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Sample records for project involving primary

  1. Frequency comparison involving the Romanian primary length standard RO.1 within the framework of the EUROMET Project #498

    Science.gov (United States)

    Popescu, Gheorghe

    2001-06-01

    An international frequency comparison was carried out at the Bundesamt fuer Eich- und Vermessungswessen (BEV), Vienna, within the framework of the EUROMET Project #498 from August 29 to September 5, 1999. The frequency differences obtained when the RO.1 laser from the National Institute for Laser, Plasma and Radiation Physics (NILPRP), Romania, was compared with five lasers from Austria (BEV1), Czech Republic (PLD1), France (BIPM3), Poland (GUM1) and Hungary (OMH1) are reported. Frequency differences were computed by using the matrix determinations for the group d, e, f, g. Considering the frequency differences measured for a group of three lasers compared to each other, we call the closing frequency the difference between measured and expected frequency difference (resulting from the previous two measurements). For the RO1 laser, when the BIPM3 laser was the reference laser, the closing frequencies range from +8.1 kHz to - 3.8 kHz. The relative Allan standard deviation was used to express the frequency stability and resulted 3.8 parts in 1012 for 100 s sampling time and 14000 s duration of the measurements. The averaged offset frequency relative to the BIPM4 stationary laser was 5.6 kHz and the standard deviation was 9.9 kHz.

  2. Strengthening primary healthcare through community involvement in ...

    African Journals Online (AJOL)

    Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study. Hilary Adie, Thomas Igbang, Akaninyene Otu, Ekanem Braide, Okpok Okon, Edet Ikpi, Charles Joseph, Alexander Desousa, Johannes Sommerfeld ...

  3. Renal involvement in primary antiphospholipid syndrome.

    Science.gov (United States)

    Marcantoni, Carmelita; Emmanuele, Carmela; Scolari, Francesco

    2016-08-01

    Antiphospholipid syndrome is an autoimmune disorder characterized by recurrent venous or arterial thrombosis and/or pregnancy-related problems associated with persistently elevated levels of antiphospholipid antibodies. The kidney is a major target organ in both primary and secondary antiphospholipid syndrome. This review describes several aspects of the renal involvement in the primary form of the syndrome, in particular the histological pattern of the so-called antiphospholipid syndrome nephropathy (APSN). APSN is a vascular nephropathy characterized by small vessel vaso-occlusive lesions associated with fibrous intimal hyperplasia of interlobular arteries, recanalizing thrombi in arteries and arterioles, and focal atrophy, a constellation of morphological lesions suggestive of primary antiphospholipid syndrome.

  4. Primary Mural Endocarditis Without Valvular Involvement.

    Science.gov (United States)

    Tahara, Mai; Nagai, Tomoo; Takase, Yoshiyuki; Takiguchi, Shunichi; Tanaka, Yoshiaki; Kunihara, Takashi; Arakawa, Junko; Nakaya, Kazuhiro; Hamabe, Akira; Gatate, Youdou; Kujiraoka, Takehiko; Tabata, Hirotsugu; Katsushika, Shuichi

    2017-03-01

    Primary mural endocarditis is an extremely rare infection in which nonvalvular endocardial involvement is seen without any cardiac structural abnormalities such as ventricular septal defects. The rapid and precise diagnosis of this disease remains challenging. We present 2 cases (67- and 47-year-old male patients) of pathologically confirmed primary mural endocarditis that could have been detected by initial transthoracic echocardiography in the emergency department. Transthoracic echocardiography and transesophageal echocardiography play critical roles in the early recognition and confirmation of primary mural endocarditis. © 2017 by the American Institute of Ultrasound in Medicine.

  5. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

    Full Text Available Odontogenesis is a complex process wherein more than 200 genes are known to play a significant role in tooth development. An imbalance can lead to an abnormality in the number, size, shape or structure of the developing tooth/teeth. The presence of an extra dental lamina forms a supernumerary tooth. The supernumerary teeth are of two types: A rudimentary tooth where the supernumerary tooth does not resemble any tooth in the normal series or a supplemental tooth in which this anomalous tooth resembles one in the normal series. It is also very rare to encounter triple teeth in primary dentition. The union of these teeth may be through fusion, gemination, concrescence or a combination of fusion and gemination. Presented is a rare case of concrescence involving maxillary deciduous incisors and a supplemental tooth in a 7-year-old boy. The differential diagnosis, etiology, and complications of primary anterior triple teeth are discussed.

  6. Primary bone lymphoma with multiple vertebral involvement

    Directory of Open Access Journals (Sweden)

    Showkat Hussain Dar

    2013-01-01

    Full Text Available A 20-year-old student presented with 2 months history of fever and night sweats, 15 days history of low backache, progressive weakness of both limbs of 7 days duration, and urinary retention for last 24 h. Examination revealed a sensory level at D 10 dermatome and grade two power in both the lower limbs with absent reflexes. Examination of spine revealed a knuckle at T8 level, which was tender on palpation. MRI spine showed erosion of D11-12 and L1 in vertebral bodies with destruction of left pedicles, transverse processes and lamina, and a prominent psoas abscess. Post gadolinium study revealed ring-enhancing lesions in the D11-12 and L1 vertebrae as well as the dural sac. Fine needle aspiration cytology (FNAC and bone biopsy demonstrated a non-Hodgkin′s lymphoma (NHL, large cell high-grade of the spine (primary, which as per age is the youngest case of NHL ever reported in literature with multiple vertebral involvement.

  7. The Western Primary School 'Quiet Room' Project.

    Science.gov (United States)

    King, Angus; Chantler, Zara

    2002-01-01

    This article describes a "Quiet Room" project for students with social, emotional, and behavioral problems at a British primary school. The Quiet Room was designed to provide a nurturing environment away from the classroom in which a child's emotional needs can be explored on a one-to-one basis. Benefits for children, parents, and…

  8. Primary cutaneous lymphoma with involvement of external genitalia

    International Nuclear Information System (INIS)

    Viscandi, C.; Campo, L. del

    1998-01-01

    We describe the radiological findings recorded in a case of primary B cells cutaneous lymphoma that presented with involvement of penis and scrotum. The patient was referred to our center to undergo an ultrasonographic study. (Author) 7 refs

  9. The impact of consumer involvement in research: an evaluation of consumer involvement in the London Primary Care Studies Programme.

    Science.gov (United States)

    Wyatt, Katrina; Carter, Mary; Mahtani, Vinita; Barnard, Angela; Hawton, Annie; Britten, Nicky

    2008-06-01

    The value of consumer involvement in health services research is widely recognized. While there is a growing body of evidence about the principles of good consumer involvement, there is little research about the effect that involvement can have on the research. This evaluation assessed the level and impact of consumer involvement in the London Primary Care Studies Programme (LPCSP), all of whose individual projects had to demonstrate substantial involvement as a condition of funding. To evaluate consumer involvement in the LPSCP and understand what impact consumers had on the research process and outcomes. A multi-method case study approach was undertaken, using survey techniques, interviews, focus groups, observation and scrutiny of written documents. The overall data set comprised 61 questionnaires, 44 semi-structured interviews, 2 focus groups and 15 hours of observation of meetings. Eleven primary care-based research projects which together made up the LPCSP. An in-depth description of consumer involvement in the Programme was produced. Nine projects had consumers as co-applicants, four projects had been completed before the evaluation began and one was still ongoing at the time of the evaluation. Of the eight projects which have produced final reports, all met their aims and objectives. Consumers had had an additional impact in the research, in the initial design of the study, in recruitment of the research subjects, in developing data collection tools, in collecting the data, in analysis and disseminating the findings. Consumer involvement in National Health Service research is a relatively recent policy development and while there is an increasing amount of literature about how and why consumers should be involved in research, there is less evidence about the impact of such involvement. This evaluation provides evidence about the impact that consumers have not only on the research process but also on the outcomes of the research.

  10. Project Design Concept - Primary Ventilation System

    International Nuclear Information System (INIS)

    MCGREW, D.L.

    2000-01-01

    Tank Farm Restoration and Safe Operation (TFRSO), Project W-3 14 was established to provide upgrades that would improve the reliability and extend the system life of portions of the waste transfer, electrical, ventilation, instrumentation and control systems for the Hanford Site Tank Farms. An assessment of the tank farm system was conducted and the results are documented in system assessment reports. Based on the deficiencies identified in the tank farm system assessment reports, and additional requirements analysis performed in support of the River Protection Project (RPP), an approved scope for the TFRSO effort was developed and documented in the Upgrade Scope Summary Report (USSR), WHC-SD-W314-RPT-003, Rev. 4. The USSR establishes the need for the upgrades and identifies the specific equipment to be addressed by this project. This Project Design Concept (PDC) is in support of the Phase 2 upgrades and provides an overall description of the operations concept for the W-314 Primary Ventilation Systems. Actual specifications, test requirements, and procedures are not included in this PDC. The PDC is a ''living'' document, which will be updated throughout the design development process to provide a progressively more detailed description of the W-314 Primary Ventilation Systems design. The Phase 2 upgrades to the Primary Ventilation Systems shall ensure that the applicable current requirements are met for: Regulatory Compliance; Safety; Mission Requirements; Reliability; and Operational Requirements

  11. Primary extradural leiomyosarcoma involving cavernous sinus in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Hanni V Gulwani

    2014-01-01

    Full Text Available Intracranial leiomyosarcoma (LMS are uncommon malignancies and usually encountered after systemic metastases. Limited cases of primary intracranial LMSs have been reported in the literature. It mostly affects immunocompromised individuals in association with Epstein-Barr virus infection. This is the unusual first case being reported of primary LMS in immunocompetent patient with involvement of cavernous sinus.

  12. Homework Involvement among Hong Kong Primary School Students

    Science.gov (United States)

    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…

  13. The silent partners? Leading parental involvement in primary schools in areas experiencing educational inequality.

    OpenAIRE

    O'Reilly, Siobhan

    2012-01-01

    This research project explored and examined parental involvement in two primary school with an emphasis on ‘leading’ this involvement. Both schools were situated in designated DEIS Urban Band 1 areas in Dublin. DEIS Urban Band 1 schools are identified as areas of high levels of socioeconomic disadvantage. The project was contextualised within the current national policy which has committed to parents as partners in their child’s education and the evidence from international literature clearly...

  14. Safety Technology Research Program in the field of pressurized water reactors. 1. Technical report on advancement project RS 36/2. Emergency cooling program service life experiments: reflooding experiments involving the primary loop systems

    International Nuclear Information System (INIS)

    Schweickert, H.; Kremin, H.; Mandl, R.; Riedle, V.; Ruthrof, K.; Sarkar, J.; Schmidt, H.

    The reflooding of the hot reactor core is to be examined for a pressurized water reactor (PWR), using a model of the entire primary loop system. The scale of the model is to be 1:340 in cross-section, with the heights represented full-scale. In addition to the goals of the project, a description of the test facility, including data collection and control equipment is presented. The instrumentation, the planned test program and the test procedure are briefly set forth

  15. Interdisciplinary Collaboration: Librarian Involvement in Grant Projects

    Science.gov (United States)

    Brandenburg, Marci D.; Cordell, Sigrid Anderson; Joque, Justin; MacEachern, Mark P.; Song, Jean

    2017-01-01

    Librarians are excellent research collaborators, although librarian participation is not usually considered, thereby making access to research funds difficult. The University of Michigan Library became involved in the university's novel funding program, MCubed, which supported innovative interdisciplinary research on campus, primarily by funding…

  16. Primary multifocal tuberculous osteomyelitis with involvement of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Chang, D.S. [New York University School of Medicine, New York, New York (United States); Rafii, M.; McGuinness, G. [Department of Radiology, NYU Medical Center, New York, NY (United States); Jagirdar, J.S. [Department of Pathology, NYU Medical Center, New York, New York (United States)

    1998-11-01

    Two cases of primary multifocal tuberculous osteomyelitis with involvement of the rib cage are presented. The lungs were normal and the appearance of the skeletal lesions did not suggest tuberculosis. These lesions were predominantly lytic, with minimal soft tissue involvement. Tuberculosis should be high in the differential diagnosis of multiple destructive bone lesions, especially in patients from regions where tuberculosis is endemic. (orig.) With 5 figs., 21 refs.

  17. 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…

  18. Developing consumer involvement in rural HIV primary care programmes.

    Science.gov (United States)

    Mamary, Edward M; Toevs, Kim; Burnworth, Karla B; Becker, Lin

    2004-06-01

    As part of a broader medical and psychosocial needs assessment in a rural region of northern California, USA, five focus groups were conducted to explore innovative approaches to creating a system of consumer involvement in the delivery of HIV primary care services in the region. A total of five focus groups (n = 30) were conducted with clients from three of five counties in the region with the highest number of HIV patients receiving primary care. Participants were recruited by their HIV case managers. They were adults living with HIV, who were receiving health care, and who resided in a rural mountain region of northern California. Group discussions explored ideas for new strategies and examined traditional methods of consumer involvement, considering ways they could be adapted for a rural environment. Recommendations for consumer involvement included a multi-method approach consisting of traditional written surveys, a formal advisory group, and monthly consumer led social support/informal input groups. Specific challenges discussed included winter weather conditions, transportation barriers, physical limitations, confidentiality concerns, and needs for social support and education. A multiple-method approach would ensure more comprehensive consumer involvement in the programme planning process. It is also evident that methods for incorporating consumer involvement must be adapted to the specific context and circumstances of a given programme.

  19. Managing externally financed projects: the Integrated Primary Health Care Project in Bolivia.

    Science.gov (United States)

    Homedes, N

    2001-12-01

    Bolivia is one of the poorest countries in Latin America. Health indicators are very poor, communicable diseases are prevalent and, coupled with malnutrition, remain the major killers of children under 5 years old. The Integrated Primary Health Care Project (PROISS) was a US$39 million project executed by the Ministry of Health (MOH), 50% financed by the World Bank and aimed at improving primary health care in the four largest Bolivian municipalities. The implementation of the project started in 1990 and ended in 1997. During implementation it went through three distinct phases: Phase 1 (1990-94) was a period characterized by conflict and confusion; Phase 2 (1995-mid-1996) documented major improvements in coverage and service quality; and Phase 3 (mid-1996-97) witnessed the decline of the project. This paper explores the factors that contributed to the success and the decline of the project, draws lessons for project managers and international agencies involved in the definition and implementation of social sector projects, and discusses the unlikelihood that externally financed projects can have a sustainable impact on the development of the health sector of recipient countries.

  20. Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis.

    Science.gov (United States)

    Gong, Eun Jeong; Kim, Do Hoon; Chun, Joo Hyun; Ahn, Ji Yong; Choi, Kwi-Sook; Jung, Kee Wook; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon-Yong; Kim, Jin Ho; Song, In Hye; Kim, Yong-Gil

    2016-07-15

    Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low.

  1. Telemedicine and primary health: The virtual doctor project Zambia

    OpenAIRE

    Mupela, Evans; Mustarde, Paul; Jones, Huw

    2011-01-01

    This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

  2. The Esperance primary prevention of suicide project.

    Science.gov (United States)

    Slaven, Janine; Kisely, Stephen

    2002-10-01

    Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. To evaluate the effect of three evidence-based initiatives for the primary prevention of suicide: (i) providing suicide awareness sessions for staff members in health, education and social services; (ii) limiting the sale of over the counter analgesics (aspirin and paracetamol) to packets containing less than the minimum lethal dose; and (iii) implementing Commonwealth media guidelines in the reporting of suicides by media. Changes in knowledge, awareness, attitudes, comfort and use, before and after each intervention were assessed using standardized instruments and pro forma derived from previous work, such as the Youth Suicide Prevention Training Manual and Suicide Intervention Beliefs Scale. Percentage changes in the number of retail outlets selling over the counter analgesics to less than potentially lethal quantities (less than 8 g of paracetamol or aspirin) were also measured. Media representatives were interviewed to gain their perceptions of Commonwealth Guidelines for the reporting of suicide, and encouraged to consult the project team before reporting suicide related issues. The baseline survey illustrated that mental health staff and general practitioners were more aware of suicide issues, risk factors for suicide and awareness of professional and ethical responses than staff from other services, and were more willing to raise the issue with a person at risk. Thirty-three subjects participated in suicide awareness training of whom 21 (66%) returned questionnaires. There were significant increases in awareness of suicide-related issues and risk factors, as well as reported levels of knowledge of professional and ethical responses and comfort, competence and confidence levels when assisting a person at risk. Only three media representatives were aware of the Commonwealth Health Department Guidelines for reporting suicide and only

  3. Ten Projects to Involve Your Students Directly in French.

    Science.gov (United States)

    van Lent, Peter C.

    1981-01-01

    Proposes 10 activities to provide French classes of all levels with a broad spectrum of language projects involving direct and active use of French including students polling each other, skits based on television commercials, geographical "show and tell," cooking French dishes, writing a monthly newspaper, and field trips. (BK)

  4. Personality Characteristics Of Teachers Involved In The Delivery Of Primary Healthy Care (Sevagram Experiment

    Directory of Open Access Journals (Sweden)

    Singh D

    1990-01-01

    Full Text Available An attempt was made to study the personality traits influencing the performance of 17 primary school teachers selected under ICMR project in Wardha district, to investigate feasibility and effectiveness of their involvement as primary health care workers vis-Ã -vis the 19 community health volunteers introduced by the State Government in the non-teacher villages of the project at the same time. The results indicated that both the teachers and community health volunteers preferred preventive and promotive health tasks and they showed no significant difference on the motivation and leadership orientation scale. The teachers, because of their job security and promotional avenues were satisfied with their achievements and were full of hopes and aspirations but the same was not true with the community health volunteers. This was due to their comparatively poor economic conditions and unstable sources of livelihood.

  5. Intercultural Education in Primary School: A Collaborative Project

    Science.gov (United States)

    Santos, Marta; Araújo e Sá, Maria Helena; Simões, Ana Raquel

    2014-01-01

    In this article, we present and discuss a collaborative project on intercultural education developed by a group of educational partners. The group was made up of 12 people representing different institutions in the community, namely primary schools, cultural and social associations and the local council. The project takes an intercultural approach…

  6. Investigating shadows: a pedagogical intervention project with primary school children

    Science.gov (United States)

    Noversa, Silvana; Abreu, Cátia; Varela, Paulo; Costa, Manuel F. M.

    2014-07-01

    This communication results from a pedagogical intervention project, carried out at a primary school in the district of Braga - Portugal. The intervention took place in a class of the 3rd year, composed of 16 students, and it incorporated the practice of inquiry-based science teaching addressing the theme "Light Experiments", which is part of the "Environmental Studies" curricular area. Various class activities were planned and implemented concerning some of the factors that influence the shadow of an object, in order to find answers to the following three questions: a) will 3rd year students, aged 7/8 years, be able to construct and execute an investigation strategy that involves manipulating and controlling variables? b) what are the main difficulties experienced by students in the designing and execution of such a strategy? c) how will students, in interaction with the teacher and with their peers, gradually design and execute their investigation strategy in order to respond to the problem formulated? The project adopted an action research methodology. A careful record was kept of the events most relevant to the questions under study in each class. This data was used to prepare the class diaries - descriptive and reflective narratives prepared based on recorded audio and field notes made during participant observation in the context of the classroom. A content analysis of the diaries has identified a few elements that provide answers to the research questions raised. In order to plan and implement a research project with children in the 7/8 years old range require a high level of scaffolding to allow students to gradually build a coherent strategy to tackle the research problem. Teacher's role is crucial. The teacher, by questioning and inducing reasoning and discussion, promotes encourages and regulates the cognitive activity of students. Some level of autonomy should be given to the students in large group collaborative work.

  7. Communication and Stakeholder Involvement in Environmental Remediation Projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-05-15

    The way in which members of the public perceive a contamination situation and an approach to the remediation of contaminated land will influence the decision making process in a variety of ways. Through communication between experts, decision makers and members of stakeholder communities, participatory processes and negotiation between different interest groups can sometimes be used effectively as mechanisms for improving the overall decision making process. The intention is to ensure a technically sound and socially acceptable decision that meets norms of adequacy or satisfactory performance in relation to a whole range of different concerns. Good communication strategies will encourage cooperation and understanding between different interested parties in remediation projects. Involvement of affected or interested persons can prevent fear driven reactions, which potentially damage public response and create undue expectations or unnecessary anxiety. For all environmental remediation (ER) cases, there is a risk that the process will fail if it does not respect social, environmental, political and economic dimensions. This requires open, clear and mutually agreed lines of communication among stakeholders within a well defined legal framework. A general recommendation is to involve them from a very early point in the process. This publication presents ER in plain language in such a way that implementers and regulators can communicate the motives and objectives of remediation projects to a variety of stakeholder communities in order to improve mutual understanding and facilitate dialogue between interested parties. ER is considered from two perspectives: technical and non-technical. A section that gives general ideas on the strategies to deal with stakeholder involvement and which discusses different aspects of the communication approaches in ER is then included. It is recognized that social, cultural and political situations are very diverse in different countries in

  8. Communication and Stakeholder Involvement in Environmental Remediation Projects

    International Nuclear Information System (INIS)

    2014-01-01

    The way in which members of the public perceive a contamination situation and an approach to the remediation of contaminated land will influence the decision making process in a variety of ways. Through communication between experts, decision makers and members of stakeholder communities, participatory processes and negotiation between different interest groups can sometimes be used effectively as mechanisms for improving the overall decision making process. The intention is to ensure a technically sound and socially acceptable decision that meets norms of adequacy or satisfactory performance in relation to a whole range of different concerns. Good communication strategies will encourage cooperation and understanding between different interested parties in remediation projects. Involvement of affected or interested persons can prevent fear driven reactions, which potentially damage public response and create undue expectations or unnecessary anxiety. For all environmental remediation (ER) cases, there is a risk that the process will fail if it does not respect social, environmental, political and economic dimensions. This requires open, clear and mutually agreed lines of communication among stakeholders within a well defined legal framework. A general recommendation is to involve them from a very early point in the process. This publication presents ER in plain language in such a way that implementers and regulators can communicate the motives and objectives of remediation projects to a variety of stakeholder communities in order to improve mutual understanding and facilitate dialogue between interested parties. ER is considered from two perspectives: technical and non-technical. A section that gives general ideas on the strategies to deal with stakeholder involvement and which discusses different aspects of the communication approaches in ER is then included. It is recognized that social, cultural and political situations are very diverse in different countries in

  9. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors.

    Science.gov (United States)

    Supper, I; Catala, O; Lustman, M; Chemla, C; Bourgueil, Y; Letrilliart, L

    2015-12-01

    The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses. Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists. Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another's roles and competences, shared information, confidentiality and responsibility, team building and interprofessional training, long-term funding and joint monitoring. Interprofessional organization and training based on appropriate models should support collaboration development. The active participation of the patient is required to go beyond professional boundaries and hierarchies. Multidisciplinary research projects are recommended. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Primary hyperparathyroidism with classic and severe skeletal involvement

    OpenAIRE

    Sandoval, Mark Anthony S; Paz-Pacheco, Elizabeth

    2010-01-01

    A 63-year-old woman has had multiple repeated fractures. A diagnosis of primary hyperparathyroidism (PHPT) was made after she was found to be hypercalcaemic with an elevated level of intact parathyroid hormone (iPTH). Radiographs revealed classic and severe bone findings in PHPT, features which were common in the past but are thought to be rare at this modern age. She also had nephrolithiasis and osteoporosis. An enlarged parathyroid gland was seen on ultrasound and CT scan, and hyperfunction...

  11. Implementation of municipal health promoting projects in primary schools: teachers perspective

    DEFF Research Database (Denmark)

    Nordin, Lone Lindegard

    2013-01-01

    . The project is funded by the Danish Ministry of Science, University of Aarhus and Silkeborg municipality, and involves 5 primary schools, 23 teachers and 233 pupils from 7th to 9 class. The project is positioned within the critical approach to school health education and health promotion, developed......Implementation of municipally health promoting projects' in primary schools: teachers perspective Research question This paper discusses the findings from a qualitative research, that aimed to investigate how teachers in primary schools implemented municipal health promoting projects focusing...... that there is a “gap” between policy and practice according to aim, content and methods, and that teachers practice can be explained as coping mechanism. The key findings include: • Teachers practice is closer to traditional health education than critical health education. • Teachers priorities the mandatory teaching...

  12. The involvement of private general practitioners in visiting primary ...

    African Journals Online (AJOL)

    Clear expectations and a confusion of roles leads to lack of teamwork, thus it is important to have clearly established models for such involvement. Doctors working in district hospitals mostly visit clinics, but their workload, staff shortages and transport often interfere with these visits. As a form of private-public partnership, ...

  13. Interventions for improving older patients' involvement in primary care episodes.

    NARCIS (Netherlands)

    Wetzels, R.V.; Harmsen, M.; Weel, C. van; Grol, R.P.T.M.; Wensing, M.J.P.

    2007-01-01

    BACKGROUND: There is a growing expectation among patients that they should be involved in the delivery of medical care. Accumulating evidence from empirical studies shows that patients of average age who are encouraged to participate more actively in treatment decisions have more favourable health

  14. EVALUATION OF NEW PRIMARY TEACHERS ORIENTATION COURSE PROJECT LAUNCHED THROUGH ALLAMA IQBAL OPEN UNIVERSITY, ISLAMABAD PAKISTAN

    Directory of Open Access Journals (Sweden)

    Syed Manzoor H. SHAH

    2011-07-01

    Full Text Available Primary Education is an important stage in the education system of any country. Every developed and developing nation is keen to develop and improve its primary education. In service training of the primary school teachers is a major factor in improving primary education. In Pakistan efforts have been made from the very beginning to improve the primary education especially in the late seventy’s. Different Non Governmental Organizations (NGOs, Donors Agencies and Institutions had been involved in taking different initiatives for the improvement of the quality of primary education. New Primary Teachers Orientation Course (N-PTOC was a similar effort of the Norwegian Agency for Development Co-operation (NORAD in joint collaboration of Allama Iqbal Open University, Islamabad (AIOU. The major objective of the project was to improve the teaching of primary school teachers through selected microteaching skills, lesson planning, use of teaching kit and AV aids. This project was started in 1991-92 and completed in the year, 1999. Different studies were conducted which indicated that the project has an impact on the performance of the trained teachers. The present study aimed for evaluation of the N-PTOC project launched through Allama Iqbal Open University, Islamabad. The study is based on the documentary analysis. All the existing record of the project including different reports, documents etc. were consulted for the purpose. It was concluded that the project achieved its trainee teacher’s targets up to 70% and training of tutors and senior tutors up to 100%. Moreover the project produced a model teachers training module for the in-service training of the primary school teachers. There were some problems and challenges in its implementation including; late release of funds, shifting of targets to next semester and its non continuation by the AIOU.

  15. Ecological and Intercultural Citizenship in the Primary English as a Foreign Language (EFL) Classroom: An Online Project in Argentina

    Science.gov (United States)

    Porto, Melina

    2016-01-01

    This article describes an online intercultural citizenship project concerning the environment in the primary English-language classroom carried out in 2013/2014 between Argentina and Denmark. It is part of a network of projects coordinated by Michael Byram that involves teachers and researchers in Europe, the US and East Asia. The project is…

  16. INCA project for investigation of primary cosmic radiation spectrum

    International Nuclear Information System (INIS)

    Aleksandrov, K.V.; Erlykin, A.D.; Zhdanov, G.B.

    2002-01-01

    The scientific purposes of the INCA project and application of the ionization-neutron calorimeter for direct measurements of the cosmic rays spectrum and composition in the knee area and the primary electrons spectrum by 10 14 - 10 13 eV are discussed. The new effective method for the primary electrons and protons separation with the complex rejection coefficient of 10 -5 - 10 -6 is proposed for studying the primary electrons spectrum by E e > 1 TeV. The experimental and calculation data are in good agreement [ru

  17. Primary hyperparathyroidism with classic and severe skeletal involvement.

    Science.gov (United States)

    Sandoval, Mark Anthony S; Paz-Pacheco, Elizabeth

    2010-08-26

    A 63-year-old woman has had multiple repeated fractures. A diagnosis of primary hyperparathyroidism (PHPT) was made after she was found to be hypercalcaemic with an elevated level of intact parathyroid hormone (iPTH). Radiographs revealed classic and severe bone findings in PHPT, features which were common in the past but are thought to be rare at this modern age. She also had nephrolithiasis and osteoporosis. An enlarged parathyroid gland was seen on ultrasound and CT scan, and hyperfunction was demonstrated by scintigraphy. Parathyroidectomy was performed. Histopathologic analysis revealed a parathyroid adenoma. She developed the hungry-bone syndrome 7 days postoperatively, which resolved with with administration of calcium and calcitriol.

  18. Lessons learnt from a primary care asthma improvement project.

    Science.gov (United States)

    Lenney, Warren; Clayton, Sadie; Gilchrist, Francis J; Price, David; Small, Iain; Smith, Judy; Sutton, Emma J

    2016-01-07

    Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.

  19. Effective Strategies for Teaching Evolution: The Primary Evolution Project

    Science.gov (United States)

    Hatcher, Chris

    2015-01-01

    When Chris Hatcher joined the Primary Evolution Project team at the University of Reading, his goal was to find effective strategies to teach evolution in a way that keeps children engaged and enthused. Hatcher has collaborated with colleagues at the University's Institute of Education to break the evolution unit down into distinct topics and…

  20. The assessment of depressive patients' involvement in decision making in audio-taped primary care consultations.

    NARCIS (Netherlands)

    Loh, A.; Simon, D.; Hennig, K.; Hennig, B.; Harter, M.; Elwyn, G.

    2006-01-01

    OBJECTIVE: In primary care of depression treatment options such as antidepressants, counseling and psychotherapy are reasonable. Patient involvement could foster adherence and clinical outcome. However, there is a lack of empirical information about the extent to which general practitioners involve

  1. Projector primary-based optimization for superimposed projection mappings

    Science.gov (United States)

    Ahmed, Bilal; Lee, Jong Hun; Lee, Yong Yi; Lee, Kwan H.

    2018-01-01

    Recently, many researchers have focused on fully overlapping projections for three-dimensional (3-D) projection mapping systems but reproducing a high-quality appearance using this technology still remains a challenge. On top of existing color compensation-based methods, much effort is still required to faithfully reproduce an appearance that is free from artifacts, colorimetric inconsistencies, and inappropriate illuminance over the 3-D projection surface. According to our observation, this is due to the fact that overlapping projections are treated as an additive-linear mixture of color. However, this is not the case according to our elaborated observations. We propose a method that enables us to use high-quality appearance data that are measured from original objects and regenerate the same appearance by projecting optimized images using multiple projectors, ensuring that the projection-rendered results look visually close to the real object. We prepare our target appearances by photographing original objects. Then, using calibrated projector-camera pairs, we compensate for missing geometric correspondences to make our method robust against noise. The heart of our method is a target appearance-driven adaptive sampling of the projection surface followed by a representation of overlapping projections in terms of the projector-primary response. This gives off projector-primary weights to facilitate blending and the system is applied with constraints. These samples are used to populate a light transport-based system. Then, the system is solved minimizing the error to get the projection images in a noise-free manner by utilizing intersample overlaps. We ensure that we make the best utilization of available hardware resources to recreate projection mapped appearances that look as close to the original object as possible. Our experimental results show compelling results in terms of visual similarity and colorimetric error.

  2. Patient and public involvement in primary care research - an example of ensuring its sustainability.

    Science.gov (United States)

    Jinks, Clare; Carter, Pam; Rhodes, Carol; Taylor, Robert; Beech, Roger; Dziedzic, Krysia; Blackburn, Steven; Hughes, Rhian; Ong, Bie Nio

    2016-01-01

    The international literature on patient and public involvement (PPI) in research covers a wide range of issues, including active lay involvement throughout the research cycle; roles that patients/public can play; assessing impact of PPI and recommendations for good PPI practice. One area of investigation that is less developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. This paper focuses on the issues of sustainability, the importance of institutional leadership and the creation of a robust infrastructure in order to achieve long-term and wide-ranging PPI in research strategy and programmes. We use the case of a Primary Care Research Centre to provide a historical account of the evolution of PPI in the Centre and identified a number of key conceptual issues regarding infrastructure, resource allocation, working methods, roles and relationships. The paper concludes about the more general applicability of the Centre's model for the long-term sustainability of PPI in research.

  3. Projecting Fatalities in Crashes Involving Older Drivers, 2000-2025

    Energy Technology Data Exchange (ETDEWEB)

    Hu, P.S.

    2001-03-23

    As part of this research effort, we developed a new methodology for projecting elderly traffic crash fatalities. This methodology separates exposure to crashes from crash risk per se, and further divides exposure into two components, the number of miles driven and the likelihood of being a driver. This component structure permits conceptually different determinants of traffic fatalities to be projected separately and has thorough motivation in behavioral theory. It also permits finer targeting of particular aspects of projections that need improvement and closer linking of projections to possible policy instruments for influencing them.

  4. Team collaborative innovation management based on primary pipes automatic welding project

    International Nuclear Information System (INIS)

    Li Jing; Wang Dong; Zhang Ke

    2012-01-01

    The welding quality of primary pipe directly affects the safe operation of nuclear power plants. Primary pipe automatic welding, first of its kind in China, is a complex systematic project involving many facets, such as design, manufacturing, material, and on-site construction. A R and D team was formed by China Guangdong Nuclear Power Engineering Co., Ltd. (CNPEC) together with other domestic nuclear power design institutes, and manufacturing and construction enterprises. According to the characteristics of nuclear power plant construction, and adopting team collaborative innovation management mode, through project co-ordination, resources allocation and building production, education and research collaborative innovation platform, CNPEC successfully developed the primary pipe automatic welding technique which has been widely applied to the construction of nuclear power plant, creating considerable economic benefits. (authors)

  5. Particulate Air Contamination in Puerto Rico: A Student Involvement Project.

    Science.gov (United States)

    Eckert, Richard R.

    1979-01-01

    Describes a research project undertaken by physics undergraduate students to monitor particulate air contamination in Ponce, Puerto Rico, and to determine the meteorological factors which contribute to it. (GA)

  6. Public involvement in multi-objective water level regulation development projects-evaluating the applicability of public involvement methods

    International Nuclear Information System (INIS)

    Vaentaenen, Ari; Marttunen, Mika

    2005-01-01

    Public involvement is a process that involves the public in the decision making of an organization, for example a municipality or a corporation. It has developed into a widely accepted and recommended policy in environment altering projects. The EU Water Framework Directive (WFD) took force in 2000 and stresses the importance of public involvement in composing river basin management plans. Therefore, the need to develop public involvement methods for different situations and circumstances is evident. This paper describes how various public involvement methods have been applied in a development project involving the most heavily regulated lake in Finland. The objective of the project was to assess the positive and negative impacts of regulation and to find possibilities for alleviating the adverse impacts on recreational use and the aquatic ecosystem. An exceptional effort was made towards public involvement, which was closely connected to planning and decision making. The applied methods were (1) steering group work, (2) survey, (3) dialogue, (4) theme interviews, (5) public meeting and (6) workshops. The information gathered using these methods was utilized in different stages of the project, e.g., in identifying the regulation impacts, comparing alternatives and compiling the recommendations for regulation development. After describing our case and the results from the applied public involvement methods, we will discuss our experiences and the feedback from the public. We will also critically evaluate our own success in coping with public involvement challenges. In addition to that, we present general recommendations for dealing with these problematic issues based on our experiences, which provide new insights for applying various public involvement methods in multi-objective decision making projects

  7. Local involvement in CDM biogas projects: Argentine experiences

    NARCIS (Netherlands)

    Serna Martín, A.; Dietz, T.

    2008-01-01

    Mitigating climate change and contributing to the sustainable development of host countries are the goals of the CDM. In order to achieve these goals, projects follow an implementation chain, which starts with the design and ends with the issuance of Certified Emission Reductions (CERs). During the

  8. Involving the public into HEP through IT challenges and projects

    CERN Document Server

    Adam Bourdarios, Claire; The ATLAS collaboration

    2016-01-01

    The ATLAS collaboration has recently setup three outreach projects and global challenges which have a strong IT component and could not have been envisaged without the growth of general public computing resources and network connectivity. HEP has exciting and difficult problems like the extraction of the Higgs boson signal, and at the same time data scientists have advanced algorithms. The goal of the Higgs Machine Learning (HiggsML) project was to bring the two together by a “challenge”: machine learning experts could compete online to obtain the best Higgs→ττ signal significance on a set of ATLAS fully simulated Monte Carlo signal and background events. The first challenge of this kind ran from May to September 2014, drawing considerable attention, and new projects followed in the context of the CERN open data initiative. Higgs Hunters is the only physics-related project hosted on a web-based citizen science platform called Zooniverse. Volunteers usually contributing to space, natural world and huma...

  9. Integrating Community into the Classroom: Community Gardening, Community Involvement, and Project-Based Learning.

    Science.gov (United States)

    Langhout, Regina Day; Rappaport, Julian; Simmons, Doretha

    2002-01-01

    Culturally relevant, ongoing project-based learning was facilitated in a predominantly African American urban elementary school via a community garden project. The project involved teachers, students, university members, and community members. This article evaluates the project through two classroom-community collaboration models, noting common…

  10. SPIRE Project: Parental Involvement in Young Children's ESL Reading Development

    Science.gov (United States)

    Harji, Madhubala Bava; Balakrishnan, Kavitha; Letchumanan, Krishnanveni

    2016-01-01

    Realising the clear dichotomy between schools and homes, the Malaysia government has now turned its attention to stakeholders and called for an increase involvement of parents, who are critical in transforming the education system. However, a clear line of demarcation continues to exist between the two prime educators of young children. Schools…

  11. Parent Involvement in Education Project (PIEP): Annual Report.

    Science.gov (United States)

    Southwest Educational Development Lab., Austin, TX.

    This survey is the fifth in a series conducted to gather information about attitudinal barriers to parent involvement and to examine their implications for teacher training. In six states (Arkansas, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas), school superintendents, school board presidents, and state agency officials were asked about…

  12. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

    Science.gov (United States)

    Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

    2018-01-01

    In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded

  13. Managing delayed projects. Cernavoda NPP - Romania. Importance of NGO involvement

    International Nuclear Information System (INIS)

    Rotaru, I.

    2003-01-01

    In Romania there is a diversity of civil societies with respect to the attitude towards nuclear power. Among the dedicated societies supporting nuclear power development there are: the Romanian Atomic Forum (Ratomet), affiliated to the European Atomic Forum; the Romanian Nuclear Power Association (Arden), affiliated to the European Nuclear Society; the Romanian Radioprotection Society (SR Rp), affiliated to the Radiation Protection Association. The main dedicated activities of above mentioned Non-governmental Organizations (Ng) are: establishing contacts and organizing meeting with Romanian political decision making factors, mass media representatives, institutional entities, civil society ect.; orienting and co-coordinating activities of Romanian companies involved in production and services for nuclear energy; serving as contact point for relevant international communication and business relation; creating internal working groups for certain theme or sub-domain and suggested solution for a particular issue, including experts even from outside of the association; performing lobby activities ect

  14. Central nervous system involvement in primary Sjogren`s syndrome manifesting as multiple sclerosis.

    Science.gov (United States)

    Liu, Jing-Yao; Zhao, Teng; Zhou, Chun-Kui

    2014-04-01

    Central nervous system symptoms in patients with primary Sjogren`s syndrome are rare. They can present as extraglandular manifestations and require a differential diagnosis from multiple sclerosis. Due to a variety of presentations, Sjogren`s syndrome with neurologic involvement may be difficult to diagnose. Here, we report a case of a 75-year-old woman who was first diagnosed with multiple sclerosis in 2010, but who was subsequently diagnosed with primary Sjogren`s syndrome 2 years later after showing signs of atypical neurologic manifestations. Therefore, primary Sjogren`s syndrome should be suspected in patients who present with atypical clinical and radiologic neurologic manifestations.

  15. Regulatory and Stakeholder Involvement is Key to Successful Project Completion

    International Nuclear Information System (INIS)

    Ballinger, K. S.; Coleman, S. J.; Shoemake, J. M.; Olds, T. E.

    2006-01-01

    Public involvement participation is an integral and effective component of the U.S. Department of Energy's (DOE) activities that ensures crucial decisions are made with the benefit and consideration of public perspectives. This component brings a broad range of diverse viewpoints and values into DOE's decision-making processes before end decision points are reached. Early involvement enables DOE to make more informed decisions, improve quality through collaborative efforts, and helps to build mutual understanding and trust between DOE and the public it serves. During the cold war, the production of thousands of nuclear warheads was an outstanding engineering achievement that created materials and technologies that were vital to national interest and security; however, it also created a legacy of perplexing toxic nuclear waste. The significant challenges presented by the liquid and solid nuclear wastes stored at the Hanford Site, were formally acknowledged by the U.S. Congress when it directed DOE to establish the Office of River Protection (ORP). The office was assigned the single, dedicated mission of retrieving, treating, and disposing of all waste contained in 177 huge underground storage tanks at the Hanford Site in Southeastern Washington State. As part of this on-going mission of cleanup, the Office of River Protection must make sound decisions that uphold not only the Department of Energy's interests, but more importantly, the interests of the state of Washington. Public participation is an open, ongoing, two-way communication, both formal and informal, between DOE and its stakeholders, regulatory agencies and Tribal governments. Similarly, public information is a means to keep the public informed of progress or to status ongoing activities and/or issues. Another facet of this process is that various laws and regulations govern public participation and information when it comes to Hanford cleanup, including the Hanford Federal Facility Agreement and Consent

  16. Students in a School Environment: A Project Focused on Family Involvement of At-Risk

    Science.gov (United States)

    Denney, Pat

    2011-01-01

    This project examined family involvement of at risk students in mid-west communities. The purpose of this project was to study the affect of family involvement on at-risk student achievement. The redefining of the perception of America has resulted in a crisis of academic performance in the traditionally slow-changing education systems. This topic…

  17. Social Skills Scores: The Impact of Primary School Population Characteristics and Parental Involvement

    Science.gov (United States)

    Dekker, Karien; Kamerling, Margje

    2017-01-01

    Purpose: The paper aims to examine to what extent and why parental involvement as well as characteristics of ethnic school population influence social skills scores (social position, behavioural skills) of students. Design/methodology/approach: The study used the COOL5-18 database (2010) that included 553 Dutch primary schools and nearly 38,000…

  18. Homework Involvement and Functions: Perceptions of Hong Kong Chinese Primary School Students and Parents

    Science.gov (United States)

    Tam, Vicky C. W.; Chan, Raymond M. C.

    2011-01-01

    This study examines the perceptions of Chinese students and parents in Hong Kong on homework involvement, assignment type and homework functions. The relationships of homework perceptions to student and parent attributes are also assessed. The sample includes 1393 pairs of students and their parents from 36 primary schools in Hong Kong. Findings…

  19. Primary lymphoma of the breast involving both axillae with bilateral breast carcinoma

    Directory of Open Access Journals (Sweden)

    Rubin Gary

    2008-05-01

    Full Text Available Abstract Background Primary Non-Hodgkin's Lymphoma (PHNL of the breast is a rare entity, while secondary involvement of the breast with diffuse disease of Non-Hodgkin's lymphoma (NHL is more common. However, PNHL is the most frequent haematopoietic tumour of the breast. Diagnostic criteria for PNHL of the breast are presence of technically adequate pathologic specimens, close association of mammary tissue and lymphomatous infiltrate, no prior diagnosis of an extarammamary lymphoma, and no evidence of concurrent widespread disease, except for ipsilateral axillary lymph nodes if concomitant with the primary lesion. Case presentation A 57-year-old woman was recalled because her screening mammograms revealed three separate lesions in her right breast and one in the left. Histology of the lesions confirmed lymphoma in one breast with ductal carcinoma in the other. Conclusion Most of reported cases in literature have been involving the right breast, and almost all the patients were females. NHLs of the breast typically present as unilateral mass; the frequency of bilateral disease at first presentation ranges from 5–25%. Our objective is to report a case of primary lymphoma of the breast involving both axillae with concomitant bilateral primary breast cancer which has not been reported yet to our best of knowledge in literature.

  20. Job involvement of primary healthcare employees: does a service provision model play a role?

    Science.gov (United States)

    Koponen, Anne M; Laamanen, Ritva; Simonsen-Rehn, Nina; Sundell, Jari; Brommels, Mats; Suominen, Sakari

    2010-05-01

    To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.

  1. DETERMINATION OF EDUCATIONAL EFFICIENCY AND STUDENTS’ INVOLVEMENT IN THE FLIPPED BIOLOGY CLASSROOM IN PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Vera S. Županec

    2018-02-01

    Full Text Available The Flipped Classroom (FC is a teaching approach in which students gain the first-exposure learning with online materials outside the classroom, and then, in the classroom, they focus on interactive or engaging exercises. Despite its considerable publicity, the studies focused on the FC in primary education are deficient. The aim of this research is to determine efficiency and students’ involvement in the flipped Biology classroom in primary school, compared to the conventional classroom (CC approach. Educational efficiency and students’ involvement are measured by combining the values of the students’ performance and mental effort on the test. Each task in the test was followed by the 5-point Likert scale for evaluation of invested mental effort. The total sample of this research included 112 students, aged from 12 to 13. The results show that the FC approach contributes to the reduction of the students’ mental effort and an increase in the students’ performance. On the basis of calculated efficiency and students’ involvement of applied teaching approaches, it was concluded that the FC represents a feasible and efficient approach to Biology primary education.

  2. 32 CFR 37.220 - How involved should the Government program official be in the project?

    Science.gov (United States)

    2010-07-01

    ... official be in the project? 37.220 Section 37.220 National Defense Department of Defense OFFICE OF THE... Technology Investment Agreements § 37.220 How involved should the Government program official be in the project? (a) TIAs are used to carry out cooperative relationships between the Federal Government and the...

  3. A Study on the Evaluation of Science Projects of Primary School Students Based on Scientific Criteria

    Science.gov (United States)

    Gungor, Sema Nur; Ozer, Dilek Zeren; Ozkan, Muhlis

    2013-01-01

    This study re-evaluated 454 science projects that were prepared by primary school students between 2007 and 2011 within the scope of Science Projects Event for Primary School Students. Also, submitted to TUBITAK BIDEB Bursa regional science board by MNE regional work groups in accordance with scientific research methods and techniques, including…

  4. Applications and Prospects of Modularization Technology in HTR Project Starting from Primary Loop Cavity Construction

    International Nuclear Information System (INIS)

    Yang Guokang; Chen Jing; Huang Wen; Lin Lizhi; Sun Yunlun; Chen Yan; Mao Jiaxin; Wang Yougang; Wang Jinwen; Lin Mingfeng; Yang Mingshan

    2014-01-01

    Primary loop cavity is one of the key areas and major difficulties in HTR-PM project construction. In order to shorten the construction schedule and improve the construction quality, researches on modular design and construction of primary loop cavity has been carried out and the results have been applied in HTR-PM project construction, and got significant application benefit. This paper summarizes the modularization technology application research and project implementation results of primary loop cavity, and analyzes the application and prospects of modularization technology in the HTR project construction. (author)

  5. Partners in projects: preparing for public involvement in health and social care research.

    Science.gov (United States)

    Parkes, Jacqueline H; Pyer, Michelle; Wray, Paula; Taylor, Jane

    2014-09-01

    In recent years, several UK and, international funders of health and social care related research have adopted the policy of requiring explicit evidence of the 'public' voice in all aspects of project design. For many academic researchers engaged within research, evaluations or audit projects, this formal requirement to actively engage members of the public will present them with both benefits and challenges to securing knowledgeable, skilled, and confident lay representation onto project teams. This could potentially lead to the exploitation of those individuals who are available, appropriately informed, and adequately prepared for such activities. Currently, much of the preparation of patients or members of the public for research involvement tends to be aligned to specific projects; however, with the call for greater active and meaningful involvement of lay representatives in future national and international funding applications, there is clearly a growing need to 'train' sufficient numbers of confident and competent representatives to meet this growing demand. This paper describes the development of a specifically designed research awareness training programme and underpinning theoretical model, which has been specifically designed to support active and meaningful lay involvement in research, evaluations and audit projects. Developed over a four year period, the course is a culmination of learning extracted from a series of four completed research projects, which have incorporated an element of public and patient involvement (PPI) training in their overall design. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Parent Involvement in Inclusive Primary Schools in New Zealand: Implications for Improving Practice and for Teacher Education

    Science.gov (United States)

    Hornby, Garry; Witte, Chrystal

    2010-01-01

    A critical factor in the success of inclusive schools is effective parent involvement in the education of children with special educational needs. This article reports the results of a survey of the practice of parent involvement in inclusive primary schools in a large city in New Zealand. Interviews were conducted with 21 primary school…

  7. Psychosis in primary angiitis of the central nervous system involving bilateral thalami: a case report.

    Science.gov (United States)

    Kim, Sangha; Kim, Doh Kwan

    2015-01-01

    To report a case of primary angiitis of the central nervous system (PACNS), a rare inflammatory disease restricted to the central nervous system (CNS), with unusual clinical presentation mimicking schizophrenia. Case report. A 45-year-old male presented with alteration of consciousness and confusion. Brain magnetic resonance imaging (MRI) scan showed a mass-like enhancing lesion involving bilateral thalami, and biopsy revealed findings compatible with PACNS. The patient was treated with corticosteroids. Psychotic symptoms crystallized over the initial 2 months after the diagnosis and persisted for over a year. Severity of his symptoms improved with gradual normalization of the radiologic findings and antipsychotic medication. Our case highlights the importance of considering PACNS as a differential diagnosis of a tumor-like mass lesion in the CNS and the significance of thalamic involvement in the pathogenesis of psychotic symptoms including delusions and hallucinations. Copyright © 2015. Published by Elsevier Inc.

  8. Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement

    International Nuclear Information System (INIS)

    Anderson, S.E.; Heini, P.; Kalbermatten, D.; Sauvain, M.J.; Stauffer, E.; Geiger, L.; Johnston, J.O.; Roggo, A.; Steinbach, L.S.

    2003-01-01

    Initial presentation with primary spinal involvement in chronic recurrent multifocal osteomyelitis of childhood (CRMO) is rare. Our objective was to review the imaging appearances of three patients who had CRMO who initially presented with isolated primary spinal involvement.Design and patients The imaging, clinical, laboratory and histology findings of the three patients were retrospectively reviewed. Imaging included seven spinal MR imaging scans, one computed tomography scan, nine bone scans, two tomograms and 16 radiographs. These were reviewed by two musculoskeletal radiologists and a consensus view is reported. All three patients presented with atraumatic spinal pain and had extensive bone spinal pathology. The patients were aged 11, 13 and 12 years. There were two females and one male.Results and conclusions The initial patient had thoracic T6 and T8 vertebra plana. Bone scan showed additional vertebral body involvement. Follow-up was available over a 3 year period. The second patient had partial collapse of T9 and, 2 years later, of C6. Subsequently extensive multifocal disease ensued and follow-up was available over 8 years. The third patient initially had L3 inferior partial collapse and 1 year later T8 involvement with multifocal disease. Follow-up was available over 3 years. The imaging findings of the three patients include partial and complete vertebra plana with a subchondral line adjacent to endplates associated with bone marrow MR signal alterations. Awareness of the imaging appearances may help the radiologist to include this entity in the differential diagnosis in children who present with spinal pathology and no history of trauma. Histopathological examination excludes tumor and infection but with typical imaging findings may not always be necessary. (orig.)

  9. The meaning of community involvement in health: the perspective of primary health care communities

    Directory of Open Access Journals (Sweden)

    GG Mchunu

    2005-09-01

    Full Text Available The goal of this study was to establish the understanding and appreciation of the essence of PHC principles in the two Primary Health Care (PHC communities. The PHC communities in this study referred to the people who were involved in the operation of the phenomenon, that is health professionals working in the health care centers and the communities served by these health care centers. It was hoped that the study would enhance the understanding of the importance of community involvement in health (CIH in health care delivery, for both community members and health professionals. A case study method was used to conduct the study. Two community health centers in the Ethekwini health district, in Kwa Zulu Natal, were studied. One health center was urban based, the other was rural based. A sample of 31 participants participated in the study. The sample comprised of 8 registered nurses, 2 enrolled nurses, 13 community members and 8 community health workers. Data was collected using individual interviews and focus groups, and was guided by the case study protocol. The findings of the study revealed that in both communities, participants had different, albeit complementary, understanding of the term ‘Community Involvement in Health’ (CIH. Essentially, for these participants, CIH meant collaboration, co-operation and involvement in decision-making.

  10. Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.

    Science.gov (United States)

    Malter, Wolfram; Hellmich, Martin; Badian, Mayhar; Kirn, Verena; Mallmann, Peter; Krämer, Stefan

    2018-06-01

    Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy with or without reconstruction). Between 2006 and 2010, 1,360 patients with primary breast cancer underwent SLNB with/without ALND with evaluation of tumor localization, multicentricity and multifocality, histological subtype, tumor size, grading, lymphovascular invasion (LVI), and estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status. These characteristics were retrospectively analyzed in univariate and multivariate logistic regression models to define significant predictive factors for sentinel lymph node involvement. The multivariate analysis demonstrated that tumor size and LVI (pbreast cancer. Because of the increased risk for metastatic involvement of axillary sentinel nodes in cases with larger breast cancer or diagnosis of LVI, patients with these breast cancer characteristics should not be spared from SLNB in a clinically node-negative situation in order to avoid false-negative results with a high potential for wrong indication of primary breast reconstruction or wrong non-indication of necessary post-mastectomy radiation therapy. The prognostic impact of avoidance of axillary staging with SLNB is analyzed in the ongoing prospective INSEMA trial. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  11. A Project in Thermal Physics Involving a Car Parked in Direct Sunlight

    Science.gov (United States)

    Lee, Wei; Gilley, Heidi L.; Caris, Joshua B.

    1997-05-01

    A research project for introductory physics students, involving an estimate of the surface temperature of the Sun using a parked car, was carried out in the Summer 1995 Research Apprenticeships in Science Program, sponsored by Edison Industrial Systems Center, for local-area high school students. This activity entails both outdoor quantitative observations and theoretical analysis, and yields a result within 12 percent of the accepted value. It was demonstrated that the use of everyday materials and outdoor observations, such as those in this project, is not only educational but also intriguing. The success of this experiment as a summer research project will be discussed.

  12. Association between postgraduate year 2 residency program characteristics and primary project publication.

    Science.gov (United States)

    Swanson, Joseph M; Shafeeq, Hira; Hammond, Drayton A; Li, Chenghui; Devlin, John W

    2018-03-15

    The association among residency program and research mentor characteristics, program director perceptions, and the publication of the primary research project for postgraduate year 2 (PGY2) graduates was assessed. Using a validated electronic survey, residency program directors (RPDs) of critical care PGY2 graduates were asked about primary research project publication success, program and research project mentor characteristics, and RPDs' perceptions surrounding project completion. All 55 RPDs surveyed responded; 44 (79%) reported being a research project mentor. PGY2 research project publications in 2011 and 2012 totaled 26 (37%) and 27 (35%), respectively. A significant relationship existed between research project publication and the number of residents in the program ( p project publication is important to their employer ( p projects versus no publications included the number of graduates in the PGY2 program (odds ratio [OR], 5.6; p project publication (OR, 10.2; p project versus no research projects was also independently associated with the RPD's perception that the employer valued research project publication (OR, 5.1; p = 0.04). A survey of RPDs of critical care PGY2 residents found that the number of PGY2 residents, the number of publications by the least experienced research mentor, and the perception that publishing the residents' research projects is important to the employer were independently associated with publication rates of residency research projects. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. Project ‘play and tell’: occupational therapy in primary health care

    Directory of Open Access Journals (Sweden)

    Débora Barbosa e Alcântara

    2012-12-01

    Full Text Available This paper reports the experience of a “storytelling and playing” group that took place in a FamilyHealth Unit in Sao Carlos, State of Sao Paulo. The group was formed as from the evaluation of the occupationaltherapist in the context of Primary Health Care, which broadly considers the daily lives of the actors involved:children, one user of the system, and the health team. From the viewpoint of Occupational Therapy, with focuson the problems of the territory, interventions linking the following matters were proposed: individual care,collective care, and co-responsibility of the community and staff in pursuit of the resignificance of the everydaylives of the actors involved. This is a concrete example of paradigm shift from the existing health model to theprecepts of the Family Health Strategy, with the involvement of users and professionals from various areas.The occupational therapist identified different demands of the territory: the need for transformation of dailylife and routine of a user; the need for children’s leisure; and the desire of the health team to build this spacethrough a playroom. The possible combination of the user, children and the team’s everyday realities composedan intervention project based on the vision of the clinic expanded. The “playing and storytelling” was able toactually transform the health care model.

  14. Bilateral primary adrenal lymphoma with central nervous system involvement: a case report

    International Nuclear Information System (INIS)

    Nacif, Marcelo Souto; Heizer, Marcia; Nahime, Carolina Benvegnu; Santos, Alair Augusto Sarmet Moreira Damas dos

    2005-01-01

    The authors review the main findings of primary adrenal lymphoma on abdominal and brain computed tomography (CT) scans and brain magnetic resonance imaging (MRI), and report a rare case of a 72-year-old male patient with deterioration in mental status progressing from recent memory loss to disorientation and ultimately dementia in a period of two months. The patient was investigated using imaging methods including brain (without intravenous administration of iodinated contrast media), chest and abdomen (pre and post intravenous administration of iodinated contrast media) CT scans and brain MRI (pre and post intravenous administration of gadolinium). Brain CT scan showed slightly hyperdense nodules adjacent to the lateral ventricles. No gross abnormalities were seen on the chest CT scan. CT of the abdomen showed solid nodules on both adrenals. Brain MRI showed diffuse nodular enhancement of the ependyma of the fourth ventricle, third ventricle, frontal and temporal horns, atria and body of the lateral ventricles. Definitive diagnosis was made by immunohistochemical study of the biopsed adrenal. After a comprehensive review of the literature the authors concluded that CT and MRI are essential methods for the detection and accurate evaluation of primary adrenal lymphomas, particularly when there is involvement of the central nervous system. MRI is more sensitive in the detection of extracerebral lesions in the epidural and subdural spaces, especially after intravenous administration of gadolinium. (author)

  15. Different strategies do not moderate primary motor cortex involvement in mental rotation: a TMS study

    Directory of Open Access Journals (Sweden)

    Koeneke Susan

    2007-08-01

    Full Text Available Abstract Background Regions of the dorsal visual stream are known to play an essential role during the process of mental rotation. The functional role of the primary motor cortex (M1 in mental rotation is however less clear. It has been suggested that the strategy used to mentally rotate objects determines M1 involvement. Based on the strategy hypothesis that distinguishes between an internal and an external strategy, our study was designed to specifically test the relation between strategy and M1 activity. Methods Twenty-two subjects were asked to participate in a standard mental rotation task. We used specific picture stimuli that were supposed to trigger either the internal (e.g. pictures of hands or tools or the external strategy (e.g. pictures of houses or abstract figures. The strategy hypothesis predicts an involvement of M1 only in case of stimuli triggering the internal strategy (imagine grasping and rotating the object by oneself. Single-pulse Transcranial Magnetic Stimulation (TMS was employed to quantify M1 activity during task performance by measuring Motor Evoked Potentials (MEPs at the right hand muscle. Results Contrary to the strategy hypothesis, we found no interaction between stimulus category and corticospinal excitability. Instead, corticospinal excitability was generally increased compared with a resting baseline although subjects indicated more frequent use of the external strategy for all object categories. Conclusion This finding suggests that M1 involvement is not exclusively linked with the use of the internal strategy but rather directly with the process of mental rotation. Alternatively, our results might support the hypothesis that M1 is active due to a 'spill-over' effect from adjacent brain regions.

  16. Different strategies do not moderate primary motor cortex involvement in mental rotation: a TMS study.

    Science.gov (United States)

    Bode, Stefan; Koeneke, Susan; Jäncke, Lutz

    2007-08-07

    Regions of the dorsal visual stream are known to play an essential role during the process of mental rotation. The functional role of the primary motor cortex (M1) in mental rotation is however less clear. It has been suggested that the strategy used to mentally rotate objects determines M1 involvement. Based on the strategy hypothesis that distinguishes between an internal and an external strategy, our study was designed to specifically test the relation between strategy and M1 activity. Twenty-two subjects were asked to participate in a standard mental rotation task. We used specific picture stimuli that were supposed to trigger either the internal (e.g. pictures of hands or tools) or the external strategy (e.g. pictures of houses or abstract figures). The strategy hypothesis predicts an involvement of M1 only in case of stimuli triggering the internal strategy (imagine grasping and rotating the object by oneself). Single-pulse Transcranial Magnetic Stimulation (TMS) was employed to quantify M1 activity during task performance by measuring Motor Evoked Potentials (MEPs) at the right hand muscle. Contrary to the strategy hypothesis, we found no interaction between stimulus category and corticospinal excitability. Instead, corticospinal excitability was generally increased compared with a resting baseline although subjects indicated more frequent use of the external strategy for all object categories. This finding suggests that M1 involvement is not exclusively linked with the use of the internal strategy but rather directly with the process of mental rotation. Alternatively, our results might support the hypothesis that M1 is active due to a 'spill-over' effect from adjacent brain regions.

  17. Factors Influencing the Private Involvement in Urban Rail Public-Private Partnership Projects in China

    Directory of Open Access Journals (Sweden)

    Yongjian Ke

    2017-03-01

    Full Text Available Private investors have been encouraged to participate in the development and operation of urban rail projects in China through Public-Private Partnerships (PPPs, given the fact that subnational governments are suffering from urgent development demands and severe fiscal pressure. However, there is no formal assessment to determine the private involvement in a PPP project. This problem is particularly critical in the sector of urban rail, in which the huge investment cannot rely on the private sector alone. This study hence aimed to uncover and identify the influencing factors. Multiple research methods, including content analysis, case study and focus group discussion were adopted to achieve the research purpose. Seven types of influencing factors were identified, including project financial model, government fiscal commitment, risk allocation, public accountability, efficiency considerations, policy and regulations, and organisational marketing strategies. The findings add to the current knowledge base by uncovering the drivers behind private involvement in a PPP project. They are also beneficial for industry practitioners as a basis/checklist to determine the private involvement.

  18. Policies and practices of parental involvement and parent-teacher relations in Irish primary education: a critical discourse analysis

    OpenAIRE

    Bennett, Brigid

    2015-01-01

    This thesis presents a critical discourse analysis of policies of parental involvement in Irish education from the past decade. It explores three questions: Do discourses of parental involvement and teacher professionalism construct parent-teacher relations in Irish primary education?; What implications do these constructions have for policies and practices of parent-teacher relationships, particularly parent-teacher partnerships, in Irish primary education?; How can these constructions be ch...

  19. Teaching Basic Programming Concepts to Young Primary School Students Using Tablets: Results of a Pilot Project

    Science.gov (United States)

    Fokides, Emmanuel

    2018-01-01

    The study presents the results of a project in which tablets and a ready-made application were used for teaching basic programming concepts to young primary school students (ages 7-9). A total of 135 students participated in the study, attending primary schools in Athens, Greece, divided into three groups. The first was taught conventionally. The…

  20. Investigating and Stimulating Primary Teachers' Attitudes Towards Science: Summary of a Large-Scale Research Project

    Science.gov (United States)

    Walma van der Molen, Juliette; van Aalderen-Smeets, Sandra

    2013-01-01

    Attention to the attitudes of primary teachers towards science is of fundamental importance to research on primary science education. The current article describes a large-scale research project that aims to overcome three main shortcomings in attitude research, i.e. lack of a strong theoretical concept of attitude, methodological flaws in…

  1. Investigating and stimulating primary teachers’ attitudes towards science: Summary of a large-scale research project

    NARCIS (Netherlands)

    Walma van der Molen, Julie Henriëtte; van Aalderen-Smeets, Sandra

    2013-01-01

    Attention to the attitudes of primary teachers towards science is of fundamental importance to research on primary science education. The current article describes a large-scale research project that aims to overcome three main shortcomings in attitude research, i.e. lack of a strong theoretical

  2. Undergraduate Research Involving Deaf and Hard-of-Hearing Students in Interdisciplinary Science Projects

    Directory of Open Access Journals (Sweden)

    Todd Pagano

    2015-05-01

    Full Text Available Scientific undergraduate research in higher education often yields positive outcomes for student and faculty member participants alike, with underrepresented students often showing even more substantial gains (academic, professional, and personal as a result of the experience. Significant success can be realized when involving deaf and hard-of-hearing (d/hh undergraduate students, who are also vastly underrepresented in the sciences, in interdisciplinary research projects. Even d/hh Associate degree level students and those in the first two years of their postsecondary careers can contribute to, and benefit from, the research process when faculty mentors properly plan/design projects. We discuss strategies, including the dissemination/communication of research results, for involving these students in research groups with different communication dynamics and share both findings of our research program and examples of successful chemical and biological research projects that have involved d/hh undergraduate students. We hope to stimulate a renewed interest in encouraging diversity and involving students with disabilities into higher education research experiences globally and across multiple scientific disciplines, thus strengthening the education and career pipeline of these students.

  3. 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…

  4. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  5. Primary teachers conducting inquiry projects : effects on attitudes towards teaching science and conducting inquiry

    NARCIS (Netherlands)

    van Aalderen-Smeets, Sandra; Walma van der Molen, Julie Henriëtte; van Hest, Erna G.W.C.M.; Poortman, Cindy Louise

    2017-01-01

    This study used an experimental, pretest-posttest control group design to investigate whether participation in a large-scale inquiry project would improve primary teachers’ attitudes towards teaching science and towards conducting inquiry. The inquiry project positively affected several elements of

  6. Primary Teachers Conducting Inquiry Projects: Effects on Attitudes towards Teaching Science and Conducting Inquiry

    Science.gov (United States)

    van Aalderen-Smeets, Sandra I.; Walma van der Molen, Juliette H.; van Hest, Erna G. W. C. M.; Poortman, Cindy

    2017-01-01

    This study used an experimental, pretest-posttest control group design to investigate whether participation in a large-scale inquiry project would improve primary teachers' attitudes towards teaching science and towards conducting inquiry. The inquiry project positively affected several elements of teachers' attitudes. Teachers felt less anxious…

  7. Parent involvement in beginning primary school: Correlates and changes in involvement across the first two years of school in a New Zealand sample.

    Science.gov (United States)

    McDowall, Philippa S; Taumoepeau, Mele; Schaughency, Elizabeth

    2017-06-01

    This study described the relations of parents' and teachers' beliefs and attitudes to forms of parents' involvement in children's first two years of primary school. Parents of children in their first year of primary school (age 5) were recruited from 12 classrooms within four schools in New Zealand; 196 families participated in their child's first year, and 124 families continued to participate in their child's second school year. Parents completed the Family-Involvement Questionnaire, New Zealand, and we archivally collected parent-documented children's oral reading homework. Teachers' rated helpfulness of parents' involvement at school (level 2) and parents' rated teacher invitations to be involved and their perceived time and energy (level 1) contributed to school-based involvement in Year 1 in multilevel models, with parents' rated teacher invitations for involvement also found to predict Year 1 home-school communication in regression analyses. Contributors to Year 1 child-parent reading in multilevel models included level 1 predictors of two or more adults in the home and parents' perceived time and energy. Longitudinal analyses suggested both consistency and change in each form of involvement from Year 1 to Year 2, with increases in each form of involvement found to be associated with increases in parents' and/or teachers' views about involvement in Year 2 in cross-sectional time-series analyses. Implications for schools wanting to engage families are that parents' involvement in children's schooling may be influenced by parents' perceptions of their capacity, teachers' engagement efforts, and the school's climate for involvement. This is a special issue paper "Family Engagement in Education and Intervention". Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  8. Community participation in primary health care projects of the Muldersdrift Health and Development Programme

    Directory of Open Access Journals (Sweden)

    M. Barker

    2007-09-01

    Full Text Available After numerous teething problems (1974-1994, the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP. The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC activities and the involvement of a variety of community groups. As the PHC projects evolved overtime, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question “What was the level of community participation in PHC projects of the MHDP?” Based on the question the following objectives were set, i.e. i to evaluate the community participation in PHC initiatives; ii to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; iii to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; iv to evaluate the MHDP’s implementation of a people-centred approach to community participation in PHC; and v the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twentythree (N=23 PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the “Criteria to evaluate community participation in PHC projects” instrument (a quantitative tool. Structured group interviews were done with PHC projects’ executive committee members. The Joint Management Committee’s data was collected through mailed

  9. Involving youth with disabilities in the development and evaluation of a new advocacy training: Project TEAM.

    Science.gov (United States)

    Kramer, Jessica; Barth, Yishai; Curtis, Katie; Livingston, Kit; O'Neil, Madeline; Smith, Zach; Vallier, Samantha; Wolfe, Ashley

    2013-04-01

    This paper describes a participatory research process in which six youth with disabilities (Youth Panel) participated in the development and evaluation of a manualized advocacy training, Project TEAM (Teens making Environment and Activity Modifications). Project TEAM teaches youth with disabilities how to identify environmental barriers, generate solutions, and request accommodations. The Youth Panel conducted their evaluation after the university researcher implemented Project TEAM with three groups of trainees. The Youth Panel designed and administered a survey and focus group to evaluate enjoyment and usefulness of Project TEAM with support from an advocate/researcher. Members of the Youth Panel analyzed survey response frequencies. The advocate/researcher conducted a content analysis of the open-ended responses. Sixteen of 21 Project TEAM trainees participated in the evaluation. The evaluation results suggest that the trainees found the interactive and individualized aspects of the Project TEAM most enjoyable and useful. Some instructional materials were difficult for trainees with cognitive disabilities to understand. The Youth Panel's involvement in the development of Project TEAM may explain the relatively positive experiences reported by trainees. Project TEAM should continue to provide trainees with the opportunity to apply concepts in real-life situations. Project TEAM requires revisions to ensure it is enjoyable and useful for youth with a variety of disabilities. • Group process strategies, picture-based data collection materials, peer teamwork, and mentorship from adults with disabilities can enable youth with disabilities to engage in research. • Collaborating with youth with disabilities in the development of new rehabilitation approaches may enhance the relevance of interventions for other youth with disabilities. • Youth with cognitive disabilities participating in advocacy and environment-focused interventions may prefer interactive and

  10. Primary Amyloidosis With Renal Involvement: Outcomes in 77 Consecutive Patients at a Single Center.

    Science.gov (United States)

    Wong, Sandy W; Toskic, Denis; Warner, Melissa; Varga, Cindy; Moreno-Koehler, Alejandro; Fein, Daniel; Fogaren, Teresa; Lee, Lisa; Oliver, Colin M; Guthrie, Spencer D; Comenzo, Raymond L

    2017-11-01

    Outcomes in primary amyloid renal patients are of interest as the era of monoclonal antibody therapies begins. We studied 77 consecutive primary amyloid renal patients (58% men) for renal progression (end stage renal disease [ESRD]), renal response (RR), and overall survival (OS). At diagnosis median age was 63 (range, 35-81) years, estimated glomerular filtration rate 70 mL/min (range, 5-114), difference between involved and uninvolved free light chains 127 mg/L (range, 1-9957), ESRD 4%, renal stage 2 and 3 78%, and cardiac stage 2 and 3 56%. Ninety-six percent received bortezomib and 44% stem cell transplantation as well as bortezomib, 68% achieved complete or very good partial hematologic response (CR/VGPR), 34% had ESRD, and 39% RR. Median times to ESRD and RR were 18 (range, 3-81) and 12 (range, 2-30) months, respectively. Median OS was not reached in this cohort and was not reached from onset of ESRD. More than two-thirds of patients with ESRD also achieved CR/VGPR. In those without ESRD at diagnosis, baseline creatinine and absent RR predicted progression to ESRD in multivariate Cox regression analysis, whereas CR/VGPR predicted RR. In multivariate Cox regression analysis, cardiac stage and achievement of CR/VGPR predicted OS, enabling construction of a prognostic model. Anti-plasma cell therapies provide a definite albeit limited benefit and new approaches to amyloid-related organ dysfunction are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Primary care physicians' willingness to disclose oncology errors involving multiple providers to patients.

    Science.gov (United States)

    Mazor, Kathleen; Roblin, Douglas W; Greene, Sarah M; Fouayzi, Hassan; Gallagher, Thomas H

    2016-10-01

    Full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences is the current standard for physicians in the USA. To examine the extent to which primary care physicians' perceptions of event-level, physician-level and organisation-level factors influence intent to disclose a medical error in challenging situations. Cross-sectional survey containing two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care coordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses. The study was conducted in the context of the HMO Cancer Research Network Cancer Communication Research Center. Primary care physicians from three integrated healthcare delivery systems located in Washington, Massachusetts and Georgia; responses from 297 participants were included in these analyses. The dependent variable intent to disclose included intent to provide an apology, an explanation, information about the cause and plans for preventing recurrences. Independent variables included event-level factors (responsibility for the event, perceived seriousness of the event, predictions about a lawsuit); physician-level factors (value of patient-centred communication, communication self-efficacy and feelings about practice); organisation-level factors included perceived support for communication and time constraints. A majority of respondents would not fully disclose in either situation. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication. These variables were consistently associated with intent to disclose. To make meaningful progress towards improving disclosure; physicians, risk managers, organisational leaders, professional organisations and

  12. Primary NK/T cell lymphoma nasal type of the stomach with skin involvement: a case report

    Directory of Open Access Journals (Sweden)

    Sebastian Kobold

    2009-12-01

    Full Text Available Since nasal NK/T cell lymphoma and NK/T cell lymphoma nasal type are rare diseases, gastric involvement has seldom been seen. We report a unique case of a patient with a primary NK/T cell lymphoma nasal type of the stomach with skin involvement. The patient had no history of malignant diseases and was diagnosed with hematemesis and intense bleeding from his gastric primary site. Shortly after this event, exanthemic skin lesions appeared with concordant histology to the primary site. Despite chemotherapy, the patient died one month after the first symptomatic appearance of disease.

  13. Global Dynamical Systems Involving Generalized -Projection Operators and Set-Valued Perturbation in Banach Spaces

    Directory of Open Access Journals (Sweden)

    Yun-zhi Zou

    2012-01-01

    Full Text Available A new class of generalized dynamical systems involving generalized f-projection operators is introduced and studied in Banach spaces. By using the fixed-point theorem due to Nadler, the equilibrium points set of this class of generalized global dynamical systems is proved to be nonempty and closed under some suitable conditions. Moreover, the solutions set of the systems with set-valued perturbation is showed to be continuous with respect to the initial value.

  14. Involvement in sports clubs and informal sport activities of primary and secondary school children in Liechtenstein

    Directory of Open Access Journals (Sweden)

    Jürgen Kühnis

    2016-04-01

    Full Text Available Sport involvement among children and adolescents has been a central field of research in sport science since years. This paper documents the participation of 11- to 15-year-olds in sport clubs and informal sport activities in Liechtenstein and examines possible gender- and age-specific differences. The analysis is based on four cross-sectional studies from 2004 to 2015 and includes the data of 1’262 children in primary (5th grade and secondary (7th and 9th grades school. According to our findings sports and exercise are considered to be one of the main leisure-time activities for all school levels (irrespective of gender. The percentage of fully sport-abstinent adolescents by 11- and 13-year-olds is about 5 %; by 15-year-olds is around 10 %. The culmination of sports club membership (with current 84.7 % appears to be at the age of 11 (5th grade. After the switch to secondary school the sports club commitment tends to decrease, while the high attendance of the informal sport activities (>85 % shows relatively stable age development. In contrast to other child and youth studies, our data indicates a levelling tendency and dissolution of classic gender differences not only in sports club commitment but also in informal sports among girls and boys.

  15. MuSC is involved in regulating axonal fasciculation of mouse primary vestibular afferents.

    Science.gov (United States)

    Kawauchi, Daisuke; Kobayashi, Hiroaki; Sekine-Aizawa, Yoko; Fujita, Shinobu C; Murakami, Fujio

    2003-10-01

    Regulation of axonal fasciculation plays an important role in the precise patterning of neural circuits. Selective fasciculation contributes to the sorting of different types of axons and prevents the misrouting of axons. However, axons must defasciculate once they reach the target area. To study the regulation of fasciculation, we focused on the primary vestibulo-cerebellar afferents (PVAs), which show a dramatic change from fasciculated axon bundles to defasciculated individual axons at their target region, the cerebellar primordium. To understand how fasciculation and defasciculation are regulated in this system, we investigated the roles of murine SC1-related protein (MuSC), a molecule belonging to the immunoglobulin superfamily. We show: (i) by comparing 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (Dil) labelling and anti-MuSC immunohistochemistry, that downregulation of MuSC in PVAs during development is concomitant with the defasciculation of PVA axons; (ii) in a binding assay with cells expressing MuSC, that MuSC has cell-adhesive activity via a homophilic binding mechanism, and this activity is increased by multimerization; and (iii) that MuSC also displays neurite outgrowth-promoting activity in vestibular ganglion cultures. These findings suggest that MuSC is involved in axonal fasciculation and its downregulation may help to initiate the defasciculation of PVAs.

  16. Transforming primary healthcare by including the stakeholders involved in delivering care to people living in poverty: EQUIhealThY study protocol.

    Science.gov (United States)

    Loignon, Christine; Hudon, Catherine; Boudreault-Fournier, Alexandrine; Dupéré, Sophie; Macaulay, Ann C; Pluye, Pierre; Gaboury, Isabelle; Haggerty, Jeannie L; Fortin, Martin; Goulet, Émilie; Lambert, Mireille; Pelissier-Simard, Luce; Boyer, Sophie; de Laat, Marianne; Lemire, Francine; Champagne, Louise; Lemieux, Martin

    2013-03-11

    Ensuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations. This study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decision-making role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews. The proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty

  17. Physicians' accounts of frontline tensions when implementing pilot projects to improve primary care.

    Science.gov (United States)

    Mansfield, Elizabeth; Bhattacharyya, Onil; Christian, Jennifer; Naglie, Gary; Steriopoulos, Vicky; Webster, Fiona

    2018-03-19

    Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

  18. Proposed Tenaska Washington II Generation Project : Final Environmental Impact Statement. Volume 2: Public Involvement.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1994-01-01

    In regard to the proposed Tenaska Washington II Generation Project, the goal of the Bonneville Power Administration`s (BPA) Environmental Impact Statement (EIS) public involvement process is to determine the issues to be examined and pertinent analyses to be conducted and to solicit comments on the content and quality of information presented in the Draft Environmental Impact Statement (DEIS). Comments and questions are solicited from the public and government agencies during the scoping process and during the comment period and public hearing on the DEIS, to find out what is of most concern to them. The end product of the public involvement process is the Comment Report which follows in part of this volume on Public Involvement.

  19. We love our school toilets: involving primary school students in improving their school toilets.

    Science.gov (United States)

    Senior, Elizabeth

    2014-03-01

    This article reports on the planning, implementation and evaluation of an intervention to improve school students' experience of using the school toilet in a primary school in Melbourne, Australia. 20 students from grades 2-6 participated in focus groups, to discuss what they valued about the school and raise awareness of issues they were not happy about. A common theme from all of the focus groups was that students reported avoiding use of the school toilets. Using the ideas generated from the focus groups, the student council (with input from staff), developed a self-administered pre- and post-test questionnaire. This was given to 220 students in grades 1-4, aged 6-10 years. Improvements suggested by the students were made to the toilet block, and then a post-test was administered. Independent t tests were conducted. The pre-test indicated that 71% of girls and 65% of boys feared the behaviour of other students in the toilet. Overwhelmingly, the qualitative comments focused on poor student behaviour in the toilets, with lack of privacy due to student misbehaviour mentioned in 90% of the comments. After the toilets were revamped, the greatest gains were made in students' attitudes toward the toilets, with a 37% increase in students who indicated they now liked the toilet facility. Incidents of vandalism also decreased; however, student misconduct in the toilets was still regarded as a problem. Involving students in refurbishing their toilets improved how students viewed the toilets and reduced vandalism; however, a different intervention is required to change inappropriate behaviours in the toilet.

  20. The integrated project: a promising promotional strategy for primary health care.

    Science.gov (United States)

    Daniel, C; Mora, B

    1985-10-01

    The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain

  1. Towards efficient use of research resources: a nationwide database of ongoing primary care research projects in the Netherlands.

    Science.gov (United States)

    Kortekaas, Marlous F; van de Pol, Alma C; van der Horst, Henriëtte E; Burgers, Jako S; Slort, Willemjan; de Wit, Niek J

    2014-04-01

    PURPOSE. Although in the last decades primary care research has evolved with great success, there is a growing need to prioritize the topics given the limited resources available. Therefore, we constructed a nationwide database of ongoing primary care research projects in the Netherlands, and we assessed if the distribution of research topics matched with primary care practice. We conducted a survey among the main primary care research centres in the Netherlands and gathered details of all ongoing primary care research projects. We classified the projects according to research topic, relation to professional guidelines and knowledge deficits, collaborative partners and funding source. Subsequently, we compared the frequency distribution of clinical topics of research projects to the prevalence of problems in primary care practice. We identified 296 ongoing primary care research projects from 11 research centres. Most projects were designed as randomized controlled trial (35%) or observational cohort (34%), and government funded mostly (60%). Thematically, most research projects addressed chronic diseases, mainly cardiovascular risk management (8%), depressive disorders (8%) and diabetes mellitus (7%). One-fifth of the projects was related to defined knowledge deficits in primary care guidelines. From a clinical primary care perspective, research projects on dermatological problems were significantly underrepresented (P = 0.01). This survey of ongoing projects demonstrates that primary care research has a firm basis in the Netherlands, with a strong focus on chronic disease. The fit with primary care practice can improve, and future research should address knowledge deficits in professional guidelines more.

  2. Integrating mental health services into primary HIV care for women: the Whole Life project.

    OpenAIRE

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, i...

  3. Project Experiences of the Implementation of the Primary Bleed and Feed System

    International Nuclear Information System (INIS)

    Sanz, S.; Lang, J.; Schmid, J.

    2015-01-01

    Modernization activities play a very important role in the enhancement of the safety and reliability of nuclear power plants. The main focus is on increasing the plant availability, the operational flexibility or the integration of new, additional equipment to satisfy safety requirements, as in this case with the implementation of the design modification primary circuit “Primary Bleed & Feed” (PB&F) of the primary circuit, in the consideration of a beyond design basis accident. Primary B&F prevents the high pressure core melt path and allows an additional alternative heat removal by depressurising the primary system and coolant injection with passive and/or active low pressure systems, when the normal core cooling is not available because of loss of water inventory in the steam generators. The goal of this paper is to show some general good practices gained during the implementation of the Primary Bleed and Feed, System from the project conception to the system implementation. Basically, practice shows that some of the crucial factors which contributed to a successful project execution were based on (i) good interface management between the new system and the existing plant components, (ii) a close coordination of the single engineering disciplines and simultaneous activities, (iii) safety culture and quality assurance were set as priority during the entire project development. (author)

  4. The Changing Experiences of Primary Teachers: Responding to Scenarios Involving Diverse Sexualities

    Science.gov (United States)

    van Leent, Lisa; Ryan, Mary

    2016-01-01

    Sex education and diverse sexualities are controversial topics within the primary school arena. Concepts of childhood innocence have influenced sex education curriculum, policy development and teaching practices within schools. However, research shows that primary school-aged students are aware of and talk about sexualities. The aim of this…

  5. User and stakeholder involvement for relevant, reliable and robust local-scale climate projections in Norway

    Science.gov (United States)

    Neby, Simon; Sobolowski, Stefan

    2017-04-01

    How can users and stakeholders be actively involved with providing input to and using output from local-scale climate projections? How can the scientific community better understand the needs of local actors? And how should communication and cooperation efforts be organized? These are critical questions we aim to answer in a climate services project funded by the Norwegian Research Council (R3: Relevant, Reliable and Robust local-scale climate projections for Norway). The project takes into consideration not only the scientific issues in establishing useful local-scale climate projections, but also addresses the "usability gap" between climate information and decision-making. The lack of effective communication between scientists and user communities often result in outputs and products that are not matched with decision-relevant climate information. In the R3 project, the scientific participants actively engage with a range of users that have quite different information needs: municipalities, infrastructure developers, agriculture, energy producers, insurance companies, and more. In this particular presentation, we present our experiences concerning three specific issues that relate to the stakeholder-science interface: 1) Preferences are not clear-cut and pre-defined. In practice, this means that stakeholders often do not have precise information about their needs, nor precise information about how, where and whether their needs can be voiced. Similarly, science communities tend to presuppose that stakeholders are interested and have well-articulated needs, which is hardly the case. Collectively, that means that there is a need for an approach that guides the articulation and prioritization of preferences in a manner that integrates both scientific and stakeholder perspectives and takes the integrity of both perspectives seriously. 2) Technologies are unclear. Although information may be produced and used, past experiences, trial and error processes and pragmatic

  6. Being useful: achieving indigenous youth involvement in a community-based participatory research project in Alaska

    Directory of Open Access Journals (Sweden)

    Tara Ford

    2012-05-01

    Full Text Available Objectives. To report on a participatory research process in southwest Alaska focusing on youth involvement as a means to facilitate health promotion. We propose youth-guided community-based participatory research (CBPR as way to involve young people in health promotion and prevention strategizing as part of translational science practice at the community-level. Study design. We utilized a CBPR approach that allowed youth to contribute at all stages. Methods. Implementation of the CBPR approach involved the advancement of three key strategies including: (a the local steering committee made up of youth, tribal leaders, and elders, (b youth-researcher partnerships, and (c youth action-groups to translate findings. Results. The addition of a local youth-action and translation group to the CBPR process in the southwest Alaska site represents an innovative strategy for disseminating findings to youth from a research project that focuses on youth resilience and wellbeing. This strategy drew from two community-based action activities: (a being useful by helping elders and (b being proud of our village. Conclusions. In our study, youth informed the research process at every stage, but most significantly youth guided the translation and application of the research findings at the community level. Findings from the research project were translated by youth into serviceable action in the community where they live. The research created an experience for youth to spend time engaged in activities that, from their perspectives, are important and contribute to their wellbeing and healthy living. Youth-guided CBPR meant involving youth in the process of not only understanding the research process but living through it as well.

  7. The involvement of extended families in the wellness of orphans in a primary school in Masvingo city in Zimbabwe

    OpenAIRE

    2014-01-01

    D.Phil. (Career and Life Orientation) The study focuses on how extended families are involved on the wellness of orphans at a primary school in Masvingo City in Zimbabwe. Through an ethnographic research design, the study aimed to establish the involvement of extended families and challenges they face in rendering support and care to orphans. This study draws an intensive ethnographic research interrogative approach through observations, interviews, researcher made test and document analys...

  8. Stake holder involvement in the Canadian review process for uranium production projects in Northern Saskatchewan

    International Nuclear Information System (INIS)

    Underhill, D.

    2004-01-01

    This report describes the Canadian environmental review process for uranium production projects as a case study for the purpose of understanding the nature and value of stakeholder involvement in the management of radiological hazards. While the Canadian review process potentially applies to any development, this case study focuses on the assessment of the uranium projects of northern Saskatchewan conducted during the 1990's. It describes the environmental assessment (EA) conducted in the 1990's for six new uranium facilities (including mines and mills and related tailings disposal sites) planned in northern Saskatchewan. Both the Canadian federal and the Saskatchewan provincial government have extensive environmental review processes that must under law be complete before any major industrial development judged to have potential environmental impacts is undertaken within their respective territories. However, even in those instances where no clear potential environmental impacts are evident, Canadian law mandates 'if public concern about the proposal is such that a public review is desirable, the initiating department shall refer the proposal to the Minister for review by a Panel'. (Wh95) As a stakeholder under law, in both Canada and Saskatchewan, the public plays an important role in the environmental review process. To encourage participation and assist the public in its review the two governments may provide funding (as done in this review) to assist qualified individuals or groups to participant in the review process. The first section of this case study sets the scene. It describes the Saskatchewan uranium mining story, focusing on how the importance of the public stakeholder evolved to become a major component, under law, in the EA process for new uranium mines. This increase in stakeholder involvement opportunities coincided with heightened public concern for the socio-economic impacts of the projects. In the late 1980's both governments were advised by

  9. Primary teachers conducting inquiry projects : the effect on attitude towards science and inquiry

    NARCIS (Netherlands)

    van Aalderen-Smeets, Sandra; Walma van der Molen, Julie Henriëtte

    2015-01-01

    This paper presents the results of a theoretically informed professionalisation project that was set up to improve primary teachers’ attitudes towards science and attitude towards inquiry. A positive attitude towards science is of fundamental importance for teachers when stimulating interest in

  10. The Use of Wikis in a Science Inquiry-Based Project in a Primary School

    Science.gov (United States)

    Lau, Wilfred W. F.; Lui, Vicky; Chu, Samuel K. W.

    2017-01-01

    This study explored the use of wikis in a science inquiry-based project conducted with Primary 6 students (aged 11-12). It used an online wiki-based platform called PBworks and addressed the following research questions: (1) What are students' attitudes toward learning with wikis? (2) What are students' interactions in online group collaboration…

  11. Pupils' Views about Spiders. Learning in Science Project (Primary). Working Paper No. 123.

    Science.gov (United States)

    Hawe, Eleanor

    The Learning in Science Project (Primary)--LISP(P)--investigated the ideas and interests about spiders held by 8- to 10-year-old children. Data included 303 questions--and answers to some of the questions--about spiders obtained from children in four classes and from responses obtained during individual interviews with 10 children from each age…

  12. Ipsilateral corticotectal projections from the primary, premotor and supplementary motor cortical areas in adult macaque monkeys: a quantitative anterograde tracing study

    Science.gov (United States)

    Fregosi, Michela; Rouiller, Eric M.

    2018-01-01

    The corticotectal projection from cortical motor areas is one of several descending pathways involved in the indirect control of spinal motoneurons. In non-human primates, previous studies reported that cortical projections to the superior colliculus originated from the premotor cortex and the primary motor cortex, whereas no projection originated from the supplementary motor area. The aim of the present study was to investigate and compare the properties of corticotectal projections originating from these three cortical motor areas in intact adult macaques (n=9). The anterograde tracer BDA was injected into one of these cortical areas in each animal. Individual axonal boutons, both en passant and terminaux, were charted and counted in the different layers of the ipsilateral superior colliculus. The data confirmed the presence of strong corticotectal projections from the premotor cortex. A new observation was that strong corticotectal projections were also found to originate from the supplementary motor area (its proper division). The corticotectal projection from the primary motor cortex was quantitatively less strong than that from either the premotor or supplementary motor areas. The corticotectal projection from each motor area was directed mainly to the deep layer of the superior colliculus, although its intermediate layer was also a consistent target of fairly dense terminations. The strong corticotectal projections from non-primary motor areas are in position to influence the preparation and planning of voluntary movements. PMID:28921678

  13. Moroccan Mothers' Involvement in Dialogic Literary Gatherings in a Catalan Urban Primary School: Increasing Educative Interactions and Improving Learning

    Science.gov (United States)

    de Botton, Lena; Girbés, Sandra; Ruiz, Laura; Tellado, Itxaso

    2014-01-01

    This article analyses a case study on Moroccan mothers' involvement in the Dialogic Literary Gathering (DLG) in an urban primary school in Catalonia (Spain). DLG is a dialogic learning environment that improves reading skills and communicative abilities and promotes school-community links. This activity has been identified in previous European…

  14. How can we increase the involvement of primary health care in the treatment of tobacco dependence? A meta-analysis.

    NARCIS (Netherlands)

    Anderson, P.D.; Jané Llopis, E.

    2004-01-01

    AIMS: A systematic review of studies testing the effectiveness of educational and practice base strategies to increase the involvement of primary health-care practitioners in the treatment of tobacco dependence. DATA SOURCES: MEDLINE, EMBASE, CINAHL and the Cochrane Library (1966-2001). Selection

  15. Proceedings of the topical session on stakeholder involvement in decommissioning projects

    International Nuclear Information System (INIS)

    Santiago, Juan Luis; Chandler, Steve; Metcalfe, Doug; Le Bars, Yves

    2006-01-01

    Set up by the Radioactive Waste Management Committee (RWMC), the WPDD brings together senior representatives of national organisations who have a broad overview of Decommissioning and Dismantling (D and D) issues through their work as regulators, implementers, R and D experts or policy makers. These include representatives from regulatory authorities, industrial decommissioners from the NEA Co-operative Programme on Exchange of Scientific and Technical Information on Nuclear Installation Decommissioning Projects (CPD), and cross-representation from the other NEA Committees. The EC is a member of the WPDD and the IAEA is participating as an observer. This broad participation provides good possibilities for the co-ordination efforts amongst activities in the international programmes. At its sixth meeting, in Paris, 14-16 November 2005, the WPDD held a topical session on the 'Stakeholder Involvement in Decommissioning Projects'. The topical session was jointly planned and run with members of the NEA Forum on Stakeholder Confidence (FSC). This report documents the topical session. The main text summarises the lessons learnt and includes the rapporteurs reports. Appendix 1 and 2 provide the agenda of the topical session and all contributed papers respectively. The Topical session also provided a stimuli to review all the contributions in the area of stakeholder involvement that the WPDD has received since its inception. A list of references is provided in Appendix 3. The topical session was meant to provide an exchange of information and experience on the following issues: - Views from Stakeholders Regarding Stakeholder Involvement and Their Own Role. - Case Studies on Stakeholders Confidence. At the end of each session time was allotted for a plenary discussion. The Rapporteur reviewed the main points and the lessons learnt at the end of the whole Topical Session. (authors)

  16. The use of public participation and economic appraisal for public involvement in large-scale hydropower projects: Case study of the Nam Theun 2 Hydropower Project

    International Nuclear Information System (INIS)

    Mirumachi, Naho; Torriti, Jacopo

    2012-01-01

    Gaining public acceptance is one of the main issues with large-scale low-carbon projects such as hydropower development. It has been recommended by the World Commission on Dams that to gain public acceptance, public involvement is necessary in the decision-making process (). As financially-significant actors in the planning and implementation of large-scale hydropower projects in developing country contexts, the paper examines the ways in which public involvement may be influenced by international financial institutions. Using the case study of the Nam Theun 2 Hydropower Project in Laos, the paper analyses how public involvement facilitated by the Asian Development Bank had a bearing on procedural and distributional justice. The paper analyses the extent of public participation and the assessment of full social and environmental costs of the project in the Cost-Benefit Analysis conducted during the project appraisal stage. It is argued that while efforts were made to involve the public, there were several factors that influenced procedural and distributional justice: the late contribution of the Asian Development Bank in the project appraisal stage; and the issue of non-market values and discount rate to calculate the full social and environmental costs. - Highlights: ► Public acceptance in large-scale hydropower projects is examined. ► Both procedural and distributional justice are important for public acceptance. ► International Financial Institutions can influence the level of public involvement. ► Public involvement benefits consideration of non-market values and discount rates.

  17. Primary Sjögren′s syndrome without ocular involvement: A rare case report

    Directory of Open Access Journals (Sweden)

    Tushar Phulambrikar

    2014-01-01

    Full Text Available Sjögren′s Syndrome (SS is a chronic systemic autoimmune disorder, characterized by the lymphocytic infiltration of lacrimal and salivary glands, giving rise to dry eyes (keratoconjunctivitis sicca and dry mouth (xerostomia. Primary Sjögren′s Syndrome commonly presents only with sicca manifestations; whereas, secondary Sjögren′s syndrome occurs in connection with other autoimmune rheumatic diseases. Primary Sjögren′s syndrome without ocular manifestation is rarely reported in the literature. Here we report a case of a 45-year-old female, who presented to us with complaints of dryness of mouth and dysphagia, without any ocular and systemic manifestations. On further evaluation she was diagnosed as a case of Primary Sjögren′s syndrome. With this case report, we intend to emphasize the importance of an early diagnosis of this disorder, along with a brief review of various diagnostic criteria.

  18. A critical analysis of the implementation of service user involvement in primary care research and health service development using normalization process theory.

    Science.gov (United States)

    Tierney, Edel; McEvoy, Rachel; O'Reilly-de Brún, Mary; de Brún, Tomas; Okonkwo, Ekaterina; Rooney, Michelle; Dowrick, Chris; Rogers, Anne; MacFarlane, Anne

    2016-06-01

    There have been recent important advances in conceptualizing and operationalizing involvement in health research and health-care service development. However, problems persist in the field that impact on the scope for meaningful involvement to become a routine - normalized - way of working in primary care. In this review, we focus on current practice to critically interrogate factors known to be relevant for normalization - definition, enrolment, enactment and appraisal. Ours was a multidisciplinary, interagency team, with community representation. We searched EBSCO host for papers from 2007 to 2011 and engaged in an iterative, reflexive approach to sampling, appraising and analysing the literature following the principles of a critical interpretive synthesis approach and using Normalization Process Theory. Twenty-six papers were chosen from 289 papers, as a purposeful sample of work that is reported as service user involvement in the field. Few papers provided a clear working definition of service user involvement. The dominant identified rationale for enrolling service users in primary care projects was linked with policy imperatives for co-governance and emancipatory ideals. The majority of methodologies employed were standard health services research methods that do not qualify as research with service users. This indicates a lack of congruence between the stated aims and methods. Most studies only reported positive outcomes, raising questions about the balance or completeness of the published appraisals. To improve normalization of meaningful involvement in primary care, it is necessary to encourage explicit reporting of definitions, methodological innovation to enhance co-governance and dissemination of research processes and findings. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  19. Primary epidural lymphoma without vertebral involvement in a HIV-positive patient

    International Nuclear Information System (INIS)

    Perez, M. O.; Grive, E.; Quiroga, S.; Rovira, A.

    1999-01-01

    Epidural involvement is rarely associated with lymphoma, it being more typical of non-Hodgkin's lymphoma in advanced stages of the disease. The invasion of the epidural space is usually caused by the extension of a paravertebral mass or by the affected vertebrae. However, the epidural space alone can be involved. We present a case of epidural lymphoma in a patient who presented with clinical evidence of spinal cord compression. Magnetic resonance disclosed the existence of an epidural mass compressing and displacing the spinal cord without involving the adjacent vertebra or the associated paravertebral mass. (Author) 9 refs

  20. Perceptions of School Heads on Parents? Involvement on the Zimbabwean Primary Schools

    OpenAIRE

    THEMBINKOSI TSHABALALA

    2013-01-01

    The involvement of parents in Zimbabwean schools is governed by Statutory Instrument 87 of 1992 (SI87) for non-government schools and Statutory Instrument 379 of 1998 (SI379) (Bowora and Mpofu, 1998) for government schools. Non-government schools are run by School Development Committees (SDCs) and government schools are run by School Development Associations (SDAs). It is argued that comprehensive parent involvement is a pre-requisite for improving the culture of teaching and learning in scho...

  1. A survey of infectious agents as risk factors for primary sclerosing cholangitis: are Chlamydia species involved?

    NARCIS (Netherlands)

    Ponsioen, Cyriel Y.; Defoer, Jacqueline; ten Kate, Fiebo J. W.; Weverling, Gerrit J.; Tytgat, Guido N. J.; Pannekoek, Yvonne; Wertheim-Dillen, Pauline M. E.

    2002-01-01

    Objectives The aetiology of primary sclerosing cholangitis (PSC) is unknown, and the role of micro-organisms has been studied only to a limited extent. We tested the hypothesis that past or persisting infection with common viruses or atypical bacteria might play a role in genetically susceptible

  2. On the involvement of single-bond rotation in the primary photochemistry of photoactive yellow protein

    NARCIS (Netherlands)

    Stahl, A.D.; Hospes, M.; Singhal, K.; van Stokkum, I.; van Grondelle, R.; Groot, M.L.; Hellingwerf, K.J.

    2011-01-01

    Prior experimental observations, as well as theoretical considerations, have led to the proposal that C4-C7 single-bond rotation may play an important role in the primary photochemistry of photoactive yellow protein (PYP). We therefore synthesized an analog of this protein's 4-hydroxy-cinnamic acid

  3. Nocardia brasiliensis primary pulmonary nocardiosis with subcutaneous involvement in an immunocompetent patient.

    Science.gov (United States)

    Amatya, R; Koirala, R; Khanal, B; Dhakal, S S

    2011-01-01

    This is a report of an unusual case of Nocardia brasiliensis causing primary pulmonary nocardiosis with disseminated subcutaneous lesions in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pulmonary and cutaneous lesions and the need for vigorous management for complete cure.

  4. Nocardia brasiliensis primary pulmonary nocardiosis with subcutaneous involvement in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    R Amatya

    2011-01-01

    Full Text Available This is a report of an unusual case of Nocardia brasiliensis causing primary pulmonary nocardiosis with disseminated subcutaneous lesions in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pulmonary and cutaneous lesions and the need for vigorous management for complete cure.

  5. Patterns in professional growth of science teachers involved in a team-based PD project

    DEFF Research Database (Denmark)

    Nielsen, Birgitte Lund

    and learning and subsequent discussion of this material. Repeated interviews were analyzed using an adapted version of the interconnected model of teachers’ professional growth. The results show various ways of experimenting with new approaches to be important for three of the teachers while a novice teacher...... the participants refer to. Conclusion is that there are professional growth patterns, especially a pattern involving experimenting, which have a forward-pointing potential to be used to inform school based PD. The results implicate that the same PD project can frame experimenting into practice in various tempi...... and with differentiated facilitation aligned to the individual teacher’s current needs and that external support of science resource teachers can be an integrated part of school based PD....

  6. Primary-care based participatory rehabilitation: users' views of a horticultural and arts project.

    Science.gov (United States)

    Barley, Elizabeth A; Robinson, Susan; Sikorski, Jim

    2012-02-01

    Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project in South London. Semi-structured interviews were conducted with 16 participants (referred to as 'coworkers') of Sydenham Garden. Seven were female. Participants were aged between 38 and 91 years and had a range of severe mental and physical health problems; most had depression. The interviews were analysed using constant comparison and thematic analysis. Data were overwhelmingly positive concerning participation. Coworkers considered participation in the project to promote wellbeing by providing purposeful and enjoyable activity and interest, improving mood and self-perceptions, and providing an escape from life's pressures. Being outdoors was considered therapeutic. The most-valued aspect of participation was the social contact derived as a result of it. Many of the coworkers who were interviewed developed transferable skills, including nationally recognised qualifications, which they valued highly. Delivery of horticultural therapy and participatory arts is a feasible model for improving wellbeing in patients in primary care who have serious illness. Longer-term studies are needed to address what happens to people after leaving such projects.

  7. Primary-care based participatory rehabilitation: users’ views of a horticultural and arts project

    Science.gov (United States)

    Barley, Elizabeth A; Robinson, Susan; Sikorski, Jim

    2012-01-01

    Background Participation in horticulture and arts may improve wellbeing in those with mental and physical illness. Aim To conduct an in-depth exploration of the views and experience of participants of a primary-care-based horticultural and participatory arts rehabilitation project (Sydenham Garden). Design and setting Qualitative interview study of a primary-care-based horticultural and participatory arts rehabilitation project in South London. Method Semi-structured interviews were conducted with 16 participants (referred to as ‘coworkers’) of Sydenham Garden. Seven were female. Participants were aged between 38 and 91 years and had a range of severe mental and physical health problems; most had depression. The interviews were analysed using constant comparison and thematic analysis. Results Data were overwhelmingly positive concerning participation. Coworkers considered participation in the project to promote wellbeing by providing purposeful and enjoyable activity and interest, improving mood and self-perceptions, and providing an escape from life’s pressures. Being outdoors was considered therapeutic. The most-valued aspect of participation was the social contact derived as a result of it. Many of the coworkers who were interviewed developed transferable skills, including nationally recognised qualifications, which they valued highly. Conclusion Delivery of horticultural therapy and participatory arts is a feasible model for improving wellbeing in patients in primary care who have serious illness. Longer-term studies are needed to address what happens to people after leaving such projects. PMID:22520790

  8. Flexibility analysis of main primary heat transport system : Narora Atomic Power Project

    International Nuclear Information System (INIS)

    Rastogi, S.K.

    1975-01-01

    The paper presents flexibility analysis problem of main primary heat transport system and the approximate analysis that has been made to estimate the loads coming on major equipments. The primary heat transport system for Narora Atomic Power Project is adopting vertical steam generators and pumps equally divided on either side of the reactor with inter-connecting pipes and feeders. Since the system is mainly spring supported with movement of a few points in certain direction defined but no anchorage, it represents a good problem for flexibility analysis which can only be solved in one step by developing a good computer programme. (author)

  9. Topography and collateralization of dopaminergic projections to primary motor cortex in rats.

    Science.gov (United States)

    Hosp, Jonas A; Nolan, Helen E; Luft, Andreas R

    2015-05-01

    Dopaminergic signaling within the primary motor cortex (M1) is necessary for successful motor skill learning. Dopaminergic neurons projecting to M1 are located in the ventral tegmental area (VTA, nucleus A10) of the midbrain. It is unknown which behavioral correlates are encoded by these neurons. The objective here is to investigate whether VTA-M1 fibers are collaterals of projections to prefrontal cortex (PFC) or nucleus accumbens (NAc) or if they form a distinct pathway. In rats, multiple-site retrograde fluorescent tracers were injected into M1, PFC and the core region of the NAc and VTA sections investigated for concomitant labeling of different tracers. Dopaminergic neurons projecting to M1, PFC and NAc were found in nucleus A10 and to a lesser degree in the medial nucleus A9. Neurons show high target specificity, minimal collateral branching to other than their target area and hardly cross the midline. Whereas PFC- and NAc-projecting neurons are indistinguishably intermingled within the ventral portion of dopaminergic nuclei in middle and caudal midbrain, M1-projecting neurons are only located within the dorsal part of the rostral midbrain. Within M1, the forelimb representation receives sevenfold more dopaminergic projections than the hindlimb representation. This strong rostro-caudal gradient as well as the topographical preference to dorsal structures suggest that projections to M1 emerged late in the development of the dopaminergic systems in and form a functionally distinct system.

  10. Involving Roma parents: analysing the good practice of a primary school in Ghent

    NARCIS (Netherlands)

    Wauters, J.; Van Mol, C.; Clycq, N.; Michielsen, J.; Timmerman, C.

    2017-01-01

    Recently, societal and academic attention toward the topic of Roma integration has been increasing. With this article we aim to make a contribution to the domain of educational research. We explore strategies that schools can adopt to improve the involvement of Roma parents. Using a theory-based

  11. Understanding the direct involvement of parents in policy development and school activities in a primary school

    Directory of Open Access Journals (Sweden)

    Tobin Bernie

    2017-12-01

    Full Text Available It is acknowledged that parental engagement with children’s learning and education is of vital importance. But, there is a tendency to confuse engagement with learning with engagement with the school. While all types of parents’ involvement can have a positive effect, it is actually what parents do with their child at home that has the greatest impact. However, unless parental involvement in learning is embedded in whole-school processes it is unlikely to as effective as possible. This paper documents an action research study that explores the inclusion of parents and home values in the construction of the teaching and learning environment. This was a small step towards positive parent-teacher collaboration, which allowed an exchange of knowledge, values and cultural background experiences. In acknowledging the ways in which the parents already engaged with their children’s learning, it began to enhance self-efficacy in their ability to directly affect this learning. This work has also provoked reflexive engagement of my influence and understanding of involving parents of children with additional and diverse learning needs. But, it also details the transformative journey that influenced my thinking about how we as a school could begin to develop whole-school processes to directly involve parents in policy development and school activities.

  12. The Memory-Impairing Effects of Septal GABA Receptor Activation Involve GABAergic Septo-Hippocampal Projection Neurons

    Science.gov (United States)

    Krebs-Kraft, Desiree L.; Wheeler, Marina G.; Parent, Marise B.

    2007-01-01

    Septal infusions of the [gamma]-aminobutyric acid (GABA)[subscript A] agonist muscimol impair memory, and the effect likely involves the hippocampus. GABA[subscript A] receptors are present on the perikarya of cholinergic and GABAergic septo-hippocampal (SH) projections. The current experiments determined whether GABAergic SH projections are…

  13. Computed tomographic feature of regional lymph nodes involvement in primary hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kim, Ki Whang; Kim, Hyung Sik; Lee, Jong Tae; Chung, Tae Sub; Sub, Jung Ho; Auh, Yong Ho

    1987-01-01

    The resectability of hepatocellular carcinoma is determined by the extent of hepatic involvement, the presence or absence of venous invasion and the presence or absence of extrahepatic metastasis. Extrahepatic spread to regional lymph node represent contraindication to surgical resection. Despite the importance of regional node metastasis, their CT appearance is poorly understood. 19 cases of hepatoma collected during Oct, 1982 to May, 1985 at New York Hospital-Cornell Medical center and 73 cases of hepatoma collected during Mar, 1985 to Sept, 1986 at Yonsei University Medical College were reviewed and analysed. Regional lymph node involvement were divided into four main groups with subgrouping according to the location and lymphatic pathway. 1.lymph nodes in lesser omentum: hepatic, portocaval, left gastric and celiac nodes. 2.lymph nodes around pancrease head: subpyloric, superior mesenteric, preaortic retropancreatic, and precaval retropancreatic lymph nodes. 3.paraaortic nodes: left paraaortic, interaorticocaval, retrocaval and preaortic below 3rd duodenum. 4.phrenic nodes: lower parasternal, middle phrenic and retrocrural nodes. The results were as follows: 1.The frequency of regional node involvement, cases collected at New York Hospital-Cornell Medical center, is hepatic node in 5 (26.3%), portocaval node in 8 (42.1%), left gastric in 4 (21.1%), celiac in 7 (36.8%), precaval retropancreatic in 5 (26.3%) preaortic retropancreatic in 4 (21.1%) interaorticocaval in 7 (36.8%) retrocaval in 4 (21.4%) and lower parasternal in (5.3%). 2.The frequency of regional node involvement, cases collected at Yonsei University college of Medicine, is hepatic in 20.5%, portocaval in 24.7% left gastric in 19.2% celiac in 19.2%, precaval retropancreatic in 8.2%, preaortic retropancreatic in 5.5%, left paraaortic in 12.3%, interaorticocaval in 12.3%, retrocaval in 11.0% low parasternal in 0.8%, superior mesenteric in 4.1% subpyloric 1.4% and preaortic below 3rd duodenum in 1

  14. Computed tomographic feature of regional lymph nodes involvement in primary hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Whang; Kim, Hyung Sik; Lee, Jong Tae; Chung, Tae Sub; Sub, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Auh, Yong Ho [New York Hospital-Cornell Medical Center, (United States)

    1987-04-15

    The resectability of hepatocellular carcinoma is determined by the extent of hepatic involvement, the presence or absence of venous invasion and the presence or absence of extrahepatic metastasis. Extrahepatic spread to regional lymph node represent contraindication to surgical resection. Despite the importance of regional node metastasis, their CT appearance is poorly understood. 19 cases of hepatoma collected during Oct, 1982 to May, 1985 at New York Hospital-Cornell Medical center and 73 cases of hepatoma collected during Mar, 1985 to Sept, 1986 at Yonsei University Medical College were reviewed and analysed. Regional lymph node involvement were divided into four main groups with subgrouping according to the location and lymphatic pathway. 1.lymph nodes in lesser omentum: hepatic, portocaval, left gastric and celiac nodes. 2.lymph nodes around pancrease head: subpyloric, superior mesenteric, preaortic retropancreatic, and precaval retropancreatic lymph nodes. 3.paraaortic nodes: left paraaortic, interaorticocaval, retrocaval and preaortic below 3rd duodenum. 4.phrenic nodes: lower parasternal, middle phrenic and retrocrural nodes. The results were as follows: 1.The frequency of regional node involvement, cases collected at New York Hospital-Cornell Medical center, is hepatic node in 5 (26.3%), portocaval node in 8 (42.1%), left gastric in 4 (21.1%), celiac in 7 (36.8%), precaval retropancreatic in 5 (26.3%) preaortic retropancreatic in 4 (21.1%) interaorticocaval in 7 (36.8%) retrocaval in 4 (21.4%) and lower parasternal in (5.3%). 2.The frequency of regional node involvement, cases collected at Yonsei University college of Medicine, is hepatic in 20.5%, portocaval in 24.7% left gastric in 19.2% celiac in 19.2%, precaval retropancreatic in 8.2%, preaortic retropancreatic in 5.5%, left paraaortic in 12.3%, interaorticocaval in 12.3%, retrocaval in 11.0% low parasternal in 0.8%, superior mesenteric in 4.1% subpyloric 1.4% and preaortic below 3rd duodenum in 1

  15. F18 FDG positron emission tomography revelation of primary testicular lymphoma with concurrent multiple extra nodal involvement

    International Nuclear Information System (INIS)

    Vamsy, Mohana; Dattatreya, P.S.; Parakh, Megha; Dayal, Monal; Prabhakar Rao, V.V.S.

    2013-01-01

    Primary testicular lymphoma (PTL) a relatively rare disease of non-Hodgkin's lymphomas occurring with a lesser incidence of 1-2% has a propensity to occur at later ages above 50 years. PTL spreads to extra nodal sites due to deficiency of extra cellular adhesion molecules. We present detection of multiple sites of extra nodal involvement of PTL by F-18 positron emission tomography/computed tomography study aiding early detection of the dissemination thus aiding in staging and management. (author)

  16. Primary Malignant Melanoma of the Genitourinary Tract with Upper and Lower Tracts Involvement

    Directory of Open Access Journals (Sweden)

    Broderick Sutton

    2013-01-01

    Full Text Available A 91-year-old female presented with lower extremity swelling and shortness of breath. Laboratory analysis revealed elevations in blood urea nitrogen and creatinine along with microscopic hematuria on urinalysis. Computed tomography imaging showed moderate right hydronephrosis with dilatation of the proximal ureter with a soft tissue density at a transition point. Endoscopic evaluation revealed multiple raised, fleshy, and hemorrhagic masses throughout the bladder which are present in both ureters. Biopsy of these lesions revealed malignant melanoma invading the lamina propria. No dermatologic lesions were identified suggesting a primary malignant melanoma of the genitourinary system.

  17. Applied aspects of content projecting of lexicology and phraseology teaching of future primary school teachers

    Directory of Open Access Journals (Sweden)

    Марія Михайлівна Греб

    2015-01-01

    Full Text Available In the article it is considered the applied aspects of content projecting of lexicology and phraseology teaching of future primary school teachers basing on the principles of developing education. These principles are realized gradually (theoretical, practical, research stages and stage of independent work. Also these principles are guaranteed by the system of exercises and tasks of three levels of complexity which promotes increasing of motivation, self-development, self-realization of subjects of educational process

  18. Primary male neuroendocrine adenocarcinoma involving the nipple simulating Merkel cell carcinoma - a diagnostic pitfall.

    Science.gov (United States)

    Mecca, Patricia; Busam, Klaus

    2008-02-01

    Male breast cancer is a rare entity accounting for Nipple skin/subcutaneous tumors in men are even rarer. Likewise, true neuroendocrine carcinoma of the breast, defined as > 50% of tumor cells staining for either chromogranin or synaptophysin, is not a common entity, usually occurring in older women. We present the case of a 70-year-old man with a slowly growing nipple mass that had enlarged over the previous 1.5 years. The histology consisted of nests, trabeculae and sheets of basaloid cells with rare abortive gland formation and a pushing edge. The case was originally misdiagnosed as a Merkel cell carcinoma, based largely on histologic morphology. Strong staining for synaptophysin (in greater than 50% of cells), CD56, keratins AE1 : AE3 and Cam 5.2, as well as estrogen receptor and progesterone receptor was noted. Myoepithelial cells within in situ areas were identified using stains for calponin and 4A4, supporting a primary mammary duct origin. Additionally, a substantial portion of cells stained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), confirming some overlap with sweat duct differentiation. To the best of our knowledge, although reported in the male breast, no case of primary nipple neuroendocrine carcinoma in a male patient has been reported in the literature. The gender of the patient and association with the skin of the chest wall probably contributed to the original misdiagnosis of Merkel cell carcinoma in this patient.

  19. Peripheral nervous system involvement in primary burning mouth syndrome--results of a pilot study.

    Science.gov (United States)

    Puhakka, A; Forssell, H; Soinila, S; Virtanen, A; Röyttä, M; Laine, M; Tenovuo, O; Teerijoki-Oksa, T; Jääskeläinen, S K

    2016-05-01

    The pathophysiology of primary burning mouth syndrome (BMS) has remained enigmatic, but recent studies suggest pathology within the nervous system at multiple levels. This study aimed to investigate in detail the contribution of either focal or generalized alterations within the peripheral nervous system (PNS) in the etiopathogenesis of BMS. Intraepithelial nerve fiber density (IENFD) of tongue mucosa was assessed in 10 carefully characterized BMS, and the results were compared to 19 age- and gender-matched cadaver controls, 6 with lifetime diabetes. Extensive neurophysiologic and psychophysical examinations of the trigeminal system and distal extremities were performed to profile PNS function in BMS. Patients with BMS had significantly fewer intraepithelial nerve fibers (0,27, s.e. 0,18 mm(-1); P = 0.0253) than non-diabetic controls (0,92, s.e. 0,15 mm(-1)). In the subepithelial space, the amount of nerve fibers did not differ between the groups. The majority (9/10) of patients with BMS showed neurophysiologic or psychophysical signs of a more generalized PNS dysfunction. Our results in neurophysiologically optimally characterized BMS patients confirm that pure focal small fiber neuropathy of the oral mucosa has a role in the pathophysiology of primary BMS. Furthermore, BMS may be related to a more generalized, yet subclinical peripheral neuropathy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Developing Federated Services within Seismology: IRIS' involvement in the CoopEUS Project

    Science.gov (United States)

    Ahern, T. K.; Trabant, C. M.; Stults, M.

    2014-12-01

    As a founding member of the CoopEUS initiative, IRIS Data Services has partnered with five data centers in Europe and the UC Berkeley (NCEDC) in the US to implement internationally standardized web services to access seismological data using identical methodologies. The International Federation of Digital Seismograph Networks (FDSN) holds commission status within IASPEI/IUGG and as such is the international body that governs data exchange formats and access protocols within seismology. The CoopEUS project involves IRIS and UNAVCO as part of the EarthScope project and the European collaborators are all members of the European Plate Observing System (EPOS). CoopEUS includes one work package that attempts to coordinate data access between EarthScope and EPOS facilities. IRIS has worked with its partners in the FDSN to develop and adopt three key international service standards within seismology. These include 1) fdsn-dataselect, a service that returns time series data in a variety of standard formats, 2) fdsn-station, a service that returns related metadata about a seismic station in stationXML format, and 3) fdsn-event, a service that returns information about earthquakes and other seismic events in QuakeML format. Currently the 5 European data centers supporting these services include the ORFEUS Data Centre in the Netherlands, the GFZ German Research Centre for Geosciences in Potsdam, Germany, ETH Zurich in Switzerland, INGV in Rome, Italy, and the RESIF Data Centre in Grenoble France. Presently these seven centres can all be accessed using standardized web services with identical service calls and returns results in standardized ways. IRIS is developing an IRIS federator that will allow a client to seamlessly access information across the federated centers. Details and current status of the IRIS Federator will be presented.

  1. The Impact of an Implementation Project on Primary Care Staff Perceptions of Delivering Brief Alcohol Advice

    Directory of Open Access Journals (Sweden)

    Hanna Reinholdz

    2016-01-01

    Full Text Available Objective. To explore how the perceptions and experiences of working with risky drinkers change over time among primary health care staff during a systematic implementation project. Methods. Qualitative focus group interviews took place before and after the implementation of the project. Results. The staff displayed a positive change during the implementation period with regard to awareness, knowledge, and confidence that led to a change in routine practice. Throughout the project, staff were committed to engaging with risky drinkers and appeared to have been learning-by-doing. Conclusions. The results indicated a positive attitude to alcohol prevention work but staff lack knowledge and confidence in the area. The more practical experience during the study is, the more confidence seems to have been gained. This adds new knowledge to the science of implementation studies concerning alcohol prevention measures, which have otherwise shown disappointing results, emphasizing the importance of learning in practice.

  2. CITON involvement in CETRAD project on 'Education and training in radiation protection and radioactive waste'

    International Nuclear Information System (INIS)

    Comsa, Olivia; Meglea, Claudia; Banutoiu, Marina; Paraschiva, M. V.; Meglea, S.

    2003-01-01

    Within the European Community and world-wide there is extensive experience in the principles and practice of radiation protection and radioactive waste management. Nuclear skills and capabilities have grown and evolved since the inception of nuclear technology in the 1940s. However, with the current stagnation of the nuclear industry it is increasingly acknowledged that the skills and expertise held by the generation who grew up with nuclear technology are being passed on to new generations of experts. This poses a significant risk to the community who will need to manage nuclear liabilities for long times into the future in order to protect future society from radiological hazards. Notwithstanding that the state of the art in nuclear waste management is undoubtedly high in many organizations, it is very clear that there is continuous need for the provision of education and training in this area. The various training and education programmes throughout Europe are at different stages of development. There is undoubtedly a need for harmonization of the numerous programmes and there would be great benefit to countries at early stages of development due to the learning experiences from the more developed organizations. The objective of CETRAD is to develop proposals for structuring and delivering both education and training in the management of the geological disposal of long-lived radioactive waste and radiation protection across Europe. This proposal is seen as a forerunner of a more comprehensive pan-European Network in this area, which it is planned, will emerge from this work. The project activities will be carried out in two phases. Phase 1 will involve national evaluations of both the needs for education and training and the existing infrastructure and resources in the field of radiation protection and radioactive waste management. Phase 2 will involve development of specific proposals for education and training based on the needs identified in Phase 1. (authors)

  3. Primary myelofibrosis with or without mutant MPL: comparison of survival and clinical features involving 603 patients.

    Science.gov (United States)

    Pardanani, A; Guglielmelli, P; Lasho, T L; Pancrazzi, A; Finke, C M; Vannucchi, A M; Tefferi, A

    2011-12-01

    MPL and JAK2V617F mutation analysis was performed in 603 patients with primary myelofibrosis (PMF) seen at the Mayo Clinic, USA (n=329) or University of Florence, Italy (n=274). Mutant MPL was detected in 49 (8.1%) patients and JAK2V617F in 350 (58%); 4 patients showed both mutations. MPLW515L/K was the commonest mutation; 2 patients showed novel mutations (L513ins and Q516-P518insAAAA). The US and Italy patient cohorts were separately analyzed for comparison of survival and clinical features between MPL-mutated, JAK2-mutated and JAK2/MPL-unmutated cases. JAK2/MPL-unmutated patients were significantly younger than their JAK2-mutated counterparts, in both patient cohorts (PMPL was associated with older age (PMPL has narrow and inconsistent phenotypic effect in PMF and does not influence overall or leukemia-free survival.

  4. Nursing involvement in risk and patient safety management in Primary Care.

    Science.gov (United States)

    Coronado-Vázquez, Valle; García-López, Ana; López-Sauras, Susana; Turón Alcaine, José María

    Patient safety and quality of care in a highly complex healthcare system depends not only on the actions of professionals at an individual level, but also on interaction with the environment. Proactive risk management in the system to prevent incidents and activities targeting healthcare teams is crucial in establishing a culture of safety in centres. Nurses commonly lead these safety strategies. Even though safety incidents are relatively infrequent in primary care, since the majority are preventable, actions at this level of care are highly effective. Certification of services according to ISO standard 9001:2008 focuses on risk management in the system and its use in certifying healthcare centres is helping to build a safety culture amongst professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Primary Ewing's Sarcoma/Primitive Neuroectodermal Tumor of Kidney with Caval Involvement in a Pregnant Woman.

    Science.gov (United States)

    Ding, Yinghui; Huang, Zhenlin; Ding, Yafei; Jia, Zhankui; Gu, Chaohui; Xue, Rui; Yang, Jinjian

    2016-01-01

    In this article, we report the case of a woman in whom was found an abdominal mass during pregnancy and who underwent nephrectomy and extraction of the emboli after delivery. The kidney had a volume of 15 × 10 × 8 cm and pathological diagnosis was primary Ewing's sarcoma. The patient was treated with conventional chemotherapy for 1 year after surgery, at which time multiple metastases were found. From this case, we surmise that hormonal changes that occur during pregnancy may accelerate the growth of Ewing's sarcoma of the kidney, suggesting that renal tumors in pregnant women demand serious attention and that anti-cancer treatment should begin as soon as possible. © 2016 S. Karger AG, Basel.

  6. [Prevalence of renal involvement in a population of type Ii diabetics followed up in primary care].

    Science.gov (United States)

    Marín, R; Coca, A; Tranche, S; Rodríguez Mañas, L; Abellán, J; Moyá, A

    2002-01-01

    Patients with type 2 diabetes use to be managed in their primary care settings during the early stages of the disease. The main objective of the study was to determine renal impairment prevalence, and to assess its significance, within type 2 diabetics controlled by their family physicians. Transverse observation of patients with type 2 diabetes who were the first 20 unselected cases seen by 183 family physicians from 16 of the 17 Autonomic Communities of our country. The following variables were determined: serum creatinine, glucose, and HbA1c concentrations, proteinuria (dipstick test in a first-voided morning urine sample), blood pressure levels, and associated cardiovascular disease. Data from 3,583 type 2 diabetic subjects were evaluated. Mean age was 64 +/- 10 years and 45% were male. A serum creatinine > or = 1.2 mg/dl was observed in 523 (15.5%) patients. Proteinuria was present in 794 (23.5%) cases, being > or = 2 + in 215 (6.5%) subjects. Patients with a serum creatinine > or = 1.2 mg/dl were older, shower higher blood pressure levels, and suffered from more cardiovascular disease (32.0 vs 19.5%) than those with a serum creatinine or = 2 + proteinuria (p or = 140/90 mmHg in 69% of the cases, being < 130/85 mmHg in only 8% of the subjects. There is a high prevalence of renal impairment, approximately of 25% within type 2 diabetic patients seen at the primary care level. Optimal blood pressure level seems to be extremely infrequent bearing in mind the diagnosis of diabetes and the associated cardiovascular disease.

  7. CNS involvement in primary Sjogren Syndrome: assessment of gray and white matter changes with MRI and voxel-based morphometry.

    Science.gov (United States)

    Tzarouchi, Loukia C; Tsifetaki, Niki; Konitsiotis, Spyridon; Zikou, Anastasia; Astrakas, Loukas; Drosos, Alexandros; Argyropoulou, Maria I

    2011-11-01

    The purpose of this study was to evaluate with MRI the involvement of gray matter and white matter structures in patients with primary Sjögren syndrome. Fifty-three patients with primary Sjögren syndrome, 18 age- and disease duration-matched patients with systemic sclerosis, and 35 age-matched control subjects were examined for differences in white matter hyperintensities (WMHIs) detected on FLAIR MR images. Differences in brain volume between patients with primary Sjögren syndrome and controls were studied by application of voxel-based morphometry to a 3D T1-weighted sequence. WMHIs were observed in 38 of the 53 patients with primary Sjögren syndrome, six of 18 patients with systemic sclerosis, and 17 of 35 controls. The numbers of WMHIs 2 mm or larger and the number smaller than 2 mm were higher in patients with primary Sjögren syndrome than in controls (≥ 2 mm, p = 0.004; syndrome patients and that in systemic sclerosis patients. After control for age, a positive relation was found between disease duration and total number of WMHIs (p = 0.037) and number of WMHIs 2 mm or larger (p = 0.023) in patients with primary Sjögren syndrome. In comparison with the controls, patients with primary Sjögren syndrome had decreased gray matter volume in the cortex, deep gray matter, and cerebellum. Associated loss of white matter volume was observed in areas corresponding to gray matter atrophy and in the corpus callosum (p syndrome have WMHIs and gray and white matter atrophy, probably related to cerebral vasculitis.

  8. Religious factors associated with alcohol involvement: results from the Mauritian Joint Child Health Project.

    Science.gov (United States)

    Luczak, Susan E; Prescott, Carol A; Dalais, Cyril; Raine, Adrian; Venables, Peter H; Mednick, Sarnoff A

    2014-02-01

    The purpose of this study was to examine religious factors associated with alcohol involvement in Mauritius. The three main religions on the island, Hinduism, Catholicism, and Islam, promote different views of the appropriate use of alcohol. Based on reference group theory, we hypothesized that both the content of a religion's alcohol norms and an individual's religious commitment would relate to alcohol use behavior. Participants were from the Joint Child Health Project, a longitudinal study that has followed a birth cohort of 1.795 individuals since 1972 when they were 3 years old. All available participants (67%; 55% male) were assessed in mid-adulthood on religious variables, lifetime drinking, and lifetime alcohol use disorders. Across religions, individuals who viewed their religion as promoting abstinence were less likely to be drinkers. Religious commitment was associated with reduced probability of drinking only in those who viewed their religion as promoting abstinence. Among drinkers, abstention norms and religious commitment were not associated with lower likelihood of alcohol use disorders. In Catholics who viewed their religion as promoting abstinence and still were drinkers, high religious commitment was associated with increased risk for alcohol use disorders. Predictions based on reference group theory were largely supported, with religious norms and commitment differentially related to alcohol use and problems both across religions and among individuals within religions. Findings highlight the importance of examining multiple aspects of religion to better understand the relationship of religion with alcohol behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. KCNQ channels are involved in the regulatory volume decrease response in primary neonatal rat cardiomyocytes

    DEFF Research Database (Denmark)

    Calloe, Kirstine; Nielsen, Morten Schak; Grunnet, Morten

    2007-01-01

    of neonatal rat cardiomyocytes was studied in intact single cells attached to coverslips, i.e. with an intact cytoskeleton. The potential contribution of KCNQ (Kv7) channels to the RVD response and the possible involvement of the F-actin cytoskeleton were investigated. The rate of RVD was significantly...... changes the structure of the F-actin cytoskeleton, leading to a more rounded cell shape, less pronounced F-actin stress fibers and patches of actin. In the presence of cytochalasin D (1 microM), a potent inhibitor of actin polymerization, the RVD response was strongly reduced, confirming a possible role...... for an intact F-actin cytoskeleton in linking cell swelling to activation of ion transport in neonatal rat cardiomyocytes. Udgivelsesdato: 2007-Jun...

  10. Heart of Lymphoma: Primary Mediastinal Large B-Cell Lymphoma with Endomyocardial Involvement

    Directory of Open Access Journals (Sweden)

    Elisa Rogowitz

    2013-01-01

    Full Text Available Primary mediastinal B-cell lymphoma (PMBCL is an uncommon aggressive subset of diffuse large B-cell lymphomas. Although PMBCL frequently spreads locally from the thymus into the pleura or pericardium, it rarely invades directly through the heart. Herein, we report a case of a young Mexican female diagnosed with PMBCL with clear infiltration of lymphoma through the cardiac wall and into the right atrium and tricuspid valve leading to tricuspid regurgitation. This was demonstrated by cardiac MRI and transthoracic echocardiogram. In addition, cardiac MRI and CT scan of the chest revealed the large mediastinal mass completely surrounding and eroding into the superior vena cava (SVC wall causing a collar of stokes. The cardiac and SVC infiltration created a significant therapeutic challenge as lymphomas are very responsive to chemotherapy, and treatment could potentially lead to vascular wall rupture and hemorrhage. Despite the lack of conclusive data on chemotherapy-induced hemodynamic compromise in such scenarios, her progressive severe SVC syndrome and respiratory distress necessitated urgent intervention. In addition to the unique presentation of this rare lymphoma, our case report highlights the safety of R-CHOP treatment.

  11. Adverse effects of the antimalaria drug, mefloquine: due to primary liver damage with secondary thyroid involvement?

    Directory of Open Access Journals (Sweden)

    Herxheimer Andrew

    2002-03-01

    Full Text Available Abstract Background Mefloquine is a clinically important antimalaria drug, which is often not well tolerated. We critically reviewed 516 published case reports of mefloquine adverse effects, to clarify the phenomenology of the harms associated with mefloquine, and to make recommendations for safer prescribing. Presentation We postulate that many of the adverse effects of mefloquine are a post-hepatic syndrome caused by primary liver damage. In some users we believe that symptomatic thyroid disturbance occurs, either independently or as a secondary consequence of the hepatocellular injury. The mefloquine syndrome presents in a variety of ways including headache, gastrointestinal disturbances, nervousness, fatigue, disorders of sleep, mood, memory and concentration, and occasionally frank psychosis. Previous liver or thyroid disease, and concurrent insults to the liver (such as from alcohol, dehydration, an oral contraceptive pill, recreational drugs, and other liver-damaging drugs may be related to the development of severe or prolonged adverse reactions to mefloquine. Implications We believe that people with active liver or thyroid disease should not take mefloquine, whereas those with fully resolved neuropsychiatric illness may do so safely. Mefloquine users should avoid alcohol, recreational drugs, hormonal contraception and co-medications known to cause liver damage or thyroid damage. With these caveats, we believe that mefloquine may be safely prescribed in pregnancy, and also to occupational groups who carry out safety-critical tasks. Testing Mefloquine's adverse effects need to be investigated through a multicentre cohort study, with small controlled studies testing specific elements of the hypothesis.

  12. Effects of exposure to high glucose on primary cultured hippocampal neurons: involvement of intracellular ROS accumulation.

    Science.gov (United States)

    Liu, Di; Zhang, Hong; Gu, Wenjuan; Zhang, Mengren

    2014-06-01

    Recent studies showed that hyperglycemia is the main trigger of diabetic cognitive impairment and can cause hippocampus abnormalities. The goal of this study is to explore the effects of different concentrations of high glucose for different exposure time on cell viability as well as intracellular reactive oxygen species (ROS) generation of primary cultured hippocampal neurons. Hippocampal neurons were exposed to different concentrations of high glucose (50, 75, 100, 125, and 150 mM) for 24, 48, 72 and 96 h. Cell viability and nuclear morphology were evaluated by MTT and Hoechst assays, respectively. Intracellular ROS were monitored using the fluorescent probe DCFH-DA. The results showed that, compared with control group, the cell viability of all high glucose-treated groups decreased significantly after 72 h and there also was a significant increase of apoptotic nuclei in high glucose-treated groups from 72 to 96 h. Furthermore, 50 mM glucose induced a peak rise in ROS generation at 24 h and the intracellular ROS levels of 50 mM glucose group were significantly higher than the corresponding control group from 6 to 72 h. These results suggest that hippocampal neurons could be injured by high glucose exposure and the neuronal injury induced by high glucose is potentially mediated through intracellular ROS accumulation.

  13. Oxidative stress is involved in Dasatinib-induced apoptosis in rat primary hepatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Xue, Tao; Luo, Peihua; Zhu, Hong; Zhao, Yuqin [Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058 (China); Wu, Honghai; Gai, Renhua; Wu, Youping [Center for Drug Safety Evaluation and Research of Zhejiang University, Hangzhou 310058 (China); Yang, Bo [Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058 (China); Yang, Xiaochun, E-mail: yangxiaochun@zju.edu.cn [Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058 (China); Center for Drug Safety Evaluation and Research of Zhejiang University, Hangzhou 310058 (China); He, Qiaojun, E-mail: qiaojunhe@zju.edu.cn [Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058 (China); Center for Drug Safety Evaluation and Research of Zhejiang University, Hangzhou 310058 (China)

    2012-06-15

    Dasatinib, a multitargeted inhibitor of BCR–ABL and SRC kinases, exhibits antitumor activity and extends the survival of patients with chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL). However, some patients suffer from hepatotoxicity, which occurs through an unknown mechanism. In the present study, we found that Dasatinib could induce hepatotoxicity both in vitro and in vivo. Dasatinib reduced the cell viability of rat primary hepatocytes, induced the release of alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) in vitro, and triggered the ballooning degeneration of hepatocytes in Sprague–Dawley rats in vivo. Apoptotic markers (chromatin condensation, cleaved caspase-3 and cleaved PARP) were detected to indicate that the injury induced by Dasatinib in hepatocytes in vitro was mediated by apoptosis. This result was further validated in vivo using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assays. Here we found that Dasatinib dramatically increased the level of reactive oxygen species (ROS) in hepatocytes, reduced the intracellular glutathione (GSH) content, attenuated the activity of superoxide dismutase (SOD), generated malondialdehyde (MDA), a product of lipid peroxidation, decreased the mitochondrial membrane potential, and activated nuclear factor erythroid 2-related factor 2 (Nrf2) and mitogen-activated protein kinases (MAPK) related to oxidative stress and survival. These results confirm that oxidative stress plays a pivotal role in Dasatinib-mediated hepatotoxicity. N-acetylcysteine (NAC), a typical antioxidant, can scavenge free radicals, attenuate oxidative stress, and protect hepatocytes against Dasatinib-induced injury. Thus, relieving oxidative stress is a viable strategy for reducing Dasatinib-induced hepatotoxicity. -- Highlights: ►Dasatinib shows potential hepatotoxicity both in vitro and in vivo. ►Apoptosis plays a vital role in Dasatinib

  14. Identification of G Protein-Coupled Receptors (GPCRs in Primary Cilia and Their Possible Involvement in Body Weight Control.

    Directory of Open Access Journals (Sweden)

    Yoshihiro Omori

    Full Text Available Primary cilia are sensory organelles that harbor various receptors such as G protein-coupled receptors (GPCRs. We analyzed subcellular localization of 138 non-odorant GPCRs. We transfected GPCR expression vectors into NIH3T3 cells, induced ciliogenesis by serum starvation, and observed subcellular localization of GPCRs by immunofluorescent staining. We found that several GPCRs whose ligands are involved in feeding behavior, including prolactin-releasing hormone receptor (PRLHR, neuropeptide FF receptor 1 (NPFFR1, and neuromedin U receptor 1 (NMUR1, localized to the primary cilia. In addition, we found that a short form of dopamine receptor D2 (DRD2S is efficiently transported to the primary cilia, while a long form of dopamine receptor D2 (DRD2L is rarely transported to the primary cilia. Using an anti-Prlhr antibody, we found that Prlhr localized to the cilia on the surface of the third ventricle in the vicinity of the hypothalamic periventricular nucleus. We generated the Npy2r-Cre transgenic mouse line in which Cre-recombinase is expressed under the control of the promoter of Npy2r encoding a ciliary GPCR. By mating Npy2r-Cre mice with Ift80 flox mice, we generated Ift80 conditional knockout (CKO mice in which Npy2r-positive cilia were diminished in number. We found that Ift80 CKO mice exhibited a body weight increase. Our results suggest that Npy2r-positive cilia are important for body weight control.

  15. Identification of G Protein-Coupled Receptors (GPCRs) in Primary Cilia and Their Possible Involvement in Body Weight Control.

    Science.gov (United States)

    Omori, Yoshihiro; Chaya, Taro; Yoshida, Satoyo; Irie, Shoichi; Tsujii, Toshinori; Furukawa, Takahisa

    2015-01-01

    Primary cilia are sensory organelles that harbor various receptors such as G protein-coupled receptors (GPCRs). We analyzed subcellular localization of 138 non-odorant GPCRs. We transfected GPCR expression vectors into NIH3T3 cells, induced ciliogenesis by serum starvation, and observed subcellular localization of GPCRs by immunofluorescent staining. We found that several GPCRs whose ligands are involved in feeding behavior, including prolactin-releasing hormone receptor (PRLHR), neuropeptide FF receptor 1 (NPFFR1), and neuromedin U receptor 1 (NMUR1), localized to the primary cilia. In addition, we found that a short form of dopamine receptor D2 (DRD2S) is efficiently transported to the primary cilia, while a long form of dopamine receptor D2 (DRD2L) is rarely transported to the primary cilia. Using an anti-Prlhr antibody, we found that Prlhr localized to the cilia on the surface of the third ventricle in the vicinity of the hypothalamic periventricular nucleus. We generated the Npy2r-Cre transgenic mouse line in which Cre-recombinase is expressed under the control of the promoter of Npy2r encoding a ciliary GPCR. By mating Npy2r-Cre mice with Ift80 flox mice, we generated Ift80 conditional knockout (CKO) mice in which Npy2r-positive cilia were diminished in number. We found that Ift80 CKO mice exhibited a body weight increase. Our results suggest that Npy2r-positive cilia are important for body weight control.

  16. Early Involvement and Integration in Construction Projects: The Benefits of DfX in Elimination of Wastes

    Directory of Open Access Journals (Sweden)

    Heikki Halttula

    2017-12-01

    Full Text Available Typical construction processes provide waste: material waste but especially process-related waste. The majority of this waste can be avoided with efficient planning in the front end of projects. The main aim is to describe how the concept of Design for Excellence (DfX can reduce the most severe waste in construction projects. Based on a literature review of waste and requirements that aid early involvement and integration, we created a survey for analyzing and prioritizing types of waste in the construction industry. We describe how DFX reduces this waste, especially through the use of early involvement and integration. When applied, DfX creates incentives for project stakeholders to eliminate waste automatically through early involvement and integration.

  17. Learning to work together - lessons from a reflective analysis of a research project on public involvement.

    Science.gov (United States)

    Howe, A; Mathie, E; Munday, D; Cowe, M; Goodman, C; Keenan, J; Kendall, S; Poland, F; Staniszewska, S; Wilson, P

    2017-01-01

    Patient and public involvement (PPI) in research is very important, and funders and the NHS all expect this to happen. What this means in practice, and how to make it really successful, is therefore an important research question. This article analyses the experience of a research team using PPI, and makes recommendations on strengthening PPI in research. There were different PPI roles in our study - some people were part of the research team: some were on the advisory group; and there were patient groups who gave specific feedback on how to make research work better for their needs. We used minutes, other written documents, and structured individual and group reflections to learn from our own experiences over time. The main findings were:- for researchers and those in a PPI role to work in partnership, project structures must allow flexibility and responsiveness to different people's ideas and needs; a named link person can ensure support; PPI representatives need to feel fully included in the research; make clear what is expected for all roles; and ensure enough time and funding to allow meaningful involvement. Some roles brought more demands but also more rewards than others - highlighting that it is important that people giving up their time to help with research experience gains from doing so. Those contributing to PPI on a regular basis may want to learn new skills, rather than always doing the same things. Researchers and the public need to find ways to develop roles in PPI over time. We also found that, even for a team with expertise in PPI, there was a need both for understanding of different ways to contribute, and an evolving 'normalisation' of new ways of working together over time, which both enriched the process and the outputs. Background Patient and public involvement (PPI) is now an expectation of research funders, in the UK, but there is relatively little published literature on what this means in practice - nor is there much evaluative research

  18. Primary problems associated with the health and welfare of employees observed when implementing lean manufacturing projects.

    Science.gov (United States)

    Rampasso, Izabela Simon; Anholon, Rosley; Gonçalves Quelhas, Osvaldo Luiz; Filho, Walter Leal

    2017-01-01

    Lean philosophy is used by companies to increase productivity and reduce costs. Although uncontested benefits are created, it is necessary to highlight the problems related to employees' health and welfare caused by implementing lean manufacturing projects. The primary objective of this paper is to review the literature and identify the most relevant problems created by lean philosophy for employees. Research about the theme was performed on many international databases over three months, and an initial sample of 77 papers was found. Twenty-seven sources were utilized. We identified 22 categories of problems related to health and welfare of employees. The most cited problem was work intensification, mentioned by thirteen papers. Increased stress and increased responsibilities, demands and, consequently, pressure on the workers are among the primary problems observed in the research.

  19. Dissemination of the Project's Findings. National Seminar (14th, Zagreb, Yugoslavia, July 5-7, 1989). The CDCC's Project No. 8: "Innovation in Primary Education."

    Science.gov (United States)

    Galton, Maurice

    A 3-day conference was convened in Zagreb, Yugoslavia for the purpose of disseminating results of the Council of Europe's Council for Cultural Cooperation's (CDCC) Project 8, Innovation in Primary Education (IPE). Changes in theoretical approaches to and organizational practices of primary education in Yugoslavia were discussed. A total of 61…

  20. Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH.

    Science.gov (United States)

    El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A; Rowe, Jessica; Almonte, Maria; Witte, Susan

    2014-01-01

    This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90). The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. Clinical

  1. Descending projections from the dysgranular zone of rat primary somatosensory cortex processing deep somatic input.

    Science.gov (United States)

    Lee, Taehee; Kim, Uhnoh

    2012-04-01

    In the mammalian somatic system, peripheral inputs from cutaneous and deep receptors ascend via different subcortical channels and terminate in largely separate regions of the primary somatosensory cortex (SI). How these inputs are processed in SI and then projected back to the subcortical relay centers is critical for understanding how SI may regulate somatic information processing in the subcortex. Although it is now relatively well understood how SI cutaneous areas project to the subcortical structures, little is known about the descending projections from SI areas processing deep somatic input. We examined this issue by using the rodent somatic system as a model. In rat SI, deep somatic input is processed mainly in the dysgranular zone (DSZ) enclosed by the cutaneous barrel subfields. By using biotinylated dextran amine (BDA) as anterograde tracer, we characterized the topography of corticostriatal and corticofugal projections arising in the DSZ. The DSZ projections terminate mainly in the lateral subregions of the striatum that are also known as the target of certain SI cutaneous areas. This suggests that SI processing of deep and cutaneous information may be integrated, to a certain degree, in this striatal region. By contrast, at both thalamic and prethalamic levels as far as the spinal cord, descending projections from DSZ terminate in areas largely distinguishable from those that receive input from SI cutaneous areas. These subcortical targets of DSZ include not only the sensory but also motor-related structures, suggesting that SI processing of deep input may engage in regulating somatic and motor information flow between the cortex and periphery. Copyright © 2011 Wiley-Liss, Inc.

  2. Influence of 4-H Horse Project Involvement on Development of Life Skills

    Science.gov (United States)

    Anderson, K. P.; Karr-Lilienthal, L.

    2011-01-01

    Four-H horse project members who competed in non-riding horse contests were surveyed to evaluate the influence of their horse project participation on life-skill development. Contests in which youth competed included Horse Bowl, Demonstrations, Public Speaking, and Art. Youth indicated a positive influence on both life-skill development and horse…

  3. Reaping the harvest: nursing student service involvement with a campus gardening project.

    Science.gov (United States)

    Ahonen, Kathleen; Lee, Carolyn; Daker, Emily

    2012-01-01

    The authors describe the development and incorporation of a multidisciplinary community garden as a service project in a baccalaureate nursing cohort in an urban university. The concepts of professional ethics and service, application of nutritional theory to a community cohort, and competencies in community health nursing are briefly discussed and applied to this service project.

  4. Surgical Interventions for Organ and Limb Ischemia Associated With Primary and Secondary Antiphospholipid Antibody Syndrome With Arterial Involvement.

    Science.gov (United States)

    Hinojosa, Carlos A; Anaya-Ayala, Javier E; Bermudez-Serrato, Karla; García-Alva, Ramón; Laparra-Escareno, Hugo; Torres-Machorro, Adriana; Lizola, Rene

    2017-11-01

    The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined. Demographics, comorbidities, manifestations, procedures, complications, and other factors affecting outcomes were recorded. Fourteen patients (mean age 35 years old, standard deviation ±14) were evaluated and treated by our service. Six (43%) of them had primary APS and 8 (57%) had secondary APS; 11 (79%) were female. Two (14%) experienced distal aorta and iliac arteries involvement, 3 (21%) visceral vessels disease, 2 (14%) in upper and 7 (50%) in the lower extremity vasculatures. Thirteen (93%) patients underwent direct open revascularization and 1 with hand ischemia (Raynaud disease) underwent sympathectomy. During the mean follow-up period of 48 months, reinterventions included a revision of the proximal anastomosis of an aortobifemoral bypass graft, 1 (7%) abdominal exploration for bleeding, 1 (7%) graft thrombectomy, and 4 (29%) amputations (2 below the knee, 1 above the knee, and 1 transmetatarsal). One (7%) death occurred secondary to sepsis in a patient who had acute mesenteric ischemia. Significant differences in clinical manifestations and outcomes were not observed among patients with primary and secondary APS. All patients remained on systemic anticoagulation. APS is a prothrombotic disorder that may lead to arterial involvement with less frequency than the venous circulation but has significant morbidity and limb loss rate. Arterial reconstruction seems feasible in an attempt to salvage organs and limbs; however, research is necessary to establish the

  5. Primary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care.

    Science.gov (United States)

    Huang, Kevin B; Weber, Urs; Johnson, Jennifer; Anderson, Nathanial; Knies, Andrea K; Nhundu, Belinda; Bautista, Cynthia; Poskus, Kelly; Sheth, Kevin N; Hwang, David Y

    2018-01-01

    An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients. We compared the mean score for the survey subsection regarding shared decision making (graded on a 100-point scale), as well as individual survey items, between those who reported the patient's PCP involvement in any medical decision making versus those who did not. Among 263 respondents, there was no difference in mean overall decision-making satisfaction scores for those who reported involvement (81.1; SD = 15.2) versus those who did not (80.1; SD = 12.8; P = .16). However, a higher proportion reporting involvement felt completely satisfied with their 1) inclusion in the ICU decision making process (75.9% vs 61.4%; P = .055), and 2) control over the care of the patient (73.6% vs 55.6%; P = .02), with no difference regarding consistency of clinical information provided by the medical team (64.8% vs 63.5%; P = 1.00). Families who report involvement of a patient's PCP in medical decision making for critically ill patients may be more satisfied than those who do not with regard to specific aspects of ICU decision making. Further research would help understand how best to engage PCPs in shared decisions. © Copyright 2018 by the American Board of Family Medicine.

  6. Five Fatty Acyl-Coenzyme A Reductases Are Involved in the Biosynthesis of Primary Alcohols in Aegilops tauschii Leaves

    Directory of Open Access Journals (Sweden)

    Meiling Wang

    2017-06-01

    Full Text Available The diploid Aegilops tauschii is the D-genome donor to hexaploid wheat (Triticum aestivum and represents a potential source for genetic study in common wheat. The ubiquitous wax covering the aerial parts of plants plays an important role in protecting plants against non-stomatal water loss. Cuticular waxes are complex mixtures of very-long-chain fatty acids, alkanes, primary and/or secondary alcohols, aldehydes, ketones, esters, triterpenes, sterols, and flavonoids. In the present work, primary alcohols were identified as the major components of leaf cuticular wax in Ae. tauschii, with C26:0-OH being the dominant primary alcohol. Analysis by scanning electron microscope revealed that dense platelet-shaped wax crystals were deposited on leaf surfaces of Ae. tauschii. Ten putative wax biosynthetic genes encoding fatty acyl-coenzyme A reductase (FAR were identified in the genome of Ae. tauschii. Five of these genes, Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6, were found expressed in the leaf blades. Heterologous expression of the five Ae.tFARs in yeast (Saccharomyces cerevisiae showed that Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6 were predominantly responsible for the accumulation of C16:0, C18:0, C26:0, C24:0, and C28:0 primary alcohols, respectively. In addition, nine Ae.tFAR paralogous genes were located on D chromosome of wheat and the wheat nullisomic–tetrasomic lines with the loss of Ae.tFAR3 and Ae.tFAR4 paralogous genes had significantly reduced levels of primary alcohols in the leaf blades. Collectively, these data suggest that Ae.tFAR1, Ae.tFAR2, Ae.tFAR3, Ae.tFAR4, and Ae.tFAR6 encode alcohol-forming FARs involved in the biosynthesis of primary alcohols in the leaf blades of Ae. tauschii. The information obtained in Ae. tauschii enables us to better understand wax biosynthesis in common wheat.

  7. Experience and meaning of user involvement: some explorations from a community mental health project.

    Science.gov (United States)

    Truman, Carole; Raine, Pamela

    2002-05-01

    With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analysed using a grounded theory approach to provide insights into: the organisational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what 'successful' user participation may involve and the conditions which underpin 'success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognise their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organisations, but also by service providers and non-involved users.

  8. Do project management and network governance contribute to inter-organisational collaboration in primary care? A mixed methods study.

    Science.gov (United States)

    Schepman, Sanneke; Valentijn, Pim; Bruijnzeels, Marc; Maaijen, Marlies; de Bakker, Dinny; Batenburg, Ronald; de Bont, Antoinette

    2018-06-07

    The need for organisational development in primary care has increased as it is accepted as a means of curbing rising costs and responding to demographic transitions. It is only within such inter-organisational networks that small-scale practices can offer treatment to complex patients and continuity of care. The aim of this paper is to explore, through the experience of professionals and patients, whether, and how, project management and network governance can improve the outcomes of projects which promote inter-organisational collaboration in primary care. This paper describes a study of projects aimed at improving inter-organisational collaboration in Dutch primary care. The projects' success in project management and network governance was monitored by interviewing project leaders and board members on the one hand, and improvement in the collaboration by surveying professionals and patients on the other. Both qualitative and quantitative methods were applied to assess the projects. These were analysed, finally, using multi-level models in order to account for the variation in the projects, professionals and patients. Successful network governance was associated positively with the professionals' satisfaction with the collaboration; but not with improvements in the quality of care as experienced by patients. Neither patients nor professionals perceived successful project management as associated with the outcomes of the collaboration projects. This study shows that network governance in particular makes a difference to the outcomes of inter-organisational collaboration in primary care. However, project management is not a predictor for successful inter-organisational collaboration in primary care.

  9. High-dose methotrexate following intravitreal methotrexate administration in preventing central nervous system involvement of primary intraocular lymphoma.

    Science.gov (United States)

    Akiyama, Hiroki; Takase, Hiroshi; Kubo, Fumito; Miki, Tohru; Yamamoto, Masahide; Tomita, Makoto; Mochizuki, Manabu; Miura, Osamu; Arai, Ayako

    2016-10-01

    In order to prevent central nervous system (CNS) involvement and improve the prognosis of primary intraocular lymphoma (PIOL), we prospectively evaluated the efficacy of combined therapy using intravitreal methotrexate (MTX) and systemic high-dose MTX on treatment-naïve PIOL. Patients with newly diagnosed PIOL whose lymphoma was limited to the eyes were enrolled. The patients were treated with weekly intravitreal MTX until the ocular lesions were resolved, followed by five cycles of systemic high-dose MTX (3.5 g/m 2 ) every other week. Ten patients were enrolled in this study and completed the treatment. All patients achieved complete response for their ocular lesions with rapid decrease of intravitreal interleukin-10 concentration. Adverse events of intravitreal and systemic high-dose MTX were mild and tolerable. With a median follow-up of 29.5 months, four patients (40%) experienced the CNS disease development and the mean CNS lymphoma-free survival (CLFS) time was 51.1 months. Two-year CLFS, which was the primary end-point of the study, was 58.3% (95% confidence interval, 23.0-82.1%). In contrast, eight patients were treated with intravitreal MTX alone in our institute, and their 2-year CLFS was 37.5% (95% confidence interval, 8.7-67.4%). In conclusion, systemic high-dose MTX following intravitreal MTX is feasible and might be effective in preventing CNS involvement of PIOL. Further arrangements are worth considering in order to improve the effects. This study was registered with UMIN Clinical Trials Registry (UMIN000003921). © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  10. The productivity and cost-efficiency of models for involving nurse practitioners in primary care: a perspective from queueing analysis.

    Science.gov (United States)

    Liu, Nan; D'Aunno, Thomas

    2012-04-01

    To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model. © Health Research and Educational Trust.

  11. Contracting communities: Conceptualizing Community Benefits Agreements to improve citizen involvement in urban development projects

    NARCIS (Netherlands)

    Janssen-Jansen, Leonie; Veen, van der Menno

    2017-01-01

    Contractual agreements are becoming increasingly important for city governments seeking to manage urban development. Contractual governance involves direct relations between the local state and different public and private actors and citizens. Although abundant literature exists on public–private

  12. Chronic obstructive pulmonary disease (COPD) rehabilitation at primary health‐care centres – the KOALA project

    DEFF Research Database (Denmark)

    Godtfredsen, Nina Skavlan; Grann, Ove; Larsen, Hanne Bormann

    2012-01-01

    Background:  Implementation of pulmonary rehabilitation in primary health care in Denmark is a new challenge in the management of patients with chronic obstructive pulmonary disease (COPD). Objectives:  To assess the feasibility of introducing a nationwide web-based tool for data recording...... not meet the criteria for pulmonary rehabilitation in terms of dyspnoea upon exertion at the baseline visit. Furthermore, information on severity of COPD is missing for 18% of the attendants. The majority of the referred patients have moderate COPD, which is in accordance with the intentions...... and quality assurance in the rehabilitation programmes and to evaluate whether patients are referred correctly according to Danish guidelines for community based COPD rehabilitation. Methods:  Participation in the KOALA project has been offered to the municipalities since October 2007. As of October 2010, 62...

  13. The management of dental caries in primary teeth - involving service providers and users in the design of a trial.

    Science.gov (United States)

    Marshman, Zoe; Innes, Nicola; Deery, Chris; Hall, Melanie; Speed, Chris; Douglas, Gail; Clarkson, Jan; Rodd, Helen

    2012-08-22

    There is a lack of evidence for the effective management of dental caries in children's primary teeth. The trial entitled 'Filling Children's Teeth: Indicated Or Not?' (FiCTION) was designed to examine the clinical and cost effectiveness, in primary dental care, of three different approaches to the management of caries in primary teeth. However, before the FiCTION main trial commenced, a pilot trial was designed. Service provider (dentists and other members of the team including dental nurses and practice managers) and participant (child participants and their parents) involvement was incorporated into the pilot trial. The aim of this study is to describe service providers' and users' perspectives on the pilot trial to identify improvements to the conduct and design of the FiCTION main trial. Qualitative interviews (individual and group) were held with dentists, dental team members, children and parents involved in the FiCTION pilot trial. Individual interviews were held with four dentists and a group interview was held with 17 dental team members. Face-to-face interviews were held with four parents and children (four- to eight-years old) representing the three arms of the trial and five telephone interviews were conducted with parents. All interviews were transcribed verbatim. Framework analysis was used. Overall, service providers, children and parents found the pilot trial to be well conducted and an interesting experience. Service providers highlighted the challenges of adhering to research protocols, especially managing the documentation and undertaking new clinical techniques. They indicated that the time and financial commitments were greater than they had anticipated. Particular difficulties were found recruiting suitable patients within the timeframe. For parents recruitment was apparently more related to trusting their dentist than the content of information packs. While some of the older children understood what a study was, others did not understand or

  14. HANFORD DOUBLE SHELL TANK (DST) THERMAL & SEISMIC PROJECT BUCKLING EVALUATION METHODS & RESULTS FOR THE PRIMARY TANKS

    Energy Technology Data Exchange (ETDEWEB)

    MACKEY TC; JOHNSON KI; DEIBLER JE; PILLI SP; RINKER MW; KARRI NK

    2007-02-14

    This report documents a detailed buckling evaluation of the primary tanks in the Hanford double-shell waste tanks (DSTs), which is part of a comprehensive structural review for the Double-Shell Tank Integrity Project. This work also provides information on tank integrity that specifically responds to concerns raised by the Office of Environment, Safety, and Health (ES&H) Oversight (EH-22) during a review of work performed on the double-shell tank farms and the operation of the aging waste facility (AWF) primary tank ventilation system. The current buckling review focuses on the following tasks: (1) Evaluate the potential for progressive I-bolt failure and the appropriateness of the safety factors that were used for evaluating local and global buckling. The analysis will specifically answer the following questions: (a) Can the EH-22 scenario develop if the vacuum is limited to -6.6-inch water gage (w.g.) by a relief valve? (b) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario can develop? (c) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario cannot develop? (2) Develop influence functions to estimate the axial stresses in the primary tanks for all reasonable combinations of tank loads, based on detailed finite element analysis. The analysis must account for the variation in design details and operating conditions between the different DSTs. The analysis must also address the imperfection sensitivity of the primary tank to buckling. (3) Perform a detailed buckling analysis to determine the maximum allowable differential pressure for each of the DST primary tanks at the current specified limits on waste temperature, height, and specific gravity. Based on the I-bolt loads analysis and the small deformations that are predicted at the unfactored limits on vacuum and axial loads, it is very unlikely that the EH-22 scenario (i.e., progressive I-bolt failure leading to global

  15. 31 CFR 537.412 - Investments in entities involved in economic development projects in Burma.

    Science.gov (United States)

    2010-07-01

    ... economic development projects in Burma. 537.412 Section 537.412 Money and Finance: Treasury Regulations... economic development of resources located in Burma is prohibited by § 537.204 where the company's profits are predominantly derived from the company's economic development of resources located in Burma. (b...

  16. Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

    Directory of Open Access Journals (Sweden)

    Luis M. Amezcua-Guerra

    2013-01-01

    Full Text Available Objective. To characterize the ultrasound (US pattern of joint involvement in primary Sjögren’s syndrome (pSS. Methods. Seventeen patients with pSS, 18 with secondary Sjögren’s syndrome (sSS, and 17 healthy controls underwent US examinations of various articular regions. Synovitis (synovial hypertrophy/joint effusion, power Doppler (PD signals, and erosions were assessed. Results. In patients with pSS, synovitis was found in the metacarpophalangeal joints (MCP, 76%, wrists (76%, and knees (76%, while the proximal interphalangeal joints, elbows, and ankles were mostly unscathed. Intra-articular PD signals were occasionally detected in wrists (12%, elbows (6%, and knees (6%. Erosions were evident in the wrists of three (18% patients with pSS, one of these also having anti-cyclic citrullinated peptide (anti-CCP antibodies. While US synovitis does not discriminate between sSS and pSS, demonstration of bone erosions in the 2nd MCP joints showed 28.8% sensitivity and 100% specificity for diagnosing sSS; in comparison, these figures were 72.2 and 94.1% for circulating anti-CCP antibodies. Conclusions. In pSS, the pattern of joint involvement by US is polyarticular, bilateral, and symmetrical. Synovitis is the US sign most commonly found in patients with pSS, especially in MCP joints, wrists, and knees, and bone erosions also may occur.

  17. MECHANISMS IN ENDOCRINOLOGY: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects.

    Science.gov (United States)

    Verdelli, C; Corbetta, S

    2017-01-01

    Primary hyperparathyroidism (PHPT) is the third most common endocrine disease. Kidney is a target of both chronic elevated PTH and calcium in PHPT. The classic PHPT complications of symptomatic kidney stones and nephrocalcinosis have become rare and the PHPT current presentation is asymptomatic with uncertain and long-lasting progression. Nonetheless, the routine use of imaging and of biochemical determinations have revealed the frequent occurrence of asymptomatic kidney stones, hypercalciuria and reduced kidney function in asymptomatic PHPT patients. Though the pathogenesis is far from being elucidated, PHPT is associated with reduced renal function, in terms of estimated glomerular filtration rate, and related increased morbidity and mortality. In the last decade, the effort of the Kidney Disease: Improving Global Outcomes (KDIGO) panel of experts highlighted that even mild reduction of kidney function is associated with increased risk of cardiovascular disease. These considerations provided the basis for the Fourth Workshop recommendations of a more extensive diagnostic workout about kidney features and of wider criteria for parathyroid surgery including asymptomatic kidney disease. Moreover, kidney involvement in PHPT is likely to be affected by variants of genes coding the key molecules regulating the calcium and ions renal handling; these features might have clinical relevance and should be considered both during diagnostic workout and follow-up. Finally, the effects of parathyroid surgery and of medical treatment on kidney involvement of PHPT are reviewed. © 2017 European Society of Endocrinology.

  18. Consumer satisfaction among patients and their general practitioners about involving nurse specialists in primary care for patients with urinary incontinence.

    Science.gov (United States)

    Albers-Heitner, Pytha; Winkens, Ron; Berghmans, Bary; Joore, Manuela; Nieman, Fred; Severens, Johan; Lagro-Janssen, Toine

    2013-06-01

    Urinary incontinence (UI) is a very common problem, but existing guidelines on UI are not followed. To bring care in line with guidelines, we planned an intervention to involve nurse specialists on UI in primary care and assessed this in a randomised controlled trial. Alongside this intervention, we assessed consumer satisfaction among patients and general practitioners (GPs). Patients' satisfaction with the care provided by either nurse specialists (intervention group) or GPs (control group), respectively, was measured with a self-completed questionnaire. GPs' views on the involvement of nurse specialists were measured in a structured telephone interview. The patient satisfaction score on the care offered by nurse specialists was 8.4 (scale 1-10), vs. 6.7 for care-as-usual by GPs. Over 85% of patients would recommend nurse specialist care to their best friends and 77% of the GPs considered the role of the nurse specialist to be beneficial, giving it a mean score of 7.2. Although the sample was relatively small and the stability of the results only provisionally established, substituting UI care from GP to nurse specialist appears to be welcomed by both patients and GPs. Small changes like giving additional UI-specific information and devoting more attention to UI (which had been given little attention before) would provide a simple instrument to stimulate patients to change their behaviour in the right direction. © 2012 Nordic College of Caring Science.

  19. Phenix Power Plant Decommissioning Project. Treatment of the Primary Cold Trap

    International Nuclear Information System (INIS)

    Deluge, M.

    2008-01-01

    Phenix is a sodium-cooled fast neutron reactor located at the CEA's Rhone Valley Center where it was commissioned in 1974. It has an electric power rating of 250 MW and is operated jointly by the CEA and EDF. Its primary role today is to investigate the transmutation of long-lived radioactive waste into shorter-lived wasteform. Its final shutdown is scheduled for the beginning of 2009. In this context the Phenix Power Plant Decommissioning Project was initiated in 2003. It covers the definitive cessation of plant operation and the dismantling (D and D) operations together with the final shutdown preparatory phase. The final shutdown phase includes the operations authorized within the standard operating methodological framework. The dismantling phase also comprises treatment of sodium-bearing waste and dismantling of the nuclear facilities (reactor block, shielded cells, etc.). Treatment of the Phenix primary cold trap is scheduled to begin in 2016. The analysis program includes the following steps: - Accurately determine the contamination in the trap by carrying out gamma spectrometry measurement campaigns from 2007 to 2013 (the remaining difficulty will be to accurately determine the distribution of the contamination). - Validate the safety studies for the ELA facility. This work is currently in progress; ELA will be commissioned following inactive qualification testing. - Proceed with cutting tests on the knit mesh filter, which are scheduled to begin in 2008

  20. The challenge of involving elderly patients in primary care using an electronic communication tool with their professionals : A mixed methods study

    NARCIS (Netherlands)

    De Jong, Catharina C.; Ros, Wynand J.G.; Van Leeuwen, Mia; Schrijvers, Guus

    2017-01-01

    Background: Elderly patients in primary care often have multiple health problems, with different healthcare professionals involved. For consistency in care, it is required that communication amongst professionals and patient-systems (patient and informal-carers) be well tuned.

  1. IRPhE-DRAGON-DPR, OECD High Temperature Reactor Dragon Project, Primary Documents

    International Nuclear Information System (INIS)

    2004-01-01

    Description: The DRAGON Reactor Experiment (DRE): The first demonstration High temperature gas reactor (HTGR) was built in the 1960's. Thirteen OECD countries began a project in 1959 to build an experimental reactor known as Dragon at Winfrith in the UK. The reactor - which operated successfully between 1966 and 1975 - had a thermal output of 20 MW and achieved a gas outlet temperature of 750 deg. C. The High Temperature Reactor concept, if it justified its expectations, was seen as having its place as an advanced thermal reactor between the current thermal reactor types such as the PWR, BWR, and AGR and the sodium cooled fast breeder reactor. It was expected that the HTR would offer better thermal efficiency, better uranium utilisation, either with low enriched uranium fuel or high enriched uranium thorium fuel, better inherent safety and lower unit power costs. In the event all these potential advantages were demonstrated to be in principle achievable. This view is still shared today. In fact Very High Temperature Reactors is one of the concepts retained for Generation IV. Projects on constructing Modular Pebble Bed Reactors are under way. Here all available Dragon Project Reports (DPR) - approximately 1000 - are collected in electronic form. An index points to the reports (PDF format); each table in the report is accessible in EXCEL format with the aim of facilitating access to the data. These reports describe the design, experiments and modelling carried out over a period of 17 years. 2 - Related or auxiliary information: IRPHE-HTR-ARCH-01, Archive of HTR Primary Documents NEA-1728/01. 3 - Software requirements: Acrobat Reader, Microsoft Word, HTML Browser required

  2. Science teachers' meaning-making when involved in a school-based professional development project

    DEFF Research Database (Denmark)

    Nielsen, Birgitte Lund

    2012-01-01

    A group of teachers’ meaning-making when they are collaboratively analyzing artifacts from practice in local science classrooms in a school-based professional development (PD) project is examined through repeated interviews and represented as meaning-making maps. The interpretation of the teachers......’ meaningmaking includes both their reference to outcomes from the project and their expressed ideas about teaching and learning of science. All four teachers refer to experiences from experimenting in their classrooms and interpret the collected artifacts in relation to students’ learning. Furthermore, they all...... felt encouraged to continue collaboration around science. During the interviews, the teachers emphasize various elements apparently connected to concrete challenges they each experience in their professional work. Implications in relation to the design of PD are discussed....

  3. Science teachers' meaning-making when involved in a school-based professional development project

    DEFF Research Database (Denmark)

    Nielsen, Birgitte Lund

    2012-01-01

    A group of teachers' meaning-making when they are collaboratively analyzing artifacts from practice in local science classrooms in a school-based professional development (PD) project is examined through repeated interviews and represented as meaning-makig maps. The interpretation of the teachers......' meaning-making includes both their reference to outcomes from the project and their expressed ideas about teaching and learning of science. All four teachers refer to experiences from experimenting in their classrooms and interpret the collected artifacts in relation to students' learning. Furthermore......, they all felt encouraged to continue collaboration around science. During the interviews, the teachers emphasize various elements apparently connected to concrete challenges they each experience in their professional work. Implications in relation to the design of PD are discussed....

  4. Design, Utility, and History of the Colorado Adoption Project: Examples Involving Adjustment Interactions1

    OpenAIRE

    Rhea, Sally Ann; Bricker, Josh B.; Corley, Robin P.; DeFries, John C.; Wadsworth, Sally J.

    2013-01-01

    This paper describes the Colorado Adoption Project (CAP), a longitudinal study in behavioral development, and discusses how adoption studies may be used to assess genetic and environmental etiologies of individual differences for important developmental outcomes. Previous CAP research on adjustment outcomes in childhood and adolescence which found significant interactions, including gene-environment interactions, is reviewed. New research suggests mediating effects of menarche and religiosity...

  5. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.

    Science.gov (United States)

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-09-25

    Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.

  6. Involving patients in care decisions improves satisfaction: an outcomes-based quality improvement project.

    Science.gov (United States)

    Leff, Ellen W

    2004-05-01

    A home care agency used quality improvement processes to improve patient satisfaction survey ratings. The focus was on involving patients in decisions about their care. A multidisciplinary team developed creative strategies to increase staff awareness and enhance customer service skills, which had dramatic results.

  7. Balancing Autonomy Rights and Protection: Children's Involvement in a Child Safety Online Project

    Science.gov (United States)

    Ost, Suzanne

    2013-01-01

    Researchers who involve children in their research are faced with the challenge of choosing between differing theoretical approaches which can prioritise children's autonomy rights or their "vulnerability" and their need to be protected. Somewhat confusingly, ethical guidelines seem to reflect a combination of these approaches. Even when…

  8. Summary of case studies presented at the WPDD topical session on stakeholder involvement in decommissioning projects - november 14, 2005

    International Nuclear Information System (INIS)

    Metcalfe, Doug

    2006-01-01

    Full text of publication follows: Two case studies were presented on experiences with stakeholder involvement in decommissioning projects. The first paper described the development of the United Kingdom Atomic Energy Authority's (UKAEA) stakeholder involvement activities for the Dounreay Nuclear Reactor Test Establishment. The second paper presented the US Nuclear Regulatory Commission regulatory process for decommissioning that includes opportunities for public involvement. The presentation contrasted the stakeholder involvement for two commercial US nuclear power plants (NPPs) that completed decommissioning in 2005, the Trojan NPP and the Maine Yankee NPP. The two case studies highlighted the importance of involving stakeholders in decommissioning projects, and provide important lessons learned. The Dounreay case study demonstrated the UKAEA's determination and commitment to continuously improve its stakeholder engagement program. In 2002, the UKAEA set out to broaden its stakeholder program by improving both public understanding and participation. With regard to public understanding, the UKAEA committed to keep the public informed on decommissioning developments, and ensure that communication was in an understandable form. To improve participation, the UKAEA actively worked to identify and engage stakeholders. The UKAEA then made efforts to involve stakeholders in decision-making activities, including the use of stakeholder panels to discuss and consider options for specific aspects of the Dounreay decommissioning and site restoration plan. In 2004, the UKAEA commissioned an independent review of its stakeholder involvement program to assess the program's effectiveness and benchmark it against best practices. The program was found to be useful, and positive feedback was provided on the use of stakeholder panels and the UKAEA's determination to deliver a broad based and effective stakeholder strategy. Recommendations to UKAEA included involving stakeholders

  9. Unimodal primary sensory cortices are directly connected by long-range horizontal projections in the rat sensory cortex

    Directory of Open Access Journals (Sweden)

    Jimmy eStehberg

    2014-09-01

    Full Text Available Research based on functional imaging and neuronal recordings in the barrel cortex subdivision of primary somatosensory cortex (SI of the adult rat has revealed novel aspects of structure-function relationships in this cortex. Specifically, it has demonstrated that single whisker stimulation evokes subthreshold neuronal activity that spreads symmetrically within gray matter from the appropriate barrel area, crosses cytoarchitectural borders of SI and reaches deeply into other unimodal primary cortices such as primary auditory (AI and primary visual (VI. It was further demonstrated that this spread is supported by a spatially matching underlying diffuse network of border-crossing, long-range projections that could also reach deeply into AI and VI. Here we seek to determine whether such a network of border-crossing, long-range projections is unique to barrel cortex or characterizes also other primary, unimodal sensory cortices and therefore could directly connect them. Using anterograde (BDA and retrograde (CTb tract-tracing techniques, we demonstrate that such diffuse horizontal networks directly and mutually connect VI, AI and SI. These findings suggest that diffuse, border-crossing axonal projections connecting directly primary cortices are an important organizational motif common to all major primary sensory cortices in the rat. Potential implications of these findings for topics including cortical structure-function relationships, multisensory integration, functional imaging and cortical parcellation are discussed.

  10. Primary Angle Closure and Sequence Variants within MicroRNA Binding Sites of Genes Involved in Eye Development.

    Directory of Open Access Journals (Sweden)

    Haihong Shi

    Full Text Available The formation of primary angle closure (PAC and primary angle closure glaucoma (PACG is regulated by a tissue remodeling pathway that plays a critical role in eye development. MicroRNAs (miRNAs are powerful gene expression regulators and may exert their effects on tissue remodeling genes. This study investigated the associations between gene variants (single-nucleotide polymorphism, SNP in miRNA binding sites in the 3'-UTR region of genes involved in eye development and PAC.The sample consisted of 232 PAC subjects and 306 controls obtained from a population-based cohort in the Funing District of Jiangsu, China. The markers include 9 SNPs in the COL11A1, PCMTD1, ZNRF3, MTHFR, and ALPPL2 genes respectively. SNP genotyping was performed with a TaqMan-MGB probe using an RT-PCR system.Of the 9 SNPs studied, the frequency of the minor A allele of COL11A1 rs1031820 was higher in the PAC group than in the control group in allele analysis (p = 0.047. The genotype analysis indicated that MTHFR rs1537514 is marginally associated with PAC (p = 0.014. The CC genotype of rs1537514 was present solely in the PAC group. However, the differences lost significance after Bonferroni correction.Our study reveals a possible association of COL11A1 and MTHFR with PAC in the Han Chinese population. These results will contribute to an improved understanding of the genetic basis of PACG.

  11. Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project.

    Science.gov (United States)

    Labonté, Ronald; Sanders, David; Packer, Corinne; Schaay, Nikki

    2014-01-01

    The 4-year (2007-2011) Revitalizing Health for All international research program (http://www.globalhealthequity.ca/projects/proj_revitalizing/index.shtml) supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a 'research user' from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacity-enhancement meetings were organized to refine methods and to discuss and assess cross-case findings. Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups), secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action) was found in many of the cases. Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include:1. Well-trained and supported community health workers (CHWs) able to work effectively with marginalized communities2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation) and formal (though program management structures)3.

  12. Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

    Directory of Open Access Journals (Sweden)

    Ronald Labonté

    2014-08-01

    Full Text Available Background: The 4-year (2007–2011 Revitalizing Health for All international research program (http://www.globalhealthequity.ca/projects/proj_revitalizing/index.shtml supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a ‘research user’ from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacity-enhancement meetings were organized to refine methods and to discuss and assess cross-case findings. Objective: Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups, secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. Results: Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action was found in many of the cases. Conclusions: Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include: 1. Well-trained and supported community health workers (CHWs able to work effectively with marginalized communities 2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation and formal

  13. Summary report of the University of Manchester involvement in the Chemval project

    International Nuclear Information System (INIS)

    Chandratillake, M.R.; Newton, G.W.A.; Robinson, V.J.

    1991-01-01

    Chemval is an international geochemical exercise, which aims at applying and validating predictive computer programmes describing the chemistry of radionuclides in the geosphere. As a component of the CEC Mirage project - second phase (on migration of radionuclides in the geosphere), Chemval is carried out in the framework of the third Community R and D programme on radioactive waste management and storage (1985-89). It is jointly funded by the Commission of the European Communities and Her Majesty's Inspectorate of Pollution (UK Department of the Environment)

  14. Involving patients in patient safety programmes: A scoping review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Trier, Hans; Valderas, Jose M; Wensing, Michel; Martin, Helle Max; Egebart, Jonas

    2015-09-01

    Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based recommendations in this area. Scoping review of the literature 2006-2011 about methods and effects of involving patients in patient safety in primary care identified evidence for previous experiences of patient involvement in patient safety. This information was fed back to an expert panel for the development of recommendations for healthcare professionals and policy makers. The scoping review identified only weak evidence in support of the effectiveness of patient involvement. Identified barriers included a number of patient factors but also the healthcare workers' attitudes, abilities and lack of training. The expert panel recommended the integration of patient safety in the educational curricula for healthcare professionals, and expected a commitment from professionals to act as first movers by inviting and encouraging the patients to take an active role. The panel proposed a checklist to be used by primary care clinicians at the point of care for promoting patient involvement. There is only weak evidence on the effectiveness of patient involvement in patient safety. The recommendations of the panel can inform future policy and practice on patient involvement in safety in primary care.

  15. Involving patients in patient safety programmes: A scoping review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

    NARCIS (Netherlands)

    Trier, H.; Valderas, J.M.; Wensing, M.; Martin, H.M.; Egebart, J.

    2015-01-01

    BACKGROUND: Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. OBJECTIVE: To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based

  16. Can the BestGrid Process Improve Stakeholder Involvement in Electricity Transmission Projects?

    Directory of Open Access Journals (Sweden)

    Nadejda Komendantova

    2015-08-01

    Full Text Available The European Union has set ambitious targets for deployment of renewable energy sources to reach goals of climate change mitigation and energy security policies. However, the current state of electricity transmission infrastructure is a major bottleneck for further scaling up of renewable energy in the EU. Several thousands of kilometers of new lines have to be constructed and upgraded to accommodate growing volumes of intermittent renewable electricity. In many countries, construction of electricity transmission projects has been delayed for several years due to concerns of local stakeholders. The innovative BESTGRID approach, reported here, brings together transmission system operators (TSOs and non-governmental organizations (NGOs to discuss and understand the nature of stakeholder concerns. This paper has three objectives: (1 to understand stakeholder concerns about the deployment of electricity transmission grids in four pilot projects according to five guiding principles: need, transparency, engagement, environment, and impacts on human health as well as benefits; (2 to understand how these principles can be addressed to provide a basis for better decision-making outcomes; and (3 to evaluate the BESTGRID process based on feedback received from stakeholders and the level of participation achieved according to the ladder of Arnstein. This paper goes beyond a discussion of “measures to mitigate opposition” to understand how dialogue between TSOs and the public—represented mainly by NGOs and policy-makers—might lead to a better decision-making process and more sustainable electricity transmission infrastructure deployment.

  17. Parent-adolescent joint projects involving leisure time and activities during the transition to high school.

    Science.gov (United States)

    Marshall, Sheila K; Young, Richard A; Wozniak, Agnieszka; Lollis, Susan; Tilton-Weaver, Lauree; Nelson, Margo; Goessling, Kristen

    2014-10-01

    Leisure research to date has generally overlooked planning and organizing of leisure time and activities between parents and adolescents. This investigation examined how a sample of Canadian adolescents and their parents jointly constructed and acted on goals related to adolescents' leisure time during the move from elementary to high school. Using the Qualitative Action-Project Method, data were collected over an 8-10 month period from 26 parent-adolescent dyads located in two urban sites, through video-taped conversations about leisure time, video recall interviews, and telephone monitoring interviews. Analysis of the data revealed that the joint projects of the 26 dyads could be grouped into three clusters: a) governance transfer or attempts to shift, from parent to adolescent, responsibility over academic demands, organizing leisure time, and safety with peers, b) balancing extra-curricular activities with family life, academics, and social activities, and c) relationship adjustment or maintenance. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  18. Primary Effusion Lymphoma Involving both Pleural and Abdominal Cavities in a Patient with Hepatitis B Virus-related Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Pei-Ying Hsieh

    2007-01-01

    Full Text Available Primary effusion lymphoma (PEL is an unusual form of non-Hodgkin's lymphoma, which is characterized by lymphomatous effusion in body cavities, but no associated mass lesions. It is usually associated with an immunodeficient state most often with the human immunodeficiency virus (HIV. We describe a 54-year-old man with HIV-negative PEL, with a history of hepatitis B virus-related liver cirrhosis. Both abdominal and pleural cavities were involved; no solid tumor masses were found and bone marrow investigations were normal. The ascites and pleural effusion contained numerous pleomorphic lymphoid cells. Immunophenotyping was positive for CD138. Chromosome study showed complex cytogenetics. The genomic human herpesvirus-8 was detected in the lymphoma cells. It is postulated that the immuno-suppressed state in this patient may have been caused by cirrhosis. The patient received four cycles of chemotherapy of CHOP and Picibanil (OK-432 intraperitoneal administration. However, no durable remission was achieved. Adefovir failed to halt the progressive liver failure after the development of YMDD mutant related to lamivudine. He died of sepsis and hepatic failure.

  19. Teaching weather and climate science in primary schools - a pilot project from the UK Met Office

    Science.gov (United States)

    Orrell, Richard; Liggins, Felicity; Challenger, Lesley; Lethem, Dom; Campbell, Katy

    2017-04-01

    Wow Schools is a pilot project from the Met Office with an aim to inspire and educate the next generation of scientists and, uniquely, use the data collected by schools to improve weather forecasts and warnings across the UK. Wow Schools was launched in late 2015 with a competition open to primary schools across the UK. 74 schools entered the draw, all hoping to be picked as one of the ten lucky schools taking part in the pilot scheme. Each winning school received a fully automatic weather station (AWS), enabling them to transmit real-time local weather observations to the Met Office's Weather Observation Website (WOW - wow.metoffice.gov.uk), an award winning web portal for uploading and sharing a range of environmental observations. They were also given a package of materials designed to get students out of the classroom to observe the weather, get hands-on with the science underpinning weather forecasting, and analyse the data they are collecting. The curriculum-relevant materials were designed with the age group 7 to 11 in mind, but could be extended to support other age groups. Each school was offered a visit by a Wow Schools Ambassador (a Met Office employee) to bring the students' learning to life, and access to a dedicated forecast for its location generated by our new supercomputer. These forecasts are improved by the school's onsite AWS reinforcing the link between observations and forecast production. The Wow Schools pilot ran throughout 2016. Here, we present the initial findings of the project, examining the potential benefits and challenges of working with schools across the UK to: enrich students' understanding of the science of weather forecasting; to source an ongoing supply of weather observations and discover how these might be used in the forecasting process; and explore what materials and business model(s) would be most useful and affordable if a wider roll-out of the initiative was undertaken.

  20. Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

    Science.gov (United States)

    Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

    2016-04-01

    Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

  1. The primary vestibular projection to the cerebellar cortex in the pigeon (Columba livia)

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, I.E.; Schwarz, D.W.

    1983-06-01

    The cerebellar cortex of the pigeon receiving direct vestibular afferents was delineated by anterograde transport of (/sup 3/H)-amino acids injected into the vestibular nerve. Labelled mossy fiber rosettes in the granular layer were concentrated in lobule X (nodulus) and to a lesser extent, in the ventral portion of lobule IXd (uvula and paraflocculus). A few solitary labelled rosettes were also found in more dorsal portions of lobule IX, as well as in the anterior lobe between lobule II and IV. The lingula remained unlabelled. Discrete injections of (/sup 3/H)-leucine into the cristae of each of the three semicircular canals or the utricular macula yielded a similar distribution of fewer labelled rosettes. A few primary mossy fiber terminals labelled after cochlear injections are attributed to afferents from the lagenar macula. Since effective diffusion of label from the injection site was excluded by controls, it is concluded that projection of individual canal and macula nerves to the vestibulocerebellar cortex is not topographically separated. It is proposed that this extensive convergence of various afferents is required by the cerebellum to compute precise and directionally specific control signals during head rotation in all conceivable planes.

  2. The primary vestibular projection to the cerebellar cortex in the pigeon (Columba livia)

    International Nuclear Information System (INIS)

    Schwarz, I.E.; Schwarz, D.W.

    1983-01-01

    The cerebellar cortex of the pigeon receiving direct vestibular afferents was delineated by anterograde transport of [ 3 H]-amino acids injected into the vestibular nerve. Labelled mossy fiber rosettes in the granular layer were concentrated in lobule X (nodulus) and to a lesser extent, in the ventral portion of lobule IXd (uvula and paraflocculus). A few solitary labelled rosettes were also found in more dorsal portions of lobule IX, as well as in the anterior lobe between lobule II and IV. The lingula remained unlabelled. Discrete injections of [ 3 H]-leucine into the cristae of each of the three semicircular canals or the utricular macula yielded a similar distribution of fewer labelled rosettes. A few primary mossy fiber terminals labelled after cochlear injections are attributed to afferents from the lagenar macula. Since effective diffusion of label from the injection site was excluded by controls, it is concluded that projection of individual canal and macula nerves to the vestibulocerebellar cortex is not topographically separated. It is proposed that this extensive convergence of various afferents is required by the cerebellum to compute precise and directionally specific control signals during head rotation in all conceivable planes

  3. Involving stakeholders in the commissioning and implementation of fishery science projects: experiences from the U.K. Fisheries Science Partnership.

    Science.gov (United States)

    Armstrong, M J; Payne, A I L; Deas, B; Catchpole, T L

    2013-10-01

    Following from similar initiatives worldwide, the U.K.'s Fisheries Science Partnership (FSP) was established in 2003 to provide the fishing industry with opportunities to propose and participate in scientific studies in collaboration with fishery scientists. Key concepts were that most of the available funding would support industry participation, that industry, not scientists, would come up with the ideas for projects, and that commercial fishing vessels and fishing methods would be used to address specific concerns of the fishing industry in a scientifically controlled manner. Nearly 100 projects had been commissioned by March 2012, covering annual time-series surveys of stocks subject to traditional assessment, and ad hoc projects on, e.g. gear selectivity, discard survival, tagging and migration and fishery development. The extent to which the results of the projects have been used by stakeholders, fishery scientists and fishery managers at a national and E.U. level is evaluated, along with the degree of industry interest and involvement, and reasons are identified for successes or failures in the uptake of the results into management and policy. Finally, the question is posed whether the programme has been successful in improving the engagement of the fishing community in the science-management process and in fostering communication and greater trust between fishers, scientists and managers. © 2013 Crown Copyright. © 2013 The Fisheries Society of the British Isles.

  4. Midwifery students experience of teamwork projects involving mark-related peer feedback.

    Science.gov (United States)

    Hastie, Carolyn R; Fahy, Kathleen M; Parratt, Jenny A; Grace, Sandra

    2016-06-01

    Lack of teamwork skills among health care professionals endangers patients and enables workplace bullying. Individual teamwork skills are increasingly being assessed in the undergraduate health courses but rarely defined, made explicit or taught. To remedy these deficiencies we introduced a longitudinal educational strategy across all three years of the Bachelor of Midwifery program. To report on students' experiences of engaging in team based assignments which involved mark-related peer feedback. Stories of midwifery students' experiences were collected from 17 participants across the three years of the degree. These were transcribed and analysed thematically and interpreted using feminist collaborative conversations. Most participants reported being in well-functioning teams and enjoyed the experience; they spoke of 'we' and said 'Everyone was on Board'. Students in poorly functioning teams spoke of 'I' and 'they'. These students complained about the poor performance of others but they didn't speak up because they 'didn't want to make waves' and they didn't have the skills to be able to confidently manage conflict. All participants agreed 'Peer-related marks cause mayhem'. Teamwork skills should be specifically taught and assessed. These skills take time to develop. Students, therefore, should be engaged in a teamwork assignment in each semester of the entire program. Peer feedback should be moderated by the teacher and not directly related to marks. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  5. Sum rules and other properties involving resonance projection operators. [for optical potential description of electron scattering from atoms and ions

    Science.gov (United States)

    Berk, A.; Temkin, A.

    1985-01-01

    A sum rule is derived for the auxiliary eigenvalues of an equation whose eigenspectrum pertains to projection operators which describe electron scattering from multielectron atoms and ions. The sum rule's right-hand side depends on an integral involving the target system eigenfunctions. The sum rule is checked for several approximations of the two-electron target. It is shown that target functions which have a unit eigenvalue in their auxiliary eigenspectrum do not give rise to well-defined projection operators except through a limiting process. For Hylleraas target approximations, the auxiliary equations are shown to contain an infinite spectrum. However, using a Rayleigh-Ritz variational principle, it is shown that a comparatively simple aproximation can exhaust the sum rule to better than five significant figures. The auxiliary Hylleraas equation is greatly simplified by conversion to a square root equation containing the same eigenfunction spectrum and from which the required eigenvalues are trivially recovered by squaring.

  6. Involving women.

    Science.gov (United States)

    Agbo, J

    1994-01-01

    I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

  7. Genetic heterogeneity and minor CYP1B1 involvement in the molecular basis of primary congenital glaucoma in Gypsies.

    Science.gov (United States)

    Sivadorai, P; Cherninkova, S; Bouwer, S; Kamenarova, K; Angelicheva, D; Seeman, P; Hollingsworth, K; Mihaylova, V; Oscar, A; Dimitrova, G; Kaneva, R; Tournev, I; Kalaydjieva, L

    2008-07-01

    Primary congenital glaucoma (PCG) is a genetically heterogeneous disorder of autosomal recessive inheritance, with mutations in the cytochrome P450 1B1 (CYP1B1) gene detected in an average of approximately 50% of cases worldwide. The Roma/Gypsies are considered to be a rare example of a single founder CYP1B1 mutation, E387K (identified in the Slovak Roma), accounting for 100% of disease alleles. Contrary to this concept, unusual genetic heterogeneity was revealed in this study of 21 Gypsy PCG patients from Bulgaria and 715 controls from the general Gypsy population. In our small sample of affected subjects, we identified five different CYP1B1 mutations - four known (E229K, R368H, E387K and R390C) and one novel and potentially pathogenic (F445I), which together accounted for approximately 30% of disease alleles. E387K was rare in both the patient and the control group, indicating that its high frequency in the Slovak Roma is the product of local founder effect not representative of the overall molecular pattern of PCG in the Gypsy population. Data on other Mendelian disorders and on the population genetics of the Gypsies suggest that a true founder mutation is likely to exist and has remained undetected. Our analysis of another candidate gene, MYOC, and the GLC3B and GLC3C loci did not provide support for their involvement. The molecular basis of PCG in the Gypsies is thus unresolved, and diagnostic analyses should be extended beyond the E387K mutation.

  8. Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence within State Domestic Violence Coalitions

    Science.gov (United States)

    Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

    2015-01-01

    Background: Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states.…

  9. Translating sickle cell guidelines into practice for primary care providers with Project ECHO

    Directory of Open Access Journals (Sweden)

    Lisa M. Shook

    2016-11-01

    Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.

  10. HANFORD DOUBLE SHELL TANK THERMAL AND SEISMIC PROJECT BUCKLING EVALUATION METHODS AND RESULTS FOR THE PRIMARY TANKS

    Energy Technology Data Exchange (ETDEWEB)

    MACKEY TC; JOHNSON KI; DEIBLER JE; PILLI SP; RINKER MW; KARRI NK

    2009-01-14

    This report documents a detailed buckling evaluation of the primary tanks in the Hanford double-shell waste tanks (DSTs), which is part of a comprehensive structural review for the Double-Shell Tank Integrity Project. This work also provides information on tank integrity that specifically responds to concerns raised by the Office of Environment, Safety, and Health (ES&H) Oversight (EH-22) during a review of work performed on the double-shell tank farms and the operation of the aging waste facility (AWF) primary tank ventilation system. The current buckling review focuses on the following tasks: (1) Evaluate the potential for progressive anchor bolt failure and the appropriateness of the safety factors that were used for evaluating local and global buckling. The analysis will specifically answer the following questions: (a) Can the EH-22 scenario develop if the vacuum is limited to -6.6-inch water gage (w.g.) by a relief valve? (b) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario can develop? (c) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario cannot develop? (2) Develop influence functions to estimate the axial stresses in the primary tanks for all reasonable combinations of tank loads based on detailed finite element analysis. The analysis must account for the variation in design details and operating conditions between the different DSTs. The analysis must also address the imperfection sensitivity of the primary tank to buckling. (3) Perform a detailed buckling analysis to determine the maximum allowable differential pressure for each of the DST primary tanks at the current specified limits on waste temperature, height, and specific gravity. Based on the concrete anchor bolt loads analysis and the small deformations that are predicted at the unfactored limits on vacuum and axial loads, it is very unlikely that the EH-22 scenario (i.e., progressive anchor bolt

  11. HANFORD DOUBLE-SHELL TANK THERMAL AND SEISMIC PROJECT-BUCKLING EVALUATION METHODS AND RESULTS FOR THE PRIMARY TANKS

    International Nuclear Information System (INIS)

    Mackey, T.C.; Johnson, K.I.; Deibler, J.E.; Pilli, S.P.; Rinker, M.W.; Karri, N.K.

    2009-01-01

    This report documents a detailed buckling evaluation of the primary tanks in the Hanford double-shell waste tanks (DSTs), which is part of a comprehensive structural review for the Double-Shell Tank Integrity Project. This work also provides information on tank integrity that specifically responds to concerns raised by the Office of Environment, Safety, and Health (ES and H) Oversight (EH-22) during a review of work performed on the double-shell tank farms and the operation of the aging waste facility (AWF) primary tank ventilation system. The current buckling review focuses on the following tasks: (1) Evaluate the potential for progressive anchor bolt failure and the appropriateness of the safety factors that were used for evaluating local and global buckling. The analysis will specifically answer the following questions: (a) Can the EH-22 scenario develop if the vacuum is limited to -6.6-inch water gage (w.g.) by a relief valve? (b) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario can develop? (c) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario cannot develop? (2) Develop influence functions to estimate the axial stresses in the primary tanks for all reasonable combinations of tank loads based on detailed finite element analysis. The analysis must account for the variation in design details and operating conditions between the different DSTs. The analysis must also address the imperfection sensitivity of the primary tank to buckling. (3) Perform a detailed buckling analysis to determine the maximum allowable differential pressure for each of the DST primary tanks at the current specified limits on waste temperature, height, and specific gravity. Based on the concrete anchor bolt loads analysis and the small deformations that are predicted at the unfactored limits on vacuum and axial loads, it is very unlikely that the EH-22 scenario (i.e., progressive anchor

  12. The Asian Development Bank's past and future involvement in financing gas projects in developing member countries of the Bank

    International Nuclear Information System (INIS)

    Chua, S.B.

    1991-01-01

    This paper presents a review of the Bank's involvement in financing gas projects in its developing member countries (DMC's). The paper highlights the scope of the Bank's past activities in the sector, the DMC's which had received assistance from the Bank, the types of projects financed by the Bank, the benefits expected to be derived from the projects, and the past problems encountered by the Bank. The operational framework under which past Bank lending to the gas sector was conducted is also described. The prospects of natural gas playing a prominent role as an environmentally preferred energy source to oil and coal are outlined. Indications of the direction of the Bank's future efforts to help its gas-resource-rich as well as its gas-resource-poor DMC's to quicken the use of natural gas are given. While emphasizing the Bank's contributions in helping its DMC's to increase gas supply to alleviate energy shortages, the paper stresses the important role the Bank has played and will play in institution-building and sector-development work. The paper explores the possibility for the Bank to expand its operations in the gas sector which will lead to the efficient and accelerated development of a clean energy source that will help its DMC's avoid a third oil crisis and reduce the damaging build-up of a greenhouse gas which now threatens to harm the global environment

  13. Health promotion in primary care: How should we intervene? A qualitative study involving both physicians and patients

    Directory of Open Access Journals (Sweden)

    Cortada Josep M

    2011-03-01

    Full Text Available Abstract Background The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP at the primary health care (PHC level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness are also widely recognised. The objectives of this research were: a to gain an in-depth understanding of general practitioners' (GPs and patients' perceptions about HPP in PHC, and b to define the areas that could be improved in future interventions. Methods Qualitative methodology focussed on the field of health services research. Information was generated on the basis of two GP-based and two patient-based discussion groups, all of which had previously participated in two interventions concerning healthy lifestyle promotion (tobacco and physical exercise. Transcripts and field notes were analysed on the basis of a sociological discourse-analysis model. The results were validated by triangulation between researchers. Results GPs and patients' discourses about HPP in PHC were different in priorities and contents. An overall explanatory framework was designed to gain a better understanding of the meaning of GP-patient interactions related to HPP, and to show the main trends that emerged from their discourses. GPs linked their perceptions of HPP to their working conditions and experience in health services. The dimensions in this case involved the orientation of interventions, the goal of actions, and the evaluation of results. For patients, habits were mainly related to ways of life particularly influenced by close contexts. Health conceptions, their role as individuals, and the orientation of their demands were the most important dimensions in patients' sphere. Conclusions HPP activities in PHC need to be understood and assessed in the context of their interaction with the conditioning trends in health services and patients

  14. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    International Nuclear Information System (INIS)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di; Ionascu, Dan

    2012-01-01

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non–small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non–small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T L N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T L N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 ± 0.7 cm and 0.8 ± 0.3 cm, respectively, for B and T L N. Primary and involved LN expansions were 0.7 ± 0.5 cm and 1.1 ± 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T L N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  15. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ionascu, Dan, E-mail: Dan.ionascu@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-03-15

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T{sub L}N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T{sub L}N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 {+-} 0.7 cm and 0.8 {+-} 0.3 cm, respectively, for B and T{sub L}N. Primary and involved LN expansions were 0.7 {+-} 0.5 cm and 1.1 {+-} 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T{sub L}N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  16. Projected US timber and primary forest product market impacts of climate change mitigation through timber set-asides

    Science.gov (United States)

    Prakash Nepal; Peter J. Ince; Kenneth E. Skog; Sun J. Chang

    2013-01-01

    Whereas climate change mitigation involving payments to forest landowners for accumulating carbon on their land may increase carbon stored in forests, it will also affect timber supply and prices. This study estimated the effect on US timber and primary forest product markets of hypothetical timber set-aside scenarios where US forest landowners would be paid to forego...

  17. "Just dreaming of them": The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ).

    Science.gov (United States)

    Beier, Klaus M; Oezdemir, Umut C; Schlinzig, Eliza; Groll, Anna; Hupp, Elena; Hellenschmidt, Tobias

    2016-02-01

    The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. The NADI program and the JOICFP integrated project: partners in delivering primary health care.

    Science.gov (United States)

    Arshat, H; Othman, R; Kuan Lin Chee; Abdullah, M

    1985-10-01

    The NADI program (pulse in Malay) was initially launched as a pilot project in 1980 in Kuala Lumpur, Malaysia. It utilized an integrated approach involving both the government and the private sectors. By sharing resources and expertise, and by working together, the government and the people can achieve national development faster and with better results. The agencies work through a multi-level supportive structure, at the head of which is the steering committee. The NADI teams at the field level are the focal points of services from the various agencies. Members of NADI teams also work with urban poor families as well as health groups, parents-teachers associations, and other similar groups. The policy and planning functions are carried out by the steering committee, the 5 area action committees and the community action committees, while the implementation function is carried out by the area program managers and NADI teams. The chairman of each area action committee is the head of the branch office of city hall. Using intestinal parasite control as the entry point, the NADI Integrated Family Development Program has greatly helped in expanding inter-agency cooperation and exchange of experiences by a coordinated, effective and efficient resource-mobilization. The program was later expanded to other parts of the country including the industrial and estate sectors. Services provided by NADI include: comprehensive health services to promote maternal and child health; adequate water supply, proper waste disposal, construction of latrines and providing electricity; and initiating community and family development such as community education, preschool education, vocational training, family counseling and building special facilities for recreational and educational purposes.

  19. Curriculum Integration in Distance Learning at Primary and Secondary Educational Levels on the Example of eTwinning Projects

    Directory of Open Access Journals (Sweden)

    Elżbieta Gajek

    2017-12-01

    Full Text Available Curriculum integration is one of the concepts which has been discussed for years. Telecollaborative projects, which employ elements of distance learning, provide opportunities for putting the idea into practice. Analysis of eTwinning projects undertaken in Polish schools aims at demonstrating the integrative role of distance learning approaches and their contribution to integration of various themes in educational context. As the eTwinning framework is very flexible, allowing for teacher and students autonomy the projects may vary in the topics, age and number of participants, duration scope within curriculum etc. The study shows various levels and perspectives of curriculum integration which take place in eTwinning projects. It also discusses the role of distance learning at primary and secondary educational levels. The challenge is to transform international collaboration of selected schools an everyday practice for all learners and teachers.

  20. European recommendations for primary prevention of congenital anomalies: a joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans.

    Science.gov (United States)

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca; Barisic, Ingeborg; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Calzolari, Elisa; Carbone, Pietro; Curran, Rhonda; Garne, Ester; Gatt, Miriam; Latos-Bieleńska, Anna; Khoshnood, Babak; Irgens, Lorentz; Mantovani, Alberto; Martínez-Frías, Maria Luisa; Neville, Amanda; Rißmann, Anke; Ruggeri, Stefania; Wellesley, Diana; Dolk, Helen

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe. © 2014 S. Karger AG, Basel.

  1. Factors associated with professional satisfaction in primary care: Results from EUprimecare project.

    Science.gov (United States)

    Sanchez-Piedra, Carlos Alberto; Jaruseviciene, Lina; Prado-Galbarro, Francisco Javier; Liseckiene, Ida; Sánchez-Alonso, Fernando; García-Pérez, Sonia; Sarria Santamera, Antonio

    2017-12-01

    Given the importance of primary care to healthcare systems and population health, it seems crucial to identify factors that contribute to the quality of primary care. Professional satisfaction has been linked with quality of primary care. Physician dissatisfaction is considered a risk factor for burnout and leaving medicine. This study explored factors associated with professional satisfaction in seven European countries. A survey was conducted among primary care physicians. Estonia, Finland, Germany and Hungary used a web-based survey, Italy and Lithuania a telephone survey, and Spain face to face interviews. Sociodemographic information (age, sex), professional experience and qualifications (years since graduation, years of experience in general practice), organizational variables related to primary care systems and satisfaction were included in the final version of the questionnaire. A logistic regression analysis was performed to assess the factors associated with satisfaction among physicians. A total of 1331 primary care physicians working in primary care services responded to the survey. More than half of the participants were satisfied with their work in primary care services (68.6%). We found significant associations between satisfaction and years of experience (OR = 1.01), integrated network of primary care centres (OR = 2.8), patients having direct access to specialists (OR = 1.3) and professionals having access to data on patient satisfaction (OR = 1.3). Public practice, rather than private practice, was associated with lower primary care professional satisfaction (OR = 0.8). Elements related to the structure of primary care are associated with professional satisfaction. At the individual level, years of experience seems to be associated with higher professional satisfaction.

  2. Effectiveness of involving a nurse specialist for patients with urinary incontinence in primary care: results of a pragmatic multicentre randomised controlled trial.

    NARCIS (Netherlands)

    Albers-Heitner, P.C.; Lagro-Janssen, A.L.M.; Joore, M.M.; Berghmans, B.L.; Nieman, F.F.; Venema, P.P.; Severens, J.J.; Winkens, R.R.

    2011-01-01

    BACKGROUND: Urinary incontinence (UI) primary care management is substandard, offering care rather than cure despite the existence of guidelines that help to improve cure. Involving nurse specialists on incontinence in general practice could be a way to improve care for UI patients. AIMS: We studied

  3. The effects of parental reading socialization and early school involvement on children's academic performance: A panel study of primary school pupils in the Netherlands

    NARCIS (Netherlands)

    Kloosterman, J.G.; Notten, N.J.W.R.; Tolsma, J.; Kraaykamp, G.L.M.

    2011-01-01

    This study examines the extent to which parental reading socialization and early school involvement account for performance differences between low-status and high-status children in successive primary school grades. It investigates not only the direct effects of these parental practices on

  4. The effects of parental reading socialization and early school involvement on children's academicperformance : a panelstudy of primary school pupils in the Netherlands.

    NARCIS (Netherlands)

    Notten, N.; Tolsma, J.; Kraaykamp, G.; Kloosterman, R.

    2010-01-01

    This study examines the extent to which parental reading socialization and early school involvement account for performance differences between low-status and high-status children in successive primary school grades. It investigates not only the direct effects of these parental practices on

  5. The effects of parental reading socialization and early school involvement on children's academic performance: a panel study of primary school pupils in the Netherlands

    NARCIS (Netherlands)

    Kloostermann, R.; Notten, N.; Tolsma, J.; Kraaykamp, G.

    2011-01-01

    This study examines the extent to which parental reading socialization and early school involvement account for performance differences between low-status and high-status children in successive primary school grades. It investigates not only the direct effects of these parental practices on

  6. Characterization of systemic disease in primary Sjogren's syndrome : EULAR-SS Task Force recommendations for articular, cutaneous, pulmonary and renal involvements

    NARCIS (Netherlands)

    Ramos-Casals, Manuel; Brito-Zeron, Pilar; Seror, Raphaele; Bootsma, Hendrika; Bowman, Simon J.; Doerner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Theander, Elke; Bombardieri, Stefano; De Vita, Salvatore; Mandl, Thomas; Ng, Wan-Fai; Kruize, Aike; Tzioufas, Athanasios; Vitali, Claudio

    2015-01-01

    Objective. To reach a European consensus on the definition and characterization of the main organspecific extraglandular manifestations in primary SS. Methods. The EULAR-SS Task Force Group steering committee agreed to approach SS-related systemic involvement according to the EULAR SS Disease

  7. The effects of extraction of pulpally involved primary teeth on weight, height and BMI in underweight Filipino children: a cluster randomized clinical trial

    NARCIS (Netherlands)

    Monse, B.; Duijster, D.; Sheiham, A.; Grijalva-Eternod, C.S.; van Palenstein Helderman, W.H.; Hobdell, M.H.

    2012-01-01

    Background: Severe dental caries and the treatment thereof are reported to affect growth and well-being of young children. The objective of this study was to assess the effects of extraction of severely decayed pulpally involved primary teeth on weight and height in underweight preschool Filipino

  8. The Challenges of Primary Sources, Collaboration, and the K-16 Elizabeth Murray Project

    Science.gov (United States)

    Cleary, Patricia; Neumann, David

    2009-01-01

    In recent years, the use of primary sources in the history and social studies classroom has been increasingly promoted as a necessary and welcome practice, one designed to improve the quality of history education and to encourage student interest and engagement. Although some K-12 educators have been wary of adopting the use of primary sources,…

  9. Multislice CT as a Primary Screening Tool for the Prediction of an Involved Mesorectal Fascia and Distant Metastases in Primary Rectal Cancer : A Multicenter Study

    NARCIS (Netherlands)

    Wolberink, Steven V. R. C.; Beets-Tan, Regina G. H.; de Haas-Kock, Danielle F. M.; van de Jagt, Eric J.; Span, Mark M.; Wiggers, Theo

    PURPOSE: The purposes of this study were to assess whether multislice CT can identify tumors having a free or involved circumferential margin, to investigate the additional role of multislice CT as a "one-stop shopping'' staging tool for staging nodal and distant metastases. METHODS: A total of 250

  10. Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence Within State Domestic Violence Coalitions

    Science.gov (United States)

    Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

    2018-01-01

    Background Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. Objective DELTA PREP’s summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? Results DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. Conclusion Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation. PMID:26245932

  11. A Blended Learning Approach to Teaching Project Management: A Model for Active Participation and Involvement: Insights from Norway

    Directory of Open Access Journals (Sweden)

    Bassam A. Hussein

    2015-04-01

    Full Text Available The paper demonstrates and evaluates the effectiveness of a blended learning approach to create a meaningful learning environment. We use the term blended learning approach in this paper to refer to the use of multiple or hybrid instructional methods that emphasize the role of learners as contributors to the learning process rather than recipients of learning. Contribution to learning is attained by using in class gaming as pathways that ensure active involvement of learners. Using a blended learning approach is important in order to be able to address different learning styles of the target group. The approach was also important in order to be able to demonstrate different types of challenges, issues and competences needed in project management. Student evaluations of the course confirmed that the use of multiple learning methods and, in particular, in class gaming was beneficial and contributed to a meaningful learning experience.

  12. Department of Physics' Involvement of the Impact Testing Project of the High Speed Civil Transport Program (HSCT)

    Science.gov (United States)

    VonMeerwall, Ernst D.

    1994-01-01

    The project involved the impact testing of a kevlar-like woven polymer material, PBO. The purpose was to determine whether this material showed any promise as a lightweight replacement material for jet engine fan containment. The currently used metal fan containment designs carry a high drag penalty due to their weight. Projectiles were fired at samples of PBO by means of a 0.5 inch diameter Helium powered gun. The Initial plan was to encase the samples inside a purpose-built steel "hot box" for heating and ricochet containment. The research associate's responsibility was to develop the data acquisition programs and techniques necessary to determine accurately the impacting projectile's velocity. Beyond this, the Research Associate's duties include any physical computations, experimental design, and data analysis necessary.

  13. Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Terminal Operations HITL 1B Primary Results

    Science.gov (United States)

    Rorie, Conrad; Monk, Kevin; Roberts, Zach; Brandt, Summer

    2018-01-01

    This presentation provides an overview of the primary results from the Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project's second Terminal Operations human-in-the-loop simulation. This talk covers the background of this follow-on experiment, which includes an overview of the first Terminal Operations HITL performed by the project. The primary results include a look at the number and durations of detect and avoid (DAA) alerts issued by the two DAA systems under test. It also includes response time metrics and metrics on the ability of the pilot-in-command (PIC) to maintain sufficient separation. Additional interoperability metrics are included to illustrate how pilots interact with the tower controller. Implications and conclusions are covered at the end.

  14. Potential Involvement of Draxin in the Axonal Projection of Cranial Nerves, Especially Cranial Nerve X, in the Chick Hindbrain.

    Science.gov (United States)

    Zhang, Sanbing; Cui, Huixian; Wang, Lei; Kang, Lin; Huang, Guannan; Du, Juan; Li, Sha; Tanaka, Hideaki; Su, Yuhong

    2016-07-01

    The appropriate projection of axons within the nervous system is a crucial component of the establishment of neural circuitry. Draxin is a repulsive axon guidance protein. Draxin has important functions in the guidance of three commissures in the central nervous system and in the migration of neural crest cells and dI3 interneurons in the chick spinal cord. Here, we report that the distribution of the draxin protein and the location of 23C10-positive areas have a strong temporal and spatial correlation. The overexpression of draxin, especially transmembrane draxin, caused 23C10-positive axon bundles to misproject in the dorsal hindbrain. In addition, the overexpression of transmembrane draxin caused abnormal formation of the ganglion crest of the IX and X cranial nerves, misprojection of some anti-human natural killer-1 (HNK-1)-stained structures in the dorsal roof of the hindbrain, and a simultaneous reduction in the efferent nerves of some motoneuron axons inside the hindbrain. Our data reveal that draxin might be involved in the fascicular projection of cranial nerves in the hindbrain. © 2016 The Histochemical Society.

  15. The project of decontamination of Tominari primary school in date city, Fukushima prefecture

    International Nuclear Information System (INIS)

    Katsumi, Satsuki

    2013-01-01

    The previous principal reports his concerned decontamination process of the school, localizing at 60 km distance from Fukushima Nuclear Power Plant, after its Accident (Mar. 2011). The school was defined as one of 11 with >3.8 mc-Sv/h ambient dose necessary for decontamination by Japanese Ministry of Education, Culture, Sports, Science an Technology (MEXT). Measurements of the dose by Date City and MEXT started from April, which revealed that it was 3.3-5.5 mc-Sv/h at 1 m height of the schoolyard. Decontamination was done by weeding, then removal of the ground soil at 3 ) and spreading a new soil, resulting in the reduction of the dose to 0.75 mc-Sv/h at 50 cm height. Unexpectedly, the removed soil was buried for tentative storage by wrapping with Volclay tarpaulin in a 140 cm deep hole at the corner of the yard, which was a result of residents' disagreement with the scheduled estate. Decontamination of school circumstances was conducted in July by experts, PTA voluntary parents and applied volunteers with their repeated meetings involving the radiological explanation of even radiation units. The classroom ambient dose at 50 cm height was declined from 0.11 to 0.06 mc-Sv, pavements from 2-3 to 0.7-1.0, plantings from 3.7 to 0.7, and the bank between the yard and schoolhouse from 4-5 to 1-1.5. The swimming pool water was first purified with zeolite, which made its radiocesium level below the standard limit <50 Bq/L, then was released out, and the pool was filled with fresh city water (<7 Bq/L). The ambient dose 6-8 mc-Sv/h around the pool at 50 cm height was reduced to 0.7-0.8 after decontamination. The project finished within July. Now the decontamination is still under progress for the forest and resident's houses; pupils are enjoying lessons, swimming and sports; and the author looks back the successful importance of experts' easy explanation about radiology. (T.T)

  16. Potential involvement of Notch1 signalling in the pathogenesis of primary cutaneous CD30-positive lymphoproliferative disorders

    DEFF Research Database (Denmark)

    Kamstrup, M.R.; Ralfkiaer, E.; Skovgaard, G.L.

    2008-01-01

    Background The central role of Notch signalling in T-cell development and oncogenesis raises the question of the importance of this pathway in cutaneous T-cell lymphomas. Objectives To investigate the pattern of expression of Notch and its ligands, Jagged and Delta, in skin samples of primary...... obtained from three patients with LyP and two patients with primary cutaneous ALCL. Results We identified single Notch1-positive cells or small clusters of atypical cells in LyP. Similarly, strongly positive Jagged1 cells tended to be localized in clusters. Primary cutaneous ALCL had higher expression...... of Notch1 and Jagged1 compared with LyP. Cells expressing Notch1 and Jagged1 were colocalized and a subset of cells expressed both the receptor and the ligand. The expression of the ligand Delta1 was low to undetectable in both types of lymphoproliferations. A subpopulation of lymphoma cells was found...

  17. Aspirations, education and inequality in England: insights from the Effective Provision of Pre-school, Primary and Secondary Education Project

    OpenAIRE

    Baker, William; Sammons, Pam; Siraj, Iram; Sylva, Kathy; Melhuish, Edward; Taggart, Brenda

    2014-01-01

    Educational and occupational aspirations have become an important reference point in policy debates about educational inequality. Low aspirations are presented as a major barrier to closing educational attainment gaps and increasing levels of social mobility. Our paper contributes to this on-going debate by presenting data on the educational aspirations of students from the Effective Provision of Pre-School, Primary and Secondary Education Project in England. We analyse factors that help pred...

  18. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature

    OpenAIRE

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-01-01

    Background Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and dur...

  19. Public Values and Stakeholder Involvement - A new framework for Performance Assessment? The European Project RISCOM-II. Work Package 1

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell [Karinta-Konsult, Taeby (Sweden); Chataignier, Stephane [Electricite de France (France); Drottz-Sjoeberg, Britt-Marie [BMD Research (Sweden)] [and others

    2002-11-01

    RISCOM-II is a project within the fifth framework programme of the European Commission. It is based on a widely recognised need for more transparent decision processes in nuclear waste management. The objective of the RISCOM-II project is to share the knowledge of the context of radioactive waste management in various European countries and to see to what extent it is possible to apply more widely the RISCOM Model in order to improve the acceptability of radioactive waste management. Thus, the project aims to promote the development of processes involving transparency, as well as means involving greater participation of the public. Key topics studied in the RISCOM-II Project are issues in risk assessment to better understand how factual elements relate to value-laden issues and how stakeholder concerns can be addressed, as well as organizational issues affecting transparency in Europe. A range of public participation processes are analysed, some will be selected for testing and hearings are evaluated with respect to transparency. There are five participating countries: Sweden, the United Kingdom, Finland, the Czech Republic, and France, which are represented by various organizations: safety or radiation protection authorities, operators involved in nuclear wastes and the production of nuclear power, research institutes or organizations, and consultants. Work Package No 1(WP-1), Public values and performance assessment, emphasises the importance of value-laden issues involved in nuclear waste management. The expert dominance in the field has so far tended to avoid values or deal with them in seemingly factual frameworks. The objectives of (WP-1) are thus: 1. to identify value-laden issues raised by performance assessment, trying to understand how factual and technical elements relate to value-laden issues 2. to find value judgements of stakeholders, and explore if and how they could be addressed in performance assessment 3. to initiate open debate about risk and

  20. Public Values and Stakeholder Involvement - A new framework for Performance Assessment? The European Project RISCOM-II. Work Package 1

    International Nuclear Information System (INIS)

    Andersson, Kjell; Chataignier, Stephane; Drottz-Sjoeberg, Britt-Marie

    2002-11-01

    RISCOM-II is a project within the fifth framework programme of the European Commission. It is based on a widely recognised need for more transparent decision processes in nuclear waste management. The objective of the RISCOM-II project is to share the knowledge of the context of radioactive waste management in various European countries and to see to what extent it is possible to apply more widely the RISCOM Model in order to improve the acceptability of radioactive waste management. Thus, the project aims to promote the development of processes involving transparency, as well as means involving greater participation of the public. Key topics studied in the RISCOM-II Project are issues in risk assessment to better understand how factual elements relate to value-laden issues and how stakeholder concerns can be addressed, as well as organizational issues affecting transparency in Europe. A range of public participation processes are analysed, some will be selected for testing and hearings are evaluated with respect to transparency. There are five participating countries: Sweden, the United Kingdom, Finland, the Czech Republic, and France, which are represented by various organizations: safety or radiation protection authorities, operators involved in nuclear wastes and the production of nuclear power, research institutes or organizations, and consultants. Work Package No 1(WP-1), Public values and performance assessment, emphasises the importance of value-laden issues involved in nuclear waste management. The expert dominance in the field has so far tended to avoid values or deal with them in seemingly factual frameworks. The objectives of (WP-1) are thus: 1. to identify value-laden issues raised by performance assessment, trying to understand how factual and technical elements relate to value-laden issues 2. to find value judgements of stakeholders, and explore if and how they could be addressed in performance assessment 3. to initiate open debate about risk and

  1. Marine Environmental Protection Knowledge, Attitudes, Behaviors, and Curricular Involvement of Taiwanese Primary School Students in Senior Grades

    Science.gov (United States)

    Wen, Wen-cheng; Lu, Shiau-yun

    2013-01-01

    In recent years, rapid changes in the Earth's climate and environment have influenced our lives greatly. The ocean occupies 70% of the Earth's surface and is intimately related to the regulation of climate, fostering of life, and also to social economy, as well as sports and leisure. Students in the senior years of primary education are in a phase…

  2. Research and Development Projects with ICT and students as learning designers in Primary Schools

    DEFF Research Database (Denmark)

    Levinsen, Karin; Sørensen, Birgitte Holm; Tosca, Susana

    2014-01-01

    In this paper we present some methodological challenges that emerged during the process of shaping the research design for the comprehensive and complex research project Children as learning designers in a digital school. The project is the realization of our proposal to a research call from...... to the need to strengthen the populations’ digital literacy and 21st century competencies. The call’s scope was research and development projects as pilot school experiments in relation to five selected areas. The selected projects should contribute with new generalizable and practice oriented knowledge...... of how: • ICT supports students learning, • ICT release time for more teaching, and • teachers digital literacy impact on the role of ICT in the educational practice. Further the call required collaboration between universities and university colleges in order to disseminate knowledge and new practices...

  3. A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project.

    Science.gov (United States)

    Yackel, Edward E; McKennan, Madelyn S; Fox-Deise, Adrianna

    2010-01-01

    Depression, sometimes with suicidal manifestations, is a medical condition commonly seen in primary care clinics. Routine screening for depression and suicidal ideation is recommended of all adult patients in the primary care setting because it offers depressed patients a greater chance of recovery and response to treatment, yet such screening often is overlooked or omitted. The purpose of this study was to develop, to implement, and to test the efficacy of a systematic depression screening process to increase the identification of depression in family members of active duty soldiers older than 18 years at a military family practice clinic located on an Army infantry post in the Pacific. The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to develop a practice guideline incorporating a decision algorithm for nurses to screen for depression. A pilot project to institute this change in practice was conducted, and outcomes were measured. Before implementation, approximately 100 patients were diagnosed with depression in each of the 3 months preceding the practice change. Approximately 130 patients a month were assigned a 311.0 Code 3 months after the practice change, and 140 patients per month received screenings and were assigned the correct International Classification of Diseases, Ninth Revision Code 311.0 at 1 year. The improved screening and coding for depression and suicidality added approximately 3 minutes to the patient screening process. The education of staff in the process of screening for depression and correct coding coupled with monitoring and staff feedback improved compliance with the identification and the documentation of patients with depression. Nurses were more likely than primary care providers to agree strongly that screening for depression enhances quality of care. Data gathered during this project support the integration of military and civilian nurse-facilitated screening for depression in the military primary care

  4. Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project

    NARCIS (Netherlands)

    Pedersen, Marie; Andersen, Zorana J; Stafoggia, Massimo; Weinmayr, Gudrun; Galassi, Claudia; Sørensen, Mette; Eriksen, Kirsten T; Tjønneland, Anne; Loft, Steffen; Jaensch, Andrea; Nagel, Gabriele; Concin, Hans; Tsai, Ming-Yi; Grioni, Sara; Marcon, Alessandro; Krogh, Vittorio; Ricceri, Fulvio; Sacerdote, Carlotta; Ranzi, Andrea; Sokhi, Ranjeet; Vermeulen, Roel|info:eu-repo/dai/nl/216532620; Hoogh, Kees de; Wang, Meng; Beelen, Rob|info:eu-repo/dai/nl/30483100X; Vineis, Paolo; Brunekreef, Bert|info:eu-repo/dai/nl/067548180; Hoek, Gerard|info:eu-repo/dai/nl/069553475; Raaschou-Nielsen, Ole

    2017-01-01

    BACKGROUND: Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution. OBJECTIVES: We evaluated the association between residential exposure to air pollution and primary liver cancer incidence.

  5. Urachal-sigmoid fistula managed by laparoscopic assisted high anterior resection, primary anastomosis and en bloc resection of the urachal cyst and involved bladder.

    Science.gov (United States)

    Sakata, Shinichiro; Grundy, Joshua; Naidu, Sanjeev; Gillespie, Christopher

    2016-08-01

    Sigmoid-urachal fistula is exceedingly rare in adults and only a few cases have been reported in the world literature. We present the case of a 54-year-old man with symptomatic sigmoid-urachal fistula managed successfully with a laparoscopic assisted high anterior resection, primary anastomosis and an en bloc resection of the urachal cyst and the involved cuff of bladder. © 2016 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  6. Extent of Parent-Teacher Association Involvement in the Implementation of Universal Basic Education Program in Primary Schools in Northern Senatorial District of Ondo State, Nigeria

    Directory of Open Access Journals (Sweden)

    Chidi Nnebedum

    2018-05-01

    Full Text Available Pupil’ absenteeism and lateness to school, dilapidated and shortage of relevant facilities in primary schools in the Northern Senatorial District of Ondo State seems to suggest lapses in parent-teacher association involvement in school affairs. This prompted the researchers to ascertain the extent of parent-teacher association (PTA involvement in the implementation of universal basic education program in primary schools in the Northern Senatorial District of Ondo State. Three research questions guided the study and three null hypotheses were tested. The descriptive survey research design was adopted for the study. The population of the study was comprised of all 250 head teachers and all PTA members at all 250 primary schools in the Northern Senatorial District. Multiple stage sampling technique was used to sample 205 respondents made up of 75 head teachers and 130 PTA members. The researchers developed an instrument titled “Parent-Teacher Association Involvement in School Questionnaire (PTAISQ” which was used for data collection. The instrument was validated by three experts. The reliability of the instrument was ascertained using Cronbach alpha and it yielded an overall reliability coefficient value of .76. Mean and standard deviation were used to answer the research questions, while t-test was used to test the null hypotheses at .05 level of significance. The findings of the study revealed among others that the extent of PTA involvement in maintenance of facilities in the implementation of universal basic education program in primary schools in the Northern Senatorial District of Ondo State was high. Based on the findings, recommendations were made and conclusions were drawn.

  7. The Impact of Variable Phytoplankton Stoichiometry on Projections of Primary Production, Food Quality, and Carbon Uptake in the Global Ocean

    Science.gov (United States)

    Kwiatkowski, Lester; Aumont, Olivier; Bopp, Laurent; Ciais, Philippe

    2018-04-01

    Ocean biogeochemical models are integral components of Earth system models used to project the evolution of the ocean carbon sink, as well as potential changes in the physical and chemical environment of marine ecosystems. In such models the stoichiometry of phytoplankton C:N:P is typically fixed at the Redfield ratio. The observed stoichiometry of phytoplankton, however, has been shown to considerably vary from Redfield values due to plasticity in the expression of phytoplankton cell structures with different elemental compositions. The intrinsic structure of fixed C:N:P models therefore has the potential to bias projections of the marine response to climate change. We assess the importance of variable stoichiometry on 21st century projections of net primary production, food quality, and ocean carbon uptake using the recently developed Pelagic Interactions Scheme for Carbon and Ecosystem Studies Quota (PISCES-QUOTA) ocean biogeochemistry model. The model simulates variable phytoplankton C:N:P stoichiometry and was run under historical and business-as-usual scenario forcing from 1850 to 2100. PISCES-QUOTA projects similar 21st century global net primary production decline (7.7%) to current generation fixed stoichiometry models. Global phytoplankton N and P content or food quality is projected to decline by 1.2% and 6.4% over the 21st century, respectively. The largest reductions in food quality are in the oligotrophic subtropical gyres and Arctic Ocean where declines by the end of the century can exceed 20%. Using the change in the carbon export efficiency in PISCES-QUOTA, we estimate that fixed stoichiometry models may be underestimating 21st century cumulative ocean carbon uptake by 0.5-3.5% (2.0-15.1 PgC).

  8. Managing the Challenges of Leadership in ERP Implementations: An Exploratory Study of the Leadership Challenges Encountered by Project Managers Involved in ERP Implementation Projects

    Science.gov (United States)

    Wanjagi, James K.

    2013-01-01

    Increasingly, organizations are conducting more Enterprise Resource Planning (ERP) projects in order to promote organizational efficiencies. Meanwhile, minimal research has been conducted on the leadership challenges faced by project managers during the ERP project implementations and how these challenges are managed. The existing project…

  9. Shippingport Station Decommissioning Project: Removal of piping and equipment and removal of primary system components

    International Nuclear Information System (INIS)

    1989-01-01

    This report is a technical synopsis of the removal of contaminated and non-contaminated piping and equipment from the Shippingport Station Decommissioning Project (SSDP). The information is provided as a part of the Technology Transfer Program to document dismantling activities in support of reactor decommissioning. 5 refs., 29 figs., 4 tabs

  10. [Implementing daily physical education in primary school - potentials and barriers from the involved actor's point of view].

    Science.gov (United States)

    Sterdt, E; Liersch, S; Henze, V; Röbl, M; Suermann, T; Krauth, C; Walter, U

    2015-04-01

    The objective was to determine to what extent daily physical education can be implemented in primary schools, what barriers exist and how to overcome the mentioned barriers. Moreover, it was analysed to what extent daily physical education is accepted by teachers, external trainers, parents and students. Semi-structured interviews with parents (n=7), teachers (n=5) and external trainers (n=6) of the intervention schools. The intervention students (n=44) were surveyed within focus groups. All surveyed groups appraised the implementation of daily school sports as successful. The cooperation between the schools and the sports club should be maintained during a comprehensive implementation of daily physical education. Besides an improved lessons quality teachers and external trainers reported an improved social behaviour of the children. Parents perceived positive effects on the child development. All groups believe that daily physical education increases the enjoyment of children in sports. As a certain barrier a lack of resources (e. g., facilities, equipment, financial resources) in the schools were mentioned. The cooperation between the schools and the sports club proved to be an applicable model to implement daily physical education. The combination of teachers and external trainers can contribute to a higher lesson quality. Considering the perceived potentials of daily physical education by all surveyed groups, a comprehensive implementation of systematic daily physical activity promotion in the primary school setting should be tapped more strongly in future. © Georg Thieme Verlag KG Stuttgart · New York.

  11. INFLUENCE OF THE INTELLIGENCE PROJECT AT HARVARD COGNITIVE DEVELOPMENT OF STUDENTS IN PRIMARY EDUCATION. IMPLICATIONS FOR ORGANIZATIONAL AND PROFESSIONAL DEVELOPMENT IN SECOND AND THIRD CYCLE OF PRIMARY EDUCATION

    Directory of Open Access Journals (Sweden)

    Mercedes Ramos Fresno

    2014-12-01

    Full Text Available This study aims to identify the influence of the Harvard Project on IQ Intelligence students of second and third cycle of primary education and the implications for the organizational and professional development of teachers . The experience has been developed over four courses in a public school in Madrid. The methodology used , complementary , included group designs with pretest-posttest measures , participant observation and interviews. The results show the positive impact of PIH on IQ and can say that the application of PIH produce cognitive improvements in students , as measured by the intelligence test "g" of Cattell . Regarding the implications for the organizational and professional development, we have found that the implementation of PIH promotes the development of teacher professional autonomy , commitment to teaching practice , and the necessary self-criticism to constantly evaluate , creating flexible educational proposals through self-reflection. The communication of this experience positively influences both the school community and the local community, encouraging them to participate in educational projects aimed at improving the quality of teaching- learning and education.

  12. Activation of the mouse primary visual cortex by medial prefrontal subregion stimulation is not mediated by cholinergic basalo-cortical projections

    Directory of Open Access Journals (Sweden)

    Hoang Nam eNguyen

    2015-02-01

    Full Text Available The medial prefrontal cortex (mPFC exerts top-down control of primary visual cortex (V1 activity. As there is no direct neuronal projection from mPFC to V1, this functional connection may use an indirect route, i.e., via basalo-cortical cholinergic projections. The cholinergic projections to V1 originate from neurons in the horizontal limb of the diagonal band of Broca (HDB, which receive neuronal projections from the ventral part of the mPFC, composed of prelimbic (PrL and infralimbic cortices (IL. Therefore, the objective of this study was to determine whether electrical stimulation of mice mPFC subregions activate 1 V1 neurons and 2 HDB cholinergic neurons, suggesting that the HDB serves as a relay point in the mPFC-V1 interaction. Neuronal activation was quantified using c-Fos immunocytochemistry or thallium autometallography for each V1 layer using automated particle analysis tools and optical density measurement. Stimulation of IL and PrL induced significantly higher c-Fos expression or thallium labelling in layers II/III and V of V1 in the stimulated hemisphere only. A HDB cholinergic neuron-specific lesion by saporin administration reduced IL-induced c-Fos expression in layers II/III of V1 but not in layer V. However, there was no c-Fos expression or thallium labelling in the HDB neurons, suggesting that this area was not activated by IL stimulation. Stimulation of another mPFC subarea, the anterior cingulate cortex (AC, which is involved in attention and receives input from V1, activated neither V1 nor HDB. The present results indicate that IL and PrL, but not AC, stimulation activates V1 with the minor involvement of the HDB cholinergic projections. These results suggest a functional link between the ventral mPFC and V1, but this function is only marginally supported by HDB cholinergic neurons and may involve other brain regions.

  13. Risk levels for suffering a traffic injury in primary health care. The LESIONAT* project

    Directory of Open Access Journals (Sweden)

    Bel Jordi

    2010-03-01

    Full Text Available Abstract Background Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. The objectives of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions. Methods/Design Design: Cross-sectional, multicentre study. Setting: 25 urban health care centres. Study population: Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540. Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit. Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk. Discussion We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up. Trial Registration

  14. Increasing capacity for innovation in bureaucratic primary care organizations: a whole system participatory action research project.

    Science.gov (United States)

    Thomas, Paul; McDonnell, Juliet; McCulloch, Janette; While, Alison; Bosanquet, Nick; Ferlie, Ewan

    2005-01-01

    We wanted to identify what organizational features support innovation in Primary Care Groups (PCGs). Our study used a whole system participatory action research model. Four research teams provided complementary insights. Four case study PCGs were analyzed. Two had an intervention to help local facilitators reflect on their work. Data included 70 key informant interviews, observations of clinical governance interventions and committee meetings, analysis of written materials, surveys and telephone interviews of London Primary Care Organizations, interviews with 20 nurses, and interviews with 6 finance directors. A broad range of stakeholders reviewed data at annual conferences and formed conclusions about trustworthy principles. Sequential research phases were refocused in the light of these conclusions and in response to the changing political context. Five features were associated with increased organizational capacity for innovation: (1) clear structures and a vision for corporate and clinical governance; (2) multiple opportunities for people to reflect and learn at all levels of the organization, and connections between these "learning spaces"; (3) both clinicians and managers in leadership roles that encourage participation; (4) the right timing for an initiative and its adaptation to the local context; and (5) external facilitation that provides opportunities for people to make sense of their experiences. Low morale was commonly attributed to 3 features: (1) overwhelming pace of reform, (2) inadequate staff experience and supportive infrastructure, and (3) financial deficits. These features together may support innovation in other primary care bureaucracies. The research methodology enabled people from different backgrounds to make sense of diverse research insights.

  15. Quality of life in primary school children: The Health Oriented Pedagogical Project (HOPP).

    Science.gov (United States)

    Ringdal, Kristen; Ringdal, Gerd Inger; Olsen, Helene Kristin; Mamen, Asgeir; Fredriksen, Per Morten

    2018-05-01

    The primary aim of the present study was to evaluate the association between parents' level of education, measurements of physical attributes, and quality of life in a general sample of primary school children. The children's and the parents' versions of the Inventory of Life Quality in Children and Adolescents (ILC) were used to measure health-related quality of life (QOL) in 2140 school children (response rate 93%) and 1639 parents (response rate 71%) recruited from nine primary schools in Norway. A set of physical characteristics were also measured in the children: body mass index (BMI), waist circumference, average daily minutes of physical activity, aerobic fitness, and handgrip strength. The regression analysis showed stronger relationships between the covariates and QOL for the parents' assessments than for the children's. Parents' level of education was significantly related to children's QOL, with the strongest association for parental QOL assessment. Among the physical variables, aerobic fitness ( B = 0.01, p > .001 in both samples), and handgrip strength in the parents' sample ( B = 0.21, p < .05) were significantly related to the children's QOL. The present study replicated the well-known finding that parents' sociodemographic status is important for children's QOL. Our new contribution is to show that the physiological variables aerobic fitness and muscular strength also contributed significantly to explain variance in QOL. This opens up interesting perspectives on how to improve QOL among children through more emphasis on physical activity and physical fitness in schools.

  16. `You Actually Feel like You're Actually Doing Some Science': Primary Students' Perspectives of Their Involvement in the MyScience Initiative

    Science.gov (United States)

    Forbes, Anne; Skamp, Keith

    2017-07-01

    MyScience is a primary science education initiative in which being in a community of practice (CoP) is integral to the learning process. Stakeholder groups—primary teachers, primary students and scientist mentors—interact around the CoP domainof investigating scientifically and learn from each other through participation. This paper is the fifth in a series and reports 27 year 5/6 students' (from three schools) perceptions of how their views were influenced through their involvement in a MyScience CoP. Semi-structured interviews, guided by a phenomenographic framework, were the substantive data source. Primary students' perceptions about science, science learning and science teaching were analysed using attributes associated with both communities of practice and the nature of science. Findings reveal that students' perceptions of what it means to be doing science' were transformed through their participation and students were able to identify some of the contributing factors. Where appropriate, students' views were compared with the published views of their participating scientist mentors and teachers from earlier papers. Implications for science teaching and learning in primary school community of practice settings are discussed.

  17. Presentation of self and symptoms in primary care consultations involving patients from non-English speaking backgrounds.

    Science.gov (United States)

    Roberts, Celia; Sarangi, Srikant; Moss, Becky

    2004-01-01

    This paper draws on the PLEDGE research project (Patients with Limited English and Doctors in General Practice) 1 The Patients with Limited English and Doctors in General Practice (PLEDGE) project was funded by Sir Siegmund Warburg's Voluntary Settlement (2001-2003). The research team was: Celia Roberts, Roger Jones, Becky Moss, Srikant Sarangi and Val Wass. which has a database of 232 video-recorded interactions from GP surgeries in South East London. We focus on the opening episodes-the first opportunity the patient has to report on why they have come to see the doctor-to explore some of the contrasts in self presentation and the interactional work that doctors do when faced with the unexpected. Patients who speak a local London or standard variety of English present three aspects: a description of symptoms, the context in which they occurred, and an affective or epistemic stance. These 'micro discourse routines' are accomplished interactionally through the design of figure/ground relationships, framing and metacommunication and presentation of the 'moral self'. Although some patients from non-English speaking backgrounds use broadly similar 'micro discourse routines', the majority configure the relationship between medically salient facts, adequate contextual information and the stance which conveys the 'moral self' in different and apparently less 'orderly' ways. So openings often become protracted and harder work interactionally for both sides. While conversation analytic studies and communication skills textbooks represent the medical consultations as orderly, we suggest that such apparent orderliness must, at least, be partly the result of ironing out linguistic and cultural diversity. Interactional sociolinguistic analysis is used to shed light on the design of these routines and to provide analytic frameworks for doctors in reflecting on their own practice in ways which challenge patient-centred models.

  18. The Effect of Technical Assistance on Involvement and Use: The Case of a Research, Evaluation, and Technical Assistance Project

    Science.gov (United States)

    Roseland, Denise; Volkov, Boris B.; Callow-Heusser, Catherine

    2011-01-01

    In contrast to typical National Science Foundation program evaluations, the Utah State Math Science Partnership-Research, Evaluation and Technical Assistance Project (MSP-RETA) provided technical assistance (TA) in two forms: direct TA for up to 10 projects a year, and professional development sessions for a larger number of project staff. Not…

  19. Summary of stakeholder engagement session of WPDD topical session on stakeholder involvement in decommissioning projects - November 14, 2005

    International Nuclear Information System (INIS)

    Chandler, Steve

    2006-01-01

    as important as technical rigour in these documents. The Italian presentation mentioned setting up a bilateral agreement on monitoring with local authorities. This seems like a step in the right direction, but the FSC would recommend far more than that to build public confidence. Today the public expects to be directly involved in decision making on major issues that affect them, not just via elected representatives. As I mentioned in my presentation on the situation in the UK, it is also important not to raise unrealistic expectations of how much the public can influence our decisions. In much UK legislation, decisions can only be made on a strictly technical basis and the opportunity for public influence is very limited. The presentation by EDF highlighted another vital requirement for successful stakeholder engagement. That is a disciplined, project based approach within the leading organizations. If stakeholder engagement is not meticulously planned it will flat on its face, as people will be given different messages at different times. So it is very important that this disciplined approach includes both local and national players to ensure consistency. Finally, the presentation from Germany mentioned the stepwise approach to decision making. This is very much in line with FSC recommendations. It is important that stakeholders are involved right from the start of the process, and not just in the final site selection stage. The steps involved in reaching a decision must be transparent and the opportunity for stakeholder involvement in each one needs to be clear. If the legal and procedural framework incorporate this stepwise approach explicitly it is a great help for stakeholder participation

  20. Primary structure and subcellular localization of two fimbrial subunit-like proteins involved in the biosynthesis of K99 fibrillae.

    Science.gov (United States)

    Roosendaal, E; Jacobs, A A; Rathman, P; Sondermeyer, C; Stegehuis, F; Oudega, B; de Graaf, F K

    1987-09-01

    Analysis of the nucleotide sequence of the distal part of the fan gene cluster encoding the proteins involved in the biosynthesis of the fibrillar adhesin, K99, revealed the presence of two structural genes, fanG and fanH. The amino acid sequence of the gene products (FanG and FanH) showed significant homology to the amino acid sequence of the fibrillar subunit protein (FanC). Introduction of a site-specific frameshift mutation in fanG or fanH resulted in a simultaneous decrease in fibrillae production and adhesive capacity. Analysis of subcellular fractions showed that, in contrast to the K99 fibrillar subunit (FanC), both the FanH and the FanG protein were loosely associated with the outer membrane, possibly on the periplasmic side, but were not components of the fimbriae themselves.

  1. Tubulation of Class II MHC Compartments Is Microtubule Dependent and Involves Multiple Endolysosomal Membrane Proteins in Primary Dendritic Cells1

    Science.gov (United States)

    Vyas, Jatin M.; Kim, You-Me; Artavanis-Tsakonas, Katerina; Love, J. Christopher; Van der Veen, Annemarthe G.; Ploegh, Hidde L.

    2009-01-01

    Immature dendritic cells (DCs) capture exogenous Ags in the periphery for eventual processing in endolysosomes. Upon maturation by TLR agonists, DCs deliver peptide-loaded class II MHC molecules from these compartments to the cell surface via long tubular structures (endolysosomal tubules). The nature and rules that govern the movement of these DC compartments are unknown. In this study, we demonstrate that the tubules contain multiple proteins including the class II MHC molecules and LAMP1, a lysosomal resident protein, as well as CD63 and CD82, members of the tetraspanin family. Endolysosomal tubules can be stained with acidotropic dyes, indicating that they are extensions of lysosomes. However, the proper trafficking of class II MHC molecules themselves is not necessary for endolysosomal tubule formation. DCs lacking MyD88 can also form endolysosomal tubules, demonstrating that MyD88-dependent TLR activation is not necessary for the formation of this compartment. Endolysosomal tubules in DCs exhibit dynamic and saltatory movement, including bidirectional travel. Measured velocities are consistent with motor-based movement along microtubules. Indeed, nocodazole causes the collapse of endolysosomal tubules. In addition to its association with microtubules, endolysosomal tubules follow the plus ends of microtubules as visualized in primary DCs expressing end binding protein 1 (EB1)-enhanced GFP. PMID:17513769

  2. Involvement of genetic variants associated with primary open-angle glaucoma in pathogenic mechanisms and family history of glaucoma.

    Science.gov (United States)

    Mabuchi, Fumihiko; Sakurada, Yoichi; Kashiwagi, Kenji; Yamagata, Zentaro; Iijima, Hiroyuki; Tsukahara, Shigeo

    2015-03-01

    To investigate the associations between the non-intraocular pressure (IOP)-related genetic variants (genetic variants associated with vulnerability of the optic nerve independent of IOP) and primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG) and high-tension glaucoma (HTG), and between the non-IOP-related genetic variants and a family history of glaucoma. Case-control study. Japanese patients with NTG (n = 213) and HTG (n = 212) and 191 control subjects were genotyped for 5 non-IOP-related genetic variants predisposing to POAG near the SRBD1, ELOVL5, CDKN2B/CDKN2B-AS1, SIX1/SIX6, and ATOH7 genes. The load of these genetic variants was compared between the control subjects and patients with NTG or HTG and between the POAG patients with and without a family history of glaucoma. The total number of POAG risk alleles and the product of the odds ratios (POAG risk) of these genetic variants were significantly larger (P product of the odds ratios increased (P = .012 and P = .047, respectively). Non-IOP-related genetic variants contribute to the pathogenesis of HTG as well as NTG. A positive family history of glaucoma in cases of POAG is thought to reflect the influence of genetic variants predisposing to POAG. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Issues involved in food irradiation and its commercial application: a discussion paper prepared for the Primary and Allied Industries Council

    International Nuclear Information System (INIS)

    1988-01-01

    The Australian Department of Primary Industries and Energy's interest in food irradiation stems from its responsibilities under the Export Control Act (1982) and the Quarantine Act (1908) and the implications this process may have for Australian food exports and quarantine control. Food irradiation is regarded by the Department as a process which may provide an alternative to some existing conventional food treatments. It is not expected to replace completely other processes, but subject to the overseas acceptance of imported irradiated foods, it could offer Australian exporters an additional processing and/or quarantine treatment. The Department's position is that foods irradiated in approved facilities in Australia could be approved for export provided they comply with the regulatory requirements of the importing country and are appropriately labelled or identified. The Department maintains the view that the choice to use this technology is a commercial decision which will depend on many factors including: acceptability of the toxicological aspects, demand for benefits it provides, its cost and competitiveness with alternative treatments, approval by Australian and international regulatory authorities, and importantly, the willingness of consumers to buy irradiated foods

  4. Tubulation of class II MHC compartments is microtubule dependent and involves multiple endolysosomal membrane proteins in primary dendritic cells.

    Science.gov (United States)

    Vyas, Jatin M; Kim, You-Me; Artavanis-Tsakonas, Katerina; Love, J Christopher; Van der Veen, Annemarthe G; Ploegh, Hidde L

    2007-06-01

    Immature dendritic cells (DCs) capture exogenous Ags in the periphery for eventual processing in endolysosomes. Upon maturation by TLR agonists, DCs deliver peptide-loaded class II MHC molecules from these compartments to the cell surface via long tubular structures (endolysosomal tubules). The nature and rules that govern the movement of these DC compartments are unknown. In this study, we demonstrate that the tubules contain multiple proteins including the class II MHC molecules and LAMP1, a lysosomal resident protein, as well as CD63 and CD82, members of the tetraspanin family. Endolysosomal tubules can be stained with acidotropic dyes, indicating that they are extensions of lysosomes. However, the proper trafficking of class II MHC molecules themselves is not necessary for endolysosomal tubule formation. DCs lacking MyD88 can also form endolysosomal tubules, demonstrating that MyD88-dependent TLR activation is not necessary for the formation of this compartment. Endolysosomal tubules in DCs exhibit dynamic and saltatory movement, including bidirectional travel. Measured velocities are consistent with motor-based movement along microtubules. Indeed, nocodazole causes the collapse of endolysosomal tubules. In addition to its association with microtubules, endolysosomal tubules follow the plus ends of microtubules as visualized in primary DCs expressing end binding protein 1 (EB1)-enhanced GFP.

  5. Oral involvement in patients with primary Sjögren's syndrome. Multidisciplinary care by dentists and rheumatologists.

    Science.gov (United States)

    López-Pintor, Rosa María; Fernández Castro, Mónica; Hernández, Gonzalo

    2015-01-01

    Primary Sjögren's syndrome is a chronic systemic autoimmune disease that causes destruction of lacrimal and salivary glands. The most common and earliest symptoms are oral and ocular dryness. Dry mouth makes talking difficult, tasting and chewing properly, impairing quality of life of these patients. The most common oral signs and symptoms are hyposialia with or without xerostomia, tooth decay, fungal infections, traumatic oral lesions, dysphagia, dysgeusia, and inflammation of salivary glands. There are different therapeutic strategies, depending on the severity of each case, and the increase in the amount of saliva, to reduce the number of cavities and oral infections. It is particularly important to establish a close relationship between the dentist and the rheumatologist in order to make an early and correct diagnosis, promoting appropriate dietary and hygiene measures, as well as to treat and prevent potential oral complications. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  6. Development and assessment of an active strategy for the implementation of a collaborative care approach for depression in primary care (the INDI·i project).

    Science.gov (United States)

    Aragonès, Enric; Palao, Diego; López-Cortacans, Germán; Caballero, Antonia; Cardoner, Narcís; Casaus, Pilar; Cavero, Myriam; Monreal, José Antonio; Pérez-Sola, Víctor; Cirera, Miquel; Loren, Maite; Bellerino, Eva; Tomé-Pires, Catarina; Palacios, Laura

    2017-12-13

    Primary care is the principal clinical setting for the management of depression. However, significant shortcomings have been detected in its diagnosis and clinical management, as well as in patient outcomes. We developed the INDI collaborative care model to improve the management of depression in primary care. This intervention has been favorably evaluated in terms of clinical efficacy and cost-effectiveness in a clinical trial. Our aim is to bring this intervention from the scientific context into clinical practice. Objective: To test for the feasibility and impact of a strategy for implementing the INDI model for depression in primary care. A quasi-experiment conducted in primary care. Several areas will be established to implement the new program and other, comparable areas will serve as control group. The study constitutes the preliminary phase preceding generalization of the model in the Catalan public healthcare system. The target population of the intervention are patients with major depression. The implementation strategy will also involve healthcare professionals, primary care centers, as well as management departments and the healthcare organization itself in the geographical areas where the study will be conducted: Camp de Tarragona and Vallès Occidental (Catalonia). The INDI model is a program for improving the management of depression involving clinical, instructional, and organizational interventions including the participation of nurses as care managers, the efficacy and efficiency of which has been proven in a clinical trial. We will design an active implementation strategy for this model based on the PARIHS (Promoting Action on Research Implementation in Health Services) framework. Qualitative and quantitative measures will be used to evaluate variables related to the successful implementation of the model: acceptability, utility, penetration, sustainability, and clinical impact. This project tests the transferability of a healthcare intervention

  7. Trending analysis of incidents involving primary water stress corrosion cracking on Alloy 600 components at U.S. PWRs

    International Nuclear Information System (INIS)

    Takahara, Shogo; Watanabe, Norio

    2006-01-01

    Primary Water Stress Corrosion Cracking (PWSCC) which occurs on Nickel based alloy (Alloy 600) is a worldwide concern since early 1980's. Recently several significant degradations that originate from PWSCC in the reactor coolant pressure boundary (RCPB) components have been observed at U.S. PWR plants (e.g. Oconee-3, Davis Besse). The United States Nuclear Regulation Commission (NRC) has issued generic communications to address this problem and, in response to the Davis Besse event in 2002, gave the inspection order EA-03-009 for the PWR licensees to implement the inspection of the reactor vessel heads depending upon the effective degradation years. As well, in Japan, PWSCC is considered one of the safety issues, in particular, for aged nuclear power plants and actually, some plants have experienced PWSCC on RCPB components. In the present study, we analyzed the U.S. experience with Alloy 600 degradation by reviewing the licensee event reports from 1999 to 2005 and examined the trend of them mainly focusing on affected components, characteristics of cracking and inspection approaches for detecting the PWSCC. This study indicates that PWSCC is found to be occurred on the RCPB components exposed to the environment with high temperature such as the reactor vessel head, and has the tendency to happen for specific manufactures and material according to the RCPB components. As well, it is shown that for several components, the non-destructive examination is generally needed to detect and/or confirm the PWSCC after the visual inspection and different repair techniques are applied depending on the components affected. (author)

  8. Cost-effectiveness of a cardiovascular disease primary prevention programme in a primary health care setting. Results of the Polish part of the EUROACTION project.

    Science.gov (United States)

    Sović, Nevena; Pająk, Andrzej; Jankowski, Piotr; Duenas, Alejandra; Kawecka-Jaszcz, Kalina; Wolfshaut-Wolak, Renata; Stepaniak, Urszula; Kawalec, Paweł

    2013-01-01

    Well designed cardiovascular disease (CVD) prevention programmes appear to be generally applicable and effective in reducing exposure to risk factors and the incidence of disease. However, introducing them broadly into clinical practice would have a significant impact on the healthcare budget, and requires careful consideration. The purpose of this health economic analysis was to assess the potential cost-effectiveness of the model nurse-led, comprehensive CVD primary prevention programme which was prepared and introduced in the EUROACTION project, in high-risk patients in Poland. A Markov model was developed to assess the long-term costs of preventive intervention. The health states modelled were: event-free (all patients at the beginning of observation), stable angina first year, acute myocardial infarction, stable angina subsequent year, myocardial infarction subsequent year, CVD death, and other causes of death. Health benefits from the reduction in risk factors were estimated based on Framingham risk function assuming the probability of defined health states according to British registers. The time horizon of the analysis was ten years, and one Markov cycle length was one year. The analysis was prepared from the healthcare payer's perspective. A willingness to pay threshold of three gross domestic product (GDP) per capita / quality-adjusted life years (QALY) was used. Univariate sensitivity analysis was conducted. Results were presented as an incremental cost-effectiveness ratio (ICER) expressed as an incremental cost per QALY. In Poland, EUROACTION intervention resulted mainly in reductions in the prevalence of smoking (by 14%) and high blood pressure (by 7%). Intervention on other risk factors, including blood lipids, was found to be less effective. Estimated ICERs were 19,524 PLN for men and 82,262 PLN for women. The programme was even more cost-effective in smokers i.e. estimated ICERs were 12,377 PLN in men and 53,471 PLN in women. The results were most

  9. Primary olfactory projections and the nervus terminalis in the African lungfish: implications for the phylogeny of cranial nerves.

    Science.gov (United States)

    von Bartheld, C S; Claas, B; Münz, H; Meyer, D L

    1988-08-01

    Primary olfactory and central projections of the nervus terminalis were investigated by injections of horseradish peroxidase into the olfactory epithelium in the African lungfish. In addition, gonadotropin-releasing hormone (GnRH) immunoreactivity of the nervus terminalis system was investigated. The primary olfactory projections are restricted to the olfactory bulb located at the rostral pole of the telencephalon; they do not extend into caudal parts of the telencephalon. A vomeronasal nerve and an accessory olfactory bulb could not be identified. The nervus terminalis courses through the dorsomedial telencephalon. Major targets include the nucleus of the anterior commissure and the nucleus praeopticus pars superior. some fibers cross to the contralateral side. A few fibers reach the diencephalon and mesencephalon. No label is present in the "posterior root of the nervus terminalis" (= "Pinkus's nerve" or "nervus praeopticus"). GnRH immunoreactivity is lacking in the "anterior root of the nervus terminalis," whereas it is abundant in nervus praeopticus (Pinkus's nerve). These findings may suggest that the nervus terminalis system originally consisted of two distinct cranial nerves, which have fused-in evolution-in most vertebrates. Theories of cranial nerve phylogeny are discussed in the light of the assumed "binerval origin" of the nervus terminalis system.

  10. A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

    Science.gov (United States)

    Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

    2017-08-04

    Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

  11. Renal cortical involvement in children with first UTI: does it differ in the presence of primary VUR?

    Science.gov (United States)

    Aktaş, Gül Ege; Inanir, Sabahat; Turoğlu, Halil Turgut

    2008-12-01

    The aim of this study was to investigate the influence of vesicoureteral reflux (VUR) on dimercaptosuccinic acid (DMSA) scintigraphic patterns in children with first symptomatic urinary tract infection (UTI). A total of 45 children with the diagnosis of first symptomatic UTI (28 girls, 17 boys, mean age 18 months, range 1 month-11 years) were reviewed. All DMSA scans were obtained within 2 months of bacteriologically proven UTI (median 21 days, mean 26 +/- 21, 14). After the exclusion of the patients with bilateral cortical lesions, 82 renal units were analyzed. The scintigraphic patterns included regional and global description of renal cortical abnormality (normal or decreased differential renal function, regional renal function (RRF), and the number and severity of cortical lesions). Vesicoureteral reflux was detected in 26 (32%) renal units (15 with grade 1-2, 11 with grade 3-4). Renal cortical abnormality was observed in 10 renal units without VUR (10/56, 17%) and 13 renal units with VUR (13/26: 50%). Of the 15 renal units, 5 with grade 1-2 VUR (5/15) and 8 of the 11 renal units with grade 3-4 VUR (8/11) had renal cortical involvement. The most common scintigraphic pattern in the patients without VUR was the preserved RRF (>or=45%) and two or fewer photon-deficient areas. On the other hand, a decreased RRF (children with first symptomatic UTI.

  12. JULIA: calculation projection software for primary barriers shielding to X-Rays using barite

    International Nuclear Information System (INIS)

    Silva, Júlia R.A.S. da; Vieira, José W.; Lima, Fernando R. A.

    2017-01-01

    The objective was to program a software to calculate the required thicknesses to attenuate X-rays in kilovoltage of 60 kV, 80 kV, 110 kV and 150 kV. The conventional methodological parameters for structural shield calculations established by the NCRP (National Council on Radiation Protection and Measurements) were presented. The descriptive and exploratory methods allowed the construction of the JULIA. In this sense and based on the result obtained, the tool presented is useful for professionals who wish to design structural shielding in radiodiagnostic and/or therapy. The development of calculations in the computational tool corresponds to the accessibility, optimization of time and estimation close to the real. Such heuristic exercise represents improvement of calculations for the estimation of primary barriers with barite

  13. Role of a behavioural therapy involving psychodrama for the treatment of sleep disorders in paediatric primary care.

    Science.gov (United States)

    Stagnara, Jean; Lemoine, Patrick

    2017-07-28

    Sleep disorders are common in young children. Our objective was to describe a psychodrama using puppets and to assess the interest of this approach for the treatment of sleep disorders in ambulatory paediatric patients. This retrospective, observational, monocentre study was carried between 1st January 2014 and 31st December 2015. Children aged 12 months to 6 years with a sleep disorder confirmed according to the International Classification of Sleep Disorders-2 were recruited. The parents were questioned separately about their child's sleep rhythm and the family's quality of life (QoL). The child sitting on their parent's knee and, using puppets to represent the family members, the paediatrician reproduced the scenario that took place at home and demonstrated what should be changed. The parents were contacted by telephone 1-2 weeks after the therapy to determine whether the child's sleep patterns had improved. The primary endpoint was resolution of the sleep disorder. Thirty-eight children (mean age 27.2 ± 14.0 months; mean duration of sleep disorder 12.7 ± 9.5 months) were assessed. The most common sleep disorders were difficulties in falling asleep at evening bed-time (76.3%) and night-time wakening (76.3%). The main triggering factors were the birth of a sibling (30.8%) or an illness (30.8%). In the majority (52.2%) of families who were convinced that the psychodrama would work, an immediate and complete resolution of the sleep disorder was obtained within 3 days of the consultation. QoL improved in the majority of families after the consultation (QoL was average in 68.4% of families before the consultation vs. good in 84.2% after the consultation). Psychodrama was effective at bringing about an immediate and complete resolution of sleep disorders in children. This confirms the findings of other reports that show that behavioural therapy is effective in this context. This method could be adapted effectively by individual practitioners, enabling children to

  14. Developing consumer involvement in primary dental care. Report of a half-day seminar held at the Royal College of Surgeons of England on 15th September 2008.

    Science.gov (United States)

    Eaton, Kenneth A; Batchelor, Paul; Johns, David J

    2009-01-01

    The seminar on developing consumer involvement in primary dental care, held during the morning of 15th September 2008, was a collaboration between the Lay Advisory Group and Research Committee of the Faculty of General Dental Practice (UK) (FGDP[UK]). As Professor Mike Mulcahy (immediate past Dean of the Faculty) remarked during his address of welcome, it marked a new and exciting development in the Faculty's role in setting and maintaining professional standards for the benefit of patients. It brought together nearly 50 representatives of national bodies, such as the National Audit Office, consumer groups, the Faculty's Lay Advisory Group and Research Committee, the media and others. Many of the national bodies represented at the seminar had published reports on primary dental care during the last five years.

  15. The involvement of student teachers in the development of language learning tasks. Lessons from the ETALAGE project

    NARCIS (Netherlands)

    Koet, T.; Žogla, I.; Rutka, L.

    2012-01-01

    In this paper I report a small experiment about the involvement of student teachers as well as experienced professionals in the development of language learning tasks. I argue that involving student teachers as well as experienced professionals may yield better results than involving experienced

  16. Prediction of nodal involvement in primary rectal carcinoma without invasion to pelvic structures: accuracy of preoperative CT, MR, and DWIBS assessments relative to histopathologic findings.

    Directory of Open Access Journals (Sweden)

    Jun Zhou

    Full Text Available OBJECTIVE: To investigate the accuracy of preoperative computed tomography (CT, magnetic resonance (MR imaging and diffusion-weighted imaging with background body signal suppression (DWIBS in the prediction of nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. METHODS AND MATERIALS: Fifty-two subjects with primary rectal cancer were preoperatively assessed by CT and MRI at 1.5 T with a phased-array coil. Preoperative lymph node staging with imaging modalities (CT, MRI, and DWIBS were compared with the final histological findings. RESULTS: The accuracy of CT, MRI, and DWIBS were 57.7%, 63.5%, and 40.4%. The accuracy of DWIBS with higher sensitivity and negative predictive value for evaluating primary rectal cancer patients was lower than that of CT and MRI. Nodal staging agreement between imaging and pathology was fairly strong for CT and MRI (Kappa value = 0.331 and 0.348, P<0.01 but was relatively weaker for DWIBS (Kappa value = 0.174, P<0.05. The accuracy was 57.7% and 59.6%, respectively, for CT and MRI when the lymph node border information was used as the criteria, and was 57.7% and 61.5%, respectively, for enhanced CT and MRI when the lymph node enhancement pattern was used as the criteria. CONCLUSION: MRI is more accurate than CT in predicting nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. DWIBS has a great diagnostic value in differentiating small malignant from benign lymph nodes.

  17. The effects of involving a nurse practitioner in primary care for adult patients with urinary incontinence: The PromoCon study (Promoting Continence

    Directory of Open Access Journals (Sweden)

    Severens Johan

    2008-04-01

    Full Text Available Abstract Background Urinary incontinence affects approximately 5% (800.000 of the Dutch population. Guidelines recommend pelvic floor muscle/bladder training for most patients. Unfortunately, general practitioners use this training only incidentally, but prescribe incontinence pads. Over 50% of patients get such pads, costing €160 million each year. Due to ageing of the population a further increase of expenses is expected. Several national reports recommend to involve nurse specialists to support general practitioners and improve patient care. The main objective of our study is to investigate the effectiveness and cost-effectiveness of involving nurse specialists in primary care for urinary incontinence. This paper describes the study protocol. Methods/Design In a pragmatic prospective multi centre two-armed randomized controlled trial in the Netherlands the availability and involvement for the general practitioners of a nurse specialist will be compared with usual care. All consecutive patients consulting their general practitioner within 1 year for urinary incontinence and patients already diagnosed with urinary incontinence are eligible. Included patients will be followed for 12 months. Primary outcome is severity of urinary incontinence (measured with the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF. Based on ICIQ-UI SF outcome data the number of patients needed to include is 350. For the economic evaluation quality of life and costs will be measured alongside the clinical trial. For the longer term extrapolation of the economic evaluation a Markov modelling approach will be used. Discussion/Conclusion This is, to our knowledge, the first trial on care for patients with urinary incontinence in primary care that includes a full economic evaluation and cost-effectiveness modelling exercise from the societal perspective. If this intervention proves to be effective and cost-effective, implementation of this

  18. Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care—A Pilot Feasibility Project

    Science.gov (United States)

    Hauser, Michelle E.; Burgess, Jonathan D.; Eisenberg, David M.

    2015-01-01

    Introduction: Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care. Methods: Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions. Sessions were conducted by a physician and an assistant in a conference room of a traditional primary care practice as part of a pilot feasibility project. Results: Seventy patients, contributing a total of 156 patient visits, attended 17 nutrition-focused SMAs over a 4-year period. Patients were surveyed after each visit and indicated that they enjoyed the SMAs, would consider alternating SMAs with traditional one-on-one visits, and would recommend SMAs to others. Half would pay out of pocket or a higher copay to attend SMAs. Financially, the practice broke even compared with traditional one-onone office visits. Conclusion: In this feasibility study, chronic disease SMAs conducted with a culinary/nutrition focus were feasible, cost-effective, and well received by patients. Follow-up studies are needed to evaluate short- and long-term outcomes of this SMA model on obesity-related diseases. PMID:26665019

  19. Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care-A Pilot Feasibility Project.

    Science.gov (United States)

    Delichatsios, Helen K; Hauser, Michelle E; Burgess, Jonathan D; Eisenberg, David M

    2015-11-01

    Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care. Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions. Sessions were conducted by a physician and an assistant in a conference room of a traditional primary care practice as part of a pilot feasibility project. Seventy patients, contributing a total of 156 patient visits, attended 17 nutrition-focused SMAs over a 4-year period. Patients were surveyed after each visit and indicated that they enjoyed the SMAs, would consider alternating SMAs with traditional one-on-one visits, and would recommend SMAs to others. Half would pay out of pocket or a higher copay to attend SMAs. Financially, the practice broke even compared with traditional one-onone office visits. In this feasibility study, chronic disease SMAs conducted with a culinary/nutrition focus were feasible, cost-effective, and well received by patients. Follow-up studies are needed to evaluate short- and long-term outcomes of this SMA model on obesity-related diseases.

  20. Impact of the implementation of an online network support tool among clinicians of primary health care and specialists: ECOPIH Project.

    Science.gov (United States)

    Lacasta Tintorer, David; Flayeh Beneyto, Souhel; Alzaga Reig, Xavier; Mundet Tuduri, Xavier; De la Fuente, Josep Anton; Manresa, Josep Maria; Torán Monserrat, Pere; Saigí Rubió, Francesc

    2013-10-03

    There has been created an online communication tool with the objective to improve the communication among different levels of care, between Primary Care clinicians and Specialists. This tool is web 2.0 based technology (ECOPIH project). It allows to review clinical cases and to share knowledge. Our study will evaluate its impact in terms of reduction on the number of referrals to three specialties two years after the use of this tool. Open, multicenter, controlled, non random intervention study over 24 months. Study population includes 131 Primary Care Physicians assigned to nine health centers. The study will compare the clinicians that use the ECOPIH with the ones that do not use the tool. Also, professionals that start to use the tool during the period time of the study will be included.The number of annual referrals during the first and second year will be analyzed and retrospectively compared with the previous year to the implementation of the tool. Moreover, it will be assessed the level of satisfaction of the professionals with the tool and to what extend the tool responds to their needs. The implementation of ECOPIH in the field of Primary Health Care can decrease the number of referrals from primary care to specialist care.It is expected that the reduction will be more noticeable in the group of professionals that use more intensively the tool. Furthermore, we believe that it can be also observed with the professionals that read the contributions of the others.We anticipate high degree of customer satisfaction as it is a very helpful resource never used before in our environment.

  1. SLUDGE MASS REDUCTION: PRIMARY COMPOSITIONAL FACTORS THAT INFLUENCE MELT RATE FOR FUTURE SLUDGE BATCH PROJECTIONS

    International Nuclear Information System (INIS)

    Newell, J; Miller, D; Stone, M; Pickenheim, B

    2008-01-01

    The Savannah River National Laboratory (SRNL) was tasked to provide an assessment of the downstream impacts to the Defense Waste Processing Facility (DWPF) of decisions regarding the implementation of Al-dissolution to support sludge mass reduction and processing. Based on future sludge batch compositional projections from the Liquid Waste Organization's (LWO) sludge batch plan, assessments have been made with respect to the ability to maintain comparable projected operating windows for sludges with and without Al-dissolution. As part of that previous assessment, candidate frits were identified to provide insight into melt rate for average sludge batches representing with and without Al-dissolution flowsheets. Initial melt rate studies using the melt rate furnace (MRF) were performed using five frits each for Cluster 2 and Cluster 4 compositions representing average without and with Al-dissolution. It was determined, however, that the REDOX endpoint (Fe 2+ /ΣFe for the glass) for Clusters 2 and 4 resulted in an overly oxidized feed which negatively affected the initial melt rate tests. After the sludge was adjusted to a more reduced state, additional testing was performed with frits that contained both high and low concentrations of sodium and boron oxides. These frits were selected strictly based on the ability to ascertain compositional trends in melt rate and did not necessarily apply to any acceptability criteria for DWPF processing. The melt rate data are in general agreement with historical trends observed at SRNL and during processing of SB3 (Sludge Batch 3)and SB4 in DWPF. When MAR acceptability criteria were applied, Frit 510 was seen to have the highest melt rate at 0.67 in/hr for Cluster 2 (without Al-dissolution), which is compositionally similar to SB4. For Cluster 4 (with Al-dissolution), which is compositionally similar to SB3, Frit 418 had the highest melt rate at 0.63 in/hr. Based on this data, there appears to be a slight advantage of the Frit

  2. Implementation of a high-resolution workstation for primary diagnosis of projection radiography images

    Science.gov (United States)

    Good, Walter F.; Herron, John M.; Maitz, Glenn S.; Gur, David; Miller, Stephen L.; Straub, William H.; Fuhrman, Carl R.

    1990-08-01

    We designed and implemented a high-resolution video workstation as the central hardware component in a comprehensive multi-project program comparing the use of digital and film modalities. The workstation utilizes a 1.8 GByte real-time disk (RCI) capable of storing 400 full-resolution images and two Tektronix (GMA251) display controllers with 19" monitors (GMA2O2). The display is configured in a portrait format with a resolution of 1536 x 2048 x 8 bit, and operates at 75 Hz in a noninterlaced mode. Transmission of data through a 12 to 8 bit lookup table into the display controllers occurs at 20 MBytes/second (.35 seconds per image). The workstation allows easy use of brightness (level) and contrast (window) to be manipulated with a trackball, and various processing options can be selected using push buttons. Display of any of the 400 images is also performed at 20MBytes/sec (.35 sec/image). A separate text display provides for the automatic display of patient history data and for a scoring form through which readers can interact with the system by means of a computer mouse. In addition, the workstation provides for the randomization of cases and for the immediate entry of diagnostic responses into a master database. Over the past year this workstation has been used for over 10,000 readings in diagnostic studies related to 1) image resolution; 2) film vs. soft display; 3) incorporation of patient history data into the reading process; and 4) usefulness of image processing.

  3. Radon measurements in air in waterworks and indoor swimming pools - a primary mapping project

    International Nuclear Information System (INIS)

    Marinko, J.; Mjoenes, L.; Soederman, A.-L.

    2004-01-01

    In 2001 the Swedish Work Environment Authority asked five regional offices around the country; Falun, Malmoe, Vaexjoe, Umeaa and Oerebro, to measure radon in air in workplaces where water was likely to enhance radon levels indoors. Track etch detectors were used and placed in workplaces according to the SSI measurement protocol for determining the annual average radon concentration in homes. Rooms that are frequently used by employees were measured. The detectors were exposed between 1 to 3 months. 225 detectors were used in the project and analysed at the same laboratory. The results showed that the radon concentration in waterworks often is high. Measurements were made in 60 waterworks. Levels exceeding 1000 Bq/m 3 were found in 49 of them and levels exceeding 4000 Bq/m 3 were found in 21 waterworks. The variation between waterworks may be a result of the radon concentration in the raw water, the amount of radon gas escaping to the air when water is treated, the air exchange rate in the building and where the detectors were deployed. Measurements were made in 28 indoor swimming baths. The maximum level was 290 Bq/m 3 , but most concentrations were between 30 to 70 Bq/m 3 . The conclusion is that high radon levels do not seem to be a problem in indoor swimming baths. Maybe this is due to good ventilation or the fact that water often has been treated for radon before it is used in swimming pools. The results from measurement in food industries such as breweries showed no extreme radon levels except for a fish farm where levels over 1000 Bq/m 3 were measured in the farming room and 790 Bq/m 3 in the office. The radon concentrations in laundries were relatively low, between 30 and 170 Bq/m 3

  4. A Collaborative Approach to Defining the Usefulness of Impact: Lessons from a Knowledge Exchange Project Involving Academics and Social Work Practitioners

    Science.gov (United States)

    Wilkinson, Heather; Gallagher, Michael; Smith, Mark

    2012-01-01

    This paper reports on a knowledge exchange project involving academics and practitioners in six local authority social work departments. It contributes to recent debates about the coproduction of knowledge, presenting findings in three key areas: the importance of relationships for knowledge exchange; "what works" for practitioners…

  5. The realization of three special photovoltaic (PV) pilot projects. The roles and learning experiences of parties involved

    International Nuclear Information System (INIS)

    Geuzendam, C.; Van Mierlo, B.

    1995-11-01

    Experiences with the following three demonstration projects, carried out in the Netherlands, are inventorized and evaluated: (1) 16 private grid-connected PV-systems in existing houses within the framework of the project of the Organization for Renewable Energy (ODE, abbreviated in Dutch); (2) five private grid-connected roof-integrated PV-systems in renovated buildings in Leiden; and (3) the integration of PV in an acoustic baffle along the high-way A-27 near De Bilt. Attention is paid to the decision making processes, the most important actors, the management of the projects and what is learned from the experiences

  6. Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication.

    Science.gov (United States)

    Duque, Thais M; Prado, Maira; Herrera, Daniel R; Gomes, Brenda P F A

    2018-03-23

    The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE 2 , MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p  0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.

  7. The Microbiological@mind project: a public engagement initiative of Turin University bringing microbiology and health education into primary schools.

    Science.gov (United States)

    Scalas, Daniela; Roana, Janira; Mandras, Narcisa; Cuccu, Sonia; Banche, Giuliana; Marra, Elisa Simona; Collino, Nicoletta; Piersigilli, Giorgia; Allizond, Valeria; Tullio, Vivian; Cuffini, Anna Maria

    2017-10-01

    Despite ongoing global efforts, antimicrobial resistance continues to threaten the treatment of an ever-increasing range of bacterial infections. There is substantial evidence that public education programs that foster microbial literacy amongst young school audiences may improve correct knowledge of specific health issues, such as prevention of microbial infections and responsible use of antibiotics. The aim of the Microbiological@mind project was to engage primary school students with the subject of microbiology, to promote both scientific interest and awareness towards correct behaviors that may ensure a safer lifestyle. Interactive workshops based on a full ''hands-on'' approach were carried out by an expert team from the University of Turin to over 1200 children aged 9-11 years at primary schools in Turin. A questionnaire (pre- and post-activity test) on the main topic (i.e. antibiotics) was used to assess project effectiveness. The workshops provided a useful means to strengthen the understanding of basic microbiology concepts amongst students. Students' baseline knowledge of antibiotics was quite low, as low percentages of correct answers on antibiotic action and use (5.0% and 12.1%, respectively) were found in the pre-activity tests. A significant increase (P teaching activity. Our findings support the idea that microbial literacy in early childhood through hands-on educational programs is of great importance to foster children's interest in science learning, and to provide young people with information about general and specific health-related issues, such as prudent antibiotic use, for a more responsible citizenship. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  8. HANFORD DOUBLE-SHELL TANK (DST) THERMAL and SEISMIC PROJECT-BUCKLING EVALUATION METHODS and RESULTS FOR THE PRIMARY TANKS

    International Nuclear Information System (INIS)

    Mackey, T.C.; Johnson, K.I.; Deibler, J.E.; Pilli, S.P.; Rinker, M.W.; Karri, N.K.

    2007-01-01

    This report documents a detailed buckling evaluation of the primary tanks in the Hanford double-shell waste tanks (DSTs), which is part of a comprehensive structural review for the Double-Shell Tank Integrity Project. This work also provides information on tank integrity that specifically responds to concerns raised by the Office of Environment, Safety, and Health (ES and H) Oversight (EH-22) during a review of work performed on the double-shell tank farms and the operation of the aging waste facility (AWF) primary tank ventilation system. The current buckling review focuses on the following tasks: (1) Evaluate the potential for progressive I-bolt failure and the appropriateness of the safety factors that were used for evaluating local and global buckling. The analysis will specifically answer the following questions: (a) Can the EH-22 scenario develop if the vacuum is limited to -6.6-inch water gage (w.g.) by a relief valve? (b) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario can develop? (c) What is the appropriate factor of safety required to protect against buckling if the EH-22 scenario cannot develop? (2) Develop influence functions to estimate the axial stresses in the primary tanks for all reasonable combinations of tank loads, based on detailed finite element analysis. The analysis must account for the variation in design details and operating conditions between the different DSTs. The analysis must also address the imperfection sensitivity of the primary tank to buckling. (3) Perform a detailed buckling analysis to determine the maximum allowable differential pressure for each of the DST primary tanks at the current specified limits on waste temperature, height, and specific gravity. Based on the I-bolt loads analysis and the small deformations that are predicted at the unfactored limits on vacuum and axial loads, it is very unlikely that the EH-22 scenario (i.e., progressive I-bolt failure leading to

  9. Co- and multimorbidity patterns in primary care based on episodes of care: results from the German CONTENT project

    Directory of Open Access Journals (Sweden)

    Rosemann Thomas

    2008-01-01

    Full Text Available Abstract Background Due to technological progress and improvements in medical care and health policy the average age of patients in primary care is continuously growing. In equal measure, an increasing proportion of mostly elderly primary care patients presents with multiple coexisting medical conditions. To properly assess the current situation of co- and multimorbidity, valid scientific data based on an appropriate data structure are indispensable. CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork is an ambitious project in Germany to establish a system for adequate record keeping and analysis in primary care based on episodes of care. An episode is defined as health problem from its first presentation by a patient to a doctor until the completion of the last encounter for it. The study aims to describe co- and multimorbidity as well as health care utilization based on episodes of care for the study population of the first participating general practices. Methods The analyses were based on a total of 39,699 patients in a yearly contact group (YCG out of 17 general practices in Germany for which data entry based on episodes of care using the International Classification of Primary Care (ICPC was performed between 1.1.2006 and 31.12.2006. In order to model the relationship between the explanatory variables (age, gender, number of chronic conditions and the response variables of interest (number of different prescriptions, number of referrals, number of encounters that were applied to measure health care utilization, we used multiple linear regression. Results In comparison to gender, patients' age had a manifestly stronger impact on the number of different prescriptions, the number of referrals and number of encounters. In comparison to age (β = 0.043, p Conclusion Documentation in primary care on the basis of episodes of care facilitates an insight to concurrently existing health problems and related medical procedures

  10. Methodology for the selection of routes for international cross-border line projects involving multiple objectives and decision-makers in the analyses of restrictions and environmental possibilities

    International Nuclear Information System (INIS)

    Angel S, Enrique; Cadena, Luis Fernando

    2005-01-01

    A scheme was developed and applied to select the optimum environmental route for international cross-border line projects, in a decision making context involving multiple objectives and multiple decision-makers, the project studied was the electricity interconnection for central America (SIEPAC) for which a prospective assessment was carried out regarding the restrictions and possibilities in the light of the Colombian environmental dimensions management model. The methodology proposed followed these stages: Definition and approval of the structure of environmental restriction and criticality variables, sectorization and selection of complex sections, definition of decision-makers for multi-objective analysis; design and application of consultation tool; definition and modeling of options applying SIG; sensitivity analysis of alternative routes and project's environment management. Different options were identified for insertion and permanence of the project according to the criteria of various interest groups and actors consulted: environmental authorities, electricity companies, scientific community and civil society

  11. Reliability ensemble averaging of 21st century projections of terrestrial net primary productivity reduces global and regional uncertainties

    Science.gov (United States)

    Exbrayat, Jean-François; Bloom, A. Anthony; Falloon, Pete; Ito, Akihiko; Smallman, T. Luke; Williams, Mathew

    2018-02-01

    Multi-model averaging techniques provide opportunities to extract additional information from large ensembles of simulations. In particular, present-day model skill can be used to evaluate their potential performance in future climate simulations. Multi-model averaging methods have been used extensively in climate and hydrological sciences, but they have not been used to constrain projected plant productivity responses to climate change, which is a major uncertainty in Earth system modelling. Here, we use three global observationally orientated estimates of current net primary productivity (NPP) to perform a reliability ensemble averaging (REA) method using 30 global simulations of the 21st century change in NPP based on the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) business as usual emissions scenario. We find that the three REA methods support an increase in global NPP by the end of the 21st century (2095-2099) compared to 2001-2005, which is 2-3 % stronger than the ensemble ISIMIP mean value of 24.2 Pg C y-1. Using REA also leads to a 45-68 % reduction in the global uncertainty of 21st century NPP projection, which strengthens confidence in the resilience of the CO2 fertilization effect to climate change. This reduction in uncertainty is especially clear for boreal ecosystems although it may be an artefact due to the lack of representation of nutrient limitations on NPP in most models. Conversely, the large uncertainty that remains on the sign of the response of NPP in semi-arid regions points to the need for better observations and model development in these regions.

  12. Distinct Laterality in Forelimb-Movement Representations of Rat Primary and Secondary Motor Cortical Neurons with Intratelencephalic and Pyramidal Tract Projections.

    Science.gov (United States)

    Soma, Shogo; Saiki, Akiko; Yoshida, Junichi; Ríos, Alain; Kawabata, Masanori; Sakai, Yutaka; Isomura, Yoshikazu

    2017-11-08

    Two distinct motor areas, the primary and secondary motor cortices (M1 and M2), play crucial roles in voluntary movement in rodents. The aim of this study was to characterize the laterality in motor cortical representations of right and left forelimb movements. To achieve this goal, we developed a novel behavioral task, the Right-Left Pedal task, in which a head-restrained male rat manipulates a right or left pedal with the corresponding forelimb. This task enabled us to monitor independent movements of both forelimbs with high spatiotemporal resolution. We observed phasic movement-related neuronal activity (Go-type) and tonic hold-related activity (Hold-type) in isolated unilateral movements. In both M1 and M2, Go-type neurons exhibited bias toward contralateral preference, whereas Hold-type neurons exhibited no bias. The contralateral bias was weaker in M2 than M1. Moreover, we differentiated between intratelencephalic (IT) and pyramidal tract (PT) neurons using optogenetically evoked spike collision in rats expressing channelrhodopsin-2. Even in identified PT and IT neurons, Hold-type neurons exhibited no lateral bias. Go-type PT neurons exhibited bias toward contralateral preference, whereas IT neurons exhibited no bias. Our findings suggest a different laterality of movement representations of M1 and M2, in each of which IT neurons are involved in cooperation of bilateral movements, whereas PT neurons control contralateral movements. SIGNIFICANCE STATEMENT In rodents, the primary and secondary motor cortices (M1 and M2) are involved in voluntary movements via distinct projection neurons: intratelencephalic (IT) neurons and pyramidal tract (PT) neurons. However, it remains unclear whether the two motor cortices (M1 vs M2) and the two classes of projection neurons (IT vs PT) have different laterality of movement representations. We optogenetically identified these neurons and analyzed their functional activity using a novel behavioral task to monitor movements

  13. Patient Involvement in Geriatric Care – Results and Experiences from a Mixed Models Design Study within Project INTEGRATE

    Directory of Open Access Journals (Sweden)

    Joern Kiselev

    2018-02-01

    Full Text Available Introduction: Patient involvement is a core component of an integrated care approach. While the benefits and prerequisites of patient involvement have been described in general and additionally for some target populations, little is known about the views and experiences of older people regarding this matter. Methods: A study with a mixed-methods design was conducted to gain a better understanding about patient involvement in geriatric care. A questionnaire on shared decision-making was administered within a group of older adults in Germany. Additionally, 7 focus groups with health professionals and geriatric patients in Germany and Estonia were held to deepen the insight of the questionnaire and discussing experiences and barriers of patient involvement. Results: Older people without an actual medical problem expressed a significantly higher desire to participate in shared decisions than those requiring actual medical care. No significant differences could be found for the desire to be informed as part of the care process. No correlation between patients’ desire and experiences on shared decision-making could be observed. In the focus groups, patients demanded a comprehensive and understandable information and education process while the health professionals’ view was very task-specific. This conflict led to a loss of trust by the patients. Conclusions: There is a gap between patients’ and health professionals’ views on patient involvement in older people. The involvement process should therefore be comprehensive and should take into account different levels of health literacy.

  14. Involvement of Individuals in the Development of Technical Solutions and Rules of Management for Building Renovation Projects: A Case Study of Latvia

    Science.gov (United States)

    Pukite, I.; Grekis, A.; Geipele, I.; Zeltins, N.

    2017-08-01

    In March 2016, the Latvian government approved a new support program for increasing energy efficiency in residential apartment buildings. For the support of renovation of apartment buildings in the period from 2016 to 2023, 166 470 588 EUR will be available. Different persons, such as energy auditors, designers, architects, project managers and builders, will be involved in the process of planning, development and implementation of building renovation. At the development stage of the building renovation project, special attention should be devoted to the first stage - energy audit and technical project development. The problem arises due to the fact that each of these individuals, during the development of technical building documentation, does not work as a completely unified system. The implementation of construction project planning and organisational management system is one of the most important factors to guarantee that the quality of building renovation project is ensured in accordance with the laws and regulatory standards. The paper studies mutual cooperation, professionalism and the role of information feedback of personnel involved in the planning stage of building renovation, which is an essential prerequisite for the renovation process in order to achieve high quality of work and reduce the energy performance indicator. The present research includes the analysis of different technical solutions and their impact on energy efficiency. Mutual harmonisation of technical specifications is also investigated.

  15. Primary health care teams put to the test a cross-sectional study from Austria within the QUALICOPC project.

    Science.gov (United States)

    Hoffmann, Kathryn; George, Aaron; Dorner, Thomas E; Süß, Katharina; Schäfer, Willemijn L A; Maier, Manfred

    2015-11-16

    Multidisciplinary Primary Health Care Teams (PHCT) provide a comprehensive approach to address the social and health needs of communities. It was the aim of this analysis to assess the number of PHCT in Austria, a country with a weak PHC system, and to compare preventive activities, psychosocial care, and work satisfaction between GPs who work and those who do not work in PHCT. Within the QUALICOPC study, data collection was performed between November 2011 and May 2012, utilizing a standardized questionnaire for GPs. A stratified sample of GPs from across Austria was invited. Statistical analyses included descriptive statistics and tests. Data from 171 GPs questionnaires were used for this analysis. Of these, 61.1 % (n = 113) had a mono-disciplinary office, 26.3 % (n = 45) worked in an office consisting of GP, receptionist and one additional primary care profession, and 7.6 % (n = 13) worked in a larger PHCT. GPs that worked in larger PHCT were younger and more involved in psychosocial and preventive care. No differences were found with regard to work satisfaction or workload. This study gives insight into the structures of PHC in Austria. The results indicate a low number of PHCT; however, the overall return rate in our sample was low with more male GPs, more GPs from urban areas and more GPs working in offices together with other physicians than the national average. Younger GPs demonstrate a greater tendency to implement this primary care practice model in their practices, which seems to be associated with an emphasis in psychosocial and preventive care. If Austria is to increase the number of PHC teams, the country should embrace the work of young GPs and should offer relevant support for PHCT. Future developments could be guided by considering effective models of good practice and governmental support as in other countries.

  16. Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

    Science.gov (United States)

    Samuels-Dennis, Joan; Xia, Liudi; Secord, Sandra; Raiger, Amelia

    2016-10-08

    Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

  17. Focus groups as a tool to collect data in a community informatics project involving elderly rural women

    CSIR Research Space (South Africa)

    Smith, R

    2015-11-01

    Full Text Available The main purpose of the extended project is to identify and investigate the aspects that will encourage elderly women in rural areas to use the ICT platform, and to determine what the physical design, content and applications should look like...

  18. Study of Bilingual-Bicultural Projects Involving Native American, Indo-European, Asian and Pacific Language Groups.

    Science.gov (United States)

    Battiste, Marie A.; And Others

    This is the final report of one of three studies in an overall project entitled "Evaluation of Bilingual Education Programs." This study was sponsored in response to a need for more information regarding bilingual-bicultural education for other than Spanish language groups. The study's objectives were to: (1) identify the major issues…

  19. Campus Community Involvement in an Experimental Food Research Project Increases Students' Motivation and Improves Perceived Learning Outcomes

    Science.gov (United States)

    Goto, K.; Bianco-Simeral, S.

    2009-01-01

    Although the effects of pedagogical strategies using collaborative learning on students' perceived learning outcomes have been studied, little has been examined about possible benefits and challenges in collaborating with the campus community in a food science research project conducted by nutrition majors. We examined the effects of involving…

  20. Three endoplasmic reticulum-associated fatty acyl-coenzyme a reductases were involved in the production of primary alcohols in hexaploid wheat (Triticum aestivum L.).

    Science.gov (United States)

    Chai, Guaiqiang; Li, Chunlian; Xu, Feng; Li, Yang; Shi, Xue; Wang, Yong; Wang, Zhonghua

    2018-03-05

    The cuticle covers the surface of the polysaccharide cell wall of leaf epidermal cells and forms an essential diffusion barrier between the plant and the environment. The cuticle is composed of cutin and wax. Cuticular wax plays an important role in the survival of plants by serving as the interface between plants and their biotic and abiotic environments, especially restricting nonstomatal water loss. Leaf cuticular waxes of hexaploid wheat at the seedling stage mainly consist of primary alcohols, aldehydes, fatty acids, alkane and esters. Primary alcohols account for more than 80% of the total wax load. Therefore, we cloned several genes encoding fatty acyl-coenzyme A reductases from wheat and analyzed their function in yeast and plants. We propose the potential use of these genes in wheat genetic breeding. We reported the cloning and characterization of three TaFARs, namely TaFAR6, TaFAR7 and TaFAR8, encoding fatty acyl-coenzyme A reductases (FAR) in wheat leaf cuticle. Expression analysis revealed that TaFAR6, TaFAR7 and TaFAR8 were expressed at the higher levels in the seedling leaf blades, and were expressed moderately or weakly in stamen, glumes, peduncle, flag leaf blade, sheath, spike, and pistil. The heterologous expression of three TaFARs in yeast (Saccharomyces cerevisiae) led to the production of C24:0 and C26:0 primary alcohols. Transgenic expression of the three TaFARs in tomato (Solanum lycopersicum) and rice (Oryza sativa) led to increased accumulation of C24:0-C30:0 primary alcohols. Transient expression of GFP protein-tagged TaFARs revealed that the three TaFAR proteins were localized to the endoplasmic reticulum (ER), the site of wax biosynthesis. The three TaFAR genes were transcriptionally induced by drought, cold, heat, powdery mildew (Blumeria graminis) infection, abscisic acid (ABA) and methyl jasmonate (MeJa) treatments. These results indicated that wheat TaFAR6, TaFAR7 and TaFAR8 are involved in biosynthesis of very-long-chain primary

  1. Identification of retinal ganglion cells and their projections involved in central transmission of information about upward and downward image motion.

    Directory of Open Access Journals (Sweden)

    Keisuke Yonehara

    Full Text Available The direction of image motion is coded by direction-selective (DS ganglion cells in the retina. Particularly, the ON DS ganglion cells project their axons specifically to terminal nuclei of the accessory optic system (AOS responsible for optokinetic reflex (OKR. We recently generated a knock-in mouse in which SPIG1 (SPARC-related protein containing immunoglobulin domains 1-expressing cells are visualized with GFP, and found that retinal ganglion cells projecting to the medial terminal nucleus (MTN, the principal nucleus of the AOS, are comprised of SPIG1+ and SPIG1(- ganglion cells distributed in distinct mosaic patterns in the retina. Here we examined light responses of these two subtypes of MTN-projecting cells by targeted electrophysiological recordings. SPIG1+ and SPIG1(- ganglion cells respond preferentially to upward motion and downward motion, respectively, in the visual field. The direction selectivity of SPIG1+ ganglion cells develops normally in dark-reared mice. The MTN neurons are activated by optokinetic stimuli only of the vertical motion as shown by Fos expression analysis. Combination of genetic labeling and conventional retrograde labeling revealed that axons of SPIG1+ and SPIG1(- ganglion cells project to the MTN via different pathways. The axon terminals of the two subtypes are organized into discrete clusters in the MTN. These results suggest that information about upward and downward image motion transmitted by distinct ON DS cells is separately processed in the MTN, if not independently. Our findings provide insights into the neural mechanisms of OKR, how information about the direction of image motion is deciphered by the AOS.

  2. EU-level competence development projects in agri-food-environment: the involvement of sectoral social partners

    NARCIS (Netherlands)

    Mulder, M.

    2006-01-01

    Purpose - The European Commission and social partner organisations at EU level encourage the lifelong development of qualifications and competence. This is reflected in many policy reports and reviews. This paper seeks to show the involvement of social partner organisations at the level of EU-funded

  3. [The CHILT I project (Children's Health Interventional Trial). A multicomponent intervention to prevent physical inactivity and overweight in primary schools].

    Science.gov (United States)

    Graf, C; Dordel, S

    2011-03-01

    Child and juvenile obesity is increasing worldwide; therefore, effective preventive strategies are warranted. The stepwise project CHILT (Children's Health Interventional Trial) was initiated in 2000 and combines in its multicomponent school-based arm CHILT I health education and physical activity for primary school children to prevent physical inactivity and overweight. The effect on obesity and physical performance was studied in 12 primary schools (intervention schools, IS) compared with 5 control schools (CS). Anthropometric data were recorded. Physical performance was measured by a coordination test for children (the "Körperkoordinationstest für Kinder", KTK) and the 6-minute run. Anthropometric and motoric data of 436 children in IS (55.0% of the population) and 179 children in CS (62.8%) were available at baseline and at follow-up. No difference in the incidence of overweight was found between the IS and CS after 4 years of intervention. Remission of overweight was higher in IS (23.2% versus 19.2%), but not significant. The increase in BMI was significantly lower in IS, in which the program was regularly performed. There was an improvement in selected items of the KTK in IS. In particular, endurance performance tended to be higher at final examination. School-based preventive intervention seems to have a positive influence on physical motor skills and the remission of overweight. To optimize the effects, a consistent and quality assured implementation and the integration of the children's whole environment are warranted.

  4. The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project: An open-label pragmatic randomised control trial comparing the efficacy of differing therapeutic agents for primary care detoxification from either street heroin or methadone [ISRCTN07752728

    Directory of Open Access Journals (Sweden)

    Sheard Laura

    2004-04-01

    Full Text Available Abstract Background Heroin is a synthetic opioid with an extensive illicit market leading to large numbers of people becoming addicted. Heroin users often present to community treatment services requesting detoxification and in the UK various agents are used to control symptoms of withdrawal. Dissatisfaction with methadone detoxification 8 has lead to the use of clonidine, lofexidine, buprenorphine and dihydrocodeine; however, there remains limited evaluative research. In Leeds, a city of 700,000 people in the North of England, dihydrocodeine is the detoxification agent of choice. Sublingual buprenorphine, however, is being introduced. The comparative value of these two drugs for helping people successfully and comfortably withdraw from heroin has never been compared in a randomised trial. Additionally, there is a paucity of research evaluating interventions among drug users in the primary care setting. This study seeks to address this by randomising drug users presenting in primary care to receive either dihydrocodeine or buprenorphine. Methods/design The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project is a pragmatic randomised trial which will compare the open use of buprenorphine with dihydrocodeine for illicit opiate detoxification, in the UK primary care setting. The LEEDS project will involve consenting adults and will be run in specialist general practice surgeries throughout Leeds. The primary outcome will be the results of a urine opiate screening at the end of the detoxification regimen. Adverse effects and limited data to three and six months will be acquired.

  5. [Drug use and involvement in risky driving styles in a sample of university students. The uniHcos project].

    Science.gov (United States)

    Jiménez-Mejías, Eladio; Medina-García, Miguel Ángel; Martínez-Ruiz, Virginia; Pulido-Manzanero, José; Fernández-Villa, Tania

    2015-09-01

    Drug and alcohol use are known to increase the risk of traffic accidents, especially among youth. However, the association between habitual drug use and the adoption of risky driving behavior is not well known. The aim of this study was to identify and quantify the association between habitual drug use and involvement in risky driving practices overall and by gender among university students. A cross sectional study was conducted. The study population was composed of 559 car drivers younger than 31 years who completed an online questionnaire during the 2011-2012 academic year. Among other factors, the questionnaire assessed the following items: habitual drug consumption (20 or more days) during the last year and involvement in other risky driving practices during the last month. A total of 27.7% of students reported they had used drugs regularly during the last year. Drug use was associated with a higher frequency of involvement in risky driving practices. In men, the factors most strongly associated with drug consumption were speeding, driving under influence of alcohol, and feeling drowsy while driving. In women, drug consumption was mainly associated with smoking while driving, drunk driving, and driving without rest. The results of our study support the hypothesis that habitual drug use is associated with an increased frequency of risky driving behavior. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. Further effort is needed to improve management of chronic pain in primary care. Results from the Arkys project

    Directory of Open Access Journals (Sweden)

    Gaetano Piccinocchi

    2016-06-01

    Full Text Available Treatment of chronic pain is challenging. The Arkys project was initiated in Italy to assist general practitioners (GPs in the management of chronic pain. The main objective of this study was to determine the usefulness of Arkys for selecting new therapeutic strategies. An online interactive questionnaire for assessing pain and guiding therapeutic decisions was made available to GPs participating to Arkys. The GPs were invited to complete the questionnaire for each patient who presented moderate-severe chronic pain, and to decide on a new analgesic treatment based on the information provided by the questionnaire. Two hundred and forty four GPs participated with a total of 3035 patients. Patients (mean age 68.9 years had mostly chronic non-cancer pain (87.7%. In 42.3%, pain had neuropathic components. Only 53.6% of patients were in treatment with analgesics (strong opioids, 38.9%; NSAIDs, 32.6%; weak opioids, 25.6%; anti-epileptics, 17.3%; paracetamol, 14.9%. Use of the questionnaire resulted in the prescription of analgesics to all patients and in increased prescription of strong opioids (69.7%. NSAID prescription decreased (12.8%, while anti-epileptics use remained stable. These findings show that current management of chronic pain in primary care is far from optimal and that efforts are needed to educate GPs and improve guideline implementation.

  7. [A pilot project of the integration of oro-dental care into the primary health care system in Cameroon].

    Science.gov (United States)

    Ngapeth-Etoundi, M; Ekoto, E

    2001-06-01

    The objective of this work is to analyse the situation of the Oral Health Care (OHC) of the population of operational district health unit in Primary Health Care (PHC) and finally integrate the component of OHC. Indeed in many countries in Africa, the World Health Organisation (WHO), in accord with the countries, have set up the policy of PHC. The agreement is that the component of OHC was neglected for quite sometimes in Cameroon. It's for this reason that a pilot project was initiated as a model so that it would be extended to all districts in this country. The method consist in investigation into the prevalence by means of questionnaire and clinical examination of the population of varied age; 900 persons were examined in the Sangmelina health district in order to master the situation of OHC. Oral dental hygiene: 70.5% of the population had a tooth brush, 79% declared they brush their teeth, The state of periodontal tissue: 75% had debris, 70% calculus, 60.7% gingivitis, The prevalence of caries: 66.9% (91.9% had between 21 and 32 teeth), 44.8% follon teeth, 50.8% of this population needed artificial teeth. The situation of the OHC in the health district of Sangmelina requires an effective prevention, consequently the importance of including this situation in PHC program of the said district.

  8. Lectin Ulex europaeus agglutinin I specifically labels a subset of primary afferent fibers which project selectively to the superficial dorsal horn of the spinal cord.

    Science.gov (United States)

    Mori, K

    1986-02-19

    To examine differential carbohydrate expression among different subsets of primary afferent fibers, several fluorescein-isothiocyanate conjugated lectins were used in a histochemical study of the dorsal root ganglion (DRG) and spinal cord of the rabbit. The lectin Ulex europaeus agglutinin I specifically labeled a subset of DRG cells and primary afferent fibers which projected to the superficial laminae of the dorsal horn. These results suggest that specific carbohydrates containing L-fucosyl residue is expressed selectively in small diameter primary afferent fibers which subserve nociception or thermoception.

  9. Projectables

    DEFF Research Database (Denmark)

    Rasmussen, Troels A.; Merritt, Timothy R.

    2017-01-01

    CNC cutting machines have become essential tools for designers and architects enabling rapid prototyping, model-building and production of high quality components. Designers often cut from new materials, discarding the irregularly shaped remains. We introduce ProjecTables, a visual augmented...... reality system for interactive packing of model parts onto sheet materials. ProjecTables enables designers to (re)use scrap materials for CNC cutting that would have been previously thrown away, at the same time supporting aesthetic choices related to wood grain, avoiding surface blemishes, and other...... relevant material properties. We conducted evaluations of ProjecTables with design students from Aarhus School of Architecture, demonstrating that participants could quickly and easily place and orient model parts reducing material waste. Contextual interviews and ideation sessions led to a deeper...

  10. Ghrelin fibers from lateral hypothalamus project to nucleus tractus solitaries and are involved in gastric motility regulation in cisplatin-treated rats.

    Science.gov (United States)

    Gong, Yanling; Liu, Yang; Liu, Fei; Wang, Shasha; Jin, Hong; Guo, Feifei; Xu, Luo

    2017-03-15

    Ghrelin can alleviate cancer chemotherapy-induced dyspepsia in rodents, though the neural mechanisms involved are not known. Therefore, ghrelin projections from the lateral hypothalamus (LH) and its involvement in the regulation of gastric motility in cisplatin-treated rats were investigated with a multi-disciplined approach. Retrograde tracing combined with fluoro-immunohistochemical staining were used to investigate ghrelin fiber projections arising from LH and projecting to nucleus tractus solitaries (NTS). Results revealed that ghrelin fibers originating in LH project to NTS. Expression of ghrelin and its receptor growth hormone secretagogue receptor (GHS-R1a) in LH and NTS were detected by Western Blot. 2days after cisplatin dosing, expression of ghrelin in LH decreased while GHS-R1a in both LH and NTS increased. In electrophysiological experiments, the effects of N-methyl-d-aspartate (NMDA) microinjection in LH on neuronal discharge of gastric distension-responsive neurons in NTS and gastric motility were assessed. NMDA in LH excited most of ghrelin-responsive gastric distension (GD)-sensitive neurons in NTS and promoted gastric motility. This effect was partially blocked by ghrelin antibody in NTS. Furthermore, the excitatory effects of NMDA in cisplatin-treated rats were weaker than those in saline-treated rats. Behaviorally, cisplatin induced a significant increase of kaolin consumption and decrease of food intake. These studies reveal a decreased expression of ghrelin in LH and up-regulation of GHS-R1a in LH and NTS, which are involved in the regulation of GD neuronal discharge in NTS and gastric motility. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Improving brain computer interface research through user involvement - The transformative potential of integrating civil society organisations in research projects

    Science.gov (United States)

    Wakunuma, Kutoma; Rainey, Stephen; Hansen, Christian

    2017-01-01

    Research on Brain Computer Interfaces (BCI) often aims to provide solutions for vulnerable populations, such as individuals with diseases, conditions or disabilities that keep them from using traditional interfaces. Such research thereby contributes to the public good. This contribution to the public good corresponds to a broader drive of research and funding policy that focuses on promoting beneficial societal impact. One way of achieving this is to engage with the public. In practical terms this can be done by integrating civil society organisations (CSOs) in research. The open question at the heart of this paper is whether and how such CSO integration can transform the research and contribute to the public good. To answer this question the paper describes five detailed qualitative case studies of research projects including CSOs. The paper finds that transformative impact of CSO integration is possible but by no means assured. It provides recommendations on how transformative impact can be promoted. PMID:28207882

  12. Improving brain computer interface research through user involvement - The transformative potential of integrating civil society organisations in research projects.

    Science.gov (United States)

    Stahl, Bernd Carsten; Wakunuma, Kutoma; Rainey, Stephen; Hansen, Christian

    2017-01-01

    Research on Brain Computer Interfaces (BCI) often aims to provide solutions for vulnerable populations, such as individuals with diseases, conditions or disabilities that keep them from using traditional interfaces. Such research thereby contributes to the public good. This contribution to the public good corresponds to a broader drive of research and funding policy that focuses on promoting beneficial societal impact. One way of achieving this is to engage with the public. In practical terms this can be done by integrating civil society organisations (CSOs) in research. The open question at the heart of this paper is whether and how such CSO integration can transform the research and contribute to the public good. To answer this question the paper describes five detailed qualitative case studies of research projects including CSOs. The paper finds that transformative impact of CSO integration is possible but by no means assured. It provides recommendations on how transformative impact can be promoted.

  13. Involvement of a Case Manager in Palliative Care Reduces Hospitalisations at the End of Life in Cancer Patients; A Mortality Follow-Back Study in Primary Care.

    Science.gov (United States)

    van der Plas, Annicka G M; Vissers, Kris C; Francke, Anneke L; Donker, Gé A; Jansen, Wim J J; Deliens, Luc; Onwuteaka-Philipsen, Bregje D

    2015-01-01

    Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner (GP) and home-care nurse. To compare cancer patients with and without additional support from a case manager on: 1) the patients' general characteristics, 2) characteristics of care and support given by the GP, 3) palliative care outcomes. This article is based on questionnaire data provided by GPs participating in two different studies: the Sentimelc study (280 cancer patients) and the Capalca study (167 cancer patients). The Sentimelc study is a mortality follow-back study amongst a representative sample of GPs that monitors the care provided via GPs to a general population of end-of-life patients. Data from 2011 and 2012 were analysed. The Capalca study is a prospective study investigating the implementation and outcome of the support provided by case managers in primary palliative care. Data were gathered between March 2011 and December 2013. The GP is more likely to know the preferred place of death (OR 7.06; CI 3.47-14.36), the place of death is more likely to be at the home (OR 2.16; CI 1.33-3.51) and less likely to be the hospital (OR 0.26; CI 0.13-0.52), and there are fewer hospitalisations in the last 30 days of life (none: OR 1.99; CI 1.12-3.56 and one: OR 0.54; CI 0.30-0.96), when cancer patients receive additional support from a case manager compared with patients receiving the standard GP care. Involvement of a case manager has added value in addition to palliative care provided by the GP, even though the role of the case manager is 'only' advisory and he or she does not provide hands-on care or prescribe medication.

  14. Education in the Mother-Tongue: A Nigerian Experiment--the Six-Year (Yoruba Medium) Primary Education Project at the University of Ife, Nigeria

    Science.gov (United States)

    Fafunwa, A. Babs

    1975-01-01

    This project was launched as a medium of instruction throughout the six-year primary course, predicted on the hypotheses that the child benefits culturally, socially, linguistically and cognitively through native language instruction, and that his command of English will be improved if it is taught as a separate subject by a specially trained…

  15. Comparison of the Effectiveness of Two Forms of the Enhancing Relationships in School Communities Project for Promoting Cooperative Conflict Resolution Education in Australian Primary Schools

    Science.gov (United States)

    Trinder, Margot; Wertheim, Eleanor H.; Freeman, Elizabeth; Sanson, Ann; Richardson, Shanel; Hunt, Sue

    2010-01-01

    This study evaluated the Enhancing Relationships in School Communities (ERIS) Project which aimed to promote constructive conflict resolution (CR) in Australian primary school communities through professional development for core teams of three-five staff (n = 33 teachers). Twelve schools were randomly assigned to a full intervention (FI) group or…

  16. IMPLEMENTATION OF THE PROJECT «CLINICAL BASES OF INTERNSHIP» WHILE PREPARING STUDENTS WITH A SPECIALTY IN «PSYCHOLOGY AND PEDAGOGY OF PRIMARY EDUCATION»

    Directory of Open Access Journals (Sweden)

    Elena G. Gutsu

    2015-01-01

    Full Text Available The aim of this work is to test new approaches to the students’practice organization in pedagogical universities on the basis of the competence approach.Methods. Diagnosis of formedness competences is carried out on the basis of the analysis of products of activity during the students’ school internship.Results. Teachers’ experience of Nizhny Novgorod State Pedagogical University of K. Minin on implementation of the innovative project «Clinical Bases of Internship » is presented. The authors have created and approved the program of school internship for the students with specialty in «Psychology and Pedagogics of Primary Education» based on the concept of the integrated clinical practice developed in higher education institution. The program involves organizational, reflexive-analytical, active-practical and project blocks. Features of clinical approach to pedagogical education are considered; requirements to school as the base of clinical practice are listed. The main content of student teaching and its role in professional formation of future elementary school teachers is disclosed. Importance of students’ project group and individual activity (the subject has to correspond to interests of employers and real needs of school are emphasized.Scientific novelty. Specifics of integrated clinical internship as a means of formation of professional metacompetences of undergraduate students are presented. The organization of pedagogical internship is reconsidered; theoretically it has to provide fast professionalizing of training, early immersion into a profession that will promote not only to successful formation of flexible pedagogical thinking, but also growth of professional motivation of students – development in them of the positive relation to work of the teacher, interest in communication with children of younger school age, and aspiration to pedagogical research creativity.Practical significance. The research

  17. Effectiveness of Problem-Solving Therapy for Older, Primary Care Patients with Depression: Results from the IMPACT Project

    Science.gov (United States)

    Arean, Patricia; Hegel, Mark; Vannoy, Steven; Fan, Ming-Yu; Unuzter, Jurgen

    2008-01-01

    Purpose: We compared a primary-care-based psychotherapy, that is, problem-solving therapy for primary care (PST-PC), to community-based psychotherapy in treating late-life major depression and dysthymia. Design and Methods: The data here are from the IMPACT study, which compared collaborative care within a primary care clinic to care as usual in…

  18. Involvement of Amylin and Leptin in the Development of Projections from the Area Postrema to the Nucleus of the Solitary Tract

    Directory of Open Access Journals (Sweden)

    Kathrin Abegg

    2017-11-01

    Full Text Available The area postrema (AP and the nucleus of the solitary tract (NTS are important hindbrain centers involved in the control of energy homeostasis. The AP mediates the anorectic action and the inhibitory effect on gastric emptying induced by the pancreatic hormone amylin. Amylin’s target cells in the AP project to the NTS, an integrative relay center for enteroceptive signals. Perinatal hormonal and metabolic factors influence brain development. A postnatal surge of the adipocyte-derived hormone leptin represents a developmental signal for the maturation of projections between hypothalamic nuclei controlling energy balance. Amylin appears to promote neurogenesis in the AP in adult rats. Here, we examined whether amylin and leptin are required for the development of projections from the AP to the NTS in postnatal and adult mice by conducting neuronal tracing studies with DiI in amylin- (IAPP−/− and leptin-deficient (ob/ob mice. Compared to wild-type littermates, postnatal (P10 and adult (P60 IAPP−/− mice showed a significantly reduced density of AP-NTS projections. While AP projections were also reduced in postnatal (P14 ob/ob mice, AP-NTS fiber density did not differ between adult ob/ob and wild-type animals. Our findings suggest a crucial function of amylin for the maturation of neuronal brainstem pathways controlling energy balance and gastrointestinal function. The impaired postnatal development of neuronal AP-NTS projections in ob/ob mice appears to be compensated in this experimental model during later brain maturation. It remains to be elucidated whether an amylin- and leptin-dependent modulation in neuronal development translates into altered AP/NTS-mediated functions.

  19. Projecting Fatalities in Crashes Involving Older Drivers, 2000–2025, CRADA No. ORNL98-0500 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Patricia S. [ORNL; Jones, Donald W. [ORNL; Reuscher, Timothy [Oak Ridge Institute for Science and Education; Schmoyer, Richard S. [ORNL; Truett, Lorena F. [ORNL

    2000-04-01

    At the turn of the century – the 20th century that is – the median age in the United States was under 30 years; America was 60% rural in nature; and there were only 36 highway fatalities all year. As we leave the 20th century behind, the route into the 21st century is very different. “Intelligent” cars speed down multi-lane “smart” highways in a nation that is 75% urban. According to the Federal Highway Administration’s Highway Statistics, there are 28,000 times more vehicles on the road in 2000 than there were in 1900, and these vehicles travel about 2.6 trillion miles each year. Annual fatalities resulting from highway crashes have also increased – by over 1100%. We see other changes as well. The face of America is changing. It is growing older. In 2025, persons 65 and over will make up 18.5% of the total population. The number of persons aged 85 and over is increasing more rapidly than any other age group. More importantly, the elderly are taking more trips, driving further, and continuing to drive much later in life. These conditions lead to concerns about traffic safety. Although the elderly are healthier and drive safer cars than they did just two decades ago, their frailty makes them more susceptible to injury than younger persons involved in traffic crashes of the same severity. In addition, visual, physical, and cognitive skills, all of which contribute to driving abilities, decrease with advancing age. The familiar “U”-shaped curve depicting the rate of fatalities per vehicle miles traveled, shows that the elderly experience a higher highway fatality rate than any other age group except teenagers. While the overall number of highway fatalities has decreased regularly since 1972, the number of fatalities of elderly travelers has continued to increase steadily. This increase is cause for concern for both the elderly driver and for other persons on the roads who migh tbe placed in danger through crashes involving elderly drivers.

  20. The importance of Probabilistic Safety Assessment in the careful study of risks involved to new nuclear power plant projects

    International Nuclear Information System (INIS)

    Mata, Jônatas F.C. da; Mesquita, Amir Z.

    2017-01-01

    The Fukushima Daiichi nuclear accident in Japan in 2011 has raised public fears about the actual safety of nuclear power plants in several countries. The response to this concern by government agencies and private companies has been objective and pragmatic in order to guarantee best practices in the design, construction, operation and decommissioning phases of nuclear reactors. In countries where the nucleo-electric matrix is consolidated, such as the United States, France and the United Kingdom, the safety assessment is carried out considering deterministic and probabilistic criteria. In the licensing stages of new projects, it is necessary to analyze and simulate the behavior of the nuclear power plant, when subjected to conditions that can lead to sequences of accidents. Each initiator event is studied and simulated through computational models, which allow the description and estimation of possible physical phenomena occurring in nuclear reactors. Probabilistic Safety Assessment (PSA) is fundamental in this process, as it studies in depth the sequences of events that can lead to the fusion of the nucleus of the nuclear reactor. Such sequences should be quantified in terms of probability of occurrence and your possible consequences, and organized through techniques such as Fault Tree Analysis and Event Tree Analysis. For these simulations, specialized computer codes for each type of phenomenon should be used, as well as databases based on experience gained in the operation of similar nuclear reactors. The present work will describe, in an objective way, the procedures for the realization of PSA and its applicability to the assurance of the operational reliability of the nuclear reactors, as well as a brief comparative between the approaches used in some countries traditionally users of thermonuclear energy and Brazil. By means of this analysis, it can be concluded that nuclear power is increasingly reliable and safe, being able to provide the necessary

  1. The importance of Probabilistic Safety Assessment in the careful study of risks involved to new nuclear power plant projects

    Energy Technology Data Exchange (ETDEWEB)

    Mata, Jônatas F.C. da, E-mail: jonatasfmata@yahoo.com.br [Universidade do Estado de Minas Gerais (UEMG), João Monlevade, MG (Brazil); Mesquita, Amir Z., E-mail: amir@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2017-07-01

    The Fukushima Daiichi nuclear accident in Japan in 2011 has raised public fears about the actual safety of nuclear power plants in several countries. The response to this concern by government agencies and private companies has been objective and pragmatic in order to guarantee best practices in the design, construction, operation and decommissioning phases of nuclear reactors. In countries where the nucleo-electric matrix is consolidated, such as the United States, France and the United Kingdom, the safety assessment is carried out considering deterministic and probabilistic criteria. In the licensing stages of new projects, it is necessary to analyze and simulate the behavior of the nuclear power plant, when subjected to conditions that can lead to sequences of accidents. Each initiator event is studied and simulated through computational models, which allow the description and estimation of possible physical phenomena occurring in nuclear reactors. Probabilistic Safety Assessment (PSA) is fundamental in this process, as it studies in depth the sequences of events that can lead to the fusion of the nucleus of the nuclear reactor. Such sequences should be quantified in terms of probability of occurrence and your possible consequences, and organized through techniques such as Fault Tree Analysis and Event Tree Analysis. For these simulations, specialized computer codes for each type of phenomenon should be used, as well as databases based on experience gained in the operation of similar nuclear reactors. The present work will describe, in an objective way, the procedures for the realization of PSA and its applicability to the assurance of the operational reliability of the nuclear reactors, as well as a brief comparative between the approaches used in some countries traditionally users of thermonuclear energy and Brazil. By means of this analysis, it can be concluded that nuclear power is increasingly reliable and safe, being able to provide the necessary

  2. Problems and risks involved in the projected storage of radioactive waste in a salt dome in the northwest of the FRG

    International Nuclear Information System (INIS)

    Mauthe, F.

    1979-01-01

    Current planning envisages long-term intermediate storage of radioactive waste and the exploration of the Gorleben salt dome by deep drilling in order to start appropriate mining work in case of favourable drilling results. The statements presented here on the problem of the 'Feasibility of ultimate storage of radioactive waste in salt deposits' (subject selected by the Government of the land Lower-Saxony) are aimed at informing the general public about the difficulties and problems involved in this waste disposal project and critically assess the arguments put forward by industry and licensing authorities in order to gain acceptance for this politically delicate project; the argumentation discussed here mainly refers to the field of geological science. (orig.) [de

  3. Effectiveness of a virtual intervention for primary healthcare professionals aimed at improving attitudes towards the empowerment of patients with chronic diseases: study protocol for a cluster randomized controlled trial (e-MPODERA project).

    Science.gov (United States)

    González-González, Ana Isabel; Orrego, Carola; Perestelo-Perez, Lilisbeth; Bermejo-Caja, Carlos Jesús; Mora, Nuria; Koatz, Débora; Ballester, Marta; Del Pino, Tasmania; Pérez-Ramos, Jeannet; Toledo-Chavarri, Ana; Robles, Noemí; Pérez-Rivas, Francisco Javier; Ramírez-Puerta, Ana Belén; Canellas-Criado, Yolanda; Del Rey-Granado, Yolanda; Muñoz-Balsa, Marcos José; Becerril-Rojas, Beatriz; Rodríguez-Morales, David; Sánchez-Perruca, Luis; Vázquez, José Ramón; Aguirre, Armando

    2017-10-30

    Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. This paper describes the protocol for a cluster randomized controlled trial. We will randomly assign 18 primary-care practices per participating region of Spain (Catalonia, Madrid and Canary Islands) to a virtual community of practice or to usual training. The primary-care practice will be the randomization unit and the primary healthcare professional will be the unit of analysis. We will need a sample of 270 primary healthcare professionals (general practitioners and nurses) and 1382 patients. We will perform randomization after professionals and patients are selected. We will ask the intervention group to participate for 12 months in a virtual community of practice based on a web 2.0 platform. We will measure the primary outcome using the Patient-Provider Orientation Scale questionnaire administered at baseline and after 12 months. Secondary outcomes will be the sociodemographic characteristics of health professionals, sociodemographic and clinical characteristics of patients, the Patient Activation Measure questionnaire for patient activation and outcomes regarding use of the virtual community of practice. We will calculate a linear mixed-effects regression to estimate the effect of participating in the virtual community of practice. This cluster randomized controlled trial will show whether a virtual intervention for primary healthcare professionals improves attitudes to the empowerment of patients with chronic diseases. ClicalTrials.gov, NCT02757781 . Registered on 25 April 2016. Protocol Version. PI15.01 22 January 2016.

  4. EMSP Project 70070: Reactivity of Primary Soil Minerals and Secondary Precipitates Beneath Leaking Hanford Waste Tanks - Final Report

    International Nuclear Information System (INIS)

    Nagy, Kathryn L.

    2004-01-01

    Since the late 1950s, leaks from 67 single-shell tanks at the Hanford Site have released about 1 million curies to the underlying sediments. The radioactive material was contained in water-based solutions generally characterized as having high pH values (basic solutions), high nitrate and nitrite concentrations, and high aluminum concentrations. The solutions were also hot, in some cases at or near boiling, as well as complex and highly variable in composition reflecting solutions obtained from multiple methods of reprocessing spent nuclear fuel. In order to understand the observed and probable distribution of radionuclides in the ground at Hanford, major reactions that likely occurred between the leaked fluids and the sediment minerals were investigated in laboratory experiments simulating environmental conditions. Reactions involving the dissolution of quartz and biotite and the simultaneous formation of new minerals were quantified at controlled pH values and temperature. Result s show that the dissolution of quartz and formation of new zeolite-like minerals could have altered the flow path of ground water and contaminant plumes and provided an uptake mechanism for positively-charged soluble radionuclides, such as cesium. The dissolution of biotite, a layered-iron-aluminum-silicate mineral, provided iron in a reduced form that could have reacted with negatively-charged soluble chromium, a toxic component of the wastes, to cause its reduction and precipitation as a new reduced-chromium mineral. The quantity of iron released in the experiments is sufficient to explain observations of reductions in dissolved chromium concentration in a plume beneath one Hanford tank. Fundamental data obtained in the project are the rates of the reactions at variable temperatures and pHs. Fundamental data were also obtained on aspects of the surface reactivity of clay or layered-silicate minerals, a small proportion of the total mass of the sediment minerals, but a large proportion

  5. European recommendations for primary prevention of congenital anomalies: A joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans

    DEFF Research Database (Denmark)

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention t...

  6. Cytotoxicity of synthetic cannabinoids on primary neuronal cells of the forebrain: the involvement of cannabinoid CB{sub 1} receptors and apoptotic cell death

    Energy Technology Data Exchange (ETDEWEB)

    Tomiyama, Ken-ichi; Funada, Masahiko, E-mail: mfunada@ncnp.go.jp

    2014-01-01

    The abuse of herbal products containing synthetic cannabinoids has become an issue of public concern. The purpose of this paper was to evaluate the acute cytotoxicity of synthetic cannabinoids on mouse brain neuronal cells. Cytotoxicity induced by synthetic cannabinoid (CP-55,940, CP-47,497, CP-47,497-C8, HU-210, JWH-018, JWH-210, AM-2201, and MAM-2201) was examined using forebrain neuronal cultures. These synthetic cannabinoids induced cytotoxicity in the forebrain cultures in a concentration-dependent manner. The cytotoxicity was suppressed by preincubation with the selective CB{sub 1} receptor antagonist AM251, but not with the selective CB{sub 2} receptor antagonist AM630. Furthermore, annexin-V-positive cells were found among the treated forebrain cells. Synthetic cannabinoid treatment induced the activation of caspase-3, and preincubation with a caspase-3 inhibitor significantly suppressed the cytotoxicity. These synthetic cannabinoids induced apoptosis through a caspase-3-dependent mechanism in the forebrain cultures. Our results indicate that the cytotoxicity of synthetic cannabinoids towards primary neuronal cells is mediated by the CB{sub 1} receptor, but not by the CB{sub 2} receptor, and further suggest that caspase cascades may play an important role in the apoptosis induced by these synthetic cannabinoids. In conclusion, excessive synthetic cannabinoid abuse may present a serious acute health concern due to neuronal damage or deficits in the brain. - Highlights: • Synthetic cannabinoids (classical cannabinoids, non-classical cannabinoids, and aminoalkylindole derivatives) induce cytotoxicity in mouse forebrain cultures. • Synthetic cannabinoid-induced cytotoxicity towards forebrain cultures is mediated by the CB{sub 1} receptor, but not by the CB{sub 2} receptor, and involves caspase-dependent apoptosis. • A high concentration of synthetic cannabinoids may be toxic to neuronal cells that express CB{sub 1} receptors.

  7. Cytotoxicity of synthetic cannabinoids on primary neuronal cells of the forebrain: the involvement of cannabinoid CB1 receptors and apoptotic cell death

    International Nuclear Information System (INIS)

    Tomiyama, Ken-ichi; Funada, Masahiko

    2014-01-01

    The abuse of herbal products containing synthetic cannabinoids has become an issue of public concern. The purpose of this paper was to evaluate the acute cytotoxicity of synthetic cannabinoids on mouse brain neuronal cells. Cytotoxicity induced by synthetic cannabinoid (CP-55,940, CP-47,497, CP-47,497-C8, HU-210, JWH-018, JWH-210, AM-2201, and MAM-2201) was examined using forebrain neuronal cultures. These synthetic cannabinoids induced cytotoxicity in the forebrain cultures in a concentration-dependent manner. The cytotoxicity was suppressed by preincubation with the selective CB 1 receptor antagonist AM251, but not with the selective CB 2 receptor antagonist AM630. Furthermore, annexin-V-positive cells were found among the treated forebrain cells. Synthetic cannabinoid treatment induced the activation of caspase-3, and preincubation with a caspase-3 inhibitor significantly suppressed the cytotoxicity. These synthetic cannabinoids induced apoptosis through a caspase-3-dependent mechanism in the forebrain cultures. Our results indicate that the cytotoxicity of synthetic cannabinoids towards primary neuronal cells is mediated by the CB 1 receptor, but not by the CB 2 receptor, and further suggest that caspase cascades may play an important role in the apoptosis induced by these synthetic cannabinoids. In conclusion, excessive synthetic cannabinoid abuse may present a serious acute health concern due to neuronal damage or deficits in the brain. - Highlights: • Synthetic cannabinoids (classical cannabinoids, non-classical cannabinoids, and aminoalkylindole derivatives) induce cytotoxicity in mouse forebrain cultures. • Synthetic cannabinoid-induced cytotoxicity towards forebrain cultures is mediated by the CB 1 receptor, but not by the CB 2 receptor, and involves caspase-dependent apoptosis. • A high concentration of synthetic cannabinoids may be toxic to neuronal cells that express CB 1 receptors

  8. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    Directory of Open Access Journals (Sweden)

    Lin Blossom Yen-Ju

    2007-06-01

    Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

  9. EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting

    Directory of Open Access Journals (Sweden)

    Garrido-Elustondo Sofia

    2010-07-01

    Full Text Available Abstract Background High blood pressure (HBP is a major risk factor for cardiovascular disease (CVD. European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD; Methods/Design This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups, all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg. All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded; Discussion The

  10. Collaboration processes and perceived effectiveness of integrated care projects in primary care: a longitudinal mixed-methods study.

    Science.gov (United States)

    Valentijn, Pim P; Ruwaard, Dirk; Vrijhoef, Hubertus J M; de Bont, Antoinette; Arends, Rosa Y; Bruijnzeels, Marc A

    2015-10-09

    Collaborative partnerships are considered an essential strategy for integrating local disjointed health and social services. Currently, little evidence is available on how integrated care arrangements between professionals and organisations are achieved through the evolution of collaboration processes over time. The first aim was to develop a typology of integrated care projects (ICPs) based on the final degree of integration as perceived by multiple stakeholders. The second aim was to study how types of integration differ in changes of collaboration processes over time and final perceived effectiveness. A longitudinal mixed-methods study design based on two data sources (surveys and interviews) was used to identify the perceived degree of integration and patterns in collaboration among 42 ICPs in primary care in The Netherlands. We used cluster analysis to identify distinct subgroups of ICPs based on the final perceived degree of integration from a professional, organisational and system perspective. With the use of ANOVAs, the subgroups were contrasted based on: 1) changes in collaboration processes over time (shared ambition, interests and mutual gains, relationship dynamics, organisational dynamics and process management) and 2) final perceived effectiveness (i.e. rated success) at the professional, organisational and system levels. The ICPs were classified into three subgroups with: 'United Integration Perspectives (UIP)', 'Disunited Integration Perspectives (DIP)' and 'Professional-oriented Integration Perspectives (PIP)'. ICPs within the UIP subgroup made the strongest increase in trust-based (mutual gains and relationship dynamics) as well as control-based (organisational dynamics and process management) collaboration processes and had the highest overall effectiveness rates. On the other hand, ICPs with the DIP subgroup decreased on collaboration processes and had the lowest overall effectiveness rates. ICPs within the PIP subgroup increased in control

  11. Design a Solid Waste Management Course for Primary School focus on Reduce-Reuse-Recycle : Project: WastED – Export of Education, Waste Management - Target market: Vietnam

    OpenAIRE

    Pham, Linh

    2014-01-01

    This product-oriented Bachelor’s thesis looks at waste-management education in primary schools. The primary objective of the study was to design a basic wastemanagement course, concisely packed in a booklet, ready-to-use for teachers and trainers. The outcome of the thesis, the booklet (content of the course) is expected to be used as one of the materials for the WastED project – Export of Education in Waste Management. The study is made up of theory sections and a product design se...

  12. Evidence-based development of school-based and family-involved prevention of overweight across Europe: The ENERGY-project's design and conceptual framework

    Directory of Open Access Journals (Sweden)

    Klepp Knut

    2010-05-01

    Full Text Available Abstract Background There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment. Methods Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1 systematic reviews of the literature, 2 secondary analyses of existing data, 3 focus group research, and 4 a cross European school-based survey. Results and discussion The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population. Conclusions The ENERGY-project is an international

  13. Co- and multimorbidity patterns in primary care based on episodes of care: results from the German CONTENT project.

    NARCIS (Netherlands)

    Laux, G.; Kuehlein, T.; Rosemann, T.J.; Szecsenyi, J.

    2008-01-01

    BACKGROUND: Due to technological progress and improvements in medical care and health policy the average age of patients in primary care is continuously growing. In equal measure, an increasing proportion of mostly elderly primary care patients presents with multiple coexisting medical conditions.

  14. Web-based screening for diabetic retinopathy in a primary care population: The EyeCheck Project

    NARCIS (Netherlands)

    Abramoff, M.D.; Suttorp-Schulten, M.S.A.

    2005-01-01

    The objective of this study was to evaluate the feasibility of ATA category 2 Web-based screening for diabetic retinopathy in a primary care population in the Netherlands. A total of 1,676 patients in a primary care setting, with diabetes, without known diabetic retinopathy, and without previous

  15. Translating 10 lessons from lean six sigma project in paper-based training site to electronic health record-based primary care practice: challenges and opportunities.

    Science.gov (United States)

    Aleem, Sohaib

    2013-01-01

    Lean Six Sigma is a well-proven methodology to enhance the performance of any business, including health care. The strategy focuses on cutting out waste and variation from the processes to improve the value and efficiency of work. This article walks through the journey of "green belt" training using a Lean Six Sigma approach and the implementation of a process improvement project that focused on wait time for patients to be examined in an urban academic primary care clinic without requiring added resources. Experiences of the training and the project at an urban paper-based satellite clinic have informed the planning efforts of a data and performance team, including implementing a 15-minute nurse "pre-visit" at primary care sites of an accountable care organization.

  16. Curriculum Integration in Distance Learning at Primary and Secondary Educational Levels on the Example of eTwinning Projects

    Science.gov (United States)

    Gajek, Elzbieta

    2018-01-01

    Curriculum integration is one of the concepts which has been discussed for years. Telecollaborative projects, which employ elements of distance learning, provide opportunities for putting the idea into practice. Analysis of eTwinning projects undertaken in Polish schools aims at demonstrating the integrative role of distance learning approaches…

  17. JOINT INVOLVEMENT IN SYPHILIS

    Directory of Open Access Journals (Sweden)

    T. I. Zlobina

    2016-01-01

    Full Text Available Joint involvement in syphilis has been considered as casuistry in recent years. At the same time, the high incidence of primary syphilis and the notified cases of late neurosyphilis may suggest that joint involvement in this disease is by no means always verified. Traditionally there are two forms of syphilitic arthritis: primary synovial (involving the articular membranes and sac and primary bone (involving the articular bones and cartilages ones. The paper describes the authors' clinical case of the primary bone form of articular syphilis in a 34-year-old man. 

  18. A quality improvement project to improve the effectiveness and patient-centredness of management of people with mild-to-moderate kidney disease in primary care.

    Science.gov (United States)

    Thomas, Nicola; Gallagher, Hugh; Jain, Neerja

    2014-01-01

    Chronic kidney disease (CKD) stages 3 to 5, affects 6-7% of the adult population and is an important risk factor for both advanced kidney disease and cardiovascular disease. This paper describes a quality improvement project that aimed to establish consistent implementation of best practice in people with stage 3-5 kidney disease who were managed in primary care. The intervention was a Care Bundle for CKD. The bundle included three evidence-based, high impact interventions based on National Institute for Care Excellence (NICE, 2008) guidance, with an additional and novel self-management element. 29 GP Practices in England and Wales began the study. They undertook training in clinical management of CKD and in facilitation of self-management, with the self-management content designed and led by patients. Practices were asked to report baseline and then monthly outcome data extracted from practice computer systems. The project team provided implementation and ongoing quality improvement support for participating Practices. Ten Practices dropped out of the study following the training. Data submissions were incomplete in six Practices who continued to apply the care bundle. At the project end, a decision was taken by the study team to perform the final analysis on those thirteen Practices which completed the project and submitted at least six sets of monthly Practice-level outcome data. In these Practices the Care Bundle was applied to under 20% of the registered CKD stage 3 to 5 population in 5 Practices, 20-29% in 3 Practices, 30-49% in 2 Practices and ≥50% in 3 Practices (998 patients in total). Of these, 671 patients (75%) agreed to the self-management component of the intervention. The reliability (at project end) in those who received the Bundle was 100%. The Bundle was applied to an additional 315 patients in the six Practices who completed the project but did not submit regular practice-level monthly data. In the thirteen remaining Practices, the achievement

  19. Learning effects of active involvement of secondary school students in scientific research within the Sparkling Science project "FlussAu:WOW!"

    Science.gov (United States)

    Poppe, Michaela; Zitek, Andreas; Scheikl, Sigrid; Heidenreich, Andrea; Kurz, Roman; Schrittwieser, Martin; Muhar, Susanne

    2014-05-01

    Due to immense technological and economic developments, human activities producing greenhouse gases, destructing ecosystems, changing landscapes and societies are influencing the world to such a degree, that the environment and human well-being are significantly affected. This results in a need to educate citizens towards a scientific understanding of complex socio-environmental systems. The OECD programme for international student assessment (PISA - http://www.pisa.oecd.org) investigated in detail the science competencies of 15-year-old students in 2006. The report documented that teenagers in OECD countries are mostly well aware of environmental issues but often know little about their causes or options to tackle these challenges in the future. For the integration of science with school learning and involving young people actively into scientific research Sparkling Science projects are funded by the Federal Ministry of Science and Research in Austria. Within the Sparkling Science Project "FlussAu:WOW!" (http://www.sparklingscience.at/de/projekte/574-flussau-wow-/) scientists work together with 15 to 18-year-old students of two Austrian High Schools over two years to assess the functions and processes in near natural and anthropogenically changed river floodplains. Within the first year of collaboration students, teachers and scientists elaborated on abiotic, biotic and spatial indicators for assessing and evaluating the ecological functionality of riverine systems. After a theoretical introduction students formulated research questions, hypotheses and planned and conducted field work in two different floodplain areas in Lower Austria. From the second year on, students are going to develop qualitative models on processes in river floodplain systems by means of the learning software "DynaLearn". The "DynaLearn" software is an engaging, interactive, hierarchically structured learning environment that was developed within the EU-FP7 project "DynaLearn" (http

  20. Promoting the inclusion of Afghan women and men in research: reflections from research and community partners involved in implementing a 'proof of concept' project.

    Science.gov (United States)

    Riggs, Elisha; Yelland, Jane; Szwarc, Josef; Casey, Sue; Chesters, Donna; Duell-Piening, Philippa; Wahidi, Sayed; Fouladi, Fatema; Brown, Stephanie

    2015-01-31

    With mounting evidence that poor maternal and child health outcomes are related to the social determinants of health, researchers need to engage with vulnerable and isolated communities to gather the evidence that is essential to determine appropriate solutions. Conventional research methods may not ensure the degree and quality of participation that is necessary for meaningful study findings. Participatory methods provide reciprocal opportunities for often excluded communities to both take part in, and guide the conduct of research. The Having a baby in a new country research project was undertaken to provide evidence about how women and men of refugee background experience health services at the time of having a baby. This two year, multifaceted proof of concept study comprised: 1) an organisational partnership to oversee the project; 2) a community engagement framework including: female and male Afghan community researchers, community and sector stakeholder advisory groups and community consultation and engagement. Inclusive research strategies that address power imbalances in research, and diversity of and within communities, are necessary to obtain the evidence required to address health inequalities in vulnerable populations. Such an approach involves mindfully adapting research processes to ensure that studies have regard for the advice of community members about the issues that affect them. Researchers have much to gain by committing time and resources to engaging communities in reciprocal ways in research processes.

  1. Secondary Science Teachers' and Students' Involvement in a Primary School Community of Science Practice: How It Changed Their Practices and Interest in Science

    Science.gov (United States)

    Forbes, Anne; Skamp, Keith

    2016-02-01

    MyScience is a primary science education initiative in which being in a community of practice is integral to the learning process. In this initiative, stakeholder groups—primary teachers, primary students and mentors—interact around the `domain' of `investigating scientifically'. This paper builds on three earlier publications and interprets the findings of the views of four secondary science teachers and five year 9 secondary science students who were first-timer participants—as mentors—in MyScience. Perceptions of these mentors' interactions with primary students were analysed using attributes associated with both `communities of practice' and the `nature of science'. Findings reveal that participation in MyScience changed secondary science teachers' views and practices about how to approach the teaching of science in secondary school and fostered primary-secondary links. Year 9 students positively changed their views about secondary school science and confidence in science through participation as mentors. Implications for secondary science teaching and learning through participation in primary school community of science practice settings are discussed.

  2. Assessment of What/For What? Teachers' and Head Teachers' Views on Using Well-Being and Involvement as a Screening Measure for Conducting Baseline Assessment on School Entry in English Primary Schools

    Science.gov (United States)

    Guimaraes, Sofia; Howe, Sally; Clausen, Sigrid Brogaard; Cottle, Michelle

    2016-01-01

    Baseline assessment has recently been trialled as part of an accountability measure in English primary schools. The research presented in this colloquium examines the views of teachers related to using well-being and involvement indicators as a starting point for baseline assessment. The findings suggest that the focus on well-being was welcomed…

  3. Teaching and Learning English through the Project Work. Innovative Pilot Teaching Project in the Pre-school and Primary School Pompeu Fabra, Vallirana, Barcelona. Investigation in Action comprehension in Primary Education

    Directory of Open Access Journals (Sweden)

    Verónica Asensio Arjona

    2017-12-01

    Full Text Available In order to impulse a methodology focused on the student, teachers have to establish the learning conditions that allow them to develop the experimentation, creativity, challenge and individual development. Below this framework, a Project Work of Teaching-Learning English as a foreign language is designed and applied at the state school Pompeu Fabra, Vallirana, Barcelona during the scholar year 2013-2014. The methodology of project work is chosen because it is the most appropriated methodology to achieve a learning focused on the student. It is executed an Action Research of the application of this Project in order to evaluate the competential progress of students. Quantitative and qualitative tools are used to execute the research. The quantitative tools are a standardized test and a Survey. The first one is applied in two moments, in October and in June, to evaluate the progress. The results are analyzed with Excel Tools to calculate the general average and each competence average. On the other hand, the qualitative tools that are used are: The Satisfaction and Self-perception Survey, validated by the University of Barcelona; the Teacher Diary of Observation; and an Evaluation Table for the Speaking. The triangulation of all the information show the English competence of student’s increase; as well as the interest of students in the English learning and the satisfaction in doing it also increases. Moreover, the Project Work is highly qualified by students as: the best activity to learn and enjoy it. This research obtains satisfactory results. It is a sample of innovation in teaching and learning English as a foreign language. As a result, the school decides to continue using the Project Work in the next scholar year.

  4. International Multicenter Study on the Impact of Extracapsular Lymph Node Involvement in Primary Surgery Adenocarcinoma of the Esophagus on Overall Survival and Staging Systems

    NARCIS (Netherlands)

    Nafteux, Philippe R.; Lerut, Antoon M.; Moons, Johnny; Hölscher, Arnulf H.; Bollschweiler, Elfriede; van Berge Henegouwen, Mark I.; Lagarde, Sjoerd M.; van Lanschot, Jan J.; Messager, Mathieu; Mariette, Christophe; D'Journo, Xavier B.; Thomas, Pascal A.; de Leyn, Paul R.

    2015-01-01

    Objective:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI)

  5. [What are we doing in neighborhoods? Description of health-promoting community activities in primary care: the FrAC Project].

    Science.gov (United States)

    March, Sebastià; Jordán Martín, Matilde; Montaner Gomis, Isabel; Benedé Azagra, Carmen Belén; Elizalde Soto, Lázaro; Ramos, María

    2014-01-01

    To describe the health-promoting community activities developed in primary health care and compare types of activities and how they are performed among autonomous regions. A descriptive multicenter study was carried out in primary care in 5 Spanish regions. We included community activities consisting of non-sporadic activities, carried out in the previous year, with the participation of the primary care team, and the active participation of the community or as a cross-sector activity. The persons responsible for each of the 194 teams were asked if the team participated in community activities and, if so, a questionnaire was completed by the person responsible for each activity. The variables consisted of the topic addressed, the target population, the professionals involved, the time and scope of implementation, evaluation, theoretical perspectives, network registration, the involvement of the community and other agents, and evaluation of this involvement. A descriptive analysis was performed, stratified by region. We identified 183 community activities in 104 teams. Although there was wide variability among regions, most activities were related to general health, nutrition and emotional-sexual health and targeted the general population, children or parents and were carried out in educational or health centers. Participating professionals had a median of 4 years of experience and a median of 2.8 professionals were involved in each activity. A total of 72.5% of the activities were performed during working hours, 75% were evaluated, and 70% were supported by theoretical and methodological perspectives. Non-health sectors were involved in 65%, local government in 60%, and nongovernmental organizations in 58.5%. Nurses were involved in 85.8% of the activities, physicians in 38.5%, and social workers in 35%. Substantial variability was detected among regions. Wide variability was found in the types of activities and their application among the community activities

  6. Examination of a board game approach to children's involvement in family-based weight management vs. traditional family-based behavioral counseling in primary care.

    Science.gov (United States)

    Sen, Merve; Uzuner, Arzu; Akman, Mehmet; Bahadir, Aliye Tugba; Borekci, Nazire Oncul; Viggiano, Emanuela

    2018-05-29

    The most effective intervention model for childhood obesity is known as family-based behavioral group treatments. There are also studies that investigate the effects of educational games for children to gain healthy eating and physical exercise habits. The aim of this study was to compare the efficacy of a family-based group treatment with an educational game (Kaledo) intervention in childhood obesity. Kaledo is a board game that was designed to improve nutritional knowledge and healthy life style habits. It is played with nutrition and activity cards that players can select from, and a total score is calculated in the end of the game according to energy intake and expenditure. Obese children between 9 and 12 ages were involved in this study. Participants randomly divided into behavioral and game intervention groups. Clinical evaluation was performed in the first and second counseling in both groups. Marmara University Family Medicine Department Obese Children and Adolescents Interview Form, Physical Activity Evaluation Form, and Three-day Food Record Form were used for this purpose. Strengths and Difficulties Questionnaire-Parent Report Version and Children's Depression Inventory were used for the assessment of psychiatric symptoms. After the clinical evaluation, an education session about healthy eating and physical activity was attended by both groups. After that, for the behavioral groups, parents and children were assigned to different groups, while for the game intervention group, parents were assigned to behavioral sessions and children were assigned to game (Kaledo) sessions. A total of six sessions with 1-h duration and 2-week interval were performed in both groups. Height and weight were measured in each session and analysis was performed on the data of the children who participated in all of the sessions. Although a total of 108 children were clinically evaluated, 52 children and their parents, 26 in the behavioral group and 26 in the game intervention

  7. Research and Development Projects with ICT and students as learning designers in Primary Schools: A methodological challenge

    DEFF Research Database (Denmark)

    Levinsen, Karin Ellen Tweddell; Sørensen, Birgitte Holm; Tosca, Susana

    of how: • ICT supports students learning, • ICT release time for more teaching, and • teachers digital literacy impact on the role of ICT in the educational practice. Further the call required collaboration between universities and university colleges in order to disseminate knowledge and new practices......In this paper we present some methodological challenges that emerged during the process of shaping the research design for the comprehensive and complex research project Children as learning designers in a digital school. The project is the realization of our proposal to a research call from...... the Danish Ministry of Education named Development projects and pilot school experiments (Udviklingsprojekter med demonstrationsskoleforsøg vedr. it i folkeskolen – see Undervisningsministeriet 2013) in the spring 2013. The call was based on a governmental decision to allocate 500 million DKR to increase...

  8. The Impact an Oratory Project generates to Primary School Students who live in Rural Areas of Cartago

    Directory of Open Access Journals (Sweden)

    María Gabriela Amador-Solano

    2014-03-01

    Full Text Available This article aims at showing the development and relevance of an extension project in seven rural schools located in “circuito 05” in the central area of Cartago. The main goal is to enhance oral commu­nication in elementary school students. The project was designed as a training workshop for the teach­ers in the chosen schools in order to be taught to students by implementing an oratory club. In each student´s dissertation, the researchers observed the enthusiasm that the project caused in the schools. Objectives, contents, activities, assessment and observations were designed in a didactic plan to be used upon needs of institutions.

  9. Possible pressurized thermal shock events during large primary to secondary leakage. The Hungarian AGNES project and PRISE accident scenarios in VVER-440/V213 type reactor

    Energy Technology Data Exchange (ETDEWEB)

    Perneczky, L. [KFKI Atomic Energy Research Inst., Budabest (Hungary)

    1997-12-31

    Nuclear power plants of WWER-440/213-type have several special features. Consequently, the transient behaviour of such a reactor system should be different from the behaviour of the PWRs of western design. The opening of the steam generator (SG) collector cover, as a specific primary to secondary circuit leakage (PRISE) occurring in WWER-type reactors happened first time in Rovno NPP Unit I on January 22, 1982. Similar accident was studied in the framework of IAEA project RER/9/004 in 1987-88 using the RELAP4/mod6 code. The Hungarian AGNES (Advanced General and New Evaluation of Safety) project was performed in the period 1991-94 with the aim to reassess the safety of the Paks NPP using state-of-the-art techniques. The project comprised three type of analyses for the primary to secondary circuit leakages: Design Basis Accident (DBA) analyses, Pressurized Thermal Shock (PTS) study and deterministic analyses for Probabilistic Safety Analysis (PSA). Major part of the thermohydraulic analyses has been performed by the RELAP5/mod2.5/V251 code version with two input models. 32 refs.

  10. Possible pressurized thermal shock events during large primary to secondary leakage. The Hungarian AGNES project and PRISE accident scenarios in VVER-440/V213 type reactor

    Energy Technology Data Exchange (ETDEWEB)

    Perneczky, L [KFKI Atomic Energy Research Inst., Budabest (Hungary)

    1998-12-31

    Nuclear power plants of WWER-440/213-type have several special features. Consequently, the transient behaviour of such a reactor system should be different from the behaviour of the PWRs of western design. The opening of the steam generator (SG) collector cover, as a specific primary to secondary circuit leakage (PRISE) occurring in WWER-type reactors happened first time in Rovno NPP Unit I on January 22, 1982. Similar accident was studied in the framework of IAEA project RER/9/004 in 1987-88 using the RELAP4/mod6 code. The Hungarian AGNES (Advanced General and New Evaluation of Safety) project was performed in the period 1991-94 with the aim to reassess the safety of the Paks NPP using state-of-the-art techniques. The project comprised three type of analyses for the primary to secondary circuit leakages: Design Basis Accident (DBA) analyses, Pressurized Thermal Shock (PTS) study and deterministic analyses for Probabilistic Safety Analysis (PSA). Major part of the thermohydraulic analyses has been performed by the RELAP5/mod2.5/V251 code version with two input models. 32 refs.

  11. Primary epidural lymphoma without vertebral involvement in a HIV-positive patient; Linfoma epidural primario sin afectacion vertebral en un paciente VIH positivo

    Energy Technology Data Exchange (ETDEWEB)

    Perez, M. O.; Grive, E.; Quiroga, S.; Rovira, A. [Hospital General Universitari Vall d`Hebron. Barcelona. (Spain)

    1999-05-01

    Epidural involvement is rarely associated with lymphoma, it being more typical of non-Hodgkin`s lymphoma in advanced stages of the disease. The invasion of the epidural space is usually caused by the extension of a paravertebral mass or by the affected vertebrae. However, the epidural space alone can be involved. We present a case of epidural lymphoma in a patient who presented with clinical evidence of spinal cord compression. Magnetic resonance disclosed the existence of an epidural mass compressing and displacing the spinal cord without involving the adjacent vertebra or the associated paravertebral mass. (Author) 9 refs.

  12. Helwan University Project Developing Primary School Pupils' Abilities and Skills at Some Egyptian Underprivileged Areas (Slums). (Field Study)

    Science.gov (United States)

    El-Tayeb, Mahmoud N.; El Nashar, Mohamed; Zeid, Mai M.; El-Sayed, Magda; Ramadan, Mohamed A.; Hamdi, Safia M.; El-Affy, Nabila; Ebeid, Amina K.; El-Marasi, Sonia S.; Abou-Elmahty, Maher

    2010-01-01

    Through directing concerted efforts and educational services of seven Faculties of Helwan University towards socially underprivileged pupils in slum areas (EL-Marg area in big Cairo) this research project had two main aims: firstly, modifying a set of arbitrary behaviors of those pupils, in a trial to develop some behavior skills associated with…

  13. Goal Attainment Scaling: A Primary Method of Treatment and Program Evaluation in Project SAIL - A Special Education Dropout Prevention Program.

    Science.gov (United States)

    Harris, Linda Hall; Thompson, John L.

    The manual discusses Project SAIL's (a special dropout prevention program) use of Goal Attainment Scaling as part of individualized education plans in the treatment of troubled adolescents and in overall program evaluation. The scaling is characterized as an explicit, respectful treatment contact through which the adolescent can learn to set…

  14. Effective Teaching of Able Pupils in the Primary School: The Findings of the Oxfordshire Effective Teachers of Able Pupils Project.

    Science.gov (United States)

    Eyre, Deborah; Coates, David; Fitzpatrick, Mary; Higgins, Chris; McClure, Lynne; Wilson, Helen; Chamberlin, Rosemary

    2002-01-01

    A review of British research on effective teaching of able students leads to a report on the Oxfordshire Effective Teachers of Able Pupils Project. This study found effective teachers shared similar beliefs about learning, had empathy with the needs of able children, created a secure classroom environment, held high expectations, used…

  15. Informal care givers’ experiences with support in primary palliative care when a case manager is involved: a descriptive study in the Netherlands.

    NARCIS (Netherlands)

    Plas, A.G.M. van der; Francke, A.L.; Deliens, L.; Jansen, W.J.J.; Vissers, K.C.; Onwuteaka-Philipsen, B.D.

    2017-01-01

    Introduction: Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal care givers. The case manager provides support in addition to the care provided by the home care nurse and

  16. Targeted prevention of lifestyle related diseases in the primary care sector – results from the TOF pilot project

    DEFF Research Database (Denmark)

    Bruun Larsen, Lars; Thilsing, Trine

    This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle-related dise...... is facilitated by a digital support system. The pilot makes use of both quantitative and qualitative research methods....... prevention and health promotion is required. This has been attempted in past efforts by offering individual preventive health checks to the general population. However, the evidence on the effectiveness of this approach is mixed. Several systematic reviews, on the other hand, suggest that health checks......This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle...

  17. Involvement of the anterior cingulate cortex in time-based prospective memory task monitoring: An EEG analysis of brain sources using Independent Component and Measure Projection Analysis.

    Directory of Open Access Journals (Sweden)

    Gabriela Cruz

    Full Text Available Time-based prospective memory (PM, remembering to do something at a particular moment in the future, is considered to depend upon self-initiated strategic monitoring, involving a retrieval mode (sustained maintenance of the intention plus target checking (intermittent time checks. The present experiment was designed to explore what brain regions and brain activity are associated with these components of strategic monitoring in time-based PM tasks.24 participants were asked to reset a clock every four minutes, while performing a foreground ongoing word categorisation task. EEG activity was recorded and data were decomposed into source-resolved activity using Independent Component Analysis. Common brain regions across participants, associated with retrieval mode and target checking, were found using Measure Projection Analysis.Participants decreased their performance on the ongoing task when concurrently performed with the time-based PM task, reflecting an active retrieval mode that relied on withdrawal of limited resources from the ongoing task. Brain activity, with its source in or near the anterior cingulate cortex (ACC, showed changes associated with an active retrieval mode including greater negative ERP deflections, decreased theta synchronization, and increased alpha suppression for events locked to the ongoing task while maintaining a time-based intention. Activity in the ACC was also associated with time-checks and found consistently across participants; however, we did not find an association with time perception processing per se.The involvement of the ACC in both aspects of time-based PM monitoring may be related to different functions that have been attributed to it: strategic control of attention during the retrieval mode (distributing attentional resources between the ongoing task and the time-based task and anticipatory/decision making processing associated with clock-checks.

  18. Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey.

    Science.gov (United States)

    Su, Meng; Zhang, Qiuli; Lu, Jiapeng; Li, Xi; Tian, Na; Wang, Yun; Yip, Winnie; Cheng, Kar Keung; Mensah, George A; Horwitz, Ralph I; Mossialos, Elias; Krumholz, Harlan M; Jiang, Lixin

    2017-08-28

    China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers. The central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China. NCT02953926. © 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.

  19. HANFORD DST THERMAL & SEISMIC PROJECT DYTRAN ANALYSIS OF SEISMICALLY INDUCED FLUID STRUCTURE INTERACTION IN A HANFORD DOUBLE SHELL PRIMARY TANK

    Energy Technology Data Exchange (ETDEWEB)

    MACKEY TC; RINKER MW; ABATT FG

    2007-02-14

    Revision 0A of this document contains new Appendices C and D. Appendix C contains a re-analysis of the rigid and flexible tanks at the 460 in. liquid level and was motivated by recommendations from a Project Review held on March 20-21, 2006 (Rinker et al Appendix E of RPP-RPT-28968 Rev 1). Appendix D contains the benchmark solutions in support of the analyses in Appendix C.

  20. FAR5, a fatty acyl-coenzyme A reductase, is involved in primary alcohol biosynthesis of the leaf blade cuticular wax in wheat (Triticum aestivum L.).

    Science.gov (United States)

    Wang, Yong; Wang, Meiling; Sun, Yulin; Wang, Yanting; Li, Tingting; Chai, Guaiqiang; Jiang, Wenhui; Shan, Liwei; Li, Chunlian; Xiao, Enshi; Wang, Zhonghua

    2015-03-01

    A waxy cuticle that serves as a protective barrier against non-stomatal water loss and environmental damage coats the aerial surfaces of land plants. It comprises a cutin polymer matrix and waxes. Cuticular waxes are complex mixtures of very long chain fatty acids (VLCFAs) and their derivatives. Results show that primary alcohols are the major components of bread wheat (Triticum aestivum L.) leaf blade cuticular waxes. Here, the characterization of TaFAR5 from wheat cv Xinong 2718, which is allelic to TAA1b, an anther-specific gene, is reported. Evidence is presented for a new function for TaFAR5 in the biosynthesis of primary alcohols of leaf blade cuticular wax in wheat. Expression of TaFAR5 cDNA in yeast (Saccharomyces cerevisiae) led to production of C22:0 primary alcohol. The transgenic expression of TaFAR5 in tomato (Solanum lycopersicum) cv MicroTom leaves resulted in the accumulation of C26:0, C28:0, and C30:0 primary alcohols. TaFAR5 encodes an alcohol-forming fatty acyl-coenzyme A reductase (FAR). Expression analysis revealed that TaFAR5 was expressed at high levels in the leaf blades, anthers, pistils, and seeds. Fully functional green fluorescent protein-tagged TaFAR5 protein was localized to the endoplasmic reticulum (ER), the site of primary alcohol biosynthesis. SDS-PAGE analysis indicated that the TaFAR5 protein possessed a molecular mass of 58.4kDa, and it was also shown that TaFAR5 transcript levels were regulated in response to drought, cold, and abscisic acid (ABA). Overall, these data suggest that TaFAR5 plays an important role in the synthesis of primary alcohols in wheat leaf blade. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

    Science.gov (United States)

    Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

    2018-06-05

    Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

  2. HANFORD DOUBLE-SHELL TANK THERMAL and SEISMIC PROJECT. DYTRAN ANALYSIS OF SEISMICALLY INDUCED FLUID-STRUCTURE INTERACTION IN A HANFORD DOUBLE-SHELL PRIMARY TANK

    International Nuclear Information System (INIS)

    MACKEY, T.C.

    2006-01-01

    M and D Professional Services, Inc. (M and D) is under subcontract to Pacific Northwest National Laboratories (PNNL) to perform seismic analysis of the Hanford Site Double-Shell Tanks (DSTs) in support of a project entitled ''Double-Shell Tank (DSV Integrity Project-DST Thermal and Seismic Analyses)''. The overall scope of the project is to complete an up-to-date comprehensive analysis of record of the DST System at Hanford in support of Tri-Party Agreement Milestone M-48-14. The work described herein was performed in support of the seismic analysis of the DSTs. The thermal and operating loads analysis of the DSTs is documented in Rinker et al. (2004). The overall seismic analysis of the DSTs is being performed with the general-purpose finite element code ANSYS'. The global model used for the seismic analysis of the DSTs includes the DST structure, the contained waste, and the surrounding soil. The seismic analysis of the DSTs must address the fluid-structure interaction behavior and sloshing response of the primary tank and contained liquid. ANSYS has demonstrated capabilities for structural analysis, but has more limited capabilities for fluid-structure interaction analysis. The purpose of this study is to demonstrate the capabilities and investigate the limitations of the finite element code MSC.Dytranz for performing a dynamic fluid-structure interaction analysis of the primary tank and contained waste. To this end, the Dytran solutions are benchmarked against theoretical solutions appearing in BNL 1995, when such theoretical solutions exist. When theoretical solutions were not available, comparisons were made to theoretical solutions to similar problems, and to the results from ANSYS simulations. Both rigid tank and flexible tank configurations were analyzed with Dytran. The response parameters of interest that are evaluated in this study are the total hydrodynamic reaction forces, the impulsive and convective mode frequencies, the waste pressures, and slosh

  3. Cooperative observations of air showers in Tasmania looking for anisotropies in 1013 - 1014 eV primaries (COALA project)

    International Nuclear Information System (INIS)

    Fenton, A.G.; Fenton, K.B.; Humble, J.E.

    1981-01-01

    Observations of cosmic ray air showers (median primary energy: 5.10 13 eV) in Tasmania have been planned to start during 1981. The observations will be carried out through collaboration of the Hobart and Nagoya groups, in order to catch cosmic ray flows in a somewhat stereoscopic manner with simultaneous observations in the northern hemisphere (Mt. Norikura). The air shower array consists of 18 unit trays of 4 m 2 proportional counters deployed over an area of 20 m x 160 m. The shower frequency in a fundamental coincidence mode is expected to be about 16,000 events per hour

  4. Segmental distribution and morphometric features of primary sensory neurons projecting to the tibial periosteum in the rat.

    Directory of Open Access Journals (Sweden)

    Tadeusz Cichocki

    2004-07-01

    Full Text Available Previous reports have demonstrated very rich innervation pattern in the periosteum. Most of the periosteal fibers were found to be sensory in nature. The aim of this study was to identify the primary sensory neurons that innervate the tibial periosteum in the adult rat and to describe the morphometric features of their perikarya. To this end, an axonal fluorescent carbocyanine tracer, DiI, was injected into the periosteum on the medial surface of the tibia. The perikarya of the sensory fibers were traced back in the dorsal root ganglia (DRG L1-L6 by means of fluorescent microscopy on cryosections. DiI-containing neurons were counted in each section and their segmental distribution was determined. Using PC-assisted image analysis system, the size and shape of the traced perikarya were analyzed. DiI-labeled sensory neurons innervating the periosteum of the tibia were located in the DRG ipsilateral to the injection site, with the highest distribution in L3 and L4 (57% and 23%, respectively. The majority of the traced neurons were of small size (area < 850 microm2, which is consistent with the size distribution of CGRP- and SP-containing cells, regarded as primary sensory neurons responsible for perception of pain and temperature. A small proportion of labeled cells had large perikarya and probably supplied corpuscular sense receptors observed in the periosteum. No differences were found in the shape distribution of neurons belonging to different size classes.

  5. Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: An International Primary CNS Lymphoma Collaborative Group report

    NARCIS (Netherlands)

    N.D. Doolittle (Nancy); L.E. Abrey (Lauren); T.N. Shenkier (Tamara); T. Siegal (Tali); J.E.C. Bromberg (Jacolien); E.A. Neuwelt (Edward); C. Soussain (Carole); K. Jahnke (Kristoph); P. Johnston (Patrick); G. Illerhaus (Gerald); D. Schiff (David); T.T. Batchelor (Tracy); S. Montoto (Silvia); D.F. Kraemer (Dale); E. Zucca (Emanuele)

    2008-01-01

    textabstractIsolated central nervous system (CNS) relapse involving the brain parenchyma is a rare complication of systemic non-Hodgkin lymphoma. We retrospectively analyzed patient characteristics, management, and outcomes of this complication. After complete response to initial non-Hodgkin

  6. Tinker Tailor Robot Pi -- The Project

    Science.gov (United States)

    Bianchi, Lynne

    2017-01-01

    Tinker Tailor Robot Pi (TTRP) is an innovative curriculum development project, which started in September 2014. It involves in-service primary and secondary teachers, university academic engineers, business partners and pupils at Key Stages 1, 2 and 3 (ages 5-14). The focus of the work has been to explore how a pedagogy for primary engineering…

  7. Telemedicine and E-Learning in a Primary Care Setting in Sudan: The Experience of the Gezira Family Medicine Project.

    Science.gov (United States)

    Mohamed, K G; Hunskaar, S; Abdelrahman, S H; Malik, E M

    2015-01-01

    Information and communication technology (ICT) is progressively used in the health sector (e-health), to provide health care in a distance (telemedicine), facilitate medical education (e-learning), and manage patients' information (electronic medical records, EMRs). Gezira Family Medicine Project (GFMP) in Sudan provides a 2-year master's degree in family medicine, with ICT fully integrated in the project. This cross-sectional study describes ICT implementation and utilization at the GFMP for the years 2011-2012. Administrative data was used to describe ICT implementation, while questionnaire-based data was used to assess candidates' perceptions and satisfaction. In the period from April 2011 to December 2012, 3808 telemedicine online consultations were recorded and over 165000 new patients' EMRs were established by the study subjects (125 candidates enrolled in the program). Almost all respondents confirmed the importance of telemedicine. The majority appreciated also the importance of using EMRs. Online lectures were highly rated by candidates in spite of the few challenges encountered by combining service provision with learning activity. Physicians highlighted some patients' concerns about the use of telemedicine and EMRs during clinical consultations. Results from this study confirmed the suitability of ICT use in postgraduate training in family medicine and in service provision.

  8. Dyslipidemia in primary care – prevalence, recognition, treatment and control: data from the German Metabolic and Cardiovascular Risk Project (GEMCAS

    Directory of Open Access Journals (Sweden)

    Wasem Jürgen

    2008-10-01

    Full Text Available Abstract Background Current guidelines from the European Society of Cardiology (ESC define low thresholds for the diagnosis of dyslipidemia using total cholesterol (TC and LDL-cholesterol (LDL-C to guide treatment. Although being mainly a prevention tool, its thresholds are difficult to meet in clinical practice, especially primary care. Methods In a nationwide study with 1,511 primary care physicians and 35,869 patients we determined the prevalence of dyslipidemia, its recognition, treatment, and control rates. Diagnosis of dyslipidemia was based on TC and LDL-C. Basic descriptive statistics and prevalence rate ratios, as well as 95% confidence intervals were calculated. Results Dyslipidemia was highly frequent in primary care (76% overall. 48.6% of male and 39.9% of female patients with dyslipidemia was diagnosed by the physicians. Life style intervention did however control dyslipidemia in about 10% of patients only. A higher proportion (34.1% of male and 26.7% female was controlled when receiving pharmacotherapy. The chance to be diagnosed and subsequently controlled using pharmacotherapy was higher in male (PRR 1.15; 95%CI 1.12–1.17, in patients with concomitant cardiovascular risk factors, in patients with hypertension (PRR 1.20; 95%CI 1.05–1.37 and cardiovascular disease (PRR 1.46; 95%CI 1.29–1.64, previous myocardial infarction (PRR 1.32; 95%CI 1.19–1.47, and if patients knew to be hypertensive (PRR 1.18; 95%CI 1.04–1.34 or knew about their prior myocardial infarction (PRR 1.17; 95%CI 1.23–1.53. Conclusion Thresholds of the ESC seem to be difficult to meet. A simple call for more aggressive treatment or higher patient compliance is apparently not enough to enhance the proportion of controlled patients. A shift towards a multifactorial treatment considering lifestyle interventions and pharmacotherapy to reduce weight and lipids may be the only way in a population where just to be normal is certainly not ideal.

  9. Assessment of an enhanced program for depression management in primary care: a cluster randomized controlled trial. The INDI project (Interventions for Depression Improvement

    Directory of Open Access Journals (Sweden)

    Hernández Josep M

    2007-09-01

    Full Text Available Abstract Background Most depressed patients are attended at primary care. However, there are significant shortcomings in the diagnosis, management and outcomes of these patients. The aim of this study is to determine whether the implementation of a structured programme for managing depression will provide better health outcomes than usual management. Methods/Design Design: A cluster-randomized controlled trial involving two groups, one of which is the control group consisting of patients who are treated for depression in the usual way and the other is the intervention group consisting of patients on a structured programme for treating depression. Setting: 20 primary care centres in the province of Tarragona (Spain Sample: 400 patients over 18 years of age who have experienced an episode of major depression (DSM-IV and who need to initiate antidepressant treatment Intervention: A multi-component programme with clinical, educational and organisational procedures that includes training for the health care provider and evidence-based clinical guidelines. It also includes primary care nurses working as care-managers who provide educational and emotional support for the patients and who are responsible for active and systematic clinical monitoring. The programme aims to improve the primary care/specialized level interface. Measurements: The patients will be monitored by telephone interviews. The interviewer will not know which group the patient belongs to (blind trial. These interviews will be given at 0, 3, 6 and 12 months. Main variables: Severity of the depressive symptoms, response rate and remission rate. Analysis: Outcomes will be analyzed on an intent-to-treat basis and the unit of analysis will be the individual patient. This analysis will take into account the effect of study design on potential lack of independence between observations within the same cluster. Discussion The effectiveness of caring for depression in primary care can be

  10. The challenge of involving elderly patients in primary care by using an electronic communication tool with their professionals: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Catharina Carolina de Jong

    2017-11-01

    Conclusion: Congredi was usable for patient-systems. The barriers found seem not to be tool-related but primarily user-related. An important barrier for daily use was limited active participation of involved professionals in a complete feedback loop. Potential for future implementation was found, as patient-systems were intrinsically motivated for better feedback with the professionals, even though in this study it only partly met their expectations.

  11. HANFORD DOUBLE-SHELL TANK THERMAL and SEISMIC PROJECT-ANSYS BENCHMARK ANALYSIS OF SEISMICALLY INDUCED FLUID-STRUCTURE INTERACTION IN A HANFORD DOUBLE-SHELL PRIMARY TANK

    International Nuclear Information System (INIS)

    MACKEY, T.C.

    2006-01-01

    M and D Professional Services, Inc. (M and D) is under subcontract to Pacific Northwest National Laboratories (PNNL) to perform seismic analysis of the Hanford Site Double-Shell Tanks (DSTs) in support of a project entitled ''Double-Shell Tank (DSV Integrity Project-DST Thermal and Seismic Analyses)''. The overall scope of the project is to complete an up-to-date comprehensive analysis of record of the DST System at Hanford in support of Tri-Party Agreement Milestone M-48-14. The work described herein was performed in support of the seismic analysis of the DSTs. The thermal and operating loads analysis of the DSTs is documented in Rinker et al. (2004). The overall seismic analysis of the DSTs is being performed with the general-purpose finite element code ANSYS. The overall model used for the seismic analysis of the DSTs includes the DST structure, the contained waste, and the surrounding soil. The seismic analysis of the DSTs must address the fluid-structure interaction behavior and sloshing response of the primary tank and contained liquid. ANSYS has demonstrated capabilities for structural analysis, but the capabilities and limitations of ANSYS to perform fluid-structure interaction are less well understood. The purpose of this study is to demonstrate the capabilities and investigate the limitations of ANSYS for performing a fluid-structure interaction analysis of the primary tank and contained waste. To this end, the ANSYS solutions are benchmarked against theoretical solutions appearing in BNL 1995, when such theoretical solutions exist. When theoretical solutions were not available, comparisons were made to theoretical solutions of similar problems and to the results from Dytran simulations. The capabilities and limitations of the finite element code Dytran for performing a fluid-structure interaction analysis of the primary tank and contained waste were explored in a parallel investigation (Abatt 2006). In conjunction with the results of the global ANSYS

  12. Keys to success of a community of clinical practice in primary care: a qualitative evaluation of the ECOPIH project.

    Science.gov (United States)

    Lacasta Tintorer, David; Manresa Domínguez, Josep Maria; Pujol-Rivera, Enriqueta; Flayeh Beneyto, Souhel; Mundet Tuduri, Xavier; Saigí-Rubió, Francesc

    2018-05-09

    The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. The objective of this article is to explore healthcare professionals' views on communities of clinical practice (CoCPs) and the changes that need to be made in an uncontrolled real-life setting after more than two years of use. A descriptive-interpretative qualitative study was conducted on a total of 29 healthcare professionals who were users and non-users of a CoCP using 2 focus groups, 3 triangular groups and 5 individual interviews. There were 18 women, 21 physicians and 8 nurses. Of the interviewees, 21 were PC professionals, 24 were users of a CoCP and 7 held managerial positions. For a system of communication between PC and SC to become a tool that is habitually used and very useful, the interviewees considered that it would have to be able to find quick, effective solutions to the queries raised, based on up-to-date information that is directly applicable to daily clinical practice. Contact should be virtual - and probably collaborative - via a platform integrated into their habitual workstations and led by PC professionals. Organisational changes should be implemented to enable users to have more time in their working day to spend on the tool, and professionals should have a proactive attitude in order to make the most if its potential. It is also important to make certain technological changes, basically aimed at improving the tool's accessibility, by integrating it into habitual clinical workstations. The collaborative tool that provides reliable, up-to-date information that is highly transferrable to clinical

  13. The Aux/IAA gene rum1 involved in seminal and lateral root formation controls vascular patterning in maize (Zea mays L.) primary roots.

    Science.gov (United States)

    Zhang, Yanxiang; Paschold, Anja; Marcon, Caroline; Liu, Sanzhen; Tai, Huanhuan; Nestler, Josefine; Yeh, Cheng-Ting; Opitz, Nina; Lanz, Christa; Schnable, Patrick S; Hochholdinger, Frank

    2014-09-01

    The maize (Zea mays L.) Aux/IAA protein RUM1 (ROOTLESS WITH UNDETECTABLE MERISTEMS 1) controls seminal and lateral root initiation. To identify RUM1-dependent gene expression patterns, RNA-Seq of the differentiation zone of primary roots of rum1 mutants and the wild type was performed in four biological replicates. In total, 2 801 high-confidence maize genes displayed differential gene expression with Fc ≥2 and FDR ≤1%. The auxin signalling-related genes rum1, like-auxin1 (lax1), lax2, (nam ataf cuc 1 nac1), the plethora genes plt1 (plethora 1), bbm1 (baby boom 1), and hscf1 (heat shock complementing factor 1) and the auxin response factors arf8 and arf37 were down-regulated in the mutant rum1. All of these genes except nac1 were auxin-inducible. The maize arf8 and arf37 genes are orthologues of Arabidopsis MP/ARF5 (MONOPTEROS/ARF5), which controls the differentiation of vascular cells. Histological analyses of mutant rum1 roots revealed defects in xylem organization and the differentiation of pith cells around the xylem. Moreover, histochemical staining of enlarged pith cells surrounding late metaxylem elements demonstrated that their thickened cell walls displayed excessive lignin deposition. In line with this phenotype, rum1-dependent mis-expression of several lignin biosynthesis genes was observed. In summary, RNA-Seq of RUM1-dependent gene expression in maize primary roots, in combination with histological and histochemical analyses, revealed the specific regulation of auxin signal transduction components by RUM1 and novel functions of RUM1 in vascular development. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  14. A comparison of outcomes involving highly cohesive, form-stable breast implants from two manufacturers in patients undergoing primary breast augmentation.

    Science.gov (United States)

    Jewell, Mark L; Jewell, James L

    2010-01-01

    Although there have been reports of single-surgeon outcomes with highly cohesive, form-stable silicone gel implants in women undergoing primary breast augmentation, there has been only one study published that compares the outcomes between the Allergan 410 and the Mentor CPG devices. The goal of the study is to compare outcomes in each cohort and to determine if quality systems and processes would have an impact on lowering the surgical revision rate, as compared to published reports for round gel implants and form-stable implants. Patients selected for the study were required to meet predefined inclusion criteria and general indications for breast augmentation. All subjects were treated uniformly with extensive informed consent prior to surgery. The entire process of breast augmentation (patient assessment, informed consent, the surgical procedure itself and postoperative instructions) was identical between the two groups. Patients were not randomized, as the studies did not start at the same time. The process for management of each patient was based on adaptation of the Toyota Production System and Lean Manufacturing, with emphasis on achieving operational excellence in the use of planning templates for surgery, including accurate management of patient expectations regarding size outcome. Outcomes data included physical breast measurements, quality of life metrics, and patient/surgeon satisfaction assessment. Adverse events were compared against published data for breast implants. Follow-up ranged between 20-77 months (Allergan 410) and 16-77 months (Mentor CPG). The outcome data indicate that these devices produce natural-appearing breasts with extremely low aggregate reoperation rate (4.2%). Only 0.8% of the reoperations were attributable to surgeon-related factors. There were no reoperations to correct mismanaged size expectations during the course of each study. There were 13 pregnancies and no difficulties with lactation were reported. Rippling (lateral

  15. Involvement of the US Department of Defense in Civilian Assistance, Part I: a quantitative description of the projects funded by the Overseas Humanitarian, Disaster, and Civic Aid Program.

    Science.gov (United States)

    Bourdeaux, Margaret Ellis; Lawry, Lynn; Bonventre, Eugene V; Burkle, Frederick M

    2010-03-01

    To review the history and goals of the US Department of Defense's largest civilian assistance program, the Overseas Humanitarian, Disaster and Civic Aid Program and to describe the number, geographic regions, years, key words, countries, and types of projects carried out under this program since 2001. Using the program's central database, we reviewed all approved projects since 2001 and tabulated them by year, combatant command, country, and key word. We also reviewed the project descriptions of projects funded between January 1, 2006, and February 9, 2008, and examined how their activities varied by combatant command and year. Of the 5395 projects in the database, 2097 were funded. Projects took place in more than 90 countries, with Southern, Pacific, and Africa Command hosting the greatest number. The most common types of projects were school, health, disaster response, and water infrastructure construction, and disaster-response training. The "global war on terror" was the key word most frequently tagged to project descriptions. Project descriptions lacked stated goals as well as implementation and coordination strategies with potential partners, and did not report outcome or impact indicators. The geographic reach of the program is vast and projects take place in a wide variety of public sectors. Yet their security and civilian assistance value remains unclear given the lack of stated project goals, implementation strategies, or measures of effectiveness. To facilitate transparency and policy discussion, we recommend project proposals include hypotheses as to how they will enhance US security, their relevance to the public sector they address, and outcome and impact indicators that can assess their value and effectiveness.

  16. Communication in cross-cultural consultations in primary care in Europe: the case for improvement. The rationale for the RESTORE FP 7 project.

    Science.gov (United States)

    van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; Burns, Nicola; O'Donnell, Catherine; Mair, Frances; Spiegel, Wolfgang; Lionis, Christos; Dowrick, Chris; O'Reilly-de Brún, Mary; de Brun, Tomas; MacFarlane, Anne

    2014-04-01

    The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions.

  17. DEVELOPMENT OF DIGITAL COMPETENCIES OF PRIMARY SCHOOL TEACHERS THROUGH BUILDING KNOWLEDGE AND SKILLS FOR WORKING WITH VISUAL PROGRAMMING ENVIRONMENT WITHIN MATH PROJECT WORK

    Directory of Open Access Journals (Sweden)

    Rumyana Y. Papancheva

    2017-07-01

    Full Text Available The paper presents a review of the contemporary school, the digital generation and the need of teachers equipped with new knowledge and skills, in particular – basic programming skills. The last change of educational system in Bulgaria after the adoption of the new pre-school and general school education act is analysed. New primary school curricula and new standards for teacher’s qualification were implemented. The new school subject “Computer modelling” is presented. Some experience of the authors from project-based work in mathematics with teachers and students is described. The aim is the formation of skills of programming by working within Scratch – visual environment for block-based coding. Some conclusions and ideas for future work are formulated.

  18. Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo).

    Science.gov (United States)

    Ciccone, Marco Matteo; Aquilino, Ambrogio; Cortese, Francesca; Scicchitano, Pietro; Sassara, Marco; Mola, Ernesto; Rollo, Rodolfo; Caldarola, Pasquale; Giorgino, Francesco; Pomo, Vincenzo; Bux, Francesco

    2010-05-06

    Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM) model and of the introduction of "care manager" nurses, trained in this specialized role, into the primary health care system. Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative "team" consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD), diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk) to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization. Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services as well as treatment paths helped promote confidence and enhance safety of chronic patient management at home. Physicians, care managers, and patients showed unanimous agreement regarding the positive impact on patient health and self-management, and attributed the outcomes to the strong "partnership" between the care manager and the patient and the collaboration between the physician and the care manager. Future studies should consider the possibility of incorporating a patient empowerment model which considers the patient as the most important member of the health team and care managers as key health care collaborators able to enhance and support services to patients provided by physicians in

  19. ALARACT Demonstration for Primary Ventilation Systems at the DST Tank Farms for the Interim Stabilization Project (Saltwell Pumping) [SEC 1 Thru 3

    International Nuclear Information System (INIS)

    STAM, E.C.

    2002-01-01

    A demonstration of As Low As Reasonably Achievable Control Technology (ALARACT) was performed for the existing Double Shell Tank (DST) farm primary ventilation systems in support of the Single Shell Tanks (SSTs) Interim Stabilization Project. The primary ventilation systems evaluated in this ALARACT are located at the 241-AW, AN, AP, and SY tank farms. Of these farms, only the AP and SY farms are scheduled to receive SST waste prior to new ventilation systems being installed at the farms. As a result, full evaluations were performed for the 241-AP and SY systems, whereas only partial evaluations were performed for the 241-AN and AW systems. The full evaluation included the evaluation of the stack sampling system, whereas the partial evaluation did not. Also, 241-AY and AZ are not scheduled to receive SST waste so they were both excluded completely from the evaluation. This ALARACT demonstration evaluated the ability of the abatement and control technologies in the DST ventilation systems identified above to function during SST waste transfers as part of the SST Interim Stabilization Project. Where available, field data (waste temperatures) gathered during actual saltwell pumping activities, were used to support this demonstration. Also used were other process data and equipment capacities associated with the system evaluation. Where actual field data were not available, conservative assumptions, based upon process knowledge and standard engineering calculation methodologies, were used. The DST ventilation systems were also evaluated for compliance against the technology standards identified in Washington Administrative Code (WAC) 246-247, Radioactive Air Emissions, as well as other governing codes and standards

  20. The Cedar Project: resilience in the face of HIV vulnerability within a cohort study involving young Indigenous people who use drugs in three Canadian cities.

    Science.gov (United States)

    Pearce, Margo E; Jongbloed, Kate A; Richardson, Chris G; Henderson, Earl W; Pooyak, Sherri D; Oviedo-Joekes, Eugenia; Christian, Wunuxtsin M; Schechter, Martin T; Spittal, Patricia M

    2015-10-29

    Indigenous scholars have long argued that it is critical for researchers to identify factors related to cultural connectedness that may protect against HIV and hepatitis C infection and buffer the effects of historical and lifetime trauma among young Indigenous peoples. To our knowledge, no previous epidemiological studies have explored the effect of historical and lifetime traumas, cultural connectedness, and risk factors on resilience among young, urban Indigenous people who use drugs. This study explored risk and protective factors associated with resilience among participants of the Cedar Project, a cohort study involving young Indigenous peoples who use illicit drugs in three cities in British Columbia, Canada. We utilized the Connor-Davidson Resilience Scale to measure resilience, the Childhood Trauma Questionnaire to measure childhood maltreatment, and the Symptom-Checklist 90-Revised to measure psychological distress among study participants. Multivariate linear mixed effects models (LME) estimated the effect of study variables on mean change in resilience scores between 2011-2012. Among 191 participants, 92 % had experienced any form of childhood maltreatment, 48 % had a parent who attended residential school, and 71 % had been in foster care. The overall mean resilience score was 62.04, with no differences between the young men and women (p = 0.871). Adjusted factors associated with higher mean resilience scores included having grown up in a family that often/always lived by traditional culture (B = 7.70, p = 0.004) and had often/always spoken their traditional language at home (B = 10.52, p resilience scores. Adjusted factors associated with diminished mean resilience scores included severe childhood emotional neglect (B = -13.34, p = 0.001), smoking crack daily (B = -5.42, p = 0.044), having been sexual assaulted (B =  14.42, p = 0.041), and blackout drinking (B = -6.19, p = 0.027). Young people in this study have faced multiple complex challenges to

  1. Explore the concept of “light” and its interaction with matter: an inquiry-based science education project in primary school

    Science.gov (United States)

    Varela, P.; Costa, M. F.

    2015-04-01

    The exploration process leading to the understanding of physical phenomena, such as light and its interaction with matter, raises great interest and curiosity in children. However, in most primary schools, children rarely have the opportunity to conduct science activities in which they can engage in an enquiry process even if by the action of the teacher. In this context, we have organised several in-service teacher training courses and carried out several pedagogic interventions in Portuguese primary schools, with the aim of promoting inquiry- based science education. This article describes one of those projects, developed with a class of the third grade, which explored the curricular topic “Light Experiments”. Various activities were planned and implemented, during a total of ten hours spread over five lessons. The specific objectives of this paper are: to illustrate and analyse the teaching and learning process promoted in the classroom during the exploration of one of these lessons, and to assess children's learning three weeks after the lessons. The results suggest that children made significant learning which persisted. We conclude discussing some processes that stimulated children’ learning, including the importance of teacher questioning in scaffolding children's learning and some didactic implications for teacher training.

  2. A critical ethnography of communication processes involving the management of oral chemotherapeutic agents by patients with a primary diagnosis of colorectal cancer: study protocol.

    Science.gov (United States)

    Mitchell, Gary; Porter, Sam; Manias, Elizabeth

    2015-04-01

    To describe the protocol used to examine the processes of communication between health professionals, patients and informal carers during the management of oral chemotherapeutic medicines to identify factors that promote or inhibit medicine concordance. Ideally communication practices about oral medicines should incorporate shared decision-making, two-way dialogue and an equality of role between practitioner and patient. While there is evidence that healthcare professionals are adopting these concordant elements in general practice there are still some patients who have a passive role during consultations. Considering oral chemotherapeutic medications, there is a paucity of research about communication practices which is surprising given the high risk of toxicity associated with chemotherapy. A critical ethnographic design will be used, incorporating non-participant observations, individual semi-structured and focus-group interviews as several collecting methods. Observations will be carried out on the interactions between healthcare professionals (physicians, nurses and pharmacists) and patients in the outpatient departments where prescriptions are explained and supplied and on follow-up consultations where treatment regimens are monitored. Interviews will be conducted with patients and their informal carers. Focus-groups will be carried out with healthcare professionals at the conclusion of the study. These several will be analysed using thematic analysis. This research is funded by the Department for Employment and Learning in Northern Ireland (Awarded February 2012). Dissemination of these findings will contribute to the understanding of issues involved when communicating with people about oral chemotherapy. It is anticipated that findings will inform education, practice and policy. © 2014 John Wiley & Sons Ltd.

  3. An early start to STEM education among year 1 primary students through project-based inquiry learning in the context of a magnet

    Science.gov (United States)

    Safiee, N.; Jusoh, Z. M.; Noor, A. M. H. M.; Tek, O. E.; Salleh, S. M.

    2018-01-01

    For the needs of the 21st century, the Government of Malaysia has conceptualized the Malaysia Education Blueprint 2013-2025 which embodies 11 strategic and operational shifts. In Shift 1, it is emphasized that the quality of Science, Technology, Engineering, and Mathematics (STEM) Education will be enhanced. This study employed the mixed-method approach using the “one-group pre-test and post-test design”. Accordingly, this paper describes the pedagogical practice of Project-based Inquiry Learning (PIL) which promotes STEM Education among Year 1 students in the move to progress in tandem with Shift 1. Specifically, using the context of a magnet which has been stipulated in the Primary School Standard Curriculum, Year 1 students experienced the STEM Education through the STEM Pedagogy in which they raised questions upon the presentation of a relevant stimulus (Inquiry Phase), explored the ways in which a train carriage or coach could be assembled by means of recycled materials and magnets (Exploration Phase), designed a train carriage (Design Phase), and ultimately reflected on their inventions (Reflection Phase). The cognitive and affective impacts through the use of this Project-based Inquiry Learning are presented. Implications for the teaching and learning of science are discussed within the context of STEM Education.

  4. Characterization of the Unusual Product from the Reaction between Cobalt(II) Chloride, Ethane-1,2-diamine, and Hydrochloric Acid: An Undergraduate Project Involving an Unknown Metal Complex.

    Science.gov (United States)

    Curtis, Neil F.; And Others

    1986-01-01

    Discusses the need for student research-type chemistry projects based upon "unknown" metal complexes. Describes an experiment involving the product from the reaction between cobalt(II) chloride, ethane-1,2-diamine (en) and concentrated hydrochloric acid. Outlines the preparation of the cobalt complex, along with procedure, results and…

  5. Fine structure of primary afferent axon terminals projecting from rapidly adapting mechanoreceptors of the toe and foot pads of the cat.

    Science.gov (United States)

    Maxwell, D J; Bannatyne, B A; Fyffe, R E; Brown, A G

    1984-04-01

    Two Pacinian corpuscle afferents and two rapidly adapting afferents from Krause corpuscles were intra-axonally labelled with horseradish peroxidase in the lumbosacral enlargement of the cat's spinal cord. Tissue was prepared for combined light and electron microscopical analysis. Boutons from both classes of afferent had similar ultrastructural appearances. They both formed from one to three synaptic junctions with dendritic shafts and spines and received axo-axonic synapses. In addition, both categories of bouton were seen to be presynaptic to structures interpreted as vesicle-containing dendrites. It is concluded that both types of afferent fibre are subject to presynaptic control and that they synapse with dorsal horn neurones which are possibly interneurones involved in primary afferent depolarization and post-synaptic dorsal column neurones.

  6. LEX Project

    DEFF Research Database (Denmark)

    Damkilde, Lars; Larsen, Torben J.; Walbjørn, Jacob

    This document is aimed at helping all parties involved in the LEX project to get a common understanding of words, process, levels and the overall concept.......This document is aimed at helping all parties involved in the LEX project to get a common understanding of words, process, levels and the overall concept....

  7. Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation.

    Science.gov (United States)

    Diez-Canseco, Francisco; Toyama, Mauricio; Ipince, Alessandra; Perez-Leon, Silvana; Cavero, Victoria; Araya, Ricardo; Miranda, J Jaime

    2018-03-15

    Despite their high prevalence and significant burden, mental disorders such as depression remain largely underdiagnosed and undertreated. The aim of the Allillanchu Project was to design, develop, and test an intervention to promote early detection, opportune referral, and access to treatment of patients with mental disorders attending public primary health care (PHC) services in Lima, Peru. The project had a multiphase design: formative study, development of intervention components, and implementation. The intervention combined three strategies: training of PHC providers (PHCPs), task shifting the detection and referral of mental disorders, and a mobile health (mHealth) component comprising a screening app followed by motivational and reminder short message service (SMS) to identify at-risk patients. The intervention was implemented by 22 PHCPs from five health centers, working in antenatal care, tuberculosis, chronic diseases, and HIV or AIDS services. Over a period of 9 weeks, from September 2015 to November 2015, 733 patients were screened by the 22 PHCPs during routine consultations, and 762 screening were completed in total. The chronic diseases (49.9%, 380/762) and antenatal care services (36.7%, 380/762) had the higher number of screenings. Time constraints and workload were the main barriers to implementing the screening, whereas the use of technology, training, and supervision of the PHCPs by the research team were identified as facilitators. Of the 733 patients, 21.7% (159/733) screened positively and were advised to seek specialized care. Out of the 159 patients with a positive screening result, 127 had a follow-up interview, 72.4% (92/127) reported seeking specialized care, and 55.1% (70/127) stated seeing a specialist. Both patients and PHCPs recognized the utility of the screening and identified some key challenges to its wider implementation. The use of a screening app supported by training and supervision is feasible and uncovers a high prevalence

  8. Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2010-04-01

    Full Text Available Marco Matteo Ciccone1, Ambrogio Aquilino2, Francesca Cortese1, Pietro Scicchitano1, Marco Sassara1, Ernesto Mola3, Rodolfo Rollo4,Pasquale Caldarola5, Francesco Giorgino6, Vincenzo Pomo2, Francesco Bux21Section of Cardiovascular Disease, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy; 2Agenzia Regionale Sanitaria – Regione Puglia (ARES, Apulia, Italy; 3ASL, Lecce, Italy; 4ASL, Brindisi, Italy; 5Cardiologia, Ospedale “Sarcone”, Terlizzi, Italy; 6Section of Endocrinology, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, ItalyPurpose: Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM model and of the introduction of “care manager” nurses, trained in this specialized role, into the primary health care system. Patients and methods: Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative “team” consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD, diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization.Results: Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services

  9. Plasticity of Select Primary Afferent Projections to the Dorsal Horn after a Lumbosacral Ventral Root Avulsion Injury and Root Replantation in Rats

    Directory of Open Access Journals (Sweden)

    Allison J. Bigbee

    2017-07-01

    Full Text Available Injuries to the conus medullaris and cauda equina portions of the spinal cord result in neurological impairments, including paralysis, autonomic dysfunction, and pain. In experimental studies, earlier investigations have shown that a lumbosacral ventral root avulsion (VRA injury results in allodynia, which may be ameliorated by surgical replantation of the avulsed ventral roots. Here, we investigated the long-term effects of an L6 + S1 VRA injury on the plasticity of three populations of afferent projections to the dorsal horn in rats. At 8 weeks after a unilateral L6 + S1 VRA injury, quantitative morphological studies of the adjacent L5 dorsal horn showed reduced immunoreactivity (IR for the vesicular glutamate transporter, VGLUT1 and isolectin B4 (IB4 binding, whereas IR for calcitonin gene-related peptide (CGRP was unchanged. The IR for VGLUT1 and CGRP as well as IB4 binding was at control levels in the L5 dorsal horn at 8 weeks following an acute surgical replantation of the avulsed L6 + S1 ventral roots. Quantitative morphological studies of the L5 dorsal root ganglia (DRGs showed unchanged neuronal numbers for both the VRA and replanted series compared to shams. The portions of L5 DRG neurons expressing IR for VGLUT1 and CGRP, and IB4 binding were also the same between the VRA, replanted, and sham-operated groups. We conclude that the L5 dorsal horn shows selective plasticity for VGLUT1 and IB4 primary afferent projections after an L6 + S1 VRA injury and surgical repair.

  10. Does sharing the electronic health record in the consultation enhance patient involvement? A mixed-methods study using multichannel video recording and in-depth interviews in primary care.

    Science.gov (United States)

    Milne, Heather; Huby, Guro; Buckingham, Susan; Hayward, James; Sheikh, Aziz; Cresswell, Kathrin; Pinnock, Hilary

    2016-06-01

    Sharing the electronic health-care record (EHR) during consultations has the potential to facilitate patient involvement in their health care, but research about this practice is limited. We used multichannel video recordings to identify examples and examine the practice of screen-sharing within 114 primary care consultations. A subset of 16 consultations was viewed by the general practitioner and/or patient in 26 reflexive interviews. Screen-sharing emerged as a significant theme and was explored further in seven additional patient interviews. Final analysis involved refining themes from interviews and observation of videos to understand how screen-sharing occurred, and its significance to patients and professionals. Eighteen (16%) of 114 videoed consultations involved instances of screen-sharing. Screen-sharing occurred in six of the subset of 16 consultations with interviews and was a significant theme in 19 of 26 interviews. The screen was shared in three ways: 'convincing' the patient of a diagnosis or treatment; 'translating' between medical and lay understandings of disease/medication; and by patients 'verifying' the accuracy of the EHR. However, patients and most GPs perceived the screen as the doctor's domain, not to be routinely viewed by the patient. Screen-sharing can facilitate patient involvement in the consultation, depending on the way in which sharing comes about, but the perception that the record belongs to the doctor is a barrier. To exploit the potential of sharing the screen to promote patient involvement, there is a need to reconceptualise and redesign the EHR. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  11. Experience-based knowledge in nuclear and radiological emergency preparedness - involvement of national stake holders. Report from the EURANOS project; Erfaringsbasert kunnskap i norsk atomberedskap - medvirkning fra beroerte parter. Rapport fra EURANOS-prosjektet

    Energy Technology Data Exchange (ETDEWEB)

    Bay-Larsen, I.; Oughton, D.; Liland, A.; Eikelmann, I.M.; Hansen, H.S.

    2009-05-15

    The report identifies and summarises the most important experiences related to long term rehabilitation of contaminated areas after the Chernobyl accident, as phrased by representatives from the agricultural sector (including reindeer herding), primary health care, academia, NGOs, local and regional authorities, as well as national authorities with responsibilities for emergency preparedness within their sector. It also includes recommendations for future collaboration to ensure competence and stake holder involvement in Norwegian nuclear and radiological emergency preparedness. (Author)

  12. Primary Pelvic Involvement of Hydatid Disease

    Directory of Open Access Journals (Sweden)

    Migraci Tosun

    2011-04-01

    Full Text Available Hydatid disease is caused by larval stage of a parasite named as Echinococcus. To diagnose this condition may be challenging without surgery and postoperative pathological examination due to limited value of serological studies but imaging techniques may give a clue when hydatid disease is suspected and hydatid disease shall be considered for differential diagnosis in pelvic mass. In the present case, we present a 75-year-old postmenopausal woman with pelvic hydatosis.

  13. Primary (AL) amyloidosis with gastrointestinal involvement

    DEFF Research Database (Denmark)

    Madsen, Lone Galmstrup; Gimsing, Peter; Schiødt, Frank V

    2009-01-01

    OBJECTIVE: Immunoglobulin light-chain (AL) amyloidosis is a rare disease that can affect several organs. The aim of this study was to characterize patients with gastrointestinal manifestations of AL amyloidosis, in terms of symptoms, biochemistry, and outcome. MATERIAL AND METHODS: Retrospectivel...

  14. Yakima/Klickitat Fisheries Project; Washington Department of Fish and Wildlife Policy/Technical Involvement and Planning, 2001-2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Easterbrooks, John A.; Pearsons, Todd N. (Washington Department of Fish and Wildlife, Olympia, WA)

    2003-03-01

    The Yakima/Klickitat Fisheries Project (YKFP) is a supplementation project sponsored by the Northwest Power Planning Council (Columbia River Basin Fish and Wildlife Program 1994, Measure 7.4K). The objectives of the YKFP are: (1) to test the hypothesis that new supplementation techniques can be used in the Yakima River Basin to increase natural production and to improve harvest opportunities while maintaining the long-term genetic fitness of the wild and native salmonid populations and keeping adverse ecological interactions within acceptable limits (Yakima Fisheries Project Final Environment Impact Statement, 1996); (2) provide knowledge about the use of supplementation, so that it may be used to mitigate effects on anadromous fisheries throughout the Columbia River Basin; (3) to maintain and improve the quantity and productivity of salmon and steelhead habitat, including those areas made accessible by habitat improvements; (4) to ensure that Project implementation remains consistent with the Council's Fish and Wildlife Program; and (5) to implement the Project in a prudent and environmentally sound manner. Current YKFP operations have been designed to test the principles of supplementation (Busack et al. 1997). The Project's experimental design has focused on the following critical uncertainties affecting supplementation: (1) The survival and reproductive success of hatchery fish after release from the hatchery; (2) The impacts of hatchery fish as they interact with non-target species and stocks; and, (3) The effects of supplementation on the long-term genetic fitness of fish stocks. The YKFP endorses an adaptive management policy applied through a project management framework as described in the Yakima/Klickitat Fisheries Project Planning Status Report (1995), Fast and Craig (1997), Clune and Dauble 1991. The project is managed by a Policy Group consisting of a representative of the Yakama Nation (YN, lead agency) and a representative of the Washington

  15. Yakima/Klickitat Fisheries Project; Washington Department of Fish and Wildlife Policy/Technical Involvement and Planning, 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Pearsons, Todd N.; Easterbrooks, John A. (Washington Department of Fish and Wildlife, Olympia, WA)

    2003-09-01

    The Yakima/Klickitat Fisheries Project (YKFP) is a supplementation project sponsored by the Northwest Power Planning Council and funded by the Bonneville Power Administration. The YKFP has adopted the definition of supplementation described by Regional Assessment of Supplementation Program (1992), which is ''the use of artificial propagation in an attempt to maintain or increase natural production while maintaining the long-term fitness of the target population, and keeping the ecological and genetic impacts on nontarget populations within specified biological limits''. Recent scientific reviews of hatchery supplementation continue to highlight the experimental nature and risk of supplementation (Independent Scientific Group 1996; National Research Council 1996; Lichatowich 1999; Independent Multidisciplinary Science Team 2000; Independent Scientific Advisory Board 2003; Hatchery Scientific Review Group 2003). In addition, many of these reviews included recommendations about the best ways to operate a supplementation program. Most of these recommendations were already being done or have been incorporated into the YKFP. The objectives of the YKFP are: (1) to test the hypothesis that new supplementation techniques can be used in the Yakima River Basin to increase natural production and to improve harvest opportunities while maintaining the long-term genetic fitness of the wild and native salmonid populations and keeping adverse ecological interactions within acceptable limits (Yakima Fisheries Project Final Environment Impact Statement, 1996); (2) provide knowledge about the use of supplementation, so that it may be used to mitigate effects on anadromous fisheries throughout the Columbia River Basin; (3) to maintain and improve the quantity and productivity of salmon and steelhead habitat, including those areas made accessible by habitat improvements; (4) to ensure that Project implementation remains consistent with the Council's Fish and

  16. Survey and analysis of satellite-based telemedicine projects involving Japan and developing nations: investigation of transmission rates, channel numbers, and node numbers.

    Science.gov (United States)

    Nakajima, I; Natori, M; Takizawa, M; Kaihara, S

    2001-01-01

    We surveyed interactive telemedicine projects via telecommunications satellite (AMINE-PARTNERS, Post-PARTNERS, and Shinshu University Project using Inmarsat satellites) offered by Japan as assistance to developing countries. The survey helped clarify channel occupation time and data transfer rates. Using our survey results, we proposed an optimized satellite model with VSATs simulating the number of required channels and bandwidth magnitude. For future implementation of VSATs for medical use in developing nations, design of telecommunication channels should take into consideration TCP/IP-based operations. We calculated that one hub station with 30-76 VSATs in developing nation can be operated on bandwidth 6 Mbps using with 128 Kbps videoconferencing system for teleconsultation and teleconference, and linking with Internet.

  17. A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries.

    Science.gov (United States)

    Humeniuk, Rachel; Ali, Robert; Babor, Thomas; Souza-Formigoni, Maria Lucia O; de Lacerda, Roseli Boerngen; Ling, Walter; McRee, Bonnie; Newcombe, David; Pal, Hemraj; Poznyak, Vladimir; Simon, Sara; Vendetti, Janice

    2012-05-01

    This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances, producing a score for each substance that falls into either a low-, moderate- or high-risk category. Prospective, randomized controlled trial in which participants were either assigned to a 3-month waiting-list control condition or received brief motivational counselling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score. Primary health-care settings in four countries: Australia, Brazil, India and the United States. A total of 731 males and females scoring within the moderate-risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants or opioids. ASSIST-specific substance involvement scores for cannabis, stimulants or opioids and ASSIST total illicit substance involvement score at baseline and 3 months post-randomization. Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST total illicit substance involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for cannabis scores (P Brazil (P illicit substance use and related risks is effective, at least in the short term, and the effect generalizes across countries. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  18. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjögren's syndrome at diagnosis in 8310 patients: a cross-sectional study from the Big Data Sjögren Project Consortium.

    Science.gov (United States)

    Brito-Zerón, Pilar; Acar-Denizli, Nihan; Zeher, Margit; Rasmussen, Astrid; Seror, Raphaele; Theander, Elke; Li, Xiaomei; Baldini, Chiara; Gottenberg, Jacques-Eric; Danda, Debashish; Quartuccio, Luca; Priori, Roberta; Hernandez-Molina, Gabriela; Kruize, Aike A; Valim, Valeria; Kvarnstrom, Marika; Sene, Damien; Gerli, Roberto; Praprotnik, Sonja; Isenberg, David; Solans, Roser; Rischmueller, Maureen; Kwok, Seung-Ki; Nordmark, Gunnel; Suzuki, Yasunori; Giacomelli, Roberto; Devauchelle-Pensec, Valerie; Bombardieri, Michele; Hofauer, Benedikt; Bootsma, Hendrika; Brun, Johan G; Fraile, Guadalupe; Carsons, Steven E; Gheita, Tamer A; Morel, Jacques; Vollenveider, Cristina; Atzeni, Fabiola; Retamozo, Soledad; Horvath, Ildiko Fanny; Sivils, Kathy; Mandl, Thomas; Sandhya, Pulukool; De Vita, Salvatore; Sanchez-Guerrero, Jorge; van der Heijden, Eefje; Trevisani, Virginia Fernandes Moça; Wahren-Herlenius, Marie; Mariette, Xavier; Ramos-Casals, Manuel

    2017-06-01

    To analyse the influence of geolocation and ethnicity on the clinical presentation of primary Sjögren's syndrome (SjS) at diagnosis. The Big Data Sjögren Project Consortium is an international, multicentre registry designed in 2014. By January 2016, 20 centres from five continents were participating. Multivariable logistic regression analyses were performed. We included 7748 women (93%) and 562 men (7%), with a mean age at diagnosis of primary SjS of 53 years. Ethnicity data were available for 7884 patients (95%): 6174 patients (78%) were white, 1066 patients (14%) were Asian, 393 patients (5%) were Hispanic, 104 patients (1%) were black/African-American and 147 patients (2%) were of other ethnicities. SjS was diagnosed a mean of 7 years earlier in black/African-American compared with white patients; the female-to-male ratio was highest in Asian patients (27:1) and lowest in black/African-American patients (7:1); the prevalence of sicca symptoms was lowest in Asian patients; a higher frequency of positive salivary biopsy was found in Hispanic and white patients. A north-south gradient was found with respect to a lower frequency of ocular involvement in northern countries for dry eyes and abnormal ocular tests in Europe (OR 0.46 and 0.44, respectively) and Asia (OR 0.18 and 0.49, respectively) compared with southern countries. Higher frequencies of antinuclear antibodies (ANAs) were reported in northern countries in America (OR=1.48) and Asia (OR=3.80) while, in Europe, northern countries had lowest frequencies of ANAs (OR=0.67) and Ro/La (OR=0.69). This study provides the first evidence of a strong influence of geolocation and ethnicity on the phenotype of primary SjS at diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

    Science.gov (United States)

    Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

    2012-08-01

    Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

  20. PET-CT-Based Auto-Contouring in Non-Small-Cell Lung Cancer Correlates With Pathology and Reduces Interobserver Variability in the Delineation of the Primary Tumor and Involved Nodal Volumes

    International Nuclear Information System (INIS)

    Baardwijk, Angela van; Bosmans, Geert; Boersma, Liesbeth; Buijsen, Jeroen; Wanders, Stofferinus; Hochstenbag, Monique; Suylen, Robert-Jan van; Dekker, Andre; Dehing-Oberije, Cary; Houben, Ruud; Bentzen, Soren M.; Kroonenburgh, Marinus van; Lambin, Philippe; Ruysscher, Dirk de

    2007-01-01

    Purpose: To compare source-to-background ratio (SBR)-based PET-CT auto-delineation with pathology in non-small-cell lung cancer (NSCLC) and to investigate whether auto-delineation reduces the interobserver variability compared with manual PET-CT-based gross tumor volume (GTV) delineation. Methods and Materials: Source-to-background ratio-based auto-delineation was compared with macroscopic tumor dimensions to assess its validity in 23 tumors. Thereafter, GTVs were delineated manually on 33 PET-CT scans by five observers for the primary tumor (GTV-1) and the involved lymph nodes (GTV-2). The delineation was repeated after 6 months with the auto-contour provided. This contour was edited by the observers. For comparison, the concordance index (CI) was calculated, defined as the ratio of intersection and the union of two volumes (A intersection B)/(A union B). Results: The maximal tumor diameter of the SBR-based auto-contour correlated strongly with the macroscopic diameter of primary tumors (correlation coefficient = 0.90) and was shown to be accurate for involved lymph nodes (sensitivity 67%, specificity 95%). The median auto-contour-based target volumes were smaller than those defined by manual delineation for GTV-1 (31.8 and 34.6 cm 3 , respectively; p = 0.001) and GTV-2 (16.3 and 21.8 cm 3 , respectively; p 0.02). The auto-contour-based method showed higher CIs than the manual method for GTV-1 (0.74 and 0.70 cm 3 , respectively; p 3 , respectively; p = 0.11). Conclusion: Source-to-background ratio-based auto-delineation showed a good correlation with pathology, decreased the delineated volumes of the GTVs, and reduced the interobserver variability. Auto-contouring may further improve the quality of target delineation in NSCLC patients

  1. Implementation and assessment of a yeast orphan gene research project: involving undergraduates in authentic research experiences and progressing our understanding of uncharacterized open reading frames.

    Science.gov (United States)

    Bowling, Bethany V; Schultheis, Patrick J; Strome, Erin D

    2016-02-01

    Saccharomyces cerevisiae was the first eukaryotic organism to be sequenced; however, little progress has been made in recent years in furthering our understanding of all open reading frames (ORFs). From October 2012 to May 2015 the number of verified ORFs had only risen from 75.31% to 78%, while the number of uncharacterized ORFs had decreased from 12.8% to 11% (representing > 700 genes still left in this category; http://www.yeastgenome.org/genomesnapshot). Course-based research has been shown to increase student learning while providing experience with real scientific investigation; however, implementation in large, multi-section courses presents many challenges. This study sought to test the feasibility and effectiveness of incorporating authentic research into a core genetics course, with multiple instructors, to increase student learning and progress our understanding of uncharacterized ORFs. We generated a module-based annotation toolkit and utilized easily accessible bioinformatics tools to predict gene function for uncharacterized ORFs within the Saccharomyces Genome Database (SGD). Students were each assigned an uncharacterized ORF, which they annotated using contemporary comparative genomics methodologies, including multiple sequence alignment, conserved domain identification, signal peptide prediction and cellular localization algorithms. Student learning outcomes were measured by quizzes, project reports and presentations, as well as a post-project questionnaire. Our results indicate that the authentic research experience had positive impacts on students' perception of their learning and their confidence to conduct future research. Furthermore, we believe that creation of an online repository and adoption and/or adaptation of this project across multiple researchers and institutions could speed the process of gene function prediction. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjogren's syndrome at diagnosis in 8310 patients : a cross-sectional study from the Big Data Sjogren Project Consortium

    NARCIS (Netherlands)

    Brito-Zeron, Pilar; Acar-Denizli, Nihan; Zeher, Margit; Rasmussen, Astrid; Seror, Raphaele; Theander, Elke; Li, Xiaomei; Baldini, Chiara; Gottenberg, Jacques-Eric; Danda, Debashish; Quartuccio, Luca; Priori, Roberta; Hernandez-Molina, Gabriela; Kruize, Aike A.; Valim, Valeria; Kvarnstrom, Marika; Sene, Damien; Gerli, Roberto; Praprotnik, Sonja; Isenberg, David; Solans, Roser; Rischmueller, Maureen; Kwok, Seung-Ki; Nordmark, Gunnel; Suzuki, Yasunori; Giacomelli, Roberto; Devauchelle-Pensec, Valerie; Bombardieri, Michele; Hofauer, Benedikt; Bootsma, Hendrika; Brun, Johan G.; Fraile, Guadalupe; Carsons, Steven E.; Gheita, Tamer A.; Morel, Jacques; Vollenveider, Cristina; Atzeni, Fabiola; Retamozo, Soledad; Horvath, Ildiko Fanny; Sivils, Kathy; Mandl, Thomas; Sandhya, Pulukool; De Vita, Salvatore; Sanchez-Guerrero, Jorge; van der Heijden, Eefje; Moca Trevisani, Virginia Fernandes; Wahren-Herlenius, Marie; Mariette, Xavier; Ramos-Casals, Manuel

    Objectives To analyse the influence of geolocation and ethnicity on the clinical presentation of primary Sjgren's syndrome (SjS) at diagnosis. Methods The Big Data Sjogren Project Consortium is an international, multicentre registry designed in 2014. By January 2016, 20 centres from five continents

  3. Tablet PCs in Elementary Education A Pilot Project at the Practice Primary School of the KPH at Campus Vienna/Krems

    Directory of Open Access Journals (Sweden)

    Anton Reiter

    2015-09-01

    Full Text Available Am Beginn des Schuljahrs 2011/2012 wurde eine Volksschulklasse der im 21. Wiener Gemeindebezirk gelegenen Praxisschule der katholischen Pädagogischen Hochschule Wien/Krems mit Tablet-PCs ausgestattet. Die Geräte wurden von der Institution und den Eltern finanziert und allen SchülerInnen einer dritten Klasse zur Verfügung gestellt. Evaluation und Dokumentation des Projekts wurde vom österreichische Ministerium für Unterricht und Frauen finanziert. Wie aktuelle internationale Studien zeigen, gewöhnen sich neunjährige SchülerInnen schnell an solche Geräte. Das war auch in der hier vorgelegten Studie zu beobachten. Die SchülerInnen waren sehr motiviert und haben verschiedene Anwendungen erprobt. Die Tablets wurden auch außerhalb des Klassenraums verwendet, was als wesentlicher Vorteil mobiler Computer gesehen werden kann. Tablet-PCs ermöglichen individuelles Lernen und können für kooperative, soziale und interaktive Lernformen während des Unterrichts und in der Freizeit verwendet werden. Als persönliche mobile Geräte katalysieren die Tablet-PCs selbstgesteuertes “just-in-time” Lernen. Alle SchülerInnen sollten daher im 21. Jahrhundert solche Geräte zur Verfügung haben. One class of the practice primary school at the church-affilated former pedagogical college (KPH at Campus Vienna/Krems located in the 21st district of the capital of Austria was equipped with Tablet PCs at the beginning of the school year 2011/2012. These devices for all students of a third class were financed by the institution and partly the parents. The Austrian Federal Ministry of Education and Women's Affairs funded the evaluation and documentation of this two-year project. As recent international studies on the use of tablets (mostly iPads in primary and secondary education confirm, also these nine years old kids quickly got familiar with the used Pearl Touchlet tablets. The pupils were highly motivated and tried out different applications. The tablets

  4. Application of unconventional geoelectrical methods to the hydrogeological examination of the Mt. S. Croce rock formations (Umbria, Italy involved in a railway tunnel project

    Directory of Open Access Journals (Sweden)

    D. Patella

    1994-06-01

    Full Text Available he project of doubling and developing of the railway line Orte-Falconara, committed by the Italian State Railway Company to the COMAVI Consortium (Rome, Italy, envisaged building the Mt. S. Croce tunnel, about 3200 m long between the stations of Narni and Nera Montoro (Umbria, ltaly. During the last phase of the feasibility project, a geophysical research based on geoelectrical prospecting methods was carried out to complement other geognostic investigations with the following goals: a to outline the complex geotectonic model of the rock system, which will be affected by the new railway layout; b to gain information on the hydrogeologic features of the survey area, in relation to the existing geologic situation and the consequent effects on the digging conditions of the tunnel and on the operation conditions of the railway layout. The geophysical work was thus organized according to the following scheme: a execution of dipole electrical sounding pro-files, to depict a series of significant tomographic pseudosections, both across and along the new railway layout; b execution of self-potential measurements, to draw an anomaly map over the whole hydrogeological network system in the survey area. The research provided information which has helped to improve the geological-structural model of the area and disclosed the hydrogelogic network, conforming to the classified field surface manifestations. At present, further detailed field investigations are being carried out, which confirm all the results obtained by the geoelectrical survey.

  5. High participation rate among 25 721 patients with broad age range in a hospital-based research project involving whole-genome sequencing - the Lausanne Institutional Biobank.

    Science.gov (United States)

    Bochud, Murielle; Currat, Christine; Chapatte, Laurence; Roth, Cindy; Mooser, Vincent

    2017-10-24

    We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing. Multivariable logistic regression analysis was used to identify personal factors, including age, gender, religion, ethnicity, citizenship, education level and mode of admission, associated with willingness to participate in this genomic research project and with interest in receiving clinically actionable incidental findings. The overall participation rate was 79% (20343/25721). Participation rate declined progressively with age, averaging 83%, 75%, 67% and 62% in patients aged rate, but not with higher willingness to receive incidental findings within the population who had agreed to participate. A large proportion of adult patients, even among the elderly, are willing to actively participate and receive incidental findings in this systematic hospital-based precision and genomic medicine research program with broad consent.

  6. A rural community's involvement in the design and usability testing of a computer-based informed consent process for the Personalized Medicine Research Project.

    Science.gov (United States)

    Mahnke, Andrea N; Plasek, Joseph M; Hoffman, David G; Partridge, Nathan S; Foth, Wendy S; Waudby, Carol J; Rasmussen, Luke V; McManus, Valerie D; McCarty, Catherine A

    2014-01-01

    Many informed consent studies demonstrate that research subjects poorly retain and understand information in written consent documents. Previous research in multimedia consent is mixed in terms of success for improving participants' understanding, satisfaction, and retention. This failure may be due to a lack of a community-centered design approach to building the interventions. The goal of this study was to gather information from the community to determine the best way to undertake the consent process. Community perceptions regarding different computer-based consenting approaches were evaluated, and a computer-based consent was developed and tested. A second goal was to evaluate whether participants make truly informed decisions to participate in research. Simulations of an informed consent process were videotaped to document the process. Focus groups were conducted to determine community attitudes towards a computer-based informed consent process. Hybrid focus groups were conducted to determine the most acceptable hardware device. Usability testing was conducted on a computer-based consent prototype using a touch-screen kiosk. Based on feedback, a computer-based consent was developed. Representative study participants were able to easily complete the consent, and all were able to correctly answer the comprehension check questions. Community involvement in developing a computer-based consent proved valuable for a population-based genetic study. These findings may translate to other types of informed consents, including those for trials involving treatment of genetic disorders. A computer-based consent may serve to better communicate consistent, clear, accurate, and complete information regarding the risks and benefits of study participation. Additional analysis is necessary to measure the level of comprehension of the check-question answers by larger numbers of participants. The next step will involve contacting participants to measure whether understanding of

  7. PARTICIPACIÓN DE PADRES DE ESTUDIANTES DE EDUCACIÓN PRIMARIA EN LA EDUCACIÓN DE SUS HIJOS EN MÉXICO/PARENTAL INVOLVEMENT IN PRIMARY SCHOOL CHILDREN IN MEXICO

    Directory of Open Access Journals (Sweden)

    Ernesto Alonso Carlos Martínez****

    2010-06-01

    Full Text Available RESUMENSe realizó un estudio descriptivo de corte cuantitativo que tuvo como propósito caracterizar la participación en laeducación de los hijos de padres de estudiantes de primaria y evaluar los efectos en la misma de variables propias de lospadres y del estudiante. Participaron en el estudio 90 padres estudiantes de una escuela primaria pública y 77 de unaprivada. Ex profeso para el estudio se elaboró un instrumento de medición el cual demostró poseer propiedades psicométricassatisfactorias. Se encontró que los padres presentan una elevada participación en la educación de los estudiantes; estaparticipación aumenta en las madres y padres con mayor nivel educativo y cuando los estudiantes tienen menor edad. Asímismo, se estableció que los padres y madres de los estudiantes con alto desempeño, participan más en la educación de sushijos versus los de estudiantes de bajo desempeño.ABSTRACTA quantitative study was performed aimed to describe parental involvement in their primary school children’s educationalprocess in Mexico and evaluate the effects on themselves of variables belonging to parents and to students. A measurementinstrument was prepared and it turned out to be useful and have satisfactory psychometric keys. Key variables weremeasured in both parents and children using a paper-based questionnaire answered by 90 public school and 77 privateschool parents. It was found that parental involvement is high in their children’s educational process; this involvementincreases in parents with a higher educational level, and when children are younger as well. It was established that childrenwith higher achievement have parents with higher levels of involvement compared to those with lower achievement.

  8. Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project.

    Science.gov (United States)

    O'Reilly-de Brún, Mary; MacFarlane, Anne; de Brún, Tomas; Okonkwo, Ekaterina; Bonsenge Bokanga, Jean Samuel; Manuela De Almeida Silva, Maria; Ogbebor, Florence; Mierzejewska, Aga; Nnadi, Lovina; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2015-09-21

    The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Galway, Ireland. There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Vermont's involvement with the DOE's high-level radioactive waste disposal crystalline repository project. Final technical report, January 1-September 30, 1986

    International Nuclear Information System (INIS)

    1986-09-01

    The US Department of Energy (DOE) is charged with siting a second repository for the disposal of highly radioactive nuclear wastes. Because of this siting process, the DOE has looked to localities in 17 states in the eastern US for possible sites in crystalline rock. During the beginning of the progress report period, crystalline rocks in Vermont were under consideration as sites for further study. Vermont, through the Vermont State Geologist's Office, was closely involved with the DOE program during this period. Our main function has been to review DOE reports; attend DOE workshops and meetings; and inform the Vermont public, with the help of the DOE, about the high-level nuclear waste repository siting process. Nine sites in Vermont were under consideration during the Regional Characterization Phase until January 16, 1986. Because of this fact, there was considerable public interest in this program. Upon release of the Draft Area Recommendation Report, Vermont crystalline rock bodies were dropped from consideration. A site in New Hampshire and two sites in Maine remained on the list. Because of the draft status of the report and the possibility that a site 20 miles from the Vermont border in New Hampshire could remain as a selected site, Vermont has stayed active and interested. Two briefings and hearings were held in the State during the comment period January 16 through April 16, 1986. A thorough review of the Draft Area Recommendation Report was completed using reviewers from our Office, State agencies, outside experts, and citizen groups. With the announcement on May 28, 1986 of the suspension of the second repository siting process in crystalline rocks, our Office has worked toward closing out our active involvement

  10. Determination of HER2 amplification in primary breast cancer using dual-colour chromogenic in situ hybridization is comparable to fluorescence in situ hybridization: a European multicentre study involving 168 specimens

    Science.gov (United States)

    García-Caballero, Tomás; Grabau, Dorthe; Green, Andrew R; Gregory, John; Schad, Arno; Kohlwes, Elke; Ellis, Ian O; Watts, Sarah; Mollerup, Jens

    2010-01-01

    García-Caballero T, Grabau D, Green A R, Gregory J, Schad A, Kohlwes E, Ellis I O, Watts S & Mollerup J (2010) Histopathology56, 472–480 Determination of HER2 amplification in primary breast cancer using dual-colour chromogenic in situ hybridization is comparable to fluorescence in situ hybridization: a European multicentre study involving 168 specimens Aims: Fluorescence in situ hybridization (FISH) can be used to reveal several genomic imbalances relevant to proper cancer diagnosis and to the correct treatment regime. However, FISH requires expensive and advanced fluorescence microscopes in addition to expertise in fluorescence microscopy. To determine whether a newly developed dual-colour chromogenic in situ hybridization (CISH) method is a suitable alternative to FISH, we analysed the human epidermal growth factor receptor 2 gene (HER2) amplification level of 168 breast cancer specimens using dual-colour CISH and FISH and compared the results. Methods and results: We found 100% agreement between HER2 status determined by FISH and dual-colour CISH. Furthermore, we observed that the time used to score slides was significantly reduced by 28% in dual-colour CISH compared with the FISH protocol. Concordance between HER2 protein status and dual-colour CISH or FISH was equally good with an overall agreement of 96.8%. Correlation between the HER2/centromere 17 gene ratios obtained with dual-colour CISH and FISH was highly significant with an overall correlation coefficient (ρ) of 0.96. Conclusions: We conclude that dual-colour CISH and bright field microscopy are excellent alternatives to FISH when analysing the HER2 status of primary breast cancer. PMID:20459554

  11. Examination of the relationship between project management critical success factors and project success of oil and gas drilling projects

    Science.gov (United States)

    Alagba, Tonye J.

    Oil and gas drilling projects are the primary means by which oil companies recover large volumes of commercially available hydrocarbons from deep reservoirs. These types of projects are complex in nature, involving management of multiple stakeholder interfaces, multidisciplinary personnel, complex contractor relationships, and turbulent environmental and market conditions, necessitating the application of proven project management best practices and critical success factors (CSFs) to achieve success. Although there is some practitioner oriented literature on project management CSFs for drilling projects, none of these is based on empirical evidence, from research. In addition, the literature has reported alarming rates of oil and gas drilling project failure, which is attributable not to technical factors, but to failure of project management. The aim of this quantitative correlational study therefore, was to discover an empirically verified list of project management CSFs, which consistent application leads to successful implementation of oil and gas drilling projects. The study collected survey data online, from a random sample of 127 oil and gas drilling personnel who were members of LinkedIn's online community "Drilling Supervisors, Managers, and Engineers". The results of the study indicated that 10 project management factors are individually related to project success of oil and gas drilling projects. These 10 CSFs are namely; Project mission, Top management support, Project schedule/plan, Client consultation, Personnel, Technical tasks, Client acceptance, Monitoring and feedback, Communication, and Troubleshooting. In addition, the study found that the relationships between the 10 CSFs and drilling project success is unaffected by participant and project demographics---role of project personnel, and project location. The significance of these findings are both practical, and theoretical. Practically, application of an empirically verified CSFs list to oil

  12. Parental involvement

    Directory of Open Access Journals (Sweden)

    Ezra S Simon

    2005-01-01

    Full Text Available Parent-Teacher Associations and other community groups can play a significant role in helping to establish and run refugee schools; their involvement can also help refugee adults adjust to their changed circumstances.

  13. Educational Policy and Children's Experience: Running Records in the Lower Primary Singaporean English Language Classroom

    Science.gov (United States)

    Jones, Sally Ann

    2011-01-01

    In this article, I report on a small project involving the use of guided reading groups, levelled texts and running records in a multilingual primary school in Singapore. I focus on running records and ask whether their use is suitable pedagogically and practically for the Singaporean context. The analysis of 22 records of primary one and primary…

  14. Ace Project as a Project Management Tool

    Science.gov (United States)

    Cline, Melinda; Guynes, Carl S.; Simard, Karine

    2010-01-01

    The primary challenge of project management is to achieve the project goals and objectives while adhering to project constraints--usually scope, quality, time and budget. The secondary challenge is to optimize the allocation and integration of resources necessary to meet pre-defined objectives. Project management software provides an active…

  15. Four Novel Cellulose Synthase (CESA Genes from Birch (Betula platyphylla Suk. Involved in Primary and Secondary Cell Wall Biosynthesis

    Directory of Open Access Journals (Sweden)

    Xuemei Liu

    2012-09-01

    Full Text Available Cellulose synthase (CESA, which is an essential catalyst for the generation of plant cell wall biomass, is mainly encoded by the CesA gene family that contains ten or more members. In this study; four full-length cDNAs encoding CESA were isolated from Betula platyphylla Suk., which is an important timber species, using RT-PCR combined with the RACE method and were named as BplCesA3, −4, −7 and −8. These deduced CESAs contained the same typical domains and regions as their Arabidopsis homologs. The cDNA lengths differed among these four genes, as did the locations of the various protein domains inferred from the deduced amino acid sequences, which shared amino acid sequence identities ranging from only 63.8% to 70.5%. Real-time RT-PCR showed that all four BplCesAs were expressed at different levels in diverse tissues. Results indicated that BplCESA8 might be involved in secondary cell wall biosynthesis and floral development. BplCESA3 appeared in a unique expression pattern and was possibly involved in primary cell wall biosynthesis and seed development; it might also be related to the homogalacturonan synthesis. BplCESA7 and BplCESA4 may be related to the formation of a cellulose synthase complex and participate mainly in secondary cell wall biosynthesis. The extremely low expression abundance of the four BplCESAs in mature pollen suggested very little involvement of them in mature pollen formation in Betula. The distinct expression pattern of the four BplCesAs suggested they might participate in developments of various tissues and that they are possibly controlled by distinct mechanisms in Betula.

  16. 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…

  17. Primary Cilia, Signaling Networks and Cell Migration

    DEFF Research Database (Denmark)

    Veland, Iben Rønn

    Primary cilia are microtubule-based, sensory organelles that emerge from the centrosomal mother centriole to project from the surface of most quiescent cells in the human body. Ciliary entry is a tightly controlled process, involving diffusion barriers and gating complexes that maintain a unique...... this controls directional cell migration as a physiological response. The ciliary pocket is a membrane invagination with elevated activity of clathrin-dependent endocytosis (CDE). In paper I, we show that the primary cilium regulates TGF-β signaling and the ciliary pocket is a compartment for CDE...... on formation of the primary cilium and CDE at the pocket region. The ciliary protein Inversin functions as a molecular switch between canonical and non-canonical Wnt signaling. In paper II, we show that Inversin and the primary cilium control Wnt signaling and are required for polarization and cell migration...

  18. Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

    Directory of Open Access Journals (Sweden)

    Togni Samantha

    2010-03-01

    Full Text Available Abstract Background Experimentation with continuous quality improvement (CQI processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. Methods We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Results Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of

  19. Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project.

    Science.gov (United States)

    Gardner, Karen L; Dowden, Michelle; Togni, Samantha; Bailie, Ross

    2010-03-13

    Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational linkages were critical to

  20. Inclusive Briefing and User Involvement

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2011-01-01

    Briefing is not just about specifying needs as requirements but also about evaluating how well design proposals fulfil needs and aspirations. Furthermore, briefing is not only about building design. Briefing starts at the preproject stage to create a basis for the project decision and can include...... by top management. The article describes the briefing processes and the methods for user involvement, identifies problem areas and points out possible improvements. The author was actively involved in the project as deputy project director, with responsibility for the briefing process, and is now...... includes a literature study on briefing and user involvement in building projects, and presents a case study of a major building project of a new headquarters and media centre for the Danish Broadcasting Corporation in Copenhagen. The building project was actively used as part of a corporate change process...

  1. Yakima/Klickitat Fisheries Project: Short Project Overview of Spring Chinook Salmon Supplementation in the Upper Yakima Basin; Washington Department of Fish and Wildlife Policy/Technical Involvement and Planning, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Fast, David E.; Bosch, William J.

    2005-09-01

    The Yakima/Klickitat Fisheries Project (YKFP) is on schedule to ascertain whether new artificial production techniques can be used to increase harvest and natural production of spring Chinook salmon while maintaining the long-term genetic fitness of the fish population being supplemented and keeping adverse genetic and ecological interactions with non-target species or stocks within acceptable limits. The Cle Elum Supplementation and Research Facility (CESRF) collected its first spring chinook brood stock in 1997, released its first fish in 1999, and age-4 adults have been returning since 2001. In these initial years of CESRF operation, recruitment of hatchery origin fish has exceeded that of fish spawning in the natural environment, but early indications are that hatchery origin fish are not as successful at spawning in the natural environment as natural origin fish when competition is relatively high. When competition is reduced, hatchery fish produced similar numbers of progeny as their wild counterparts. Most demographic variables are similar between natural and hatchery origin fish, however hatchery origin fish were smaller-at-age than natural origin fish. Long-term fitness of the target population is being evaluated by a large-scale test of domestication. Slight changes in predation vulnerability and competitive dominance, caused by domestication, were documented. Distribution of spawners has increased as a result of acclimation site location and salmon homing fidelity. Semi-natural rearing and predator avoidance training have not resulted in significant increases in survival of hatchery fish. However, growth manipulations in the hatchery appear to be reducing the number of precocious males produced by the YKFP and consequently increasing the number of migrants. Genetic impacts to non-target populations appear to be low because of the low stray rates of YKFP fish. Ecological impacts to valued non-target taxa were within containment objectives or impacts that

  2. Involvement Without Participation?

    DEFF Research Database (Denmark)

    Olsén, Peter

    2012-01-01

    The article presents a case study of a knowledge-intensive company that launched a 2-year project to improve their psychosocial working environment. All parties agreed on the project, and the methods used aimed to promote the involvement of the employees. Surprisingly, the psychosocial working...... environment did not improve; on the contrary, it deteriorated. The article highlights cultural and structural obstacles to the process, including an inadequate understanding of organisational learning and a narrow focus on market and competition. The endeavours did not consistently increase delegation...

  3. The EEE Project status and perspectives

    CERN Document Server

    Antolini, R; Baldini Ferroli, R; Bencivenni, G; Blanco, F; Bressan, E; Chiavassa, A; Cifarelli, L; Cindolo, F; Coccia, E; De Pasquale, S; Di Giovanni, A; D'Incecco, M; Fabbri, F L; Garbini, M; Gustavino, C; Hatzifotiadou, D; Imponente, G; La Rocca, P; Librizzi, F; Menghetti, H; Miozzi, S; Pappalardo,G S; Piragino, G; Riggi, F; Sartorelli, G; Sbarra, C; Selvi, M; Williams, C; Zichichi, A

    2007-01-01

    The Extreme Energy Events (EEE) project plans to build and use an array of cosmic ray telescopes for muon detection, distributed over the italian territory. The use of such telescopes, based on Multigap Resistive Plate Chambers (MRPC) will allow the study of cosmic ray showers and the correlation between multiple primaries producing distant showers. The project is also intended to involve high school teams in an advanced research work. The physics items which can be addressed by such array, and the present status and perspectives of the project are here discussed.

  4. Quality Education for the Pastoralist in Public Primary Schools in Kajiado County, Kenya: Case Study of Dupoto-E-Maa Education Project in Kajiado Central District

    Science.gov (United States)

    Ouda, James Bill; Opiyo, Rose Atieno; Wambiya, Pascal

    2015-01-01

    Conditions of learning are critical in determining quality of education. There have been real concerns raised by stakeholders regarding the quality of education for pastoralists in public primary schools in Kajiado Central District in Kenya. Interventions have been put in place to address the issue of quality education. One such intervention is…

  5. Some Observation on the Strengths and Weaknesses of the British Primary Schools. Project for Workshops--Studying Informal Education in the British Setting--England, Summer 1974.

    Science.gov (United States)

    Sorensen, Roselie

    In this paper some comparisons are made between the British Primary School system and the American school system. For example, the role of the British headmaster/mistress is considerably more powerful than the role of the American principal in areas concerning curriculum content, school personnel, use of auxiliary personnel, scheduling of…

  6. Safety Research Program for Light Water Reactors. Technical report 2: BMFT support project RS 0036 B. Reflooding experiments with regard to primary circuits (PKL) instrumentation of experimental setup

    International Nuclear Information System (INIS)

    Schweickert, H.; Mandl, R.

    The reflooding of the hot core of a PWR will be investigated in a model of the complete primary system. The demands that the instrumentation must meet as well as a description of the measurement methods used in the circuit are described. Data on the efficiency of the instruments, error estimates and constructive solutions to design problems are also given

  7. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long-term mortality impact.

    Science.gov (United States)

    Perry, Henry B; Rassekh, Bahie M; Gupta, Sundeep; Freeman, Paul A

    2017-06-01

    There is limited evidence about the long-term effectiveness of integrated community-based primary health care (CBPHC) in improving maternal, neonatal and child health. However, the interventions implemented and the approaches used by projects with such evidence can provide guidance for ending preventable child and maternal deaths by the year 2030. A database of 700 assessments of the effectiveness of CBPHC in improving maternal, neonatal and child health has been assembled, as described elsewhere in this series. A search was undertaken of these assessments of research studies, field project and programs (hereafter referred to as projects) with more than a single intervention that had evidence of mortality impact for a period of at least 10 years. Four projects qualified for this analysis: the Matlab Maternal Child Health and Family Planning (MCH-FP) P in Bangladesh; the Hôpital Albert Schweitzer in Deschapelles, Haiti; the Comprehensive Rural Health Project (CRHP) in Jamkhed, India; and the Society for Education, Action and Research in Community Health (SEARCH) in Gadchiroli, India. These four projects have all been operating for more than 30 years, and they all have demonstrated reductions in infant mortality, 1- to 4-year mortality, or under-5 mortality for at least 10 years. They share a number of characteristics. Among the most notable of these are: they provide comprehensive maternal, child health and family planning services, they have strong community-based programs that utilize community health workers who maintain regular contact with all households, they have develop strong collaborations with the communities they serve, and they all have strong referral capabilities and provide first-level hospital care. The shared features of these projects provide guidance for how health systems around the world might improve their effectiveness in improving maternal, neonatal and child health. Strengthening these features will contribute to achieving the goal of

  8. Storytelling in Projects

    DEFF Research Database (Denmark)

    Munk-Madsen, Andreas; Andersen, Peter Bøgh

    2006-01-01

    project managers should not only be concerned with project plans, but also with project stories. In this paper we explore some basic principles for transforming project plans into appealing stories. We discuss what may happen to stories once they are released into public space. And we illustrate how......Plans and stories are two different ways of communicating about projects. Project plans are formalized descriptions, primarily supporting coordination. Project stories are accounts whose primary function is emotional appeal. Project stories influence the projects’ chances of success. Therefore...... the possibilities of telling favorable stories may have repercussions on the project planning....

  9. Projets Pilotes Quebecois Portant sur L'Integration Scolaire aux Niveaux Pre-Scolaire et Primaire (Quebec Pilot Projects on Mainstreaming of Preschool and Primary-Level Schoolchildren).

    Science.gov (United States)

    Saint-Laurent, Lise; And Others

    1992-01-01

    This article synthesizes 55 Quebec (Canada) pilot projects on mainstreaming of pupils with learning disabilities, behavior disorders, physical or sensorial handicaps, or mental handicaps, at preschool and elementary levels. It focuses on extent of integration, interventions, training and support for teachers, and evaluation methodology used.…

  10. Practitioners' Views on Involving Young Children in Decision Making: Challenges for the Children's Rights Agenda

    Science.gov (United States)

    Hudson, Kim

    2012-01-01

    This article presents the key findings and discussion from a research project and subsequent report: "Involving young children in decision making: An exploration of practitioners' views". This research explored early childhood practitioners'--childcare workers, kindergarten, pre-primary and grade 1-2 teachers--views on decision making…

  11. Software Quality Perceptions of Stakeholders Involved in the Software Development Process

    Science.gov (United States)

    Padmanabhan, Priya

    2013-01-01

    Software quality is one of the primary determinants of project management success. Stakeholders involved in software development widely agree that quality is important (Barney and Wohlin 2009). However, they may differ on what constitutes software quality, and which of its attributes are more important than others. Although, software quality…

  12. Involvement of P-glycoprotein and multidrug resistance associated protein 1 in the transport of tanshinone IIB, a primary active diterpenoid quinone from the roots of Salvia miltiorrhiza, across the blood-brain barrier.

    Science.gov (United States)

    Zhou, Zhi-Wei; Chen, Xiao; Liang, Jun; Yu, Xi-Yong; Wen, Jing-Yuan; Zhou, Shu-Feng

    2007-08-01

    Tanshinone IIB (TSB) is a major constituent of Salvia miltiorrhiza, which is widely used in treatment of cardiovascular and central nervous system (CNS) diseases such as coronary heart disease and stroke. This study aimed to investigate the role of various drug transporters in the brain penetration of TSB using several in vitro and in vivo mouse and rat models. The uptake and efflux of TSB in rat primary microvascular endothelial cells (RBMVECs) were ATP-dependent and significantly altered in the presence of a P-glycoprotein (P-gp) or multidrug resistance associated protein (Mrp1/2) inhibitor. A polarized transport of TSB was found in RBMVEC monolayers with facilitated efflux from the abluminal to luminal side. Addition of a P-gp inhibitor (e.g. verapamil) in both abluminal and luminal sides attenuated the polarized transport. In an in situ rat brain perfusion model, TSB crossed the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier at a greater rate than that for sucrose, and the brain penetration was increased in the presence of a P-gp or Mrp1/2 inhibitor. The brain levels of TSB were only about 30% of that in the plasma and it could be increased to up to 72% of plasma levels when verapamil, quinidine, or probenecid was co-administered in rats. The entry of TSB to CNS increased by 67-97% in rats subjected to middle cerebral artery occlusion or treatment with the neurotoxin, quinolinic acid, compared to normal rats. Furthermore, The brain levels of TSB in mdr1a(-/-) and mrp1(-/-) mice were 28- to 2.6-fold higher than those in the wild-type mice. TSB has limited brain penetration through the BBB due to the contribution of P-gp and to a lesser extent of Mrp1 in rodents. Further studies are needed to confirm whether these corresponding transporters in humans are involved in limiting the penetration of TSB across the BBB and the clinical relevance.

  13. [Organization of primary health care in cities belonging to project for expansion and consolidation of the family health strategy in Mato Grosso State, Brazil].

    Science.gov (United States)

    Melo, Elza Machado de; Paiva, Lúcia; Alvares, Juliana; Flecha, André Luiz Dumont

    2008-01-01

    This article presents part of the results from the Baseline Study on the PROESF. The objective was to evaluate primary health care in the cities of Cuiabá, Várzea Grande, and Rondonópolis, Mato Grosso State, Brazil, based on the inter-subjectivity in human relations (among health workers, users of health services, and the public at large and within institutionalized levels of social control). A qualitative and quantitative methodology was used, including interviews with key informants; short meetings with managers; focal groups with managers; and interviews with users and health professionals from pre-selected health units. Scores were assigned to all the questions that indicated participatory processes in primary care practices in the various municipalities. Despite the geopolitical identity among the municipalities and their similar access to the same public policies, there was a significant difference in their performance of the functions pertaining to the organization of primary care and the Family Health Program, in terms of portal of entry into the system, longitudinality, comprehensiveness, and coordination. Differences were observed in the type of relations that were established (participatory versus non-participatory), corresponding to the previous difference.

  14. [The final situation in the Turkey "Stent for Life" project].

    Science.gov (United States)

    Ertaş, Gökhan; Kozan, Omer; Değertekin, Muzaffer; Kervan, Umit; Aksoy, Mehmet; Koç, Orhan; Göktekin, Omer

    2012-09-01

    The Stent for Life (SFL) project's main mission is to increase the use of primary percutaneous coronary intervention (PCI) in more than 70% of all acute ST segment elevation myocardial infarction (STEMI) patients. Previous to the SFL project, thrombolysis was the dominant reperfusion strategy since a low percentage of acute STEMI patients had access to primary PCI in our country. In this study, we present the main barriers of access to primary PCI in the centers that were involved with the SFL project. Patients with acute STEMI admitted to the centers that were involved in the SFL project between 2009 and 2011 were included in the analysis. Since the inception of the SFL project, the primary PCI rate has reached over 90% in SFL pilot cities. In the last 5 years, the number of ambulances and emergency stations has increased. Since the collaboration with 112 Emergency Service, a great majority of cases were reached via the emergency medical system. The mean door-to-balloon time for the pilot cities was 54.72±43.66 minutes. After three years of the SFL project, primary PCI has emerged as the preferred reperfusion strategy for patients with STEMI in pilot cities.

  15. Integrated Project Teams - An Essential Element of Project Management during Project Planning and Execution - 12155

    Energy Technology Data Exchange (ETDEWEB)

    Burritt, James G.; Berkey, Edgar [Longenecker and Associates, Las Vegas, NV 89135 (United States)

    2012-07-01

    Managing complex projects requires a capable, effective project manager to be in place, who is assisted by a team of competent assistants in various relevant disciplines. This team of assistants is known as the Integrated Project Team (IPT). he IPT is composed of a multidisciplinary group of people who are collectively responsible for delivering a defined project outcome and who plan, execute, and implement over the entire life-cycle of a project, which can be a facility being constructed or a system being acquired. An ideal IPT includes empowered representatives from all functional areas involved with a project-such as engineering design, technology, manufacturing, test and evaluation, contracts, legal, logistics, and especially, the customer. Effective IPTs are an essential element of scope, cost, and schedule control for any complex, large construction project, whether funded by DOE or another organization. By recently assessing a number of major, on-going DOE waste management projects, the characteristics of high performing IPTs have been defined as well as the reasons for potential IPT failure. Project managers should use IPTs to plan and execute projects, but the IPTs must be properly constituted and the members capable and empowered. For them to be effective, the project manager must select the right team, and provide them with the training and guidance for them to be effective. IPT members must treat their IPT assignment as a primary duty, not some ancillary function. All team members must have an understanding of the factors associated with successful IPTs, and the reasons that some IPTs fail. Integrated Project Teams should be used by both government and industry. (authors)

  16. Rationale and design of the PREDICE project: cost-effectiveness of type 2 diabetes prevention among high-risk Spanish individuals following lifestyle intervention in real-life primary care setting.

    Science.gov (United States)

    Costa, Bernardo; Cabré, Joan J; Sagarra, Ramon; Solà-Morales, Oriol; Barrio, Francisco; Piñol, Josep L; Cos, Xavier; Bolíbar, Bonaventura; Castell, Conxa; Kissimova-Skarbek, Katarzyna; Tuomilehto, Jaakko

    2011-08-04

    Type 2 diabetes is an important preventable disease and a growing public health problem. Based on information provided by clinical trials, we know that Type 2 diabetes can be prevented or delayed by lifestyle intervention. In view of translating the findings of diabetes prevention research into real-life it is necessary to carry out community-based evaluations so as to learn about the feasibility and effectiveness of locally designed and implemented programmes. The aim of this project was to assess the effectiveness of an active real-life primary care strategy in high-risk individuals for developing diabetes, and then evaluate its efficiency. Cost-Effectiveness analysis of the DE-PLAN (Diabetes in Europe - Prevention using Lifestyle, physical Activity and Nutritional intervention) project when applied to a Mediterranean population in Catalonia (DE-PLAN-CAT). Multicenter, longitudinal cohort assessment (4 years) conducted in 18 primary health-care centres (Catalan Health Institute). Individuals without diabetes aged 45-75 years were screened using the Finnish Diabetes Risk Score - FINDRISC - questionnaire and a 2-h oral glucose tolerance test. All high risk tested individuals were invited to participate in either a usual care intervention (information on diet and cardiovascular health without individualized programme), or the intensive DE-PLAN educational program (individualized or group) periodically reinforced. Oral glucose tolerance test was repeated yearly to determine diabetes incidence. Besides measuring the accumulated incidence of diabetes, information was collected on economic impact of the interventions in both cohorts (using direct and indirect cost questionnaires) and information on utility measures (Quality Adjusted Life Years). A cost-utility and a cost-effectiveness analysis will be performed and data will be modelled to predict long-term cost-effectiveness. The project was intended to evidence that a substantial reduction in Type 2 diabetes incidence

  17. Hanford DST Thermal and Seismic Project - Dytran Analysis Of Seismically Induced Fluid-Structure Interaction In A Hanford Double-Shell Primary Tank

    International Nuclear Information System (INIS)

    Mackey, T.C.; Rinker, M.W.; Abatt, F.G.

    2007-01-01

    Revision 0A of this document contains new Appendices C and D. Appendix C contains a re-analysis of the rigid and flexible tanks at the 460 in. liquid level and was motivated by recommendations from a Project Review held on March 20-21, 2006 (Rinker et al Appendix E of RPP-RPT-28968 Rev 1). Appendix D contains the benchmark solutions in support of the analyses in Appendix C.

  18. 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: ...

  19. Addressing the deficiencies in the evidence-base for primary practice in regional Australia - sentinel practices data sourcing (SPDS) project: a pilot study.

    Science.gov (United States)

    Ghosh, Abhijeet; Charlton, Karen E; Girdo, Lisa; Batterham, Marijka J; McDonald, Keith

    2013-08-01

    Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia. A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic disease management and prevention, prevalence of overweight and obesity, mental health indicators, medication profiling and home medicine reviews, as well as uptake of preventive health services (immunisation and cervical cancer screening). Higher than national average estimates were found for the age-adjusted prevalence of chronic diseases such as hypertension (14.3% for sample vs 10.4%, nationally), anxiety disorders (4.4% vs 3.8%) and obesity/overweight (67.1 vs 63.4%). Preventive health assessment items were undersubscribed, ranging from 6-20% in eligible patients. This pilot study has demonstrated that the scope of data collected by patient visits to their General Practitioners, facilitated through the Medicare-funded primary health care system in Australia, offers a feasible opportunity for monitoring of chronic disease prevalence and its associated risk factors. The inclusion of a larger number of sentinel sites that are generalizable to the population being served would provide an accurate and region-specific system for the purposes of population health planning at the primary care level in order to improve the overall health of the community.

  20. Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project.

    Science.gov (United States)

    Brazionis, L; Jenkins, A; Keech, A; Ryan, C; Brown, A; Boffa, J; Bursell, S

    2018-05-01

    To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy. Among 301 participants (33% male), gradable image rates were 78.7% (n = 237) for diabetic retinopathy and 83.1% (n = 250) for diabetic macular oedema, and 77.7% (n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19-86) years and known diabetes duration 9.0 (0-24) years. The prevalence of diabetic retinopathy was 47% (n = 110) and for diabetic macular oedema it was 14.4% (n = 36). In the fully gradable imaging studies, sight-threatening diabetic retinopathy prevalence was 16.2% (n = 38): 14.1% (n = 33) for clinically significant macular oedema, 1.3% (n = 3) for proliferative diabetic retinopathy and 0.9% (n = 2) for both. Sight-threatening diabetic retinopathy had been treated in 78% of detected cases. A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of 'any' diabetic retinopathy and sight-threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non-Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and

  1. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients

    Directory of Open Access Journals (Sweden)

    Engeser Peter

    2007-05-01

    Full Text Available Abstract Background The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To improve health care services for palliative patients in primary care, interested physicians in and around Heidelberg, Germany, are enabled to participate in the community-based program 'Palliative Medical Initiative North Baden (PAMINO' to improve their knowledge in dealing with palliative patients. The impact of this program on patients' health and quality of life remains to be evaluated. Methods/Design The evaluation of PAMINO is a non-randomized, controlled study. Out of the group of primary care physicians who took part in the PAMINO program, a sample of 45 physicians and their palliative patients will be compared to a sample of palliative patients of 45 physicians who did not take part in the program. Every four weeks for 6 months or until death, patients, physicians, and the patients' family caregivers in both groups answer questions to therapy strategies, quality of life (QLQ-C15-PAL, POS, pain (VAS, and burden for family caregivers (BSFC. The inclusion of physicians and patients in the study starts in March 2007. Discussion Although participating physicians value the increase in knowledge they receive from PAMINO, the effects on patients remain unclear. If the evaluation reveals a clear benefit for patients' quality of life, a larger-scale implementation of the program is considered. Trial registration: The study was registered at ‘current controlled trials (CCT’, registration number: ISRCTN78021852.

  2. Cooperative observations of air showers in Tasmania looking for anisotropies in 10 to the 13th - 10 to the 14th eV primaries /COALA project/

    Science.gov (United States)

    Fenton, A. G.; Fenton, K. B.; Humble, J. E.; Jacklyn, R. M.; Vrana, A.; Murakami, K.; Fujii, Z.; Yamada, T.; Sakakibara, S.; Fujimoto, K.; Ueno, H.; Nagashima, K.; Kondo, I.

    Observations of cosmic ray air showers in Tasmania beginning in 1981 are discussed. The shower array consists of 18 unit trays of 4-sq m proportional counters deployed over an area of 20 m x 160 m, and showers around a median primary energy of 5 x 10 to the 13th are to be observed. The observations are carried out in order to catch cosmic ray flows in a stereoscopic manner with simultaneous observations in the northern hemisphere, and the shower frequency in a fundamental coincidence mode is expected to be about 16,000 events per year.

  3. Parental Involvement and Academic Achievement

    Science.gov (United States)

    Goodwin, Sarah Christine

    2015-01-01

    This research study examined the correlation between student achievement and parent's perceptions of their involvement in their child's schooling. Parent participants completed the Parent Involvement Project Parent Questionnaire. Results slightly indicated parents of students with higher level of achievement perceived less demand or invitations…

  4. The health informatics cohort enhancement project (HICE: using routinely collected primary care data to identify people with a lifetime diagnosis of psychotic disorder

    Directory of Open Access Journals (Sweden)

    Economou Alexis

    2012-02-01

    Full Text Available Abstract Background We have previously demonstrated that routinely collected primary care data can be used to identify potential participants for trials in depression [1]. Here we demonstrate how patients with psychotic disorders can be identified from primary care records for potential inclusion in a cohort study. We discuss the strengths and limitations of this approach; assess its potential value and report challenges encountered. Methods We designed an algorithm with which we searched for patients with a lifetime diagnosis of psychotic disorders within the Secure Anonymised Information Linkage (SAIL database of routinely collected health data. The algorithm was validated against the "gold standard" of a well established operational criteria checklist for psychotic and affective illness (OPCRIT. Case notes of 100 patients from a community mental health team (CMHT in Swansea were studied of whom 80 had matched GP records. Results The algorithm had favourable test characteristics, with a very good ability to detect patients with psychotic disorders (sensitivity > 0.7 and an excellent ability not to falsely identify patients with psychotic disorders (specificity > 0.9. Conclusions With certain limitations our algorithm can be used to search the general practice data and reliably identify patients with psychotic disorders. This may be useful in identifying candidates for potential inclusion in cohort studies.

  5. Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.

    Science.gov (United States)

    Hall, Michaela T; Simms, Kate T; Lew, Jie-Bin; Smith, Megan A; Saville, Marion; Canfell, Karen

    2018-01-01

    Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017. Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males). Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates). However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives. Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses, resulting in

  6. Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.

    Directory of Open Access Journals (Sweden)

    Michaela T Hall

    Full Text Available Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017.Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males.Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates. However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives.Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses

  7. CAREM Project

    International Nuclear Information System (INIS)

    Ishida, Viviana; Gomez, Silvia

    2001-01-01

    CAREM project consists on the development and design of an advanced nuclear power plant. CAREM is a very low power innovative reactor conceived with new generation design solutions. Based on an indirect cycle integrated light water reactor using enriched uranium, CAREM has some distinctive features that greatly simplify the reactor and also contribute to a high level of safety: integrated primary system, primary system cooling by natural convection, self pressurization, and passive safety systems. In order to verify its innovative features the construction of a prototype is planned. (author)

  8. The virtual GULLIVER project

    NARCIS (Netherlands)

    Trappl, R.; Nijholt, Antinus; Stuk, M.; Zwiers, Jakob

    2002-01-01

    In this paper we discuss our virtual reality project Gulliver. This project is part of a more comprehensive project conceived by two artists, Matjaž Štuk and Alena Hudcovicová, called “Gulliver’s Museum of Living Art��?. Our part of the project involves a virtual reality version of Swift’s Gulliver

  9. Proposal of a New Public Health End of Life approach for Brazil: how the Project EstaraoSeuLado-Primary Palliative Care is working and how it can help.

    Science.gov (United States)

    Corrêa, Santiago

    2018-01-01

    Brazil has 206 million people, and 1.2 million deaths and 600,000 new cases of cancer per year. Palliative Care services are patchily distributed. The Family Health Strategy, made up from 41,000 primary care teams across Brazil forms a comprehensive primary care network. The Project EstaraoSeuLado-Primary Palliative Care developed working from Community Centers. We created a model based on compassionate communities, with community carers working alongside primary care teams. We identified people who need palliative care, gave them specific care and enrolled their carers into a program of monthly meetings called "Comunidade Cuidador". We discussed caring at end of life and provided skills training. During 2015 we ran 8 training programmes with an average of 10 carers. The major themes of discussion were carer burnout, dealing with denial and skills needed daily. The effect of these meetings was better relations between carers and professionals with expansion of the naturally occurring supportive network. The results of this project have been remarkable. The joint working of professionals and supportive networks together is recognised as being transformational. Carers themselves spread this approach by recommending it to others they know with life limiting illness. We will discuss the model and how it can be replicated more broadly across Brazil. Family Health teams can use tools of identification, evaluation and assessment working with networks including the community as an important part. We will propose a new model of End-of-Life Care to be adopted as national policy. We have implemented a compassionate community programme in the area of Rio Grande in Brazil. This has been a combination of primary care working in harmony with communities, providing education, resources and training to enhance the skill of communities to care for their dying. This is a necessary solution for Brazil, where resources and access to healthcare is limited. Our model is successful and

  10. 25 years of experience with closed cycle vapor turbogenerators as primary power source in remote telecommunications projects in Russia and CIS countries

    Energy Technology Data Exchange (ETDEWEB)

    Gropper, J. [ORMAT Industries Ltd., Yavne (Israel)

    2000-07-01

    One of the most severe problems confronting telecommunications projects in extreme arctic environment conditions, with temperatures as low as -60 C, is the supply of continuous, reliable remote power for unattended microwave repeater stations that in many cases cannot be reached by maintenance technicians for months at a time. Another important problem is that the telecommunications equipment must be kept at temperatures between 0 C and +45 C in order to ensure correct electronics operation. The obvious, simple solution of having an electrical heater in the equipment shelter is not practical because of the power required for such a heater. The use of specially designed, arctic type, closed cycle vapor turbogenerators (CCVT) and their associated non-electric heating systems in arctic telecommunication systems has solved both problems: reliable remote power in the range of 400 to 2500 Watts in provided with maintenance requirements reduced to a visit only once in 6 months or more, and required temperature ranges in equipment shelters are maintained, assuring correct operation of the sensitive electronics, without any need of electrical power. During the last 25 years, many major telecommunication projects in Siberia, Alaska and Antarctica have been designed to use and continue to use over 1200 arctic type closed cycle vapor turbogenerators. The CCVTs are designed to operate at nominal power in a range of temperatures from -60 to +45 C and at wind velocity of 120 km/hr, with acceptable gusts of 160 km/hr. They can be fuelled by either arctic kerosene or diesel fuel, or by natural or liquefied gas (LPG) and provide 24 or 48 VDC to the telecommunications equipment. The non-electric heating system associated with the CCVT draws extra heat accumulated in the CCVT's vapor turbogenerator in winter to vaporize a fluid that will transmit 1000 kcal/hr of heat to the equipment shelter or room where telecommunication equipment is located. The heating system is

  11. The Health Informatics Trial Enhancement Project (HITE: Using routinely collected primary care data to identify potential participants for a depression trial

    Directory of Open Access Journals (Sweden)

    Lyons Ronan A

    2010-04-01

    Full Text Available Abstract Background Recruitment to clinical trials can be challenging. We identified anonymous potential participants to an existing pragmatic randomised controlled depression trial to assess the feasibility of using routinely collected data to identify potential trial participants. We discuss the strengths and limitations of this approach, assess its potential value, report challenges and ethical issues encountered. Methods Swansea University's Health Information Research Unit's Secure Anonymised Information Linkage (SAIL database of routinely collected health records was interrogated, using Structured Query Language (SQL. Read codes were used to create an algorithm of inclusion/exclusion criteria with which to identify suitable anonymous participants. Two independent clinicians rated the eligibility of the potential participants' identified. Inter-rater reliability was assessed using the kappa statistic and inter-class correlation. Results The study population (N = 37263 comprised all adults registered at five general practices in Swansea UK. Using the algorithm 867 anonymous potential participants were identified. The sensitivity and specificity results > 0.9 suggested a high degree of accuracy from the algorithm. The inter-rater reliability results indicated strong agreement between the confirming raters. The Intra Class Correlation Coefficient (Cronbach's Alpha > 0.9, suggested excellent agreement and Kappa coefficient > 0.8; almost perfect agreement. Conclusions This proof of concept study showed that routinely collected primary care data can be used to identify potential participants for a pragmatic randomised controlled trial of folate augmentation of antidepressant therapy for the treatment of depression. Further work will be needed to assess generalisability to other conditions and settings and the inclusion of this approach to support Electronic Enhanced Recruitment (EER.

  12. Effect of an educational intervention in primary care physicians on the compliance of indicators of good clinical practice in the treatment of type 2 diabetes mellitus [OBTEDIGA project].

    Science.gov (United States)

    Vidal-Pardo, J I; Pérez-Castro, T R; López-Álvarez, X L; Santiago-Pérez, M I; García-Soidán, F J; Muñiz, J

    2013-08-01

    To evaluate the effect of an educational intervention among primary care physicians on several indicators of good clinical practice in diabetes care. Two groups of physicians were randomly assigned to the intervention or control group (IG and CG). Every physician randomly selected two samples of patients from all type 2 diabetic patients aged 40 years and above and diagnosed more than a year ago. Baseline and final information were collected cross-sectionally 12 months apart, in two independent samples of 30 patients per physician. The educational intervention comprised: distribution of educational materials and physicians' specific bench-marking information, an on-line course and three on-site educational workshops on diabetes. External observers collected information directly from the physicians and from the medical records of the patients on personal and family history of disease and on the evolution and treatment of their disease. Baseline information was collected retrospectively in the control group. Intervention group comprised 53 physicians who included a total of 3018 patients in the baseline and final evaluations. CG comprised 50 physicians who included 2868 patients in the same evaluations. Measurement of micro-albuminuria in the last 12 months (OR = 1.6, 95% CI: 1.1-2.4) and foot examination in the last year (OR = 2.0, 95% CI: 1.1-3.6) were the indicators for which greater improvement was found in the IG. No other indicator considered showed statistically significant improvement between groups. The identification of indicators with very low level of compliance and the implementation of a simple intervention in physicians to correct them is effective in improving the quality of care of diabetic patients. © 2013 John Wiley & Sons Ltd.

  13. The Olkiluoto 3 project

    International Nuclear Information System (INIS)

    Knoche, Ph.

    2009-01-01

    This series of slides presents the Olkiluoto 3 project involving the EPR (European Pressurized water Reactor). This EPR is the first reactor of third generation to have be put into construction. The contract was signed between the Areva-Siemens consortium and the Tvo Finn company in december 2003. The construction of the first-off reactor is always a big challenge but also opens the way for its industrial development as it brings knowledge and experience: Olkiluoto is the first international licensing of the EPR, a valuable feedback experience has been acquired on both the fabrication of the primary components and the qualification of the suppliers. A point on the state of the construction works is made at the first term 2009. (A.C.)

  14. Impact of 4 different definitions used for the assessment of the prevalence of the Metabolic Syndrome in primary healthcare:The German Metabolic and Cardiovascular Risk Project (GEMCAS

    Directory of Open Access Journals (Sweden)

    Wasem Jürgen

    2007-09-01

    Full Text Available Abstract Background The metabolic syndrome (MetSyn places individuals at increased risk for type 2 diabetes and cardiovascular disease. Prevalence rates of the population of the MetSyn are still scarce. Moreover, the impact of different definitions of the MetSyn on the prevalence is unclear. Aim here is to assess the prevalence of the MetSyn in primary health care and to investigate the impact of four different definitions of the MetSyn on the determined prevalence with regard to age, gender and socio-economic status. Methods The German-wide cross-sectional study was conducted during two weeks in October 2005 in 1.511 randomly selected general practices. Blood samples were analyzed, blood pressure and waist circumference assessed, data on lifestyle, medication, chronic disorders, and socio-demographic characteristics collected. MetSyn prevalence was estimated according to the definitions of NCEP ATP III (2001, AHA/NHLBI (2004, 2005, and IDF (2005. Descriptive statistics and prevalence rate ratios using the PROG GENMOD procedure, were calculated. Cohen's kappa was used as measure for interreliability between the different prevalence estimates. Results Data of 35,869 patients (age range: 18–99, women 61.1% were included. The prevalence was lowest using the NCEP ATP III- (all: 19.8%, men 22.7%, women: 18.0%, highest according to the IDF-definition (32.7%, 40.3%, 28.0%. The increase in prevalence with recent definitions was more pronounced for men than for women, and was particularly high for men and women aged 60–79 years. The IDF-definition resulted in a higher prevalence especially in those with the highest educational status. Agreement (kappa between the NCEP ATP III- and IDF-definition was 0.68 (men 0.61, women 0.74, between the updated the AHA/NHLBI- (2005 and IDF-definition 0.85 (men 0.79, women 0.89. Conclusion The prevalence of metabolic syndrome is associated with age, gender, and educational status and increases considerably with each

  15. Project mobilisation

    International Nuclear Information System (INIS)

    Clark, J.; Limbrick, A.

    1996-01-01

    This paper identifies and reviews the issues to be addressed and the procedures to be followed during the mobilisation of projects using LFG as an energy source. Knowledge of the procedures involved in project mobilisation, their sequence and probable timescales, is essential for efficient project management. It is assumed that the majority of projects will be situated on existing, licensed landfill sites and, in addition to complying with the relevant conditions of the waste management licence and original planning consent, any proposed developments on the site will require a separate planning consent. Experience in the UK indicates that obtaining planning permission rarely constitutes a barrier to the development of schemes for the utilisation of LFG. Even so, an appreciation of the applicable environmental and planning legislation is essential as this will enable the developer to recognise the main concerns of the relevant planning authority at an early stage of the project, resulting in the preparation of an informed and well-structured application for planning permission. For a LFG utilisation scheme on an existing landfill site, the need to carry out an environmental assessment (EA) as part of the application for planning permission will, in vitually all cases, be discretionary. Even if not deemed necessary by the planning authority, an EA is a useful tool at the planning application stage, to identify and address potential problems and to support discussions with bodies such as the Environment Agency, from whom consents or authorisations may be required. Carrying out an EA can thus provide for more cost-effective project development and enhanced environmental protection. Typically, the principal contractual arrangements, such as the purchase of gas or the sale of electricity, will have been established before the project mobilisation phase. However, there are many other contractural arrangements that must be established, and consents and permits that may be

  16. Project Finance: Basic Components

    OpenAIRE

    Alfieri Li Ojeda, Jaime

    2015-01-01

    The natural speed of the contemporary world demands large investment projects which require specialized financial techniques such as Project Finance, defined as a fund to finance investment projects of great magnitude. Every Project Finance involves a wide range of elements such as promoters, government, contractors andsuppliers, among others, that will ensure project success. La rapidez del mundo contemporáneo exige que los grandes proyectos de inversión requieran de técnicas financieras ...

  17. Impact of Project Leadership Facets on Project Outcome

    Directory of Open Access Journals (Sweden)

    Arslan Ayub

    2015-08-01

    Full Text Available The study analyzes the role of project leadership facets on effective project outcome. Numerous such initiatives have already been taken on project outcome/performance in the context of apposite leadership styles or project management. However, the current study is unique in the milieu of project outcome that it introduces a new leadership approach, which throws light on the significance of variant leadership facets on project outcome. The study uses explanatory approach; primary data is collected from project management professionals working in different project organizations. The study uses structural equation model (SEM technique to test the hypothesis. The study found a positive relationship between project leadership facets and project outcome.

  18. Integrating chronic care with primary care activities: enriching healthcare staff knowledge and skills and improving glycemic control of a cohort of people with diabetes through the First Line Diabetes Care Project in the Philippines

    Directory of Open Access Journals (Sweden)

    Grace Marie V. Ku

    2014-10-01

    Full Text Available Background: This study investigated the effects of integrating primary chronic care with current healthcare activities in two local government health units (LGHU of the Philippines on knowledge and skills of the LGHU staff and clinical outcomes for people with diabetes. Design: Integration was accomplished through health service reorganization, (redistribution of chronic care tasks, and training of LGHU staff. Levels of the staff's pre- and post-training diabetes knowledge and of their self-assessment of diabetes care-related skills were measured. Primary diabetes care with emphasis on self-care development was provided to a cohort of people with diabetes. Glycosylated hemoglobin (HbA1c and obesity measures were collected prior to and one year after full project implementation. Results: The training workshop improved diabetes knowledge (p<0.001 and self-assessed skills (p<0.001 of the LGHU staff. Significant reductions in HbA1c (p<0.001, waist–hip ratio (p<0.001 and waist circumference (p=0.011 of the cohort were noted. Although the reduction in HbA1c was somewhat greater among those whose community-based care providers showed improvement in knowledge and self-assessed skills, the difference was not statistically significant. Conclusions: Primary care for chronic conditions such as diabetes may be integrated with other healthcare activities in health services of low-to-middle-income countries such as the Philippines, utilizing pre-existing human resources for health, and may improve clinical endpoints.

  19. The Day-to-Day Work of Primary School Teachers: A Source of Professional Learning

    Science.gov (United States)

    Ambler, Trudy Belinda

    2016-01-01

    Teachers are an important influence on students' learning, and therefore the opportunity for teachers to learn and develop is something of interest to educators internationally. This article reports on a research project involving six primary school teachers who participated in one-on-one and small group interviews to explore the opportunities for…

  20. Peer Observation of Teaching: Perceptions and Experiences of Teachers in a Primary School in Cyprus

    Science.gov (United States)

    Karagiorgi, Yiasemina

    2012-01-01

    This article examines teachers' perceptions of, and experiences with, professional development opportunities involving a school-based project on peer observation of teaching. The study aims to reveal the ways in which seven teachers in one primary school in Cyprus see themselves as agents improving their own and peers' teaching through informal…

  1. Managing Parent Involvement during Crisis

    Science.gov (United States)

    Merriman, Lynette S.

    2008-01-01

    In the wake of 9/11, Hurricane Katrina, and the Virginia Tech shooting tragedy, it is no surprise that concern for students' safety is the primary reason attributed to parents' increased involvement. Parents and university administrators share in their commitment to student safety. However, college and university staff who assume responsibility…

  2. Eye involvement in haematological malignancies

    NARCIS (Netherlands)

    Riemens, J.A.

    2014-01-01

    This thesis describes the involvement of the eye in haematological malignancies and focuses on two topics; primary vitreoretinal lymphoma (PVRL) and ocular Graft-versus-Host Disease (GvHD). The aim of this thesis is first: to compare the efficacy of diverse treatment options of PVRL with regard to

  3. Summary of Research through Phase II/Year 2 of Initially Approved 3 Phase/3 Year Project - Establishing the Relationship between Fracture-Related Dolomite and Primary Rock Fabric on the Distribution of Reservoirs in the Michigan Basin

    Energy Technology Data Exchange (ETDEWEB)

    G. Grammer

    2007-09-30

    This final scientific/technical report covers the first 2 years (Phases I and II of an originally planned 3 Year/3 Phase program). The project was focused on evaluating the relationship between fracture-related dolomite and dolomite constrained by primary rock fabric in the 3 most prolific reservoir intervals in the Michigan Basin. The characterization of select dolomite reservoirs was the major focus of our efforts in Phases I and II of the project. Structural mapping and log analysis in the Dundee (Devonian) and Trenton/Black River (Ordovician) suggest a close spatial relationship among gross dolomite distribution and regional-scale, wrench fault-related NW-SE and NE-SW structural trends. A high temperature origin for much of the dolomite in these 2 studied intervals (based upon fluid inclusion homogenization temperatures and stable isotopic analyses,) coupled with persistent association of this dolomite in reservoirs coincident with wrench fault-related features, is strong evidence for these reservoirs being influenced by hydrothermal dolomitization. In the Niagaran (Silurian), there is a general trend of increasing dolomitization shelfward, with limestone predominant in more basinward positions. A major finding is that facies types, when analyzed at a detailed level, are directly related to reservoir porosity and permeability in these dolomites which increases the predictability of reservoir quality in these units. This pattern is consistent with our original hypothesis of primary facies control on dolomitization and resulting reservoir quality at some level. The identification of distinct and predictable vertical stacking patterns within a hierarchical sequence and cycle framework provides a high degree of confidence at this point that the results should be exportable throughout the basin. Much of the data synthesis and modeling for the project was scheduled to be part of Year 3/Phase III, but the discontinuation of funding after Year 2 precluded those efforts

  4. 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.

  5. 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....

  6. CAREM-25: considerations about primary coolant chemistry

    International Nuclear Information System (INIS)

    Chocron, Mauricio; Iglesias, Alberto M.; Raffo Calderon, Maria C.; Villegas, Marina

    2000-01-01

    World operating experience, in conjunction with basic studies has been modifying chemistry specifications for the primary coolant of water cooled nuclear reactors along with the reactor type and structural materials involved in the design. For the reactor CAREM-25, the following sources of information have been used: 1) Experience gained by the Chemistry Department of the National Atomic Energy Commission (CNEA, Argentina); 2) Participation of the Chemistry Department (CNEA) in international cooperation projects; 3) Guidelines given by EPRI, Siemens-KWU, AECL, etc. Given the main objectives: materials integrity, low radiation levels and personnel safety, which are in turn a balance between the lowest corrosion and activity transport achievable and considering that the CAREM-25 is a pressurized vessel integrated reactor, a group of guidelines for the chemistry and additives for the primary coolant have been given in the present work. (author)

  7. Readiness of primary school teachers to accept disabled children

    Directory of Open Access Journals (Sweden)

    Đević Rajka

    2009-01-01

    Full Text Available The paper presents the results of the research with the basic goal to study the readiness of primary school teachers to accept disabled students. Research participants were 205 teachers from primary schools at the territory of Serbia. The goal was accomplished through: (a studying attitudes towards joint education of disabled students and their peers; (b studying teachers' experiences in working with disabled students; and (c studying teachers' readiness to accept disabled students, depending on their involvement/non-involvement in projects of inclusive education. Teachers express supportive attitudes towards joint schooling, but more than one half of them think that a selective approach is necessary in that process, according to the kind and degree of developmental disability. They support joint schooling from the humanistic point of view, but express concerns about the academic achievement of classes that include disabled students. The majority of teachers had experience in working with disabled students and based on that provided interesting suggestions for improving joint schooling. Higher readiness for accepting disabled students was demonstrated by teachers whose schools were involved in the projects of inclusive education. That implies the need for involving schools in similar projects and enabling teachers' immediate contact with students with developmental disabilities.

  8. Patient involvement in hospital architecture

    DEFF Research Database (Denmark)

    Herriott, Richard

    2017-01-01

    the structure of the design process, identification and ranking of stakeholders, the methods of user-involvement and approaches to accessibility. The paper makes recommendations for a change of approach to user-participation in large-scale, long-duration projects. The paper adds new insight on an under...

  9. in primary care

    African Journals Online (AJOL)

    Claire van Deventer

    Keywords: child HIV, doctor involvement, primary health care, quality improvement ... expertise increased, PHC facilities are now expected to be able to .... organised patient documentation were revisited. .... Review: what can we learn from quality ... South Pacific: Review of evidence and lessons from an innovative.

  10. Britain's delegation to CERN, the European Centre for Nuclear Research near Geneva, voted in favour of a project which take seven years to build, involve a 27 kilometre long tunnel, and cost 230 million pounds. Now LEP receives the go-ahead later this month

    CERN Multimedia

    Llewellyn Smith, Christopher Hubert

    1981-01-01

    Britain's delegation to CERN, the European Centre for Nuclear Research near Geneva, voted in favour of a project which take seven years to build, involve a 27 kilometre long tunnel, and cost 230 million pounds. Now LEP receives the go-ahead later this month

  11. The PACARDO research project: youthful drug involvement in Central America and the Dominican Republic Proyecto de investigación PACARDO: el consumo de drogas entre la juventud en Centroamérica y la República Dominicana

    Directory of Open Access Journals (Sweden)

    Catherine M. Dormitzer

    2004-06-01

    Full Text Available OBJECTIVE: To estimate the occurrence and school-level clustering of drug involvement among school-attending adolescent youths in each of seven countries in Latin America, drawing upon evidence from the PACARDO research project, a multinational collaborative epidemiological research study. METHODS: During 1999-2000, anonymous self-administered questionnaires on drug involvement and related behaviors were administered to a cross-sectional, nationally representative sample that included a total of 12 797 students in the following seven countries: Costa Rica (n= 1 702, the Dominican Republic (n= 2 023, El Salvador (n= 1 628, Guatemala (n= 2 530, Honduras (n= 1 752, Nicaragua (n= 1 419, and Panama (n= 1 743. (The PACARDO name concatenates PA for Panamá,CA for Centroamérica,and RDO for República Dominicana. Estimates for exposure opportunity and actual use of alcohol, tobacco, inhalants, marijuana, cocaine (crack/coca paste, amphetamines and methamphetamines, tranquilizers, ecstasy, and heroin were assessed via responses about questions on age of first chance to try each drug, and first use. Logistic regression models accounting for the complex survey design were used to estimate the associations of interest. RESULTS: Cumulative occurrence estimates for alcohol, tobacco, inhalants, marijuana, and illegal drug use for the overall sample were, respectively: 52%, 29%, 5%, 4%, and 5%. In comparison to females, males were more likely to use alcohol, tobacco, inhalants, marijuana, and illegal drugs; the odds ratio estimates were 1.3, 2.1, 1.6, 4.1, and 3.2, respectively. School-level clustering was noted in all countries for alcohol and tobacco use; it was also noted in Costa Rica, El Salvador, Guatemala, and Panama for illegal drug use. CONCLUSIONS: This report sheds new light on adolescent drug experiences in Panama, the five Spanish-heritage countries of Central America, and the Dominican Republic, and presents the first estimates of school

  12. MAXimising Involvement in MUltiMorbidity (MAXIMUM) in primary care: protocol for an observation and interview study of patients, GPs and other care providers to identify ways of reducing patient safety failures.

    Science.gov (United States)

    Daker-White, Gavin; Hays, Rebecca; Esmail, Aneez; Minor, Brian; Barlow, Wendy; Brown, Benjamin; Blakeman, Thomas; Bower, Peter

    2014-08-18

    Increasing numbers of older people are living with multiple long-term health conditions but global healthcare systems and clinical guidelines have traditionally focused on the management of single conditions. Having two or more long-term conditions, or 'multimorbidity', is associated with a range of adverse consequences and poor outcomes and could put patients at increased risk of safety failures. Traditionally, most research into patient safety failures has explored hospital or inpatient settings. Much less is known about patient safety failures in primary care. Our core aims are to understand the mechanisms by which multimorbidity leads to safety failures, to explore the different ways in which patients and services respond (or fail to respond), and to identify opportunities for intervention. We plan to undertake an applied ethnographic study of patients with multimorbidity. Patients' interactions and environments, relevant to their healthcare, will be studied through observations, diary methods and semistructured interviews. A framework, based on previous studies, will be used to organise the collection and analysis of field notes, observations and other qualitative data. This framework includes the domains: access breakdowns, communication breakdowns, continuity of care errors, relationship breakdowns and technical errors. Ethical approval was received from the National Health Service Research Ethics Committee for Wales. An individual case study approach is likely to be most fruitful for exploring the mechanisms by which multimorbidity leads to safety failures. A longitudinal and multiperspective approach will allow for the constant comparison of patient, carer and healthcare worker expectations and experiences related to the provision, integration and management of complex care. This data will be used to explore ways of engaging patients and carers more in their own care using shared decision-making, patient empowerment or other relevant models. Published by

  13. Connecting Mathematics in Primary Science Inquiry Projects

    Science.gov (United States)

    So, Winnie Wing-mui

    2013-01-01

    Science as inquiry and mathematics as problem solving are conjoined fraternal twins attached by their similarities but with distinct differences. Inquiry and problem solving are promoted in contemporary science and mathematics education reforms as a critical attribute of the nature of disciplines, teaching methods, and learning outcomes involving…

  14. Savannah River bus project

    Energy Technology Data Exchange (ETDEWEB)

    Summers, W.A. [Westinghouse Savannah River Co., Aiken, SC (United States)

    1998-08-01

    The H2Fuel Bus is the world`s first hybrid hydrogen electric transit bus. It was developed through a public/private partnership involving several leading technology and industrial organizations in the Southeast, with primary funding and program management provided by the Department of Energy. The primary goals of the project are to gain valuable information on the technical readiness and economic viability of hydrogen buses and to enhance the public awareness and acceptance of emerging hydrogen technologies. The bus has been operated by the transit agency in Augusta, Georgia since April, 1997. It employs a hybrid IC engine/battery/electric drive system, with onboard hydrogen fuel storage based on the use of metal hydrides. Initial operating results have demonstrated an overall energy efficiency (miles per Btu) of twice that of a similar diesel-fueled bus and an operating range twice that of an all-battery powered electric bus. Tailpipe emissions are negligible, with NOx less than 0.2 ppm. Permitting, liability and insurance issues were addressed on the basis of extensive risk assessment and safety analyses, with the inherent safety characteristic of metal hydride storage playing a major role in minimizing these concerns. Future plans for the bus include continued transit operation and use as a national testbed, with potential modifications to demonstrate other hydrogen technologies, including fuel cells.

  15. Comparison of primary tumour volumes delineated on four-dimensional computed tomography maximum intensity projection and 18F-fluorodeoxyglucose positron emission tomography computed tomography images of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Duan, Yili; Li, Jianbin; Zhang, Yingjie; Wang, Wei; Fan, Tingyong; Shao, Qian; Xu, Min; Guo, Yanluan; Sun, Xiaorong; Shang, Dongping

    2015-01-01

    The study aims to compare the positional and volumetric differences of tumour volumes based on the maximum intensity projection (MIP) of four-dimensional CT (4DCT) and 18 F-fluorodexyglucose ( 18 F-FDG) positron emission tomography CT (PET/CT) images for the primary tumour of non-small cell lung cancer (NSCLC). Ten patients with NSCLC underwent 4DCT and 18 F-FDG PET/CT scans of the thorax on the same day. Internal gross target volumes (IGTVs) of the primary tumours were contoured on the MIP images of 4DCT to generate IGTV MIP . Gross target volumes (GTVs) based on PET (GTV PET ) were determined with nine different threshold methods using the auto-contouring function. The differences in the volume, position, matching index (MI) and degree of inclusion (DI) of the GTV PET and IGTV MIP were investigated. In volume terms, GTV PET2.0 and GTV PET20% approximated closely to IGTV MIP with mean volume ratio of 0.93 ± 0.45 and 1.06 ± 0.43, respectively. The best MI was between IGTV MIP and GTV PET20% (0.45 ± 0.23). The best DI of IGTV MIP in GTV PET was IGTV MIP in GTV PET20% (0.61 ± 0.26). In 3D PET images, the GTVPET contoured by standardised uptake value (SUV) 2.0 or 20% of maximal SUV (SUV max ) approximate closely to the IGTV MIP in target size, while the spatial mismatch is apparent between them. Therefore, neither of them could replace IGTV MIP in spatial position and form. The advent of 4D PET/CT may improve the accuracy of contouring the perimeter for moving targets.

  16. The Sydney playground project: popping the bubblewrap--unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills.

    Science.gov (United States)

    Bundy, Anita C; Naughton, Geraldine; Tranter, Paul; Wyver, Shirley; Baur, Louise; Schiller, Wendy; Bauman, Adrian; Engelen, Lina; Ragen, Jo; Luckett, Tim; Niehues, Anita; Stewart, Gabrielle; Jessup, Glenda; Brentnall, Jennie

    2011-09-01

    In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.

  17. The sydney playground project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills

    Science.gov (United States)

    2011-01-01

    Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Trial registration Australian and New Zealand Clinical

  18. The sydney playground project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills

    Directory of Open Access Journals (Sweden)

    Luckett Tim

    2011-09-01

    Full Text Available Abstract Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT, in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention, with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1 Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2 Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Trial registration Australian

  19. Design of the Bottom-up Innovation project--a participatory, primary preventive, organizational level intervention on work-related stress and well-being for workers in Dutch vocational education.

    Science.gov (United States)

    Schelvis, Roosmarijn M C; Oude Hengel, Karen M; Wiezer, Noortje M; Blatter, Birgitte M; van Genabeek, Joost A G M; Bohlmeijer, Ernst T; van der Beek, Allard J

    2013-08-15

    In the educational sector job demands have intensified, while job resources remained the same. A prolonged disbalance between demands and resources contributes to lowered vitality and heightened need for recovery, eventually resulting in burnout, sickness absence and retention problems. Until now stress management interventions in education focused mostly on strengthening the individual capacity to cope with stress, instead of altering the sources of stress at work at the organizational level. These interventions have been only partly effective in influencing burnout and well-being. Therefore, the "Bottom-up Innovation" project tests a two-phased participatory, primary preventive organizational level intervention (i.e. a participatory action approach) that targets and engages all workers in the primary process of schools. It is hypothesized that participating in the project results in increased occupational self-efficacy and organizational efficacy. The central research question: is an organization focused stress management intervention based on participatory action effective in reducing the need for recovery and enhancing vitality in school employees in comparison to business as usual? The study is designed as a controlled trial with mixed methods and three measurement moments: baseline (quantitative measures), six months and 18 months (quantitative and qualitative measures). At first follow-up short term effects of taking part in the needs assessment (phase 1) will be determined. At second follow-up the long term effects of taking part in the needs assessment will be determined as well as the effects of implemented tailored workplace solutions (phase 2). A process evaluation based on quantitative and qualitative data will shed light on whether, how and why the intervention (does not) work(s). "Bottom-up Innovation" is a combined effort of the educational sector, intervention providers and researchers. Results will provide insight into (1) the relation between

  20. Ulex europaeus agglutinin-I binding to dental primary afferent projections in the spinal trigeminal complex combined with double immunolabeling of substance P and GABA elements using peroxidase and colloidal gold.

    Science.gov (United States)

    Matthews, M A; Hoffmann, K D; Hernandez, T V

    1989-01-01

    Ulex europaeus agglutinin I (UEA-I) is a plant lectin with an affinity for L-fucosyl residues in the chains of lactoseries oligosaccharides associated with medium- and smaller-diameter dorsal root ganglion neurons and their axonal processes. These enter Lissauer's tract and terminate within the superficial laminae of the spinal cord overlapping projections known to have a nociceptive function. This implies that the surface coatings of neuronal membranes may have a relationship with functional modalities. The present investigation further examined this concept by studying a neuronal projection with a nociceptive function to determine whether fucosyl-lactoseries residues were incorporated in its primary afferent terminals. Transganglionic transport of horseradish peroxidase (HRP) following injection into tooth pulp chambers was employed to demonstrate dental pulp terminals in the trigeminal spinal complex, while peroxidase and fluorescent tags were used concomitantly to stain for UEA-I. Double immunolabeling for substance P (SP) and gamma-aminobutyric acid (GABA) using peroxidase and colloidal gold allowed a comparison of the distribution of a known excitatory nociceptive transmitter with that of UEA-I binding in specific subnuclei. Synaptic interrelationships between UEA-I positive dental pulp primary afferent inputs and specific inhibitory terminals were also examined. SP immunoreactivity occurred in laminae I and outer lamina II (IIo) of subnucleus caudalis (Vc) and in the ventrolateral and lateral marginal region of the caudal half of subnucleus interpolaris (Vi), including the periobex area in which Vi is slightly overlapped on its lateral aspect by cellular elements of Vc. The adjacent interstitial nucleus (IN) also showed an intense immunoreactivity for this peptide antibody. UEA-I binding displayed a similar distribution pattern in both Vc and Vi, but extended into lamina IIi and the superficial part of Lamina III in Vc. Dental pulp terminals were found to

  1. Sun light European Project

    Science.gov (United States)

    Soubielle, Marie-Laure

    2015-04-01

    2015 has been declared the year of light. Sunlight plays a major role in the world. From the sunbeams that heat our planet and feed our plants to the optical analysis of the sun or the modern use of sun particles in technologies, sunlight is everywhere and it is vital. This project aims to understand better the light of the Sun in a variety of fields. The experiments are carried out by students aged 15 to 20 in order to share their discoveries with Italian students from primary and secondary schools. The experiments will also be presented to a group of Danish students visiting our school in January. All experiments are carried out in English and involve teams of teachers. This project is 3 folds: part 1: Biological project = what are the mechanisms of photosynthesis? part 2: Optical project= what are the components of sunlight and how to use it? part 3: Technical project= how to use the energy of sunlight for modern devices? Photosynthesis project Biology and English Context:Photosynthesis is a process used by plants and other organisms to convert light energy, normally from the Sun, into chemical energy that can later fuel the organisms' activities. This chemical energy is stored in molecules which are synthesized from carbon dioxide and water. In most cases, oxygen is released as a waste product. Most plants perform photosynthesis. Photosynthesis maintains atmospheric oxygen levels and supplies all of the organic compounds and most of the energy necessary for life on Earth. Outcome: Our project consists in understanding the various steps of photosynthesis. Students will shoot a DVD of the experiments presenting the equipments required, the steps of the experiments and the results they have obtained for a better understanding of photosynthesis Digital pen project Electricity, Optics and English Context: Sunlight is a complex source of light based on white light that can be decomposed to explain light radiations or colours. This light is a precious source to create

  2. Memantine, a Low-Affinity NMDA Receptor Antagonist, Protects against Methylmercury-Induced Cytotoxicity of Rat Primary Cultured Cortical Neurons, Involvement of Ca2+ Dyshomeostasis Antagonism, and Indirect Antioxidation Effects.

    Science.gov (United States)

    Liu, Wei; Xu, Zhaofa; Yang, Tianyao; Xu, Bin; Deng, Yu; Feng, Shu

    2017-09-01

    Methylmercury (MeHg) is an extremely dangerous environmental pollutant that induces severe toxic effects in the central nervous system. Neuronal damage plays critical roles mediating MeHg-induced loss of brain function and neurotoxicity. The molecular mechanisms of MeHg neurotoxicity are incompletely understood. The objective of the study is to explore mechanisms that contribute to MeHg-induced neurocyte injuries focusing on neuronal Ca 2+ dyshomeostasis and alteration of N-methyl-D-aspartate receptors (NMDARs) expression, as well as oxidative stress in primary cultured cortical neurons. In addition, the neuroprotective effects of memantine against MeHg cytotoxicity were also investigated. The cortical neurons were exposed to 0, 0.01, 0.1, 1, or 2 μM methylmercury chloride (MeHgCl) for 0.5-12 h, or pre-treated with 2.5, 5, 10, or 20 μM memantine for 0.5-6 h, respectively; cell viability and LDH release were then quantified. For further experiments, 2.5, 5, and 10 μM of memantine pre-treatment for 3 h followed by 1 μM MeHgCl for 6 h were performed for evaluation of neuronal injuries, specifically addressing apoptosis; intracellular free Ca 2+ concentrations; ATPase activities; calpain activities; expressions of NMDAR subunits (NR1, NR2A, NR2B); NPSH levels; and ROS formation. Exposure of MeHgCl resulted in toxicity of cortical neurons, which were shown as a loss of cell viability, high levels of LDH release, morphological changes, and cell apoptosis. Moreover, intracellular Ca 2+ dyshomeostasis, ATPase activities inhibition, calpain activities, and NMDARs expression alteration were observed with 1 μM MeHgCl administration. Last but not least, NPSH depletion and reactive oxygen species (ROS) overproduction showed an obvious oxidative stress in neurons. However, memantine pre-treatment dose-dependently antagonized MeHg-induced neuronal toxic effects, apoptosis, Ca 2+ dyshomeostasis, NMDARs expression alteration, and oxidative stress. In conclusion, the

  3. The Dwarf Project: Vidojevica

    Science.gov (United States)

    Vince, O.

    2013-05-01

    The DWARF project is an important international project for observing eclipsing binary stars and searching for third companion which orbit around both stars. Recently, a group of researchers at the Astronomical Observatory of Belgrade joined this project using the 60 cm telescope at the Astronomical Station Vidojevica for observations. All the equipment and the human potential involved with this project from Serbia will be described in this paper.

  4. Primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    Verlecar, X.N.; Parulekar, A.H.

    Photosynthetic production in the oceans in relation to light, nutrients and mixing processes is discussed. Primary productivity in the estuarine region is reported to be high in comparison to coastal and oceanic waters. Upwelling phenomenon...

  5. Primary Hyperparathyroidism

    Science.gov (United States)

    ... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

  6. Primary Myelofibrosis

    Science.gov (United States)

    ... attack is higher. Patients also have an increased risk of acute myeloid leukemia or primary myelofibrosis . Symptoms of polycythemia vera include headaches and a feeling of fullness below the ribs on the left ...

  7. One project's waste is another project's resource

    International Nuclear Information System (INIS)

    Short, J.

    1997-01-01

    The author describes the efforts being made toward pollution prevention within the DOE complex, as a way to reduce overall project costs, in addition to decreasing the amount of waste to be handled. Pollution prevention is a concept which is trying to be ingrained into project planning. Part of the program involves the concept that ultimately the responsibility for waste comes back to the generator. Parts of the program involve efforts to reuse materials and equipment on new projects, to recycle wastes to generate offsetting revenue, and to increase awareness, accountability and incentives so as to stimulate action on this plan. Summaries of examples are presented in tables

  8. Proyecto Vedado: salud-electrónica en la atención primaria de salud. Diseño y resultados iniciales Vedado Project: electronic health in primary health care. Design and initial results

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Stusser Beltranena

    2006-12-01

    Full Text Available Se expone brevemente el diseño, justificación, resultados iniciales y perspectivos, y dificultades del portafolio de proyectos “Vedado” de salud-electrónica (salud-e en la atención primaria de salud y medicina general integral, entre los años 2002 y 2006. Se describen los resultados obtenidos con un sistema de información gerencial de atención primaria, un sistema tele electrocardiográfico de 2da. y 3ra. opinión, unos sitios web del Policlínico Vedado, un tutorial en multimedia de anatomía en atención primaria, y una universidad virtual desde este propio nivel de atención. Se enuncian los resultados perspectivos de una red electrónica y centro colaborador en investigación a distancia y en línea del sistema nacional de salud a partir de la atención primaria, del uso de asistentes personales digitales y tecnología inalámbrica, así como de una historia clínica electrónica única desde el consultorio del Médico de Familia al resto del sistema. Se concluye que los resultados obtenidos han comenzado lentamente a mejorar la eficiencia de este nivel de atención y nuestra especialidad. Se vislumbra que la continuación de estos proyectos y extensión de sus resultados originará un salto de calidad en los servicios de la Medicina General Integral en las áreas de salud, sobre todo, las rurales y más aisladas del país. Se recomienda formalizar un centro y red de investigación en salud-e desde la atención primaria, con presupuesto para proyectos de investigación, incluir técnicas de tele-cirugía y cirugía de mínimo acceso, sobre todo en áreas rurales, así como también facilitar la investigación en colaboración en salud-e y los entrenamientos e intercambios académicos en los países de avanzada.The design, rationale, initial and future results of the “Vedado” electronic health (e-health projects in primary health care and comprehensive general medicine between 2002 and 2006 are briefly exposed. The results

  9. Thoughts on primary care.

    Science.gov (United States)

    Raskin, Lynne

    2010-01-01

    The uptake of family health teams in Ontario has been tremendous. And the creation of group practices in primary care has taken root in other provinces as well. For many people, being involved with something new is exciting. At the same time, once they are committed, they discover the challenges that can be simultaneously exhilarating and frustrating. This issue of Healthcare Quarterly offers two articles that provide interesting reflections on what has been learned so far from the perspectives of both team leadership and the team members themselves within a transforming primary care system.

  10. Primary ectopic frontotemporal extradural craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Reza Pourkhalili

    2016-01-01

    Full Text Available We present a case of primary ectopic frontotemporal extradural craniopharyngioma. Primary ectopic craniopharyngiomas are very rare and have been reported involving the fourth ventricle, infrasellar region, lateral ventricle, temporal area, cerebellopontine angle, clivus, corpus callosum, and prepontine cistern. There was just 1 case of craniopharyngioma previously presented in the literature, with nearly same location as the presenting case.

  11. Project risk management: A review of an institutional project life cycle

    Directory of Open Access Journals (Sweden)

    Wanjiru Gachie

    2017-11-01

    Full Text Available This article is a desktop analysis of project risk management involving a project management institutional restructuring. The pragmatic nature of this research allows for the literature review and the document analysis to be integrated and presented as both a descriptive and analytical research. The analysis demonstrates that the project committee did not proactively manage project risk. The restructuring was a change management project, entailing the implementation of many organisational changes, such as restructuring, lay-off of some part of the administrative workforce, adoption of new technology, provision of new approaches to well-established procedures, and implementation of new performance initiative, the process which should have been managed with an effective integrated risk strategy and plan. Analysis of the restructuring project risk management exhibits little evidence of a systematic (computer based or manual record that should have provided policies, procedures, and structures for managing risk. The article concludes that the restructuring risk process was inadequate and it could not have ensured a successful project. An analysis of the restructuring project risk monitoring and control exhibits a reactive rather than proactive application of risk management procedures. The analysis further indicates that the committee failed to make use of the various project risk management processes, standards, and guidelines. Based on the conclusions, the article recommends that project risk planning, strategy, control, and monitoring should be put in place for future institutional projects. The project management team should also put in place procedures for primary stakeholders engagements, identify and address their nature of interest and power in future risk management projects