Based Program for Developing EFL Primary Pupils' Life Skills and Language Learning Strategies

Science.gov (United States)

Abdelhalim, Safaa M.

2015-01-01

This study examines the effectiveness of a proposed English language program based on integrating two forms of children literature, mainly short stories and songs, in developing the needed life skills and language learning strategies of primary school students. Besides, it emphasized the importance of providing EFL fifth year primary students with…

Finding the unexpected: pathological examination of surgically resected femoral heads

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Fornasier, V.L. [St. Michael' s Hospital, University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); Battaglia, D.M. [St. Michael' s Hospital, University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); St. Michael' s Hospital, University of Toronto, Division of Pathology, Toronto, Ontario (Canada)

2005-06-01

To study the clinically diagnosed disease process but also identify additional, clinically undetected pathologies in femoral heads resected for replacement arthroplasty. A retrospective review was carried out of the pathological findings in 460 surgically resected femoral heads. Serial sections were submitted to low-energy fine-detail radiography, then decalcified sections stained by the WHO method were examined. The preoperative clinical and imaging diagnoses were compared with the pathological findings and special interest was placed on assessing the clinical significance of any unexpected, clinically undetected findings. The most common findings included the presence of bone islands (solitary osteomas) and areas of avascular necrosis in addition to the primary joint disease for which the patient underwent surgery. The preoperative symptomatology did not distinguish between the known primary disease and the additional pathological findings. Some of the clinically unidentified lesions were of a size that fell below the ability of current clinical investigations to detect. However, the finding of lesions by tissue fine-detail radiography indicates that current, more sensitive clinical imaging techniques may identify them. Careful examination of surgically resected femoral heads is important to ensure that all pathologies are identified and assessed for clinical relevance. (orig.)

Finding the unexpected: pathological examination of surgically resected femoral heads

International Nuclear Information System (INIS)

Fornasier, V.L.; Battaglia, D.M.

2005-01-01

To study the clinically diagnosed disease process but also identify additional, clinically undetected pathologies in femoral heads resected for replacement arthroplasty. A retrospective review was carried out of the pathological findings in 460 surgically resected femoral heads. Serial sections were submitted to low-energy fine-detail radiography, then decalcified sections stained by the WHO method were examined. The preoperative clinical and imaging diagnoses were compared with the pathological findings and special interest was placed on assessing the clinical significance of any unexpected, clinically undetected findings. The most common findings included the presence of bone islands (solitary osteomas) and areas of avascular necrosis in addition to the primary joint disease for which the patient underwent surgery. The preoperative symptomatology did not distinguish between the known primary disease and the additional pathological findings. Some of the clinically unidentified lesions were of a size that fell below the ability of current clinical investigations to detect. However, the finding of lesions by tissue fine-detail radiography indicates that current, more sensitive clinical imaging techniques may identify them. Careful examination of surgically resected femoral heads is important to ensure that all pathologies are identified and assessed for clinical relevance. (orig.)

Etiology and management of primary amenorrhoea: A study of 102 cases at tertiary centre.

Science.gov (United States)

Kriplani, Alka; Goyal, Manu; Kachhawa, Garima; Mahey, Reeta; Kulshrestha, Vidushi

2017-12-01

To determine the prevalence of etiologic causes of primary amenorrhea in Indian population. A retrospective study was performed using 102 complete medical records of women with primary amenorrhea who attended the Gynaecologic Endocrinology Clinic, Department of Obstetrics and Gynaecology, AIIMS, New Delhi from September 2012 to September 2015. Cases were analysed according to clinical profile, development of secondary sexual characteristics, physical examination, pelvic and rectal examination, X-ray of chest and lumbo-sacral spine, hormone profile, pelvic USG, MRI, and cytogenetic study including karyotype. The three most common causes of primary amenorrhea were Mullerian anomalies (47%), gonadal dysgenesis (20.5%), and hypogonadotropic hypogonadism (14.7%) in the present study. There were 3 cases of Turner syndrome (45,XO), 5 cases of Swyer's syndrome (46,XY) and 2 cases of Androgen insensitivity syndrome (46,XY). One case had pituitary macroadenoma and eight cases (7.8%) were of genital tuberculosis. The present study has currently been the largest case series of primary amenorrhea from North India. Mullerian anomaly is the most prevalent etiological factor leading to amenorrhoea followed by gonadal dysgenesis in our study. Racial, genetic and environmental factors could play role in the cause of primary amenorrhea. Copyright © 2017. Published by Elsevier B.V.

Predicting recovery from whiplash injury in the primary care setting.

Science.gov (United States)

Ferrari, Robert

2014-08-01

The effect of expectation of recovery on the recovery rate of whiplash patients in the primary care setting is not known. Whiplash patients were assessed in a primary care setting within 1 week of their collision for their expectations of recovery and were re-examined 3 months later for recovery. Initial expectations of recovery predicted recovery. According to adjusted odds ratios, subjects who expected 'to get better slowly' had a recovery rate that was nearly 1.9 times that of subjects with poor recovery expectations. Subjects who expected 'to get better soon' had a recovery rate that was 2.6 times greater than either of those with poor recovery expectations. In the primary care setting, asking patients with whiplash about their expectations of recovery is a useful predictor of their outcome.

Mental health care roles of non-medical primary health and social care services.

Science.gov (United States)

Mitchell, Penny

2009-02-01

Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders.

A Tale of Five Countries: Background and Confidence in Preservice Primary Teachers in Drama Education across Five Countries

Science.gov (United States)

Russell-Bowie, Deirdre E.

2013-01-01

In many public primary schools across different countries, generalist primary teachers are required to teach all subjects, including music, dance, drama and visual arts. This study investigates the background and confidence of preservice primary teachers from five countries in relation to drama and drama education. It also examines if there is a…

Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN

DEFF Research Database (Denmark)

Rindal, D Brad; Gordan, Valeria V; Litaker, Mark S

2010-01-01

To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use.......To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use....

Management continuity from the patient perspective: comparison of primary healthcare evaluation instruments.

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Haggerty, Jeannie L; Burge, Frederick; Pineault, Raynald; Beaulieu, Marie-Dominique; Bouharaoui, Fatima; Beaulieu, Christine; Santor, Darcy A; Lévesque, Jean-Frédéric

2011-12-01

Management continuity, operationally defined as "the extent to which services delivered by different providers are timely and complementary such that care is experienced as connected and coherent," is a core attribute of primary healthcare. Continuity, as experienced by the patient, is the result of good care coordination or integration. To provide insight into how well management continuity is measured in validated coordination or integration subscales of primary healthcare instruments. Relevant subscales from the Primary Care Assessment Survey (PCAS), the Primary Care Assessment Tool - Short Form (PCAT-S), the Components of Primary Care Instrument (CPCI) and the Veterans Affairs National Outpatient Customer Satisfaction Survey (VANOCSS) were administered to 432 adult respondents who had at least one healthcare contact with a provider other than their family physician in the previous 12 months. Subscales were examined descriptively, by correlation and factor analysis and item response theory analysis. Because the VANOCSS elicits coordination problems and is scored dichotomously, we used logistic regression to examine how evaluative subscales relate to reported problems. Most responses to the PCAS, PCAT-S and CPCI subscales were positive, yet 83% of respondents reported having one or more problems on the VANOCSS Overall Coordination subscale and 41% on the VANOCSS Specialist Access subscale. Exploratory factor analysis suggests two distinct factors. The first (eigenvalue=6.98) is coordination actions by the primary care physician in transitioning patient care to other providers (PCAS Integration subscale and most of the PCAT-S Coordination subscale). The second (eigenvalue=1.20) is efforts by the primary care physician to create coherence between different visits both within and outside the regular doctor's office (CPCI Coordination subscale). The PCAS Integration subscale was most strongly associated with lower likelihood of problems reported on the VANOCSS

Respiratory compensation to a primary metabolic alkalosis in humans.

Science.gov (United States)

Feldman, Mark; Alvarez, Naiara M; Trevino, Michael; Weinstein, Gary L

2012-11-01

There is limited and disparate information about the extent of the respiratory compensation (hypoventilation) that occurs in response to a primary metabolic alkalosis in humans. Our aim was to examine the influence of the plasma bicarbonate concentration, the plasma base excess, and the arterial pH on the arterial carbon dioxide tension in 52 adult patients with primary metabolic alkalosis, mostly due to diuretic use or vomiting. Linear regression analysis was used to correlate degrees of alkalosis with arterial carbon dioxide tensions. In this alkalotic cohort, whose arterial plasma bicarbonate averaged 31.6 mEq/l, plasma base excess averaged 7.8 mEq/l, and pH averaged 7.48, both plasma bicarbonate and base excess correlated closely with arterial carbon dioxide tensions (r = 0.97 and 0.96, respectively; p respiratory compensation (hypoventilation) to primary metabolic alkalosis than has been reported in prior smaller studies.

CT findings in primary pulmonary lymphomas

International Nuclear Information System (INIS)

Cardinale, Luciano; Allasia, Marco; Cataldi, Aldo; Ferraris, Fabrizio; Fava, Cesare; Parvis, Guido

2005-01-01

Purpose. To describe the CT findings of pathologically confirmed primary pulmonary lymphomas. Materials and methods. The CT examinations of 11 patients with pathologically proven primary pulmonary lymphoma (9 BALT lymphomas and 2 non-BALT lymphomas) were retrospectively reviewed by three radiologists. Evaluated findings included morphology (consolidation, mass, nodule), number and distribution of lesions. Other CT findings such as air bronchogram, lymphadenopathy atelectasis and pleural effusion were also assessed. Results. Pulmonary lesions were depicted as air-space consolidation (pneumonia-like) in 5 patients (45%), tumour-like rounded opacity in 4 (36%), and nodules in 4 (36%). Multiple and bilateral long lesions were seen in 3 patients (27%). Air bronchogram was present in 7 patients (63%), lymphadenopathy in 3 (27%), atelectasis in 4 (36%) and pleural effusion in only 1 (9%). Conclusions. Our results agree with previous studies regarding lesion patterns and their relative frequency. A smaller number of nodules and of multiple lesions were found compared with some previous studies. The most frequent pattern was airspace consolidation [it

Behavioral medicine interventions for adult primary care settings: A review.

Science.gov (United States)

Funderburk, Jennifer S; Shepardson, Robyn L; Wray, Jennifer; Acker, John; Beehler, Gregory P; Possemato, Kyle; Wray, Laura O; Maisto, Stephen A

2018-06-07

Health care organizations are embracing integrated primary care (IPC), in which mental health and behavioral health are addressed as part of routine care within primary care settings. Behavioral medicine concerns, which include health behavior change and coping with medical conditions, are common in primary care populations. Although there are evidence-based behavioral interventions that target a variety of behavioral medicine concerns, integrated behavioral health providers need interventions that are sufficiently brief (i.e., ≤6 appointments) to be compatible with IPC. We conducted a literature review of published studies examining behavioral interventions that target prevalent behavioral medicine concerns and can feasibly be employed by IPC providers in adult primary care settings. A total of 67 published articles representing 63 original studies met eligibility criteria. We extracted data on the behavioral interventions employed, results comparing the active intervention to a comparison group, general fit with IPC, and methodological quality. The vast majority of studies examined brief interventions targeting sleep difficulties and physical activity. The most commonly employed interventions were derived from cognitive-behavioral therapy and motivational interviewing. Outcomes were generally statistically significantly in favor of the active intervention relative to comparison, with highly variable methodological quality ratings (range = 0-5; M = 2.0). Results are discussed in relation to the need for further evidence for brief behavioral interventions targeting other behavioral medicine concerns beyond sleep and physical activity, as well as for more specificity regarding the compatibility of such interventions with IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

ROOTing Out Meaning: More Morphemic Analysis for Primary Pupils

Science.gov (United States)

Mountain, Lee

2005-01-01

In an elementary-school professional development program, a group of primary teachers and a university consultant reviewed the research on morphemic analysis and then explored ways to give pupils in grades 1, 2, and 3 an early start on using prefixes, suffixes, and roots to construct word meaning. The teachers examined some middle-grade strategies…

Examination results of medical students with dyslexia.

Science.gov (United States)

McKendree, Jean; Snowling, Margaret J

2011-02-01

dyslexia is a learning disorder, the primary sign of which is significant difficulty in learning to read and spell. However, accumulating evidence suggests that many people with dyslexia can overcome their reading difficulties and enjoy high levels of educational success. There is debate about the appropriateness of different forms of summative assessment for people with dyslexia, but there is little research investigating different examination formats, particularly in higher education, including medical education. Currently, medical school examinations comprise a range of different assessments, both written and performance-based, offering an opportunity to compare performance on different formats. This study compared results between students with and without dyslexia on all summative assessment types used at one UK medical school. examination scores were collated for all summative Year 1 and 2 examinations at Hull York Medical School (HYMS) over four cohorts entering from 2004 to 2007. These included scores on two types of forced-choice question (multiple-choice and extended matching question) examinations, on short written answer examinations and on performance in a 16-station objective structured clinical examination (OSCE). Results for written answers were gathered separately for basic science questions and for questions involving critical analysis and evidence-based medicine. an overall multivariate analysis of covariance (mancova) on examinations across both years controlling for gender, ethnicity and age on entry indicated that there was no significant overall effect of dyslexia on examination results. Regression analysis further showed that dyslexia was not a significant predictor on any of the examination forms in Year 1 or Year 2. there is no indication that any of the assessment methods used in HYMS, in common with many other medical schools, disadvantage students with dyslexia in comparison with their peers. In the light of these findings, we support

Primary fibromyalgia

DEFF Research Database (Denmark)

Jacobsen, S; Jensen, L T; Foldager, M

1990-01-01

Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

MRI features of primary, secondary and metastatic medulloblastoma

International Nuclear Information System (INIS)

Buehring, U.; Strayle-Batra, M.; Kueker, W.; Freudenstein, D.; Scheel-Walter, H.-G.

2002-01-01

Medulloblastoma is the most frequent paediatric malignant brain tumour. The purpose of this study was to define imaging characteristics and contrast uptake patterns of primary and recurrent medulloblastoma using MRI. The MRI examinations of 17 histologically proven cases of medulloblastoma diagnosed in our institution (13 males and 4 females; mean age 13 years, 7 months) were reviewed in retrospect. Only patients with pre-treatment and follow-up examinations including T2-weighted images (fluid-attenuated inversion recovery or turbo spin echo) and T1-weighted images after contrast injection (0.1 mmol/kg Gd-DTPA) were included in this study. Whereas 6 of 7 tumours (n=17) were hyperintense on T2-weighted images, contrast enhancement was detected in 13 patients. Fifteen tumours occurred in the cerebellar vermis, two were located in the cerebellar hemispheres. Mean size at the time of presentation was 30.1 mm. All patients presented with some extent of an occlusive hydrocephalus. Local recurrent tumour or metastases were seen in 6 patients (3 months to 7 years, mean age 2.5 years). Whereas the T2 signal intensity of recurrent tumour or subarachnoidal metastases resembled the primary neoplasms, the contrast uptake tended to be less pronounced (n=3) or was completely absent (n=2); thus, suggestive signs of primary medulloblastoma are location in the vermis, hyperintensity on T2-weighted images and hydrocephalus. The amount of contrast enhancement is variable and nonspecific. Secondary medulloblastoma manifestation is characterized by T2 hyperintensity but not by contrast uptake. (orig.)

Early Detection of Chronic Obstructive Pulmonary Disease in Primary Care.

Science.gov (United States)

Kobayashi, Seiichi; Hanagama, Masakazu; Yanai, Masaru

2017-12-01

Objective To evaluate the effectiveness of an early detection program for chronic obstructive pulmonary disease (COPD) in a primary care setting in Japan. Methods Participants of ≥40 years of age who regularly visited a general practitioner's clinic due to chronic disease were asked to complete a COPD screening questionnaire (COPD Population Screener; COPD-PS) and undergo simplified spirometry using a handheld spirometric device. Patients who showed possible COPD were referred to a respiratory specialist and underwent a detailed examination that included spirometry and chest radiography. Results A total of 111 patients with possible COPD were referred for close examination. Among these patients, 27 patients were newly diagnosed with COPD. The patients with COPD were older, had lower BMI values, and had a longer smoking history in comparison to non-COPD patients. COPD patients also had more comorbid conditions. A diagnosis of COPD was significantly associated with a high COPD-PS score (pearly detection of undiagnosed COPD in primary care.

Pre-Service Primary Teachers' Knowledge and Understanding of Geography and Its Teaching: A Review

Science.gov (United States)

Catling, Simon

2014-01-01

It is a decade since the last review of the geographical understandings of pre-service primary teachers. Examining the range of research about novice primary teachers' geographical and environmental knowledge and understanding, it is clear there have been limited follow up studies, and there remain important gaps in the research. Research relevant…

[Routine fluoroscopic investigations after primary bariatric surgery].

Science.gov (United States)

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

Directory of Open Access Journals (Sweden)

Suh Beomseok

2012-11-01

Full Text Available Abstract Background While knowledge and risk perception have been associated with screening for second primary cancer (SPC, there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected is associated with subsequent completion of all appropriate SPC screening in cancer survivors. Methods Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. Results Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33, after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. Conclusions The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

Comparison of complications in transtrochanteric and anterolateral approaches in primary total hip arthroplasty.

LENUS (Irish Health Repository)

Cashman, James P

2008-11-01

Three surgical approaches to primary total hip arthroplasty (THA) have been in use since Charnley popularized the transtrochanteric approach. This study was designed to examine the difference in morbidity between the transtrochanteric approach and the anterolateral approach in primary THA. Information on 891 patients who underwent primary THA performed by a single surgeon was collected prospectively between 1998 and 2003 using a modified SF-36 form, preoperatively, intraoperatively, and at 3 months postoperatively. The transtrochanteric group had higher morbidity and more patients who were dissatisfied with their THA. There was a greater range of motion in the anterolateral group.

Success in Implementation of a Resident In-Service Examination Review Series.

Science.gov (United States)

Forcucci, Jessica A; Hyer, J Madison; Bruner, Evelyn T; Lewin, David N; Batalis, Nicholas I

2017-04-01

Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Radiation doses to the unborn child at diagnostic examination in Sweden

International Nuclear Information System (INIS)

Helmrot, E.

2002-01-01

This report describes methods to estimate fetal radiation doses from radiation diagnostic examinations, based on survey data from 3 hospitals in southern Sweden. The fetal dose has been calculated with available computer programs and verified by dose measurements inside a female human phantom for conventional X-ray and computed tomography (CT) examinations. Measured fetal doses have been correlated to the DAP (Dose Area Product) value or the CTDI (Computer Tomography Dose Index) and DLP (Dose Length Product) values and conversion factors have been evaluated. For nuclear medicine examinations tables for the calculations of fetal doses by administered activity are presented together with information of administered activity for normal and pregnant women in Sweden. For X-ray examinations where the uterus is outside the primary radiation fields the fetal dose is generally below 1-2 mSv. In order to calculate fetal doses documentation of fluoroscopy time and number of X-ray images, scanning parameters for the CT and administered activity for nuclear medicine examinations are necessary

Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

Science.gov (United States)

Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

2018-03-01

Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

The Image of Mathematics Held by Irish Post-Primary Students

Science.gov (United States)

Lane, Ciara; Stynes, Martin; O'Donoghue, John

2014-01-01

The image of mathematics held by Irish post-primary students was examined and a model for the image found was constructed. Initially, a definition for "image of mathematics" was adopted with image of mathematics hypothesized as comprising attitudes, beliefs, self-concept, motivation, emotions and past experiences of mathematics. Research…

Fostering Critical Thinking Practices at Primary Science Classrooms in Nepal

Science.gov (United States)

Acharya, Kamal Prasad

2016-01-01

This article examines the socio-cultural activities that have direct and indirect impacts on critical thinking practices in primary science classrooms and what kinds of teachers' activities help to foster the development of critical thinking practices in children. Meanwhile, the constructivist and the socio-cultural theoretical dimensions have…

Professional Learning in Mathematical Reasoning: Reflections of a Primary Teacher

Science.gov (United States)

Herbert, Sandra; Widjaja, Wanty; Bragg, Leicha A.; Loong, Esther; Vale, Colleen

2016-01-01

Reasoning is an important aspect in the understanding and learning of mathematics. This paper reports on a case study presenting one Australian primary teacher's reflections regarding the role played by a professional learning program in her developing understanding of mathematical reasoning. Examination of the transcripts of two interviews…

Where Cultural Games Count: The Voices of Primary Classroom Teachers

Science.gov (United States)

Nabie, Michael Johnson

2015-01-01

This study explored Ghanaian primary school teachers' values and challenges of integrating cultural games in teaching mathematics. Using an In-depth conversational interview, ten (10) certificated teachers' voices on the values and challenges of integrating games were examined. Thematic data analysis was applied to the qualitative data from the…

Can brief behavioral health interventions reduce suicidal and self-harm ideation in primary care patients?

Science.gov (United States)

Dueweke, Aubrey R; Rojas, Sasha M; Anastasia, Elizabeth A; Bridges, Ana J

2017-09-01

We examined whether brief behavioral health visits reduced suicidal and self-harm ideation among primary care patients and compared the effectiveness of interventions that targeted ideation directly (i.e., safety planning) with those that targeted ideation indirectly through management of underlying mental illness (e.g., behavioral activation). We examined first- and last-visit data from 31 primary care patients with suicidal or self-harm ideation seen by behavioral health consultants. Patients reported significantly lower frequencies of suicidal and self-harm ideation at their final visit than at their initial visit. Patients whose ideation was targeted directly showed greater improvements than patients whose ideation was targeted indirectly. Although preliminary, results suggest mild to moderate suicidal ideation could be addressed in primary care through integration of behavioral health consultants into the medical team. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Full surface examination of small spheres with a computer controlled scanning electron microscope

International Nuclear Information System (INIS)

Ward, C.M.; Willenborg, D.L.; Montgomery, K.L.

1979-01-01

This report discusses a computer automated stage and Scanning Electron Microscopy (SEM) system for detecting defects in glass spheres for inertial confinement laser fusion experiments. This system detects submicron defects and permits inclusion of acceptable spheres in targets after examination. The stage used to examine and manipulate the spheres through 4π steradians is described. Primary image recording is made on a roster scanning video disc. The need for SEM stability and methods of achieving it are discussed

Corrosion of alloy 800 in PHWR primary and secondary conditions

International Nuclear Information System (INIS)

Maroto, A.J.G.; Blesa, M.A.; Villegas, M.; Olmedo, A.M.; Bordoni, R.; Alvarez, M.G.; Sainz, R.

1998-01-01

A hot leg section of a steam generator tubing was removed for destructive examination from one of the steam generators (SG) of the Embalse Nuclear Power Plant. The tube material is Alloy 800 and carbon steel is the tube support plate material. Samples of the deposits were taken at the first tube support plate and at the top, mid-height and bottom of the sludge pile. Transverse sections were taken at several locations along the tube length measuring the oxide thicknesses and studying the morphology of the oxide layer by scanning electron microscopy on the primary and secondary side at each location. Deposit layers on the outer tube surface revealed iron as major component and the presence of calcium, phosphorous, zinc and manganese. The oxide scale thickness at the secondary side in the open area was around 22 to 30 μm. The oxide thickness grown under isothermal conditions on the corrosion test samples installed in the autoclaves facilities of the primary circuit of the plant was measured and compared with that found on the inner surface of the examined tube section. The oxide thickness of the test samples was around 1-2 μm showing the influence of the deposition of corrosion products from the coolant. Deposition and precipitation of oxide was also found in the actual tube, where the common feature was the irregularity of the oxide layer on the primary side and thicknesses values in the range 4 to 10 μm were measured. The autoclave tests and SG tubing examination permit to compare the influence of materials and of operating (flow rate, isothermal vs non-isothermal) conditions on corrosion and deposition. (author)

[Primary pigmented breast adenocarcinoma in a male patient].

Science.gov (United States)

Dauendorffer, J-N; Pages, C; Abd Alsamad, I; Bagot, M; Fraitag, S

2013-01-01

Pigmented mammary tumours are rare. Herein, we report the third case of primary pigmented breast adenocarcinoma in a male patient with clinical mimicking of nodular melanoma of the nipple. A male patient presented with a pigmented nodule of the right nipple. Histological examination of the lesion showed dermal and subcutaneous adenocarcinomatous proliferation. The perilesional stroma contained melanin both inside and outside macrophages, leading us to conclude on primary pigmented breast adenocarcinoma clinically mimicking nodular melanoma of the nipple. Local production of melanin by neoplastic cells in the mammary carcinoma was postulated as the cause of hyperpigmentation of the tumour. Other possible causes are transfer of melanin from overlying melanocytes of the pigmented areolar epidermis to the underlying neoplastic cells, or melanin synthesis by intratumoral melanocytes migrating from the epidermis (which strikes us as the most convincing interpretation for the reported case). Breast adenocarcinoma is a rare tumour in men and may present clinically as a pigmented lesion of the nipple, resulting in the problem of differential diagnosis with primary or metastasised nodular melanoma. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Using Geographic Information Systems (GIS) to understand a community's primary care needs.

Science.gov (United States)

Dulin, Michael F; Ludden, Thomas M; Tapp, Hazel; Blackwell, Joshua; de Hernandez, Brisa Urquieta; Smith, Heather A; Furuseth, Owen J

2010-01-01

A key element for reducing health care costs and improving community health is increased access to primary care and preventative health services. Geographic information systems (GIS) have the potential to assess patterns of health care utilization and community-level attributes to identify geographic regions most in need of primary care access. GIS, analytical hierarchy process, and multiattribute assessment and evaluation techniques were used to examine attributes describing primary care need and identify areas that would benefit from increased access to primary care services. Attributes were identified by a collaborative partnership working within a practice-based research network using tenets of community-based participatory research. Maps were created based on socioeconomic status, population density, insurance status, and emergency department and primary care safety-net utilization. Individual and composite maps identified areas in our community with the greatest need for increased access to primary care services. Applying GIS to commonly available community- and patient-level data can rapidly identify areas most in need of increased access to primary care services. We have termed this a Multiple Attribute Primary Care Targeting Strategy. This model can be used to plan health services delivery as well as to target and evaluate interventions designed to improve health care access.

THE CHARACTERISTICS OF SMALL FIRMS THAT SERVE AS OWNERS’ “PRIMARY EMPLOYMENT”

Directory of Open Access Journals (Sweden)

HALIL DINCER KAYA

2017-02-01

Full Text Available Our objective in this study is to examine the relation between firm characteristics and entrepreneurship as “primary employment”. What type of small firms are organized in a way to promote “primary employment”? In order to achieve that objective, we compare firm characteristics in high “primary employment” U.S. states versus in low “primary employment” states. We use the “United States Small Business Friendliness Survey” done by Kauffman Foundation and Thumptack.com in 2013. Our nonparametric tests show that in the states where relatively high percentage of owners have their business as “primary employment” (i.e. “high primary employment states”, firms tend to be limited in their operational area (i.e. operate only in that state although their sales are less local (meaning that they focus on other areas in their state rather than their own locale. In these states, while more firms are in the “home maintenance and repair” industry, fewer firms operate in the “events” industry. We also find that there is no significant difference between high- and low-primary employment states in terms of firm age and firm size. We advise policymakers to use these findings when formulating policies that support entrepreneurship as “primary employment”.

Sleep disorders associated with primary mitochondrial diseases.

Science.gov (United States)

Ramezani, Ryan J; Stacpoole, Peter W

2014-11-15

Primary mitochondrial diseases are caused by heritable or spontaneous mutations in nuclear DNA or mitochondrial DNA. Such pathological mutations are relatively common in humans and may lead to neurological and neuromuscular complication that could compromise normal sleep behavior. To gain insight into the potential impact of primary mitochondrial disease and sleep pathology, we reviewed the relevant English language literature in which abnormal sleep was reported in association with a mitochondrial disease. We examined publication reported in Web of Science and PubMed from February 1976 through January 2014, and identified 54 patients with a proven or suspected primary mitochondrial disorder who were evaluated for sleep disturbances. Both nuclear DNA and mitochondrial DNA mutations were associated with abnormal sleep patterns. Most subjects who underwent polysomnography had central sleep apnea, and only 5 patients had obstructive sleep apnea. Twenty-four patients showed decreased ventilatory drive in response to hypoxia and/ or hyperapnea that was not considered due to weakness of the intrinsic muscles of respiration. Sleep pathology may be an underreported complication of primary mitochondrial diseases. The probable underlying mechanism is cellular energy failure causing both central neurological and peripheral neuromuscular degenerative changes that commonly present as central sleep apnea and poor ventilatory response to hyperapnea. Increased recognition of the genetics and clinical manifestations of mitochondrial diseases by sleep researchers and clinicians is important in the evaluation and treatment of all patients with sleep disturbances. Prospective population-based studies are required to determine the true prevalence of mitochondrial energy failure in subjects with sleep disorders, and conversely, of individuals with primary mitochondrial diseases and sleep pathology. © 2014 American Academy of Sleep Medicine.

Classification of primary lung tumors in dogs: 210 cases (1975-1985)

International Nuclear Information System (INIS)

Ogilvie, G.K.; Haschek, W.M.; Withrow, S.J.; Richardson, R.C.; Harvey, H.J.; Henderson, R.A.; Fowler, J.D.; Norris, A.M.; Tomlinson, J.; McCaw, D.

1989-01-01

Two hundred ten dogs that had primary lung tumors diagnosed between 1975 and 1985 were evaluated. The majority of the tumors were classified as adenocarcinoma (74.8%) and alveolar carcinoma (20%). The most common clinical signs of disease were cough (52%), dyspnea (23.8%), lethargy (18.1%), weight loss (12.4%), and tachypnea (4.8%). The clinical methods that were most successful in directly or indirectly leading to a diagnosis of primary lung tumor were thoracic radiography (77.1%) and cytologic examination of fine-needle aspirate specimens (24.8%)

Primary intraocular chondrosarcoma in a dog

Directory of Open Access Journals (Sweden)

E. Perlmann

2013-12-01

Full Text Available A five-year-old male Cocker Spaniel was presented for evaluation of the right eye due to discomfort, abundant purulent discharge and progressive enlargement of the eyeball. The owner revealed that the right eye has appeared to be inflamed and smaller then the left eye for years. Ophthalmic examination revealed corneal perforation, buphthalmia and conjuctival hyperemia. Enucleating was performed due to signs of endophthalmitis and ocular discomfort. Histopathology revealed a multilobulated proliferation of chondrocytes producing hyaline cartilage with occasional pleomorphism and binucleate cells. A diagnosis of primary intraocular chondrosarcoma was done.

Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

Science.gov (United States)

Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

2018-02-22

Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

Primary contraction of skin grafts: a porcine preliminary study

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Alexander Bogdanov Berezovsky

2015-03-01

Full Text Available Aim: Skin grafting is a common clinical practice for plastic surgeons, yet primary contraction of these grafts is a neglected topic. This study was designed to investigate primary contraction and introduce the shape of skin graft as a possible factor that modifies primary contraction behavior, using porcine models. Methods: In the first series, full-thickness skin grafts (FTSGs and split-thickness skin grafts (STSGs were compared. In a second series, how the shape of the skin graft affected the degree of contraction was examined. Results: The mean percentage of FTSG shrinkage was 12.04%, and the median was 12.18%. The mean percentage of STSG shrinkage was 6.87%, and the median was 5%. Circle-shaped and square-shaped FTSGs showed mean/median graft shrinkage of 5.83%/6.93% and 4.15%/3.75%, respectively. In STSGs, the circle-shaped and square-shaped grafts had mean/median graft shrinkage of 1.07%/0% and 0.31%/0%, respectively. Conclusion: Our preliminary report revealed an expected greater shrinkage of FTSGs compared with STSGs. Furthermore, in a limited number of specimens, the shape of the skin graft seemed to affect the primary contraction of the STSGs.

Input, Process, and Learning in primary and lower secondary schools

DEFF Research Database (Denmark)

Larsen, Michael Søgaard; Nordenbo, Sven Erik; Holm, Anders

What do we want to know? What empirical research has been carried out to examine the relationship between factors in primary and lower secondary schools (inputs and processes) and the learning achieved by primary and lower secondary school pupils (outputs and outcomes)? What are the results...... with weight of evidence of this empirical research? Who wants to know and why? The project was commissioned by the Danish Evaluation Institute (Danmarks Evalueringsinstitut) and was performed on behalf of the Nordic Indicator Workgroup (DNI). DNI is a workgroup nominated by the Nordic Evaluation Network...... and development etc. within the primary and lower secondary school sector. What did we find? From 1990 to 2008, 109 studies were published on malleable school factors within school effectiveness research. Of these studies, 71 are of high or medium weight of evidence. Synthesising these studies establishes that 11...

Approach to Peripheral Neuropathy for the Primary Care Clinician.

Science.gov (United States)

Doughty, Christopher T; Seyedsadjadi, Reza

2018-02-02

Peripheral neuropathy is commonly encountered in the primary care setting and is associated with significant morbidity, including neuropathic pain, falls, and disability. The clinical presentation of neuropathy is diverse, with possible symptoms including weakness, sensory abnormalities, and autonomic dysfunction. Accordingly, the primary care clinician must be comfortable using the neurologic examination-including the assessment of motor function, multiple sensory modalities, and deep tendon reflexes-to recognize and characterize neuropathy. Although the causes of peripheral neuropathy are numerous and diverse, careful review of the medical and family history coupled with limited, select laboratory testing can often efficiently lead to an etiologic diagnosis. This review offers an approach for evaluating suspected neuropathy in the primary care setting. It will describe the most common causes, suggest an evidence-based workup to aid in diagnosis, and highlight recent evidence that allows for selection of symptomatic treatment of patients with neuropathy. Copyright © 2018 Elsevier Inc. All rights reserved.

An Effect of the Co-Operative Network Model for Students' Quality in Thai Primary Schools

Science.gov (United States)

Khanthaphum, Udomsin; Tesaputa, Kowat; Weangsamoot, Visoot

2016-01-01

This research aimed: 1) to study the current and desirable states of the co-operative network in developing the learners' quality in Thai primary schools, 2) to develop a model of the co-operative network in developing the learners' quality, and 3) to examine the results of implementation of the co-operative network model in the primary school.…

Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

Science.gov (United States)

Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

2012-01-01

This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

Tasks performed by primary caregivers and migrant live-in homecare workers in Israel

Directory of Open Access Journals (Sweden)

Esther Iecovich

2011-01-01

Full Text Available The issue of migrant live-in homecare workers has been barely addressed in the gerontological literature, in spite of the increase of older persons being cared for by such persons in many Western countries. The purposes of the study are to examine the extent to which migrant live-in homecare workers substitute family caregivers or complement the care that is provided by primary caregivers, and to examine if there are differences in primary caregivers’ involvement in providing help with activities of daily living (ADL and instrumental activities of daily living (IADL before and after hiring a migrant live-in homecare worker, by caregivers’ employment status and gender. The data were drawn from a study that included 335 triads (care recipients, their primary caregivers, and their Filipina live-in homecare workers. The findings show that for the most part primary caregivers continue to play a significant role in providing care, in particular with regard to IADL tasks, even when there is a migrant live-in homecare worker. Several patterns of division of labor between the formal and informal caregivers were identified; that is, in some cases they complement each other while in other cases the migrant live-in homecare workers substitute for the care previously provided by the primary caregivers. Significant differences between male and female caregivers and between working and nonworking caregivers were found with regard to involvement in providing care before and after employment of a migrant homecare worker.

Primary dentition status and treatment needs of children with cleft lip and/or palate

Directory of Open Access Journals (Sweden)

Ankola Anil

2005-06-01

Full Text Available The aim of this study was to assess the primary dentition status and treatment needs in children with cleft lip, cleft palate and or both. A descriptive, cross-sectional study was done through oral examination on a sample of 83, 2-5 years old cleft lip/palate children (46 boys and 37 girls. A self-designed questionnaire to obtain pertinent data related to level of education of parents and infant-feeding practices was used for recording the data while examining the children. Majority of cleft affected children had dental caries experience and required different types of treatment. The result of this study shows that: (1 all age groups of cleft affected children had dental caries experience, (2 children with primary type of cleft had less dental caries prevalence than children with cleft of secondary or combination type ( P < 0.05, (3 treatment needs due to caries were more in combination type of cleft compared to primary and secondary.

Primary and secondary exercise dependence in a community-based sample of road race runners.

Science.gov (United States)

Cook, Brian; Karr, Trisha M; Zunker, Christie; Mitchell, James E; Thompson, Ron; Sherman, Roberta; Crosby, Ross D; Cao, Li; Erickson, Ann; Wonderlich, Stephen A

2013-10-01

The purpose of our study was to examine exercise dependence (EXD) in a large community-based sample of runners. The secondary purpose of this study was to examine differences in EXD symptoms between primary and secondary EXD. Our sample included 2660 runners recruited from a local road race (M age = 38.78 years, SD = 10.80; 66.39% women; 91.62% Caucasian) who completed all study measures online within 3 weeks of the race. In this study, EXD prevalence was lower than most previously reported rates (gamma = .248, p < .001) and individuals in the at-risk for EXD category participated in longer distance races, F(8,1) = 14.13, p = .01, partial eta squared = .05. Group differences were found for gender, F(1,1921) 8.08, p = .01, partial eta squared = .004, and primary or secondary group status, F(1,1921) 159.53, p = .01, partial eta squared = .077. Implications of primary and secondary EXD differences and future research are discussed.

Local melanoma recurrences in the scar after limited surgery for primary tumor

DEFF Research Database (Denmark)

Drzewiecki, K T; Andersson, A P

1995-01-01

The clinical and histologic records of 46 consecutive patients were reviewed who during the period 1980-1993 had recurrence from melanoma in the scar after limited surgery for a skin tumor. They constituted about 50% of all patients admitted with local recurrence from melanoma during this period....... At reexamination of the primary tumors, 16 were found to be malignant melanomas and 9 were nevi (four atypical and five benign). Twenty-one were missing, 11 of which had never been set for histologic examination. The median thickness of nine measurable melanomas was 0.66 mm. The recurrences in scar consisted of 34...... recurrences in the form of a new primary in a scar following limited surgery supports the theory of limited field change around a primary melanoma. Furthermore, limited procedures for primary melanoma, if followed by a recurrence in the scar, worsen the prognosis....

Ideological Disqualification in Language Use: Being Newcomers in Primary Education

Science.gov (United States)

Gu, Mingyue Michelle; Qu, Xiaoyuan Doris

2015-01-01

This article explores the ideological complex in a Hong Kong primary school where a large number of immigrant mainland Chinese students study by examining the interview data from teachers and immigrant students. Drawing on the notions of monoglot ideology and misrecognition, this study indicates that disqualifications of some linguistic resources…

Whiteness and National Identity: Teacher Discourses in Australian Primary Schools

Science.gov (United States)

Walton, Jessica; Priest, Naomi; Kowal, Emma; White, Fiona; Fox, Brandi; Paradies, Yin

2018-01-01

The study examines how white teachers talked to children about national identity and cultural diversity by drawing on qualitative research with eight- to 12-year-old students and their teachers from four Australian primary schools with different racial, ethnic and cultural demographics. Despite a range of explicit and implicit approaches that…

ICT and quality of teaching–learning related activities in primary ...

African Journals Online (AJOL)

The paper is a report of a study carried out to examine how information and communication technology (ICT) enhance teaching learning related activities in primary schools in Ogoja education zone of Cross River State, Nigeria. To achieve the purpose of the study, one research question was formulated to direct the study.

More than Numbers: Teaching ELLs Mathematical Language in Primary Grades

Science.gov (United States)

Sistla, Michelle; Feng, Jay

2014-01-01

Teaching English Language Learners (ELL) academics while they are acquiring English language skills is a challenge for teachers. This action research examines the use of Response To Intervention (RTI) in teaching ELLs mathematical language and its effect on students' math achievement in primary grades. It shows that when mathematical language…

Developing and Implementing a Mobile Conservation Education Unit for Rural Primary School Children in Lao PDR

Science.gov (United States)

Hansel, Troy; Phimmavong, Somvang; Phengsopha, Kaisone; Phompila, Chitana; Homduangpachan, Khiaosaphan

2010-01-01

In this article, the authors examine the implementation and success of a mobile conservation education unit targeting primary schools in central Lao PDR (People's Democratic Republic). The mobile unit conducted 3-hour interactive programs for school children focused on the importance of wildlife and biodiversity around the primary schools in rural…

Effects of Support on the Attitude of the Primary Caregiver of a Child with Down Syndrome.

Science.gov (United States)

Heritage, Jeannette G.; And Others

Parents of children with mental or physical handicaps often experience overwhelming feelings of stress and anxiety. Research indicates that support for the primary caregiver can help alleviate some stressors involved in raising a child with a handicap. This study examined how level of support affects feelings of satisfaction the primary caregiver…

The Effect of Primary School Mergers on Academic Performance of Students in Rural China

Science.gov (United States)

Liu, Chengfang; Zhang, Linxiu; Luo, Renfu; Rozelle, Scott; Loyalka, Prashant

2010-01-01

We examine the impact of primary school mergers on academic performance of students using a dataset that we collected using a survey designed specifically to examine changes in the academic performance of students before and after their schools were merged. We use difference-in-differences and propensity score matching approaches and demonstrate…

Analysis of image findings in forty-one patients with primary lymphoma of the bone

International Nuclear Information System (INIS)

Yu Baohai; Liu Jie; Zhong Zhiwei; Zhao Jingpin; Peng Zhigang; Liu Jicun; Wu Wenjuan

2011-01-01

Objective: To analyze the imaging features of primary lymphoma of the bone, and discuss the special feature of the 'floating ice sign'. Methods: Forty-one cases of primary lymphoma of the bone in our unit from 1963.1-2009.6 were retrospectively studied. All 41 patients underwent X-ray examination, and 20 patients underwent CT examination, 12 patients underwent MR examination (3 cases simultaneously with enhancement). Results: Involvement of the flat bone was seen in 12 cases. Vertebral column was affected in 8 cases, and 17 cases showed lesions in long bones and irregular bones were involved in 4 cases. The most common location was the femur (10, 24.4%), followed by the ilium (8, 19.5%). Lesions were found in the metaphyses of the long bone in 11 cases (64.7%). 'Floating ice sign' was showed in the calcaneus of 2 patients and in the lumbar vertebra of 2 cases respectively, accounted for 9.8% of all cases. Slight bone destruction with soft tissue mass on CT image could be found in 12 cases, while obvious soft tissue mass was found in 9 cases. No periosteal reaction was found in 37 cases (90.2%). MRI examinations of 12 patients revealed soft tissue mass in 10 patients, and the extent of the lesion was larger in MR than CT. One case showed extensive bone destruction on MR but inconspicuous bone destruction on X-ray plain film and CT scan. Conclusion: Slight bone destruction with conspicuous soft tissue mass, conspicuous bone destruction on MR but slight or inconspicuous bone destruction on X-ray film and CT, could strongly imply the diagnosis of primary lymphoma of the bone. 'Floating ice sign' was a special imaging feature of primary lymphoma of the bone, which could be used as a clue for the diagnosis of lymphoma. (authors)

CT findings at the primary site of oropharyngeal squamous cell carcinoma within 6-8 weeks after definitive radiotherapy as predictors of primary site control

International Nuclear Information System (INIS)

Ojiri, Hiroya; Mendenhall, William M.; Mancuso, Anthony A.

2002-01-01

Purpose: To determine whether findings on CT studies, done 6 weeks after radiotherapy (RT), can predict the likelihood of ultimate control at the primary site in oropharyngeal carcinoma. Methods and Materials: Forty-six patients with oropharyngeal squamous cell carcinoma underwent RT with curative intent. A minimal 2-year clinical follow-up after RT was required. The primary site CT findings were graded for risk of recurrence on a modified 3-point scale as follows: Grade 0, no detectable focal abnormalities; Grade 1, anatomic asymmetry or focal mass 10 mm (2a) or 10 mm at the primary site, the likelihood of local control is high (93%). The study results indicate that CT findings, based on this relatively small series, may not add incremental information beyond that of clinical examination for predicting local control but may be useful as a baseline if imaging surveillance is contemplated

Obese Chinese Primary-School Students and Low Self-Esteem: A Cross-Sectional Study

OpenAIRE

Xue-Yan, Zhang; Dong-Mei, Li; Dan-Dan, Xu; Le-Shan, Zhou

2016-01-01

Objectives The aim of this study was to examine several factors related to low self-esteem among obese Chinese primary-school students. Methods A cross-sectional study was conducted between June 2009 and June 2010. A total of 1,410 primary-school students (China grades 4 - 6) in Changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (WHO) g...

Primary Malignant Melanoma of the Lung: A Case Report

Directory of Open Access Journals (Sweden)

Karagianni Evangelia

2003-11-01

Full Text Available Abstract Background Primary melanoma of the lung is an extremely rare pathological entity and sparsely reported in the literature. Case presentation A case of primary malignant melanoma of the lung in a 41-year-old female is reported. The clinical, radiological and histopathological features are discussed. The initial symptom was cough, whereas the chest radiography showed a round opacity of the right lung. The computed tomography of the chest revealed a well-demarcated mass lesion in the right upper lobe. Endobronchial mass causing obstruction of the upper lobar bronchus was the bronchoscopic finding. Patient underwent pneumonectomy. A diagnosis of melanoma was confirmed postoperatively after the immunohistochemistry. Primary nature of the tumour in the lung results from the demonstration of characteristic junctional pattern of melanoma cells beneath the bronchial epithelium on histopathology, and from exclusion of other potential primary sites in the clinical, paraclinical and laboratory examination. Conclusions Primary melanoma of the lung represents a rare pathological entity. Careful interpretation of histopathological information in correlation with all other findings from clinical and paraclinical studies can establish a diagnosis. Follow-up is necessary in order to diagnose potential dissemination or secondary sites of the disease. Due to the small number of cases reported in the literature, there is no experience on the management and the prognosis of the disease, but surgical resection remains the cornerstone of the treatment.

Prevalence of hearing loss among primary school children in Mbarara, Uganda.

Science.gov (United States)

Basañez, Irving; Nakku, Doreen; Stangl, Susan; Wanna, George B

2015-12-01

Hearing loss in children is a common entity worldwide. We examined the prevalence and etiology of hearing loss among primary school children in Mbarara, Uganda. Cross-sectional study in primary school children aged 5-14 was performed to determine the prevalence of hearing loss. Ugandan primary school children were screened for disabling hearing loss (threshold >30dB) and confirmatory audiometry was performed on those who failed the screening. There were 639 children screened. Thirty-five (5.5%) of children screened failed and were referred for further testing. Two children were lost to follow-up. The percentage of children with true hearing loss was 3.1%. The incidence of failed hearing screening and hearing loss in Mbarara, Uganda is similar to other populations. Hearing loss is a significant problem in Uganda and efforts should be made for primary, secondary, and tertiary prevention of hearing loss. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Strategies for Primary Care Stakeholders to Improve Electronic Health Records (EHRs).

Science.gov (United States)

Olayiwola, J Nwando; Rubin, Ashley; Slomoff, Theo; Woldeyesus, Tem; Willard-Grace, Rachel

2016-01-01

The use of electronic health records (EHRs) and the vendors that develop them have increased exponentially in recent years. While there continues to emerge literature on the challenges EHRs have created related to primary care provider satisfaction and workflow, there is sparse literature on the perspective of the EHR vendors themselves. We examined the role of EHR vendors in optimizing primary care practice through a qualitative study of vendor leadership and developers representing 8 companies. We found that EHR vendors apply a range of strategies to elicit feedback from their clinical users and to engage selected users in their development and design process, but priorities are heavily influenced by the macroenvironment and government regulations. To improve the "marriage" between primary care and the EHR vendor community, we propose 6 strategies that may be most impactful for primary care stakeholders seeking to influence EHR development processes. © Copyright 2016 by the American Board of Family Medicine.

Women’s Political Empowerment and Investments in Primary Schooling in India

Science.gov (United States)

Yount, Kathryn M.; Cunningham, Solveig A.; Pande, Rohini P.

2015-01-01

Using a national district-level dataset of India composed of information on investments in primary schooling (data from the District Information Survey for Education [DISE, 2007/8]) and information on demographic characteristics of elected officials (data from the Election Commission of India [ECI, 2000/04]), we examined the relationship between women’s representation in State Legislative Assembly (SLA) seats and district-level investments in primary schooling. We used OLS regressions adjusting for confounders and spatial autocorrelation, and estimated separate models for North and South India. Women’s representation in general SLA seats typically was negatively associated with investments in primary-school amenities and teachers; women’s representation in SLA seats reserved for under-represented minorities, i.e., scheduled castes and scheduled tribes, typically was positively associated with investments in primary schooling, especially in areas addressing the basic needs of poor children. Women legislators’ gender and caste identities may shape their decisions about redistributive educational policies. PMID:26924878

Amenorrhea - primary

Science.gov (United States)

... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

Readers and Texts in the Primary Years. Rethinking Reading.

Science.gov (United States)

Martin, Tony; Leather, Bob

Exploring the responses of a variety of readers from three-year-old Dominic sharing a picture book with his father to adults reading a poem by Ted Hughes, this book examines the ways in which various readers respond to different texts. The aim of the book is to develop an awareness of the issues involved in readers' responses for primary teachers.…

Academisation, School Collaboration and the Primary School Sector in England: A Story of Six School Leaders

Science.gov (United States)

Keddie, Amanda

2016-01-01

This paper presents data from a study of five English primary schools. It examines some of the challenges associated with school autonomy and collaboration for state primary schools amid the uncertainty and complexity of governance in the present English education context. The paper features the voices of six leaders gathered from interviews that…

The Dinosaur in the Classroom: What We Stand to Lose through Ability-Grouping in the Primary School

Science.gov (United States)

Marks, Rachel

2014-01-01

Embedding setting (subject-based ability-grouping) into the primary school environment creates structural conflict--physically and culturally--fundamentally changing the nature of primary schools through the imposition of secondary practices and cultures and the loss of pastoral care. This article examines the hidden implications for teachers and…

Determination of fracture toughness of human permanent and primary enamel using an indentation microfracture method.

Science.gov (United States)

Hayashi-Sakai, Sachiko; Sakai, Jun; Sakamoto, Makoto; Endo, Hideaki

2012-09-01

The purpose of the present study was to examine the fracture toughness and Vickers microhardness number of permanent and primary human enamel using the indentation microfracture method. Crack resistance and a parameter indirectly related to fracture toughness were measured in 48 enamel specimens from 16 permanent teeth and 12 enamel specimens obtained from six primary teeth. The Vickers microhardness number of the middle portion was greater than the upper portion in primary enamel. The fracture toughness was highest in the middle portion of permanent enamel, because fracture toughness greatly depends upon microstructure. These findings suggest that primary teeth are not miniature permanent teeth but have specific and characteristic mechanical properties.

Primary EFL Teachers' Technology Use in China: Patterns and Perceptions

Science.gov (United States)

Li, Guofang; Ni, Xiaopeng

2011-01-01

Drawing on survey data, this paper examines the patterns and perceptions of technology use by primary EFL teachers in China. Findings suggest that although Chinese EFL teachers hold positive attitudes toward the value of technology for teaching and learning, they use technology mainly for teacher-centered purposes, such as teaching preparation and…

A restrospective study of the nutritional status of primary school ...

African Journals Online (AJOL)

A retrospective study was conducted in Harare using data collected and compiled by the Harare City Council Nutrition Unit. Trends of nutritional status of primary school children in high density areas of Harare were examined in relation to stunting and wasting. All anthropometric data generated from 2003 to 2011 by the ...

Primary explosives

Energy Technology Data Exchange (ETDEWEB)

Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

2013-06-01

The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

Unerupted Primary Molar Teeth Positioned Inferior to the Permanent Premolar: A Case Report

Directory of Open Access Journals (Sweden)

A. Bagheri

2012-01-01

Full Text Available Primary tooth impaction is a rare finding during the development of primary dentition. Several factors contribute to the impaction of a deciduous tooth. This report describes the diagnosis and treatment of a 10-year-old boy who presented an impacted second primary mandibular molar. This tooth, located inferior to the second premolar together with an odontoma, was positioned superior to the premolar teeth. Treatment consisted of surgical removal of the impacted deciduoustooth and odontoma and placement of a passive lower lingual holdingarch. Periodic examination was indicated for follow- up. Early intervention was recommended to manage orofacial disfigurement and to avoid consequent problems.

Home health services in primary care: What can we do?

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Yasemin Çayır

2013-01-01

Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient

Inhibition of the primary motor cortex and the upgoing thumb sign

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Antonia Nucera

2017-09-01

Full Text Available Background: The upgoing thumb sign has been frequently observed in patients with minor strokes and transient ischemic attacks as an indicator of brain involvement. We assessed the effect of primary motor cortex (M1 inhibition in the development of the upgoing thumb sign. Methods: Used repetitive Transcranial Magnetic Stimulation (rTMS, 1Hz frequency for 15min, 1s ISI, 900 pulses at 60% of resting motor threshold to inhibit the right or left primary motor cortex of 10 healthy individuals. Participants were examined before and after rTMS by a neurologist who was blind to the site of motor cortex inhibition. Results: 10 neurological intact participants (5 women/5 men were recruited for this study. 2 cases were excluded due to pre-existing possible thumb signs. After the inhibition of the primary motor cortex, in 6 subjects out of 8, we observed a thumb sign contralateral to the site of primary motor cortex inhibition. In one subject an ipsilateral thumbs sign was noted. In another case, we did not find an upgoing thumb sign. Conclusion: The upgoing thumb sign is a subtle neurological finding that may be related to the primary motor cortex or corticospinal pathways involvements. Keywords: Corticospinal tract, Upper motor neuron lesions, Primary motor cortex, Transcranial magnetic stimulation

Practice Guidelines for Primary Care of Acute Abdomen 2015.

Science.gov (United States)

Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

2016-01-01

Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine, in collaboration with four other medical societies, launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines (all clinical questions and recommendations were shown in supplementary information). A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on nine subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

A CASE OF PRIMARY UTERINE LYMPHOMA

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Parikshit Sanyal

2013-06-01

Full Text Available A post menopausal lady presented with lump lower abdomen and bleeding per vaginum. USG revealed diffuse enlargement of the uterus. On hysterectomy, a grossly enlarged uterus with cystic left ovary were found. Hysterectomy was done and uterus with bilateral adnexa submitted for histopathological examination. Microscopic examination of the body of uterus revealed sheets of small lymphoid cells were found to replace the endo- and myo-metrium. These cells have small nuclei with clumped chromatin, and no prominence of nucleoli. They are not forming lymphoid follicles or germinal centers. Similar lymphoid cells were also found in the left ovary admixed with ovarian stroma. On IHC these cells were found to be CD45, CD20, CD23 positive, and negative for CD3 , CK and SMA. The case is diagnosed as a primary small lymphocytic lymphoma of uterus with left ovarian spread.

Perfusion lung scintigraphy in primary broncho-pulmonary cancer

International Nuclear Information System (INIS)

Lapergue, Paul.

1976-01-01

Research on primary broncho-pulmonary cancer has called extensively on scintigraphy and it seemed interesting to weigh up the pros and cons of the technique in this particular case. Our intention is to sum up objectively from recent documents the applications of scintigraphy in the study of primary broncho-pulmonary cancers and to attempt, on the basis of the results compiled, to show what benefits have been gained from this technique and to find out whether it has any pre-surgical value and of what kind. The technique was invariable; the tracer consists of human albumin macro-aggregates labelled with technetium 99m which by its short half-life and slight penetration enables four exposures to be taken during the same examination (front, back, right and left profiles), thus reducing the risks of mistaken diagnoses due to the use of a single incidence. Similarly the detection method was always the scintillation camera which explores the whole organ at once, considerably shortening the examination time. Lung scintigraphy by perfusion of labelled human albumin macro-aggregates offers the great advantage of being simple to use and harmless. It is easy to understand the important place it has taken in the range of methods available for lung circulation exploration [fr

Multiple primary cancer

International Nuclear Information System (INIS)

Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

1989-01-01

It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

Factors Influencing Belize District Primary School Teachers' Attitudes toward Inclusive Education

Science.gov (United States)

McKay, Maxine

2012-01-01

Inclusive education continues to be a reoccurring challenge as various factors affect to what extent teachers or educators are willing to educate children with disabilities in the regular education setting alongside their non-disabled peers. This quantitative study examined factors influencing Belize District Primary School teachers' attitudes…

Adherence of Primary Care Physicians to Evidence-Based Recommendations to Reduce Ovarian Cancer Mortality

OpenAIRE

Stewart, Sherri L.; Townsend, Julie S.; Puckett, Mary C.; Rim, Sun Hee

2016-01-01

Ovarian cancer is the deadliest gynecologic cancer. Receipt of treatment from a gynecologic oncologist is an evidence-based recommendation to reduce mortality from the disease. We examined knowledge and application of this evidence-based recommendation in primary care physicians as part of CDC gynecologic cancer awareness campaign efforts and discussed results in the context of CDC National Comprehensive Cancer Control Program (NCCCP). We analyzed primary care physician responses to questions...

The analysis of clinical effect of phacoemulsification on primary angle-closure glaucoma with cataract

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Ling Zhao

2013-07-01

Full Text Available AIM:To evaluate the clinical outcomes and affected factors of prognosis of cataract extraction by phacoemulsification with intraocular lens implantation in eyes with primary angle-closure glaucoma(PACGand co-existing cataract.METHODS: Totally 60 cases(70 eyesof PACG with cataract, including 43 eyes with acute primary angle-closure glaucoma(APACG, 27 eyes of chronic primary angle-closure glaucoma(CPACG. The main outcome measures included: visual acuity, intraocular pressure, gonioscopy, depth of anterior chamber(ACD. Patients were examined 6 months after surgery.RESULTS: After phacoemulsification, visual acuity was improved(PPPPCONCLUSION:Phacoemulsification is more effective for acute APACG than for CPACG.

Understanding Basic Temporal Relations in Primary School Pupils with Hearing Impairments.

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Dulcić, Adinda; Bakota, Koraljka; Saler, Zrinka

2015-09-01

Time can be observed as a subjective, as well as an objective phenomenon which is a component of our life, and due to its communicational needs, it is standardized by temporal signs and symbols. The aim of this study was to determine the understanding of basic temporal relations of pupils with hearing impairments. We assumed that the knowledge of basic time relations is a precondition for the acquisition of knowledge that is connected with the understanding of the syllabus in regular school programs. Three groups of pupils have been examined: pupils with hearing impairments who attend the primary school of SUVAG Polyclinic under special condition, integrated hearing impaired pupils with minor additional difficulties who attend regular primary schools in Zagreb with a prolonged expert procedure and pupils of the control group. The subjects have been examined with a measuring instrument constructed by the expert team of the Polyclinic Suvag. Twenty nine subjects have been questioned, chronologically aged between 10 and 12.

New insights into systemic amyloidosis: primary amyloidosis associated with tubercular lymphadenitis

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Shivraj Meena, Nirmal Ghati, Rita Sood, Naval Kishore Vikram

2014-11-01

Full Text Available Tuberculosis is generally followed by secondary amyloidosis. The association of primary systemic amyloidosis with tuberculosis is very rare. There is only one case thus far reported in literature. We report such a rare case of primary amyloidosis with tuberculous lymphadenopathy. A 45 year old woman presented at the medicine department of all India institute of medical sciences , New Delhi with on & off erythematous rashes over both eyes for 1 year; low grade fever, fatigue and significant weight loss for 4 months, dysphagia for solid food since 1 month. Main finding on examination were pallor, macroglossia, bilateral periorbital erythematous rashes (racoon eyes, hepatomegaly & cardiomegaly. She had raised serum alkaline phosphatase level. Chest x-ray revealed cardiomegaly. USG abdomen revealed multiple retroperitoneal mesenteric lymph nodes and hepatomegaly. USG guided FNAC from mesenteric lymph node showed acid fast bacillus. Histological examination of liver biopsy showed amyloid deposition on congo red stain. Patient was treated with DOTS category I ATT with Bortezomib and Dexamethasone based weekly chemotherapy.

Physician's self-perceived abilities at primary care settings in Indonesia.

Science.gov (United States)

Istiono, Wahyudi; Claramita, Mora; Ekawati, Fitriana Murriya; Gayatri, Aghnaa; Sutomo, Adi Heru; Kusnanto, Hari; Graber, Mark Alan

2015-01-01

Southeast Asian countries with better-skilled primary care physicians have been shown to have better health outcomes. However, in Indonesia, there has been a large number of inappropriate referrals, leading to suboptimal health outcomes. This study aimed to examine the reasons underlying the unnecessary referrals as related to Indonesian physicians' standard of abilities. This was a multiple-case study that explored physicians' self-evaluation of their abilities. Self-evaluation questionnaires were constructed from the Indonesian Standards of Physicians Competences of 2006-2012 (ISPC), which is a list of 155 diseases. This study was undertaken in three cities, three towns, and one "border-less developed" area during 2011-2014. The study involved 184 physicians in those seven districts. Data were collected using one-on-one, in-depth interviews, focus group discussions (FGDs), and clinical observations. This study found that primary care physicians in Indonesia felt that they were competent to handle less than one-third of "typical" primary care cases. The reasons were limited understanding of person-centered care principles and limited patient care services to diagnosis and treatment of common biomedical problems. Additionally, physical facilities in primary care settings are lacking. Strengthening primary health care in Indonesia requires upscaling doctors' abilities in managing health problems through more structured graduate education in family medicine, which emphasizes the bio-psycho-socio-cultural background of persons; secondly, standardizing primary care facilities to support physicians' performance is critical. Finally, a strong national health policy that recognizes the essential role of primary care physicians in health outcomes is an urgent need.

Patients‟ perceptions of primary health care services in the Eastern ...

African Journals Online (AJOL)

Seeking to understand patient perspectives is an important step in the efforts to improve the quality of health care. The purpose of this study was to examine patient satisfaction with primary health care (PHC) services. A purposive sample of 19136 patients aged 18 years and above was interviewed at 266 PHC clinics in ...

Integration of nondestructive examination reliability and fracture mechanics

International Nuclear Information System (INIS)

Doctor, S.R.; Bates, D.J.; Charlot, L.A.

1985-01-01

The primary pressure boundaries (pressure vessels and piping) of nuclear power plants are in-service inspected (ISI) according to the rules of ASME Boiler and Pressure Vessel Code, Section XI. Ultrasonic techniques are normally used for these inspections, which are periodically performed on a sampling of welds. The Integration of Nondestructive Examination (NDE) Reliability and Fracture Mechanics (FM) Program at Pacific Northwest Laboratory was established to determine the reliability of current ISI techniques and to develop recommendations that will ensure a suitably high inspection reliability. The objectives of this NRC program are to: 1) determine the reliability of ultrasonic ISI performed on commercial light-water reactor primary systems; 2) using probabilistic FM analysis, determine the impact of NDE unreliability on system safety and determine the level of inspection reliability required to ensure a suitably low failure probability; 3) evaluate the degree of reliability improvement that could be achieved using improved and advanced NDE techniques; and 4) based on material properties, service conditions, and NDE uncertainties, formulate recommended revisions to ASME Code, Section XI, and Regulatory Requirements needed to ensure suitably low failure probabilities

Aspirin overutilization for the primary prevention of cardiovascular disease

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VanWormer JJ

2014-12-01

Full Text Available Jeffrey J VanWormer,1 Aaron W Miller,2 Shereif H Rezkalla3 1Center for Clinical Epidemiology and Population Health, 2Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, WI, USA; 3Department of Cardiology, Marshfield Clinic, Marshfield, WI, USA Background: Aspirin is commonly used for the primary prevention of cardiovascular disease (CVD in the US. Previous research has observed significant levels of inappropriate aspirin use for primary CVD prevention in some European populations, but the degree to which aspirin is overutilized in the US remains unknown. This study examined the association between regular aspirin use and demographic/clinical factors in a population-based sample of adults without a clinical indication for aspirin for primary prevention.Methods: A cross-sectional analysis was performed using 2010–2012 data from individuals aged 30–79 years in the Marshfield Epidemiologic Study Area (WI, USA. Regular aspirin users included those who took aspirin at least every other day.Results: There were 16,922 individuals who were not clinically indicated for aspirin therapy for primary CVD prevention. Of these, 19% were regular aspirin users. In the final adjusted model, participants who were older, male, lived in northern Wisconsin, had more frequent medical visits, and had greater body mass index had significantly higher odds of regular aspirin use (P<0.001 for all. Race/ethnicity, health insurance, smoking, blood pressure, and lipid levels had negligible influence on aspirin use. A sensitivity analysis found a significant interaction between age and number of medical visits, indicating progressively more aspirin use in older age groups who visited their provider frequently.Conclusion: There was evidence of aspirin overutilization in this US population without CVD. Older age and more frequent provider visits were the strongest predictors of inappropriate aspirin use. Obesity was the only significant

Oral rehabilitation of primary dentition affected by amelogenesis imperfecta: a case report.

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de Souza-e-Silva, Cíntia Maria; Parisotto, Thaís Manzano; Steiner-Oliveira, Carolina; Gavião, Maria Beatriz Duarte; Nobre-Dos-Santos, Marinês

2010-05-01

The purpose of the case report was to describe the treatment of a 4(1/2)-year-old boy with amelogenesis imperfect (AI) in the primary dentition. AI is a hereditary condition that affects the development of enamel, causing quantity, structural, and compositional anomalies involving all dentitions. Consequently, the effects can extend to both the primary and secondary dentitions. A 4(1/2)-year-old boy was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of amelogenesis imperfecta. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms of both maxillary and mandibular primary incisors and canines. Improvements in the patient's psychological behavior and the elimination of tooth sensitiveness were observed, and the reestablishment of a normal occlusion resulted in improved eating habits. The child was monitored in the Pediatric Dentistry Clinic at four-month intervals until the mixed dentition stage. The oral rehabilitation of young children with AI is necessary to reestablish the stomatognathic system function, so important for a child's systemic health. An adequate medical history and a careful clinical examination were essential for a correct diagnosis. Treatment was rendered that was appropriate for the child's age and clinical/psychological characteristics. Cost-effective restorative techniques involving stainless steel and composite-resin crowns are shown for the restoration of a young patient with amelogensis imperfecta.

Validity and reliability of methods for the detection of secondary caries around amalgam restorations in primary teeth

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Mariana Minatel Braga

2010-03-01

Full Text Available Secondary caries has been reported as the main reason for restoration replacement. The aim of this in vitro study was to evaluate the performance of different methods - visual inspection, laser fluorescence (DIAGNOdent, radiography and tactile examination - for secondary caries detection in primary molars restored with amalgam. Fifty-four primary molars were photographed and 73 suspect sites adjacent to amalgam restorations were selected. Two examiners evaluated independently these sites using all methods. Agreement between examiners was assessed by the Kappa test. To validate the methods, a caries-detector dye was used after restoration removal. The best cut-off points for the sample were found by a Receiver Operator Characteristic (ROC analysis, and the area under the ROC curve (Az, and the sensitivity, specificity and accuracy of the methods were calculated for enamel (D2 and dentine (D3 thresholds. These parameters were found for each method and then compared by the McNemar test. The tactile examination and visual inspection presented the highest inter-examiner agreement for the D2 and D3 thresholds, respectively. The visual inspection also showed better performance than the other methods for both thresholds (Az = 0.861 and Az = 0.841, respectively. In conclusion, the visual inspection presented the best performance for detecting enamel and dentin secondary caries in primary teeth restored with amalgam.

Using alternative segmentation techniques to examine residential customer`s energy needs, wants, and preferences

Energy Technology Data Exchange (ETDEWEB)

Hollander, C.; Kidwell, S. [Union Electric Co., St. Louis, MO (United States); Banks, J.; Taylor, E. [Cambridge Reports/Research International, MA (United States)

1994-11-01

The primary objective of this study was to examine residential customers` attitudes toward energy usage, conservation, and efficiency, and to examine the implications of these attitudes for how the utility should design and communicate about programs and services in these areas. This study combined focus groups and customer surveys, and utilized several customer segmentation schemes -- grouping customers by geodemographics, as well as customers` energy and environmental values, beliefs, and opinions -- to distinguish different segments of customers.

Primary pleural angiosarcoma as a mimicker of mesothelioma: a case report **VS**

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Kao Yu-Chien

2011-12-01

Full Text Available Abstract Primary pleural angiosarcoma is a rare and clinically aggressive tumor. Patients usually present with chest pain, dyspnea, hemoptysis and/or cough. Radiologic studies reveal diffuse pleural thickening and pleural effusion with or without mass lesion. The clinical and radiological features both resemble those of mesothelioma, and its definite diagnosis requires careful histologic examination. However, frequent epithelioid feature and immunoreactivity to cytokeratin in primary pleural angiosarcoma further complicate the pathologic diagnosis. The use of proper immunohistochemical stains is often needed to support endothelial differentiation in the tumor cells and to exclude metastatic carcinoma and mesothelioma. We report the case of a 49-year-old male patient with primary pleural angiosarcoma, who presented with initial hemothorax, followed by a rapid progress to an inoperable status.

Employment status, employment functioning, and barriers to employment among VA primary care patients.

Science.gov (United States)

Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

2016-03-15

Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

ENIQ-qualified visual examinations by means of a remote controlled submarine

Energy Technology Data Exchange (ETDEWEB)

Tsvetkov, Elenko; Heinsius, Jan [AREVA GmbH, Erlangen (Germany)

2015-07-15

Remote visual examination is one of the most important methods for non- destructive in-service inspections of primary components in nuclear power plants. It features two main advantages: the short examination duration and the fast interpretation of results. AREVA offers operators of nuclear power plants the ''SUSI 420 HD'' SUbmarine System for Inspections to perform ENIQ-qualified visual examinations during outages without working on the critical path and causing any delay in the time schedule. The system is a remotely operated manipulator equipped with a high definition camera. With a weight of only 25 kg, there is no need for a crane to put the submarine into water. More-over, nor the use of the refueling machine neither the auxiliary bridge is required. In this way the visual examination can be performed in parallel to other activities which are on the critical path. The article takes a closer look at the essential parameters: illumination, examination distance, viewing angle, scanning speed, positioning accuracy and sizing of indications. It describes how the system can fulfill these parameters through some adaptations.

The Relationship Between Parental Psychopathology and Adolescent Psychopathology: An Examination of Gender Patterns

Science.gov (United States)

McCauley Ohannessian, Christine; Hesselbrock, Victor M.; Kramer, John; Kuperman, Samuel; Bucholz, Kathleen K.; Schuckit, Mark A.; Nurnberger, John I.

2005-01-01

The primary goal of this study was to examine the relationship between parental psychopathology (specifically, alcohol dependence and depression) and adolescent psychopathology, by the gender of the adolescent and the gender of the parent. The sample included 426 13- to 17-year-old adolescents and their parents. All participants were administered…

Normocalcemic Primary Hyperparathyroidism

Science.gov (United States)

Cusano, Natalie E.; Silverberg, Shonni J.; Bilezikian, John P.

2013-01-01

Primary hyperparathyroidism, a common endocrine disorder, is traditionally defined by hypercalcemia and elevated levels of parathyroid hormone (PTH). A newer presentation of primary hyperparathyroidism has been described over the past decade, in which PTH is elevated but serum calcium is consistently normal, in the absence of secondary causes of hyperparathyroidism, such as renal disease or vitamin D deficiency. Recognition of this phenotype of primary hyperparathyroidism, normocalcemic primary hyperparathyroidism, supports a biphasic chronological time course in some individuals in which PTH levels are first elevated but serum calcium is normal, followed by the development of frank hypercalcemia. This review focuses on the available literature regarding this newly described phenotype of primary hyperparathyroidism. PMID:23374739

The Relationship between the Values of Primary School and Music Teacher Candidates and Their Cheating Attitudes

Science.gov (United States)

Saracaloglu, Asuman Seda; Gerçeker, Ceren Saygi; Aladag, Soner

2018-01-01

The aim of this research is to examine the relationship between the values of primary and music teacher candidates and their cheating attitudes in terms of different variables. The study group of the research is composed of 249 students who are studying at the Departments of Primary School Teaching and Music Education at Adnan Menderes University…

The Pattern of Electronic Game Use and Related Bodily Discomfort in Hong Kong Primary School Children

Science.gov (United States)

Lui, Donald P. Y.; Szeto, Grace P. Y.; Jones, Alice Y. M.

2011-01-01

The present study examined the usage pattern of electronic game devices among primary school children in Hong Kong. Commonly used types of games devices were grouped into three main categories: large-screen/TV-based games, small handheld game devices and active game devices. A survey was conducted among 476 students in a local primary school, with…

A Pilot Study of Using Jazz Warm Up Exercises in Primary School Choir in Hong Kong

Science.gov (United States)

Chen, Jason Chi Wai; Lee, Han Wai

2013-01-01

This pilot study is to examine whether it is valuable to implement jazz choral practice in Hong Kong primary school setting. The findings can serve as a reference to explore the possibilities of promoting jazz education in Asian countries or in China. The participants were 70 public primary school students from grade 2 to 5 in Hong Kong. All…

Socio-Economic Factors Affecting Parents' Involvement in Homework: Practices and Perceptions from Eight Johannesburg Public Primary Schools

Science.gov (United States)

Ndebele, Misheck

2015-01-01

This paper examines socio-economic factors influencing parental involvement in homework at the Foundation Phase in eight Johannesburg public primary schools. The research was conducted among over 600 parents from schools in different geographical and socio-economic areas such as the inner city, suburban and township. Two primary schools were…

Primary care as a means of decreasing health care costs | van ...

African Journals Online (AJOL)

The study was focussedat furthering the health objectives of the Government\\'s Reconstruction and Development Programme in the area ofprimary care. The purpose of the study was to examine the possible reduction of medical scheme claims for cardiovascular disease by means of primary care, so that medical scheme ...

Predictors and Outcomes of Childhood Primary Enuresis.

Science.gov (United States)

Kessel, Ellen M; Allmann, Anna E S; Goldstein, Brandon L; Finsaas, Megan; Dougherty, Lea R; Bufferd, Sara J; Carlson, Gabrielle A; Klein, Daniel N

2017-03-01

Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood. We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 years to age 9 years. We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were more than twice as likely as females to have a lifetime diagnosis. Significant age 3 predictors of developing primary enuresis by age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 years predicted a greater likelihood of persistence through age 9. By age 9 years, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of attention-deficit/hyperactivity disorder (ADHD) and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis. Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Relationships among pain, anxiety, and depression in primary care.

Science.gov (United States)

Means-Christensen, Adrienne J; Roy-Byrne, Peter P; Sherbourne, Cathy D; Craske, Michelle G; Stein, Murray B

2008-01-01

Pain, anxiety, and depression are commonly seen in primary care patients and there is considerable evidence that these experiences are related. This study examined associations between symptoms of pain and symptoms and diagnoses of anxiety and depression in primary care patients. Results indicate that primary care patients who endorse symptoms of muscle pain, headache, or stomach pain are approximately 2.5-10 times more likely to screen positively for panic disorder, generalized anxiety disorder, or major depressive disorder. Endorsement of pain symptoms was also significantly associated with confirmed diagnoses of several of the anxiety disorders and/or major depression, with odds ratios ranging from approximately 3 to 9 for the diagnoses. Patients with an anxiety or depressive disorder also reported greater interference from pain. Similarly, patients endorsing pain symptoms reported lower mental health functioning and higher scores on severity measures of depression, social anxiety, and posttraumatic stress disorder. Mediation analyses indicated that depression mediated some, but not all of the relationships between anxiety and pain. Overall, these results reveal an association between reports of pain symptoms and not only depression, but also anxiety. An awareness of these relationships may be particularly important in primary care settings where a patient who presents with reports of pain may have an undiagnosed anxiety or depressive disorder.

Survival after bone metastasis by primary cancer type

DEFF Research Database (Denmark)

Svensson, Elisabeth; Christiansen, Christian F; Ulrichsen, Sinna P

2017-01-01

%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.29-1.57), except for cervix, ovarian and bladder cancer. CONCLUSIONS: While patients with bone metastases after most......OBJECTIVE: In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases. METHODS: We included all patients aged 18 years and older with incident hospital diagnosis of solid cancer...... between 1994 and 2010, subsequently diagnosed with BM until 2012. We followed patients from date of bone metastasis diagnosis until death, emigration or 31 December 2012, whichever came first. We computed 1-year, 3-year and 5-year survival (%) and the corresponding 95% CIs stratified on primary cancer...

The primary care amplification model: taking the best of primary care forward

Directory of Open Access Journals (Sweden)

Nicholson Caroline

2008-12-01

Full Text Available Abstract Background Primary care internationally is approaching a new paradigm. The change agenda implicit in this threatens to de-stabilise and challenge established general practice and primary care. Discussion The Primary Care Amplification Model offers a means to harness the change agenda by 'amplifying' the strengths of established general practices around a 'beacon' practice. Conclusion Such 'beacon' practices can provide a mustering point for an expanded scope of practice for primary care, integrated primary/secondary service delivery, interprofessional learning, relevant local clinical research, and a focus on local service innovation, enhancing rather than fragmenting the collective capacity of existing primary care.

Spirometry in primary care for children with asthma.

Science.gov (United States)

Banasiak, Nancy Cantey

2014-01-01

Spirometry is an essential part of diagnosing a child with asthma. The National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA) expert panels recommend spirometry to be performed on children five years of age and older as an objective assessment of lung function, to diagnosis asthma, and for ongoing yearly management of asthma (GINA, 2012; NAEPP, 2007). According to the NAEPP expert panel, history and physical examination alone are not reliable to accurately diagnose asthma, exclude alternative diagnosis, or determine lung impairment (NAEPP, 2007 Dombkowski, Hassan, Wasilevich, and Clark (2010) found 52% of physicians who provide primary care to children used spirometry, but only 21% used spirometry according to the national guidelines, and only 35% of physicians surveyed were comfortable interpreting the test results. Zanconato, Meneghelli, Braga, Zacchello, and Baraldi (2005) found that 21% of spirometry readings were interpreted incorrectly, concluding that proper training and quality control were important to provide if spirometry in the primary care office setting is to be used. The purpose of this article is to review the appropriate use of spirometry in pediatric primary care.

Does quality influence utilization of primary health care? Evidence from Haiti.

Science.gov (United States)

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

ABR Examinations: The Why, What, and How

International Nuclear Information System (INIS)

Becker, Gary J.; Bosma, Jennifer L.; Guiberteau, Milton J.; Gerdeman, Anthony M.; Frush, Donald P.; Borgstede, James P.

2013-01-01

The American Board of Radiology (ABR) has provided certification for diagnostic radiologists and other specialists and subspecialists for more than 75 years. The Board certification process is a tangible expression of the social contract between the profession and the public by which the profession enjoys the privilege of self-regulation and the public is assured that it can expect medical professionals to put patients' interests first, guarantees the competence of practitioners, and guards the public health. A primary tool used by the ABR in fulfilling this responsibility is the secure proctored examination. This article sets forth seven standards based on authoritative sources in the field of psychometrics (the science of mental measurements), and explains in each case how the ABR implements that standard. Readers are encouraged to understand that, despite the multiple opinions that may be held, these standards developed over decades by experts using the scientific method should be the central feature in any discussion or critique of examinations given for the privilege of professional practice and for safeguarding the public well-being

ABR Examinations: The Why, What, and How

Energy Technology Data Exchange (ETDEWEB)

Becker, Gary J.; Bosma, Jennifer L., E-mail: jbosma@theabr.org; Guiberteau, Milton J.; Gerdeman, Anthony M.; Frush, Donald P.; Borgstede, James P.

2013-10-01

The American Board of Radiology (ABR) has provided certification for diagnostic radiologists and other specialists and subspecialists for more than 75 years. The Board certification process is a tangible expression of the social contract between the profession and the public by which the profession enjoys the privilege of self-regulation and the public is assured that it can expect medical professionals to put patients' interests first, guarantees the competence of practitioners, and guards the public health. A primary tool used by the ABR in fulfilling this responsibility is the secure proctored examination. This article sets forth seven standards based on authoritative sources in the field of psychometrics (the science of mental measurements), and explains in each case how the ABR implements that standard. Readers are encouraged to understand that, despite the multiple opinions that may be held, these standards developed over decades by experts using the scientific method should be the central feature in any discussion or critique of examinations given for the privilege of professional practice and for safeguarding the public well-being.

Pattern of Primary Nocturnal Enuresis in Primary School Children ...

African Journals Online (AJOL)

Pattern of Primary Nocturnal Enuresis in Primary School Children (First Grade) in ... The control group consisting of 100 age-matched non-enuretic children ... was insignificantly associated with a positive family history, family size or birth rank.

The risk of healing complications in primary teeth with intrusive luxation

DEFF Research Database (Denmark)

Lauridsen, Eva; Blanche, Paul; Yousaf, Nadia

2017-01-01

BACKGROUND/AIMS: Intrusive luxation is a frequent injury in the primary dentition. Complications such as ankylosis or pulp necrosis and infection with periapical inflammation may affect the developing permanent tooth if not diagnosed and treated in time. The aim of this study was to report the risk...... of pulp necrosis (PN), pulp canal obliteration (PCO), infection-related resorption (IRR), ankylosis-related resorption (ARR) and premature tooth loss (PTL) in primary teeth following intrusive luxation, and to identify possible risk factors for PN and PTL. MATERIALS AND METHOD: A retrospective analysis...... of a cohort comprising 149 patients 194 intruded primary incisors. No treatment was performed. The follow-up programme included examination after 4 weeks, 8 weeks, 6 months, 1 year, and at 6 years of age. The minimum follow-up period was 1 year or until time of tooth loss. STATISTICS: The Kaplan Meier...

Primary ciliogenesis defects are associated with human astrocytoma/glioblastoma cells

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Rattner Jerome B

2009-12-01

Full Text Available Abstract Background Primary cilia are non-motile sensory cytoplasmic organelles that have been implicated in signal transduction, cell to cell communication, left and right pattern embryonic development, sensation of fluid flow, regulation of calcium levels, mechanosensation, growth factor signaling and cell cycle progression. Defects in the formation and/or function of these structures underlie a variety of human diseases such as Alström, Bardet-Biedl, Joubert, Meckel-Gruber and oral-facial-digital type 1 syndromes. The expression and function of primary cilia in cancer cells has now become a focus of attention but has not been studied in astrocytomas/glioblastomas. To begin to address this issue, we compared the structure and expression of primary cilia in a normal human astrocyte cell line with five human astrocytoma/glioblastoma cell lines. Methods Cultured normal human astrocytes and five human astrocytoma/glioblastoma cell lines were examined for primary cilia expression and structure using indirect immunofluorescence and electron microscopy. Monospecific antibodies were used to detect primary cilia and map the relationship between the primary cilia region and sites of endocytosis. Results We show that expression of primary cilia in normal astrocytes is cell cycle related and the primary cilium extends through the cell within a unique structure which we show to be a site of endocytosis. Importantly, we document that in each of the five astrocytoma/glioblastoma cell lines fully formed primary cilia are either expressed at a very low level, are completely absent or have aberrant forms, due to incomplete ciliogenesis. Conclusions The recent discovery of the importance of primary cilia in a variety of cell functions raises the possibility that this structure may have a role in a variety of cancers. Our finding that the formation of the primary cilium is disrupted in cells derived from astrocytoma/glioblastoma tumors provides the first

Enhanced primary and secondary performance through cognitive relaying and leveraging primary feedback

KAUST Repository

Hamza, Doha R.

2014-06-01

We consider a spectrum-sharing system, where the primary terminal operates in a time-slotted fashion and is active only when it has a packet to send. The secondary terminal uses spectrum sensing results and the primary automatic repeat request (ARQ) feedback to access the channel probabilistically. To enhance the primary\\'s system performance, the secondary user (SU) acts as a relay for the primary user (PU) in the event of transmission failure on the direct link of the latter. Closed-form expressions for the primary and secondary throughputs are obtained for the described scheme. The optimal medium access probabilities are then obtained by maximizing the secondary throughput subject to constraints that guarantee the stability of the considered queues, a minimum primary throughput, and a maximum primary queueing delay. The results clearly indicate the benefits of cognitive relaying in enhancing the throughput performance for both the PU and SU. Furthermore, by guaranteeing minimum rate and maximum delay requirements, our scheme is shown to provide a definitive notion of protection for the licensed users of the network. © 2013 IEEE.

Using Social Network Theory to Influence the Development of State and Local Primary Prevention Capacity-Building Teams

Science.gov (United States)

Cook-Craig, Patricia G.

2010-01-01

This article examines the role that social network theory and social network analysis has played in assessing and developing effective primary prevention networks across a southeastern state. In 2004 the state began an effort to develop a strategic plan for the primary prevention of violence working with local communities across the state. The…

Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia.

Science.gov (United States)

Arora, Amit; Manohar, Narendar; John, James Rufus

2017-11-23

Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5-10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child's age (Adjusted Odd's Ratio (AOR) = 1.30, 95% CI: 1.14-1.49) and mother's extraction history (AOR = 2.05, 95% CI: 1.40-3.00) were significantly associated with caries experience in the child's primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19-1.93) of primary dentition caries.

The Examination of the Attitudes of Secondary School Students towards Physical Education Course

Science.gov (United States)

Keskin, Özkan; Hergüner, Gülten; Dönmez, Ahmet; Berisha, Milaim; Üçan, Erkan

2017-01-01

The aim of this study is to examine the attitudes of primary education students towards physical education courses according to certain variables. 640 students from elementary schools in the city center and several counties of Sakarya participated in the study. In the designating of the students' attitudes towards the physical education courses,…

Using a "Makerspace" Approach to Engage Indonesian Primary Students with STEM

Science.gov (United States)

Blackley, Susan; Rahmawati, Yuli; Fitriani, Ella; Sheffield, Rachel; Koul, Rekha

2018-01-01

This paper examines the learning experiences of 291 Year 5 and 6 Indonesian primary school students, across four schools in North Jakarta, who participated in an integrated STEM project that used a 3-phase "Makerspace" approach: exposure, engagement and experimentation, and evaluation and extension. The Wiggle Bots project involved these…

Spelling Instruction in the Primary Grades: Teachers' Beliefs, Practices, and Concerns

Science.gov (United States)

Doyle, Antoinette; Zhang, Jing; Mattatall, Chris

2015-01-01

This study examined Canadian teachers' beliefs, practices and concerns about spelling instruction in the primary grades. Data from surveys (n = 56) indicated that most teachers believe that spelling is important and plan for spelling instruction. For most teachers, the spelling words and activities used, and the instructional resources they chose,…

Impact of E-Learning and Digitalization in Primary and Secondary Schools

Science.gov (United States)

Tunmibi, Sunday; Aregbesola, Ayooluwa; Adejobi, Pascal; Ibrahim, Olaniyi

2015-01-01

This study examines into the impact of e-learning and digitalization in primary and secondary schools, using Greensprings School in Lagos State, Nigeria as a case study. Questionnaire was used as a data collection instrument, and descriptive statistical method was adopted for analysis. Responses from students and teachers reveal that application…

Surveying Inclusion in Greece: Empirical Research in 2683 Primary School Students

Science.gov (United States)

Soulis, Spyridon-Georgios; Georgiou, Alexandra; Dimoula, Katerina; Rapti, Danai

2016-01-01

Students' point of view for inclusion and for their classmates with disability is essential for its successful implementation. The objectives of this work are to examine the primary school students' attitudes towards students with disabilities. The findings of the research indicate that the majority of typically developing students has a positive…

The Emergence of Inclusive Exploratory Talk in Primary Students' Peer Interaction

Science.gov (United States)

Rajala, Antti; Hilppo, Jaakko; Lipponen, Lasse

2012-01-01

In this study, we examine a prominent type of classroom talk, exploratory talk, in primary school peer interactions. Exploratory talk has been shown to be productive in facilitating problem solving and fostering school achievement. However, within the growing body of research concerning exploratory talk, the relation between exploratory talk and…

[Primary Malignant Pericardial Mesothelioma;Report of a Case].

Science.gov (United States)

Ichikawa, Seiji; Murakami, Fumihiko; Ogiwara, Hiroaki

2018-02-01

A 69-year-old male was referred to our hospital after being diagnosed as having pericarditis with pericardial effusion. The symptoms of tamponade disappeared after the effusion was drained;although the cause of pericarditis remained unidentified. About 4 months later, the tamponade symptoms recurred due to the thickened nodular pericardium. Partial pericardiectomy was performed, however the patient died on the 52nd day after surgery. Immunohistological examination with calretinin led to the diagnosis of primary malignant pericardial mesothelioma, which was an extremely rare pathology. Because the hyaluronic acid content of the effusion has been reported as a diagnostic aid for malignant mesothelioma, routine examination of the hyaluronic acid content for pericarditis with pericardial effusion may be necessary for early diagnosis and to improve prognosis.

SPEECH DISORDERS IN PRIMARY SCHOOL STUDENTS OF ISFAHAN (1998-9

Directory of Open Access Journals (Sweden)

B SHAFIEI

2002-06-01

Full Text Available Introduction. The aim of this study was to describe frequency of speech disorders in primary school students.
Methods. In a cross-sectional study 300 first and second grade primary school students were examined for speech disorders.
Results. From 300 subjects, 280 were normal (without speech disorders, 15 had articulation disorders, 2 had voice disorders, 3 had resonance disorders and no one had fluency disorders.
Discussion. The findings of this study are supported by fomer study in other countries, except frequency of fluency disorders which may due to low sample size of present study.

Analysis of neutron spectrum effects on primary damage in tritium breeding blankets

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Hee, E-mail: cyh871@snu.ac.kr [School of Energy Systems Engineering, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-744 (Korea, Republic of); Joo, Han Gyu [School of Energy Systems Engineering, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-744 (Korea, Republic of)

2012-07-15

The effect of neutron spectrum on primary damages in a structural material of a tritium breeding blanket is investigated with a newly established recoil spectrum estimation system. First, a recoil spectrum generation code is developed to obtain the energy spectrum of primary knock-on atoms (PKAs) for a given neutron spectrum utilizing the latest ENDF/B data. Secondly, a method for approximating the high energy tail of the recoil spectrum is introduced to avoid expensive molecular dynamics calculations for high energy PKAs using the concept of recoil energy of the secondary knock-on atoms originated by the INtegration of CAScades (INCAS) model. Thirdly, the modified spectrum is combined with a set of molecular dynamics calculation results to estimate the primary damage parameters such as the number of surviving point defects. Finally, the neutron spectrum is varied by changing the material of the spectral shifter and the result in primary damage parameters is examined.

Analysis of neutron spectrum effects on primary damage in tritium breeding blankets

Science.gov (United States)

Choi, Yong Hee; Joo, Han Gyu

2012-07-01

The effect of neutron spectrum on primary damages in a structural material of a tritium breeding blanket is investigated with a newly established recoil spectrum estimation system. First, a recoil spectrum generation code is developed to obtain the energy spectrum of primary knock-on atoms (PKAs) for a given neutron spectrum utilizing the latest ENDF/B data. Secondly, a method for approximating the high energy tail of the recoil spectrum is introduced to avoid expensive molecular dynamics calculations for high energy PKAs using the concept of recoil energy of the secondary knock-on atoms originated by the INtegration of CAScades (INCAS) model. Thirdly, the modified spectrum is combined with a set of molecular dynamics calculation results to estimate the primary damage parameters such as the number of surviving point defects. Finally, the neutron spectrum is varied by changing the material of the spectral shifter and the result in primary damage parameters is examined.

Increased EEG sigma and beta power during NREM sleep in primary insomnia.

Science.gov (United States)

Spiegelhalder, Kai; Regen, Wolfram; Feige, Bernd; Holz, Johannes; Piosczyk, Hannah; Baglioni, Chiara; Riemann, Dieter; Nissen, Christoph

2012-12-01

The hyperarousal model of primary insomnia suggests that a deficit of attenuating arousal during sleep might cause the experience of non-restorative sleep. In the current study, we examined EEG spectral power values for standard frequency bands as indices of cortical arousal and sleep protecting mechanisms during sleep in 25 patients with primary insomnia and 29 good sleeper controls. Patients with primary insomnia demonstrated significantly elevated spectral power values in the EEG beta and sigma frequency band during NREM stage 2 sleep. No differences were observed in other frequency bands or during REM sleep. Based on prior studies suggesting that EEG beta activity represents a marker of cortical arousal and EEG sleep spindle (sigma) activity is an index of sleep protective mechanisms, our findings may provide further evidence for the concept that a simultaneous activation of wake-promoting and sleep-protecting neural activity patterns contributes to the experience of non-restorative sleep in primary insomnia. Copyright © 2012 Elsevier B.V. All rights reserved.

Examining the development and sexual behavior of adolescent males.

Science.gov (United States)

Ott, Mary A

2010-04-01

A careful examination of young men's sexuality by health professionals in pediatrics, primary care, and reproductive health is foundational to adolescent male sexual health and healthy development. Through a review of existing published data, this article provides background and a developmental framework for sexual health services for adolescent boys. The article first defines and provides an overview of adolescent boys' sexual health, and then discusses developmentally focused research on the following topics: (1) early romantic relationships and the evolution of power and influence within these relationships; (2) developmental "readiness" for sex and curiosity; (3) boys' need for closeness and intimacy; (4) adopting codes of masculinity; (5) boys' communicating about sex; and (6) contextual influences from peers, families, and providers. This article concludes by examining the implications of these data for sexual health promotion efforts for adolescent males, including human papillomavirus vaccination.

Coexistence of primary biliary cirrhosis and myasthenia gravis: a case study.

Science.gov (United States)

Horigome, H; Nomura, T; Saso, K; Joh, T; Ohara, H; Akita, S; Sobue, S; Mizuno, Y; Kato, Y; Itoh, M

2000-01-01

We present a case that suggests a relationship between primary biliary cirrhosis and myasthenia gravis. A 43-year-old Japanese woman was admitted to the Nagoya City University Medical School, First Department of Internal Medicine with abnormal liver function in August 1991. She had had ptosis of the right eye since 1990. She had not been treated for liver disease. Ptosis of the right eye and hepatomegaly were present. Serum laboratory examinations revealed elevated biliary enzymes and IgM levels; tests were positive for antimitochondrial antibody and antiacetylcholine antibody. Liver histology revealed chronic non-suppurative destructive cholangitis and led to a diagnosis of primary biliary cirrhosis. The tensilon test was positive. Electromyography with repetitive motor nerve stimulation revealed a neuromuscular junction defect; i.e., the primary characteristic of myasthenia gravis. The patient was diagnosed with myasthenia gravis. Although the development of myasthenia gravis has previously been reported in patients with primary biliary cirrhosis during D-penicillamine administration, this is a very rare case of the coexistence of both diseases before such treatment.

Influence of STAT4 polymorphism in primary Sjögren's syndrome.

Science.gov (United States)

Palomino-Morales, Rogelio J; Diaz-Gallo, Lina-Marcela; Witte, Torsten; Anaya, Juan-Manuel; Martín, Javier

2010-05-01

To examine the influence of STAT4 rs7574865 gene polymorphism on patients with primary Sjögren's syndrome (SS). Two different cohorts were studied: 69 patients with primary SS and 296 controls from Colombia and 108 patients with primary SS and 227 controls from Germany. Samples were genotyped for the STAT4 rs7574865 single-nucleotide polymorphism with a predesigned TaqMan single-nucleotide polymorphism genotyping assay. We carried out a metaanalysis of our results combined with data published to date. Although no significant differences were observed in the allele frequencies of STAT4 rs7574865 gene polymorphism between patients and controls in Colombians (p = 0.28, OR 1.24, 95% CI 0.82-1.87) and Germans (p = 0.08, OR 1.40, 95% CI 0.96-2.02), the metaanalysis disclosed a significant effect of the T allele on disease (p = 4.7 x 10(-6), OR 1.40, 95% CI 1.21-1.62). These data reinforce the influence of STAT4 gene on primary SS and as a general autoimmune gene.

Decade-long trends in the timeliness of receipt of a primary percutaneous coronary intervention

Directory of Open Access Journals (Sweden)

Chen HY

2016-06-01

Full Text Available Han-Yang Chen,1 Joel M Gore,1,2 Kate L Lapane,1 Jorge Yarzebski,1 Sharina D Person,1 Catarina I Kiefe,1 Robert J Goldberg1,3 1Department of Quantitative Health Sciences, 2Department of Medicine, 3Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA Objectives: The purpose of this study was to examine decade-long trends (2001–2011 in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI who received a primary percutaneous coronary intervention (PCI. Methods: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629. Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED arrival. Results: The average age of this patient population was 61.9 years; 30.5% were women, and 91.7% were White. During the years under study, 50.9% of patients received a primary PCI within 90 minutes of ED arrival; this proportion increased from 2001/2003 (17.2% to 2009/2011 (70.5% (P<0.001. Having previously undergone coronary artery bypass graft surgery, arriving at the ED by car/walk-in and during off-hours were significantly associated with a higher risk of failing to receive a primary PCI within 90 minutes of ED arrival. Conclusion: The likelihood of receiving a timely primary PCI in residents of central Massachusetts hospitalized with STEMI at the major teaching/community medical centers increased dramatically during the years under study. Several groups were identified for purposes of heightened surveillance and intervention efforts to reduce the likelihood of failing to receive a timely primary PCI among patients acutely

Primary Sources of Corporate Investment in Hungary

Directory of Open Access Journals (Sweden)

Katona Klára

2017-06-01

Full Text Available This research aims to reveal how Hungarian companies have financed investments over the last two decades. Which financing strategy characterized them: was internal capital accumulation or external resources, such as bank loans or foreign capital the primary source of corporate investments? The study gives an overview of the conditions typical in the Hungarian financing and capital market over the last 25 years through an empirical analysis. Using a linear regression model, the paper examines the main investments sources among the top 5000 Hungarian firms according to revenues between 1996 and 2014. The model proved that the effect of loans in financing investments was significant and positive in all examined firms, independently from their ownership in the whole period. The rate of indebtedness of foreign companies was mainly attributable to local bank credits and not loans granted by mother companies.

[Primary hyperparathyroidism in the dog. Diagnosis, therapy and postoperative management in 19 dogs].

Science.gov (United States)

Jores, K; Kessler, M

2011-01-01

Retrospective evaluation of diagnosis and outcome in 20 dogs with primary hyperparathyroidism. In 20 dogs primary hyperparathyroidism was diagnosed and 19 patients were treated via parathyroidectomy, 10 additionally with partial thyroidectomy. Medical records of the dogs were reviewed for signalment, clinical features, laboratory findings and results of histopathologic examination. In some cases postsurgical rehabilitation of calcium metabolism required substitution with calcium and vitamin D preparations. Mean age of the dogs was 11.5 years. The most common clinical signs comprised polydipsia, polyuria, reduced activity, and stiff gait. Laboratory findings were moderate to extensive hypercalcaemia, low or low-normal serum phosphorus concentrations and normal or increased serum parathyroid hormone concentrations. None of the dogs had an elevated parathyroid hormone-related polypeptide level. Histological examination revealed 11 adenomas, six carcinomas and two glandular hyperplasias. Postsurgical management of calcium homeostasis was challenging in some cases. Tumours of the parathyroid gland can be easily treated by parathyroidectomy and usually have a good prognosis. With careful interpretation of laboratory findings of a patient presenting with hypercalcaemia and ruling out other causes of hypercalcaemia diagnosis of primary hyperparathyroidism can be easily achieved and successfully treated byparathyroidectomy.

Locoregional Recurrent or Second Primary Head and Neck Cancer: Management Strategies and Challenges.

Science.gov (United States)

Wong, Stuart J; Heron, Dwight E; Stenson, Kerstin; Ling, Diane C; Vargo, John A

2016-01-01

Treatment of patients with locoregional recurrent or second primary head and neck squamous cell cancer (HNSCC) has been guided by well-reasoned principles and informed by carefully tested chemotherapy and radiation regimens. However, clinical decision making for this population is complicated by many factors. Although surgery is generally considered the treatment of choice for patients with HNSCC with recurrent disease or new second primary disease in a previously irradiated field, operability of cases is not always straightforward. Postoperative treatment is frequently warranted but carries significant risk. In addition, the rapid rise in the incidence of HPV-associated HNSCC raises the question of whether established treatment paradigms should be re-examined in this population of patients with a much better prognosis than the non-HPV population. Furthermore, new radiation techniques and new systemic agents show early promising results in recent clinical studies, suggesting potential for practice-changing effects in the future management of this disease. This article examines each of the treatment modalities used in the care of patients with HNSCC with recurrent or new second primary disease and provides a perspective to aid clinicians in the management of this disease.

A Systematic Review of Depression Treatments in Primary Care for Latino Adults

Science.gov (United States)

Cabassa, Leopoldo J.; Hansen, Marissa C.

2007-01-01

Objective: A systematic literature review of randomized clinical trials (RCTs) assessing depression treatments in primary care for Latinos is conducted. The authors rate the methodological quality of studies, examine cultural and linguistic adaptations, summarize clinical outcomes and cost-effectiveness findings, and draw conclusions for improving…

Type of primary education is associated with condom use at sexual debut among Chilean adolescents.

Science.gov (United States)

Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia

2014-05-01

Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.

Factor analysis of the Children's Behaviour Questionnaire in a Nigerian paediatric primary care population

Directory of Open Access Journals (Sweden)

O O Omigbodun

2004-04-01

Full Text Available Objective. This paper examines the factor structure of the Yoruba translation of the Children’s Behaviour Questionnaire for Completion by Parents (CBQ administered in a Nigerian paediatric primary care population. Design. A cross-sectional questionnaire survey. Subjects. Four hundred and seventy-eight children aged 7 - 14 years who attended a primary care clinic in Ibadan, Nigeria, over a 3-month period. Methods. Parents’ ratings of the children were obtained using the Yoruba translation of the CBQ. The factor structure of this instrument was examined using principal component analysis with varimax rotation. Only factors with eigenvalues of greater than 1 were examined further. Results. The first seven dimensions were readily conceptu- alised. These factors are conduct problem, hyperactivity, emotional problem, irritability, problems with elimination, a somatic complaint and a school problem dimension. Conclusion. These factors are similar to what has been observed in other studies involving populations of children with psychopathology, with the exception of the somatic com- plaint and school problem dimension. The emergence of these two factors, which are quite different from what has been observed in other studies, may demonstrate differences that reflect the influence of language, culture and the peculiarities of a primary care setting. On the other hand the similarity of most of the factors to those found in previous studies con- firms the broad similarities in the behaviour of children across different cultures.

Dental anomalies in primary dentition and their corresponding permanent teeth.

Science.gov (United States)

Gomes, R R; Fonseca, J A C; Paula, L M; Acevedo, A C; Mestrinho, H D

2014-05-01

The objectives of this paper are to estimate the prevalence of dental anomalies in primary dentition in a sample of 2- to 5-year-old Brazilian preschool children, determine their distribution, and investigate their occurrence in the succedaneous teeth of the sample compared with a control group of children with no dental anomalies in the primary dentition. The one-stage sample comprised 1,718 two to five-year-old children with fully erupted primary dentition clinically examined for dental anomalies. All children presenting dental anomalies underwent panoramic radiographs. Descriptive statistics were performed for the studied variables. A control group matched by sex and age was studied to compare the prevalence ratio for dental anomalies in the permanent dentition. The prevalence of dental anomalies in the primary dentition was 1.8 %, with no significant statistical difference between sexes. Double teeth were the most frequently observed. Dental anomalies on the succedaneous permanent teeth were diagnosed in 54.8 % of the children with affected primary dentition. The prevalence ratio (PR) for dental anomalies in the succedaneous permanent teeth was 17.1 (confidence interval (CI) 5.33-54.12) higher compared with the control group, higher in children with bilateral anomalies (PR = 31.2, CI 10.18-94.36). An association between anomalies of the permanent dentition and the presence of dental anomalies in primary teeth was observed, especially when they occur bilaterally. The results in the present study have a clinical relevance in the diagnosis of children with dental anomalies in primary dentition. Early identification of these anomalies can aid the dentist in planning dental treatment at the appropriate time.

Primary candidiasis and squamous cell carcinoma of the larynx: report of a case.

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Lee, Dong Hoon; Cho, Hyong Ho

2013-02-01

Primary candidiasis is rare and often confused with a pre-cancerous lesion, squamous cell carcinoma, or verrucous carcinoma. We report an extremely rare case of squamous cell carcinoma of the vocal cord following primary candidiasis. A 62-year-old man presented to our department reporting a 1-month history of hoarseness. He underwent laryngeal microscopic surgery for a presumptive diagnosis of glottic carcinoma. Histopathologic examination revealed candidiasis and scattered moderate dysplasia. He was treated with itraconazole for 4 weeks, and followed up without any recurrence of candidiasis. However, the 42-month follow-up examination revealed a focal whitish lesion on the right true vocal cord, and a repeat biopsy of this area revealed squamous cell carcinoma without evidence of candidiasis. The patient was treated with radiotherapy and remains well with no signs of tumor recurrence or candidiasis.

Prevalence of early loss of primary teeth in 5-10-year-old school children in Chidambaram town.

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Ahamed, S Syed Shaheed; Reddy, Venugopal N; Krishnakumar, R; Mohan, Muthu G; Sugumaran, Durai K; Rao, Arun P

2012-01-01

The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. A total of 1121 school children (561 boys and 560 girls) between 5 and 10 years of age were selected for the study. An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Microsoft Excel/2000 (Microsoft Office XP) data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS) for Windows (version 10.0). Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P loss of primary teeth, but no differences were observed between genders (P > 0.05). The greatest prevalence was found among the 8-year olds (5.08%), and the most commonly missing teeth were the right lower primary first molars (16.82%). It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study.

The Monkey game: A computerized verbal working memory task for self-reliant administration in primary school children.

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Van de Weijer-Bergsma, Eva; Kroesbergen, Evelyn H; Jolani, Shahab; Van Luit, Johannes E H

2016-06-01

In two studies, the psychometric properties of an online self-reliant verbal working memory task (the Monkey game) for primary school children (6-12 years of age) were examined. In Study 1, children (n = 5,203) from 31 primary schools participated. The participants completed computerized verbal and visual-spatial working memory tasks (i.e., the Monkey game and the Lion game) and a paper-and-pencil version of Raven's Standard Progressive Matrices. Reading comprehension and math achievement test scores were obtained from the schools. First, the internal consistency of the Monkey game was examined. Second, multilevel modeling was used to examine the effects of classroom membership. Multilevel multivariate regression analysis was used to examine the Monkey game's concurrent relationship with the Lion game and its predictive relationships with reading comprehension and math achievement. Also, age-related differences in performance were examined. In Study 2, the concurrent relationships between the Monkey game and two tester-led computerized working memory tasks were further examined (n = 140). Also, the 1- and 2-year stability of the Monkey game was investigated. The Monkey game showed excellent internal consistency, good concurrent relationships with the other working memory measures, and significant age differences in performance. Performance on the Monkey game was also predictive of subsequent reading comprehension and mathematics performance, even after controlling for individual differences in intelligence. Performance on the Monkey game was influenced by classroom membership. The Monkey game is a reliable and suitable instrument for the online computerized and self-reliant assessment of verbal working memory in primary school children.

Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

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Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

2014-07-01

To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Exploring the effects of developing collaboration in a primary science teacher community

DEFF Research Database (Denmark)

Sillasen, Martin Krabbe

2010-01-01

This paper presents findings from a qualitative study to explore factors that may facilitate sustainable changes of collaboration in a primary science teacher community in one school. The context for this study is a development project aimed at improving science teaching by changing teacher......’s collective work in schools and developing network between schools. The objective is to improve the collaboration within primary science teacher communities on sharing best practice and developing new ways of teaching. This study represents an in-depth approach to explore possibilities and constraints for how...... a development project can facilitate sustainable change in primary science teachers’ collaboration. The purpose of the research project introduced here is to examine closer, why many development projects fail to produce sustainable results. The framework of McLaughlin and Talbert (2006) on building teacher...

Primary ovarian malignant melanoma

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Kostov Miloš

2010-01-01

Full Text Available Background. Primary ovarian malignant melanoma is extremely rare. It usually appears in the wall of a dermoid cyst or is associated with another teratomatous component. Metastatic primary malignant melanoma to ovary from a primary melanoma elsewhere is well known and has been often reported especially in autopsy studies. Case report. We presented a case of primary ovarian malignant melanoma in a 45- year old woman, with no evidence of extraovarian primary melanoma nor teratomatous component. The tumor was unilateral, macroscopically on section presented as solid mass, dark brown to black color. Microscopically, tumor cells showed positive immunohistochemical reaction for HMB-45, melan-A and S-100 protein, and negative immunoreactivity for estrogen and progesteron receptors. Conclusion. Differentiate metastatic melanoma from rare primary ovarian malignant melanoma, in some of cases may be a histopathological diagnostic problem. Histopathological diagnosis of primary ovarian malignant melanoma should be confirmed by immunohistochemical analyses and detailed clinical search for an occult primary tumor.

Primary actinomycosis in the limbs: A case report and bibliographic review

International Nuclear Information System (INIS)

Oliveira, J.M.A. de; Costa, F.P.; Lederman, H.M.; Tridenti, M.R.

1989-01-01

Primary actinomycosis in the limbs is rare. Herein is reported a case of a patient with actinomycosis in the left foot with symptoms for four years. Radiological exam showed a lesion consistent with osteomyelitis or osteosarcoma. Pathological examination confirmed actimomycosis. Effective therapy was made with improvement and cure in six months. (author)

Parenting and Preschool Child Development: Examination of Three Low-Income U.S. Cultural Groups

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Whiteside-Mansell, Leanne; Bradley, Robert H.; McKelvey, Lorraine

2009-01-01

We examined the impact of parenting behaviors on preschool children's social development in low-income families from three cultural groups: European American (n = 286), African American (n = 399), and Hispanic American (n = 164) using Spanish as the primary language in the home. Observed parenting behaviors of stimulation, responsivity, and…

The tibial nerve compression test for the diagnosis of lumbar spinal canal stenosis-A simple and reliable physical examination for use by primary care physicians.

Science.gov (United States)

Adachi, Shu; Nakano, Atsushi; Kin, Akihiro; Baba, Ichiro; Kurokawa, Yoshitaka; Neo, Masashi

2018-01-01

In the present study, we aimed to evaluate the diagnostic accuracy and suitability of the 'Tibial Nerve Compression Test (TNCT)' as a screening tool for lumbar spinal canal stenosis (LSS). A total of 108 consecutive patients admitted to our hospital for surgical treatment or diagnosis of LSS were included in this study. Fifty healthy volunteers were examined as a control group. The severity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VAS score). These scores were compared between the LSS and control groups. Moreover, they were compared before and after the operation among operated patients. The positive tenderness rate was significantly higher (92.6% [100/108]) in the LSS group than in the control group (30% [15/50]). The sensitivity and specificity of TNCT (95% confidence interval) were 0.93 (0.88-0.96) and 0.70 (0.61-0.77), respectively. Positive tenderness rates and P-VAS scores were significantly higher in the LSS group (p Test is a useful screening tool for LSS diagnosis in a primary care setting. Level II, diagnostic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Survival after bone metastasis by primary cancer type

DEFF Research Database (Denmark)

Svensson, Elisabeth; Christiansen, Christian F; Ulrichsen, Sinna P

2017-01-01

OBJECTIVE: In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases. METHODS: We included all patients aged 18 years and older with incident hospital diagnosis of solid cancer...... between 1994 and 2010, subsequently diagnosed with BM until 2012. We followed patients from date of bone metastasis diagnosis until death, emigration or 31 December 2012, whichever came first. We computed 1-year, 3-year and 5-year survival (%) and the corresponding 95% CIs stratified on primary cancer...... prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13...

PULPOTOMIES WITH PORTLAND CEMENT IN HUMAN PRIMARY MOLARS

Science.gov (United States)

Conti, Taísa Regina; Sakai, Vivien Thiemy; Fornetti, Ana Paula Camolese; Moretti, Ana Beatriz Silveira; Oliveira, Thais Marchini; Lourenço, Natalino; Machado, Maria Aparecida Andrade Moreira; Abdo, Ruy Cesar Camargo

2009-01-01

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended. PMID:19148409

Variables that predict academic procrastination behavior in prospective primary school teachers

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Asuman Seda SARACALOĞLU

2016-04-01

Full Text Available This study aimed to examine the variables predicting academic procrastination behavior of prospective primary school teachers and is conducted using the correlational survey model. The study group is composed of 294 undergraduate students studying primary school teaching programs in faculties of education at Adnan Menderes, Pamukkale, and Muğla Sıtkı Koçman Universities in Turkey. The data collection instruments used were the Procrastination Assessment Scale Students (PASS, Academic Self-Efficacy Scale (ASES, and Academic Motivation Scale (AMS. While analyzing the gathered data, descriptive analysis techniques were utilized. Moreover, while analyzing the data, power of variables namely reasons of academic procrastination, academic motivation, and academic efficacy to predict prospective primary school teachers’ academic procrastination tendencies were tested. For that purpose, stepwise regression analysis was employed. It was found that nearly half of the prospective primary school teachers displayed no academic procrastination behavior. Participants’ reasons for procrastination were fear of failure, laziness, taking risks, and rebellion against control. An average level significant correlation was found between participants’ academic procrastination and other variables. As a result, it was identified that prospective primary school teachers had less academic procrastination than reported in literature and laziness, fear of failure, academic motivation predicted academic procrastination.

Examinations on cases of surgery for radiation-induced disorders of large intestine

Energy Technology Data Exchange (ETDEWEB)

Shiba, Tadaaki [Toho Univ., Tokyo (Japan). School of Medicine

1996-11-01

Author`s experience of surgery for radiation colitis was examined and discussed on the primary disease, radiation dose, major symptoms, surgical techniques, results and post-operative complication. Patients were 1 male and 21 females of the average age of 59.5 y. The primary diseases were bladder cancer for the male and uterine cancer for the females. The radiation dose ranged from 35-120 Gy and was 63.4 Gy in a mean. The symptoms for surgery were 14 ileuses, 4 intestinal hemorrhages, 1 perforation and 3 burrows. Colostomy was performed for 18 cases; enterostomy, 2; anastomosis, 1; and enterectomy, 1, which resulted in improvement of symptoms in 5 cases, 0, 1 and 1, respectively. The author concluded that radiation colitis should be treated preventively. (K.H.)

The Practice Guidelines for Primary Care of Acute Abdomen 2015.

Science.gov (United States)

Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

2016-01-01

Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.