WorldWideScience

Sample records for providing post-treatment support

  1. Provider perceptions and expectations of breast cancer post-treatment care: A University of California Athena Breast Health Network project

    Science.gov (United States)

    Hahn, Erin E.; Ganz, Patricia A.; Melisko, Michelle; Pierce, John; von Friederichs-Fitzwater, Marlene; Lane, Karen; Hiatt, Robert

    2013-01-01

    Purpose The Athena Breast Health Network collaboration is a University of California system-wide project initiated with the intent to drive innovation in breast cancer prevention, screening and treatment. This qualitative research examines provider perceptions and expectations of post-treatment breast cancer care across five Network sites with the goal of better understanding provider behavior during the post-treatment phase of the cancer care trajectory. Methods Investigators at each site conducted semi-structured interviews with oncology specialists and primary care providers (PCPs). Interviews used case study examples and open- and closed-ended questions on the delivery of post-treatment breast cancer care. Informant responses were manually recorded by the interviewer, compiled in a database, then coded and analyzed using NVivo 9 software. Results There were 39 key informants across the sites: 14 medical oncologists, 7 radiation oncologists, 11 surgeons, 3 oncology nurses, and 4 PCPs. Care coordination was a major unprompted theme identified in the interviews. There was a perceived need for greater care coordination across institutions in order to improve delivery of post-treatment health care services and a need for greater care coordination within oncology, particularly to help avoid duplication of follow-up care and services. Participants expect frequent follow-up visits and to use biomarker tests and advanced imaging services as part of routine surveillance care. Implementing survivorship care programs was perceived as a way to improve care delivery. Conclusions These results identify a need for increased focus on care coordination during the post-treatment phase of breast cancer care within the UC system, and the potential for system and provider level interventions that could help increase coordination of post-treatment care. Implications for Cancer Survivors Breast cancer survivors do not always receive evidence-based care. This research helps to better

  2. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)

    2011-01-01

    A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...

  3. Support Net for Frontline Providers

    Science.gov (United States)

    2016-03-01

    With a multidisciplinary team that included an external evaluator (Dr. Robert Durham), and an extended research team (Drs. Alan Peterson and Bret...21.7%) indicated being single. The sample of providers included 13 clinical psychologists (21.7%), 17 counselors or psychotherapists (28.3%), three...a sample of service members from Iraq and Afghanistan. Military Medicine, 172, 359–363. Figley, C. R. (2002). Compassion fatigue: Psychotherapists

  4. PROVIDING R-TREE SUPPORT FOR MONGODB

    Directory of Open Access Journals (Sweden)

    L. Xiang

    2016-06-01

    Full Text Available Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB’s features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  5. Providing R-Tree Support for Mongodb

    Science.gov (United States)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  6. Air Systems Provide Life Support to Miners

    Science.gov (United States)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  7. Survivorship resources for post-treatment cancer survivors.

    Science.gov (United States)

    Tesauro, Gina M; Rowland, Julia H; Lustig, Craig

    2002-01-01

    The purpose of this project was to determine the scope of services and resources available to cancer survivors who have completed active treatment and their families at National Cancer Institute (NCI)-designated comprehensive cancer centers. Patient education program contacts from the 37 NCI-designated comprehensive cancer centers participated in a telephone interview. Program contacts were asked to identify the types of medical and psychosocial services that their respective cancer center offered. Telephone interviews were completed by patient education program contacts from all NCI-designated comprehensive cancer centers for a total response rate of 100%. Services pertaining to lymphedema management were identified in 70% of cancer centers. Other common services identified specifically for post-treatment cancer survivors at cancer centers were professionally led support groups (49% of cancer centers), long-term medical care (38% of cancer centers), school re-entry programs (19% of cancer centers), nutrition counseling (14% of cancer centers), and counseling addressing fertility and sexual concerns (14% of cancer centers). Results from this project outline the range of services and resources that are provided to post-treatment cancer survivors by NCI-designated comprehensive cancer centers, and can be used to develop standards of care for future cancer control programs.

  8. 20 CFR 404.1662 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 404.1662 Section 404.1662 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... support we will provide. Performance support may include, but is not limited to, any or all of the...

  9. 20 CFR 416.1062 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 416.1062 Section 416.1062 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... What support we will provide. Performance support may include, but is not limited to, any or all of the...

  10. Post-Treatment Lyme Disease Syndrome

    Science.gov (United States)

    ... is CDC concerned about Lyme disease? Post-Treatment Lyme Disease Syndrome Recommend on Facebook Tweet Share Compartir ... Dangers of long-term or alternative treatments for Lyme disease Studies funded by the National Institutes of ...

  11. Outsourcing customer support : The role of provider customer focus

    NARCIS (Netherlands)

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  12. Providing producer mobility support in NDN through proactive data replication

    OpenAIRE

    Lehmann, Matheus; Barcellos, Marinho; Mauthe, Andreas Ulrich

    2016-01-01

    Email Print Request Permissions Named Data Networking (NDN) is a novel architecture expected to overcome limitations of the current Internet. User mobility is one of the most relevant limitations to be addressed. NDN supports consumer mobility by design but fails to offer the same level of support for producer mobility. Existing approaches to extend NDN are host-centric, which conflicts with NDN principles, and provide limited support for producer mobility. This paper proposes a content-centr...

  13. Parent-to-Parent support providers: How recruits are identified.

    Science.gov (United States)

    Dodds, Robin L; Singer, George H S

    2017-10-24

    To examine selection criteria for Parent-to-Parent support parents trained to provide support to other parents of children with disabilities. Ten leaders of Parent-to-Parent programmes participated in telephone interviews to explore attributes associated with parents selected to be trained as support parents. Qualitative analysis reveals parents deemed "ready" to become support parents, build relationships, exhibit positivity, build capacities, have good communication skills and a future orientation and feel the need to give back. An additional set of attributes we have named, "red flags" are associated with parents not suitable to provide support are also presented. Parent-to-Parent support parents are informally identified by a set of characteristics that can be operationalized for screening purposes. Findings provide support for the positive influence of the peer support relationship and identify the need for a measure of parent "readiness" to assist in the recruitment of quality support parents for the Parent-to-Parent organization. © 2017 John Wiley & Sons Ltd.

  14. Providing information communication technology-based support to ...

    African Journals Online (AJOL)

    Student support is a major factor in distance education. This study was concerned with the use of ICT as a medium for providing student support at the University of Zambia. It was necessary to study the factors that would affect the application of ICT, in order to inform policy makers and managers of distance education which ...

  15. Providing Mainstream Parser Generators with Modular Language Definition Support

    OpenAIRE

    Karol, Sven; Zschaler, Steffen

    2012-01-01

    The composition and reuse of existing textual languages is a frequently re-occurring problem. One possibility of composing textual languages lies on the level of parser specifications which are mainly based on context-free grammars and regular expressions. Unfortunately most mainstream parser generators provide proprietary specification languages and usually do not provide strong abstractions for reuse. New forms of parser generators do support modular language development, but they can often...

  16. Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support.

    Science.gov (United States)

    Anstey, Erica H; Coulter, Martha; Jevitt, Cecilia M; Perrin, Kay M; Dabrow, Sharon; Klasko-Foster, Lynne B; Daley, Ellen M

    2018-02-01

    Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

  17. Providing Automatic Support for Heuristic Rules of Methods

    NARCIS (Netherlands)

    Tekinerdogan, B.; Aksit, Mehmet; Demeyer, Serge; Bosch, H.G.P.; Bosch, Jan

    In method-based software development, software engineers create artifacts based on the heuristic rules of the adopted method. Most CASE tools, however, do not actively assist software engineers in applying the heuristic rules. To provide an active support, the rules must be formalized, implemented

  18. Depressive Symptoms and Unmitigated Communion in Support Providers

    NARCIS (Netherlands)

    Jin, Lihua; Van Yperen, Nico W.; Sanderman, Robbert; Hagedoorn, Mariet

    In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self-neglect and externalized

  19. The Men's Shed: providing biopsychosocial and spiritual support.

    Science.gov (United States)

    Moylan, Matthew M; Carey, Lindsay B; Blackburn, Ric; Hayes, Rick; Robinson, Priscilla

    2015-02-01

    Community Men's Sheds (CMS) have been a unique approach within Australia for addressing and promoting men's health and well-being issues by providing biopsychosocial support. Given the decline of traditional religious influence, and the contemporary understanding of 'spirituality', it can be argued that CMS may also develop and demonstrate characteristics of a communal spirituality. This research aimed to explore the individual and community contribution of CMS in terms of men's health and well-being and subsequently whether CMS programmes satisfied the contemporary and consensus understanding of spirituality. A qualitative case study was undertaken combining both participant observation over a 6-month period and semi-structured in-depth interviews with 21 men of varying ages and occupations attending a Melbourne suburban CMS (Victoria, Australia). Thematic analysis indicated that the CMS provided a number of health and well-being benefits at individual, family, community and public health levels. These included increased self-esteem and empowerment, respite from families, a sense of belonging in the community and the opportunity to exchange ideas relating to personal, family, communal and public health issues. It is concluded that CMS, through the provision of an appropriate spatial context and organizational activities, encourage intra-personal and inter-personal reflection and interaction that subsequently results in men meaningfully, purposefully and significantly connecting with the moment, to self, to others and to their environment-and thus, CMS not only provides biopsychosocial support but can also deliver spiritual support.

  20. Providers' Response to Clinical Decision Support for QT Prolonging Drugs.

    Science.gov (United States)

    Sharma, Sunita; Martijn Bos, J; Tarrell, Robert F; Simon, Gyorgy J; Morlan, Bruce W; Ackerman, Michael J; Caraballo, Pedro J

    2017-09-02

    Commonly used drugs in hospital setting can cause QT prolongation and trigger life-threatening arrhythmias. We evaluate changes in prescribing behavior after the implementation of a clinical decision support system to prevent the use of QT prolonging medications in the hospital setting. We conducted a quasi-experimental study, before and after the implementation of a clinical decision support system integrated in the electronic medical record (QT-alert system). This system detects patients at risk of significant QT prolongation (QTc>500ms) and alerts providers ordering QT prolonging drugs. We reviewed the electronic health record to assess the provider's responses which were classified as "action taken" (QT drug avoided, QT drug changed, other QT drug(s) avoided, ECG monitoring, electrolytes monitoring, QT issue acknowledged, other actions) or "no action taken". Approximately, 15.5% (95/612) of the alerts were followed by a provider's action in the pre-intervention phase compared with 21% (228/1085) in the post-intervention phase (p=0.006). The most common type of actions taken during pre-intervention phase compared to post-intervention phase were ECG monitoring (8% vs. 13%, p=0.002) and QT issue acknowledgment (2.1% vs. 4.1%, p=0.03). Notably, there was no significant difference for other actions including QT drug avoided (p=0.8), QT drug changed (p=0.06) and other QT drug(s) avoided (p=0.3). Our study demonstrated that the QT alert system prompted a higher proportion of providers to take action on patients at risk of complications. However, the overall impact was modest underscoring the need for educating providers and optimizing clinical decision support to further reduce drug-induced QT prolongation.

  1. Women Support Providers Are More Susceptible than Men to Emotional Contagion Following Brief Supportive Interactions

    Science.gov (United States)

    Magen, Eran; Konasewich, Paul A.

    2011-01-01

    People in distress often turn to friends for emotional support. Ironically, although receiving emotional support contributes to emotional and physical health, providing emotional support may be distressing as a result of emotional contagion. Women have been found to be more susceptible than men to emotional contagion in certain contexts, but no…

  2. Meeting Basic Needs: Social Supports and Services Provided by Hospice.

    Science.gov (United States)

    Boucher, Nathan A; Kuchibhatla, Maragatha; Johnson, Kimberly S

    2017-06-01

    Describe social goods and services for which hospices assist patients and families and the resources hospices use to do so. Basic social supports and services not routinely covered by insurers may be needed by terminally ill patients and their families. Little is known about hospices' provision of such social supports and services. A 2014-2015 cross-sectional survey of hospices nationwide. Participating hospices had been in operation for at least 3 years and were located in any of the 50 states or District of Columbia. Hospices were surveyed about availability and sources of internal funds and referral to obtain basic social supports for patients. Descriptive statistics, bivariate analysis, and categorization were used to describe hospice practices. Measures included frequency and nature of goods and services provision in the prior year; and extent to which hospices used internal funds or community referral for goods and services. Over 80% (n = 203) reported internal funds covered services not reimbursed by insurers; 78% used funds in last year. Hospices used internal funds for food (81.7%), shelter (57.8%), utility bills (73.5%), and funeral costs (50%). Hospices referred patients/families to community organizations to obtain a similar range of services, including transportation, clothing, linens/towels, furniture/appliances, home repairs, and caregiver support. Hospices are using internal resources and accessing community resources to provide patients with basic social needs not routinely covered by insurance.

  3. Health information support provided by professional associations in Canada.

    Science.gov (United States)

    Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene

    2012-09-01

    Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  4. Rapid Deterioration of Basic Life Support Skills in Dentists With Basic Life Support Healthcare Provider.

    Science.gov (United States)

    Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko

    2016-01-01

    The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.

  5. Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management.

    Science.gov (United States)

    Kowitt, Sarah D; Ayala, Guadalupe X; Cherrington, Andrea L; Horton, Lucy A; Safford, Monika M; Soto, Sandra; Tang, Tricia S; Fisher, Edwin B

    2017-12-01

    Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients' feelings and cooperative with their plans) and directive (prescribing "correct" choices and feelings). In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants' ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. CFA confirmed the factor structure distinguishing between nondirective and directive support in participants' reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants' reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Peer supporters' nondirective support was associated with lower, but directive support was associated with greater depressive symptoms.

  6. Providing over-the-horizon awareness to driver support systems

    NARCIS (Netherlands)

    van Eenennaam, Martijn; Heijenk, Geert

    2008-01-01

    Vehicle-to-vehicle communications is a promising technique for driver support systems to increase traffic safety and efficiency. A proposed system is the Congestion Assistant [1], which aims at supporting drivers when approaching and driving in a traffic jam. Studies have shown great potential for

  7. Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers

    Science.gov (United States)

    Lee, Walter C., Jr.

    2015-01-01

    In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

  8. Providing 'auxiliary' academic writing support to postgraduate students

    African Journals Online (AJOL)

    cultural approach to academic writing support which was part of the inception of a broader orientation programme in a newly established Centre for Postgraduate Studies at a research intensive South African university. The role of writing ...

  9. Providing monitoring and evaluation support for CCAA projects

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

    CCAA

    In February 2010, when CCAA's program leader visited a Malawi-based project team focusing on agricultural innovations, researchers explained how helpful they had found the program's training and mentoring in outcome mapping (OM). This support, organized in 2007 and 2008 by CCAA, helped them and their partners ...

  10. The experiences of nurses in providing psychosocial support to ...

    African Journals Online (AJOL)

    The study was conducted in the surgical ICUs of two private hospitals and one public hospital in the Durban metropolitan area. Findings. Four main themes emerged from the data: cultural awareness, communication challenges, providing assistance, and lack of training. Conclusion. These findings provide implications for ...

  11. Private Training Providers: Their Characteristics and Training Activities. Support Document

    Science.gov (United States)

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…

  12. Providing of Spatial Wetland Information for Supporting National Development

    Directory of Open Access Journals (Sweden)

    Aris Poniman

    2016-05-01

    Full Text Available The wetland has a strategic role in national development. The potential uses of the wetland are varied such as for agriculture, fisheries, industries, and forestry. The intensive use of the wetland for agricultural development in Sumatera, Kalimantan, Sulawesi, and Papua through transmigration projects has been run since in 1973. Unfortunately, not all the projects were well developed, causing the social, economic, and physical environmental problems. These problems resulted in the negative impact for the life of the transmigration people. For that reason, the community empowerment for the unlucky transmigration people by handling the physical and non physical aspects is very important. This paper will describe the importance of providing spatial data and information biophysical wetland as an initial step in empowering people who live in the wetland resource.

  13. Optimization of a Virtual Power Plant to Provide Frequency Support.

    Energy Technology Data Exchange (ETDEWEB)

    Neely, Jason C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Johnson, Jay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gonzalez, Sigifredo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lave, Matthew Samuel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Delhotal, Jarod James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Increasing the penetration of distributed renewable sources, including photovoltaic (PV) sources, poses technical challenges for grid management. The grid has been optimized over decades to rely upon large centralized power plants with well-established feedback controls, but now non-dispatchable, renewable sources are displacing these controllable generators. This one-year study was funded by the Department of Energy (DOE) SunShot program and is intended to better utilize those variable resources by providing electric utilities with the tools to implement frequency regulation and primary frequency reserves using aggregated renewable resources, known as a virtual power plant. The goal is to eventually enable the integration of 100s of Gigawatts into US power systems.

  14. A mixed methods analysis of support for self-management behaviors: Perspectives of people with epilepsy and their support providers

    OpenAIRE

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E.; Sterk, Claire E.; DiIorio, Colleen; Thompson, Nancy

    2014-01-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these...

  15. 47 CFR 54.625 - Support for services beyond the maximum supported distance for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Support for services beyond the maximum supported distance for rural health care providers. 54.625 Section 54.625 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.625...

  16. The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: post-treatment results from a randomized clinical pilot.

    Science.gov (United States)

    Suchman, Nancy E; DeCoste, Cindy; Castiglioni, Nicole; McMahon, Thomas J; Rounsaville, Bruce; Mayes, Linda

    2010-09-01

    This is a report of post-treatment findings from a completed randomized pilot study testing the preliminary efficacy of the Mothers and Toddlers Program (MTP), a 12 week attachment-based individual parenting therapy for mothers enrolled in substance abuse treatment and caring for children ages birth to 36 months. Forty-seven mothers were randomized to MTP versus the Parent Education Program (PE), a comparison intervention providing individual case management and child guidance brochures. At post-treatment, MTP mothers demonstrated better reflective functioning in the Parent Development Interview, representational coherence and sensitivity, and caregiving behavior than PE mothers. Partial support was also found for proposed mechanisms of change in the MTP model. Together, preliminary findings suggest that attachment-based interventions may be more effective than traditional parent training for enhancing relationships between substance using women and their young children.

  17. Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

    Science.gov (United States)

    Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

    2011-03-10

    The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

  18. High fat diet reduces neuroprotection of isoflurane post-treatment: role of carboxyl-terminal modulator protein-Akt signaling

    OpenAIRE

    Yu, Hai; Deng, Jiao; Zuo, Zhiyi

    2014-01-01

    Objective High fat diet (HFD) contributes to the increased prevalence of obesity and hyperlipidemia in young adults, a possible cause for their recent increase in stroke. Isoflurane post-treatment provides neuroprotection. We determined whether isoflurane post-treatment induced neuroprotection in HFD-fed mice. Design and Methods Six-week old CD-1 male mice were fed HFD or regular diet (RD) for 5 or 10 weeks. Their hippocampal slices (400 ?m) were subjected to oxygen-glucose deprivation (OGD)....

  19. A reappraisal of the u.s. Clinical trials of post-treatment lyme disease syndrome.

    Science.gov (United States)

    Fallon, Brian A; Petkova, Eva; Keilp, John G; Britton, Carolyn B

    2012-01-01

    Four federally funded randomized placebo-controlled treatment trials of post-treatment Lyme syndrome in the United States have been conducted. Most international treatment guidelines summarize these trials as having shown no acute or sustained benefit to repeated antibiotic therapy. The goal of this paper is to determine whether this summary con-clusion is supported by the evidence. The methods and results of the 4 U.S. treatment trials are described and their critiques evaluated. 2 of the 4 U.S. treatment trials demonstrated efficacy of IV ceftriaxone on primary and/or secondary outcome measures. Future treatment guidelines should clarify that efficacy of IV ceftriaxone for post-treatment Lyme fatigue was demonstrated in one RCT and supported by a second RCT, but that its use was not recommended primarily due to adverse events stemming from the IV route of treatment. While repeated IV antibiotic therapy can be effective, safer modes of delivery are needed.

  20. Health organizations providing and seeking social support: a Twitter-based content analysis.

    Science.gov (United States)

    Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

    2013-09-01

    Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

  1. A mixed methods analysis of support for self-management behaviors: perspectives of people with epilepsy and their support providers.

    Science.gov (United States)

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E; Sterk, Claire E; Diiorio, Colleen; Thompson, Nancy J

    2014-02-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these individuals, 22 people with epilepsy and 16 support persons completed an in-depth interview. Rasch measurement models were used to evaluate the degree of difficulty of receiving or providing support often for nine self-management tasks. We analyzed model-data fit, person and item location along the support latent variable and differential person and item functioning. Qualitative methods were used to provide context and insight into the quantitative results. The results demonstrated good model-data fit. Help with seizures was the easiest type of support to receive or provide more often, followed by rides to a doctor's appointments and help avoiding seizure triggers. The most difficult types of support to receive or provide more often were reminders, particularly for taking and refilling medications. While most participants' responses fit the model, responses of several individuals misfit the model. Person misfit generally occurred because the scale items did not adequately capture some individuals' behaviors. These results could be useful in designing interventions that use support as a means of improving self-management. Additionally, the results provide information to improve or expand current measures of support for epilepsy self-management to better assess the experiences of people with epilepsy and their support persons. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Rationales for Support That African American Grandmothers Provide to Their Children Who Are Parenting Adolescents

    Science.gov (United States)

    Sumo, Jen'nea; Dancy, Barbara; Julion, Wrenetha; Wilbur, JoEllen

    2015-01-01

    African American grandmothers are known to be a major source of support for their children who are parenting adolescents, but little is known about why they provide support. The purpose of this study was to describe the kinds of support provided by African American maternal and paternal grandmothers to their parenting adolescents and the reasons…

  3. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on supported services for rural health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported...

  4. Support provider's appraisal detection bias and the efficacy of received support in medical students preparing for an exam.

    Science.gov (United States)

    Knoll, Nina; Schulz, Ute; Schwarzer, Ralf; Rosemeier, Hans Peter

    2006-09-01

    Matching social support to the recipient's needs requires diagnostic sensitivity on the part of the provider. In particular, support needs to be responsive to the recipient's stress-related appraisals to be maximally effective. To assess the impact of bias in interpersonal stress assessment, medical students in 43 dyads reported on their own and each other's stress appraisals, social support, affect and performance during a 5-day preparation period culminating in a multiple choice examination. Less biased perceptions of loss appraisals by support providers within dyads were followed by support transactions associated with lower negative affect and better exam performance among recipients. More biased perceptions of threat appraisals were followed by increases in the recipients' negative affect. Results therefore suggest that support is more effective when the provider understands the recipient's concerns.

  5. Social Skills Training for Juvenile Delinquents: Post-Treatment Changes

    NARCIS (Netherlands)

    van der Stouwe, Trudy; Asscher, J.J.|info:eu-repo/dai/nl/288661834; Stams, G.J.J.M.; Hoeve, M.; van der Laan, Peter H.

    2016-01-01

    Objectives: To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods: The sample consisted of juveniles who received Tools4U,

  6. Social skills training for juvenile delinquents : Post-treatment changes

    NARCIS (Netherlands)

    van der Stouwe, T.; Asscher, J.J.; Hoeve, M.; van der Laan, P.H.; Stams, G.J.J.M.

    2016-01-01

    Objectives To examine the post-treatment effectiveness of an outpatient, individual social skills training for juvenile delinquents in the Netherlands and to conduct moderator tests for age, gender, ethnicity, and risk of reoffending. Methods The sample consisted of juveniles who received Tools4U, a

  7. Parents and Peers as Providers of Support in Adolescents' Social Network: A Developmental Perspective

    Science.gov (United States)

    del Valle, Jorge F.; Bravo, Amaia; Lopez, Monica

    2010-01-01

    The authors carried out an assessment of social support networks with a sample of 884 Spanish adolescents aged 12 to 17. The main goal was to analyze the development of the figures of parents and peers as providers of social support in the two basic dimensions of emotional and instrumental support. In peers, they distinguished between the contexts…

  8. Beliefs about the empirical support of drug abuse treatment interventions: a survey of outpatient treatment providers.

    Science.gov (United States)

    Benishek, Lois A; Kirby, Kimberly C; Dugosh, Karen Leggett; Padovano, Alicia

    2010-03-01

    This study assessed substance abuse treatment providers' beliefs about empirically supported treatments (ESTs) to determine if providing information about empirical support for interventions would change beliefs. Treatment providers (N=136) completed an interview regarding five interventions with varied empirical support: contingency management (CM), motivational interviewing (MI), relapse prevention (RP), 12-step approaches (TSA), and verbal confrontation (VC). Participants then read primers describing empirical support for each intervention prior to completing a repeat interview. Overall, providers reported positive beliefs about ESTs. Baseline beliefs about empirical support for each intervention were inflated relative to that of expert raters except for CM. After reading the primers, beliefs about efficacy changed in the direction of the experts for all interventions except MI, but continued to be inflated except for CM. Willingness to utilize interventions increased for RP, MI, and CM and decreased for TSA and VC, but remained higher than warranted by empirical support. Copyright 2009. Published by Elsevier Ireland Ltd.

  9. Using Variables in School Mathematics: Do School Mathematics Curricula Provide Support for Teachers?

    Science.gov (United States)

    Dogbey, James

    2016-01-01

    This study employed content analysis to examine 3 popular middle-grades mathematics curricula in the USA on the support they provide for teachers to implement concepts associated with variables in school mathematics. The results indicate that each of the 3 curricula provides some type of support for teachers, but in a varied amount and quality.…

  10. (Too) Anxious to help? Social support provider anxiety and cardiovascular function.

    Science.gov (United States)

    Kent de Grey, Robert G; Uchino, Bert N; Smith, Timothy W; Baucom, Brian R W

    2018-01-01

    Provider factors, such as anxiety, may be important in understanding effects of received social support (SS), which are less consistently positive than those of perceived SS. Due to the dyadic nature of support, anxiety on the part of the provider was predicted to influence the effectiveness of received SS. This laboratory study examined effects of SS provider anxiety within unacquainted dyads on cardiovascular reactivity during acute stress. 148 participants were assigned to support roles, and each dyad was randomized to low or high provider anxiety. Results include that SS provider anxiety resulted in greater blood pressure reactivity and less recovery toward baseline diastolic blood pressure within the dyad. Overall, it appears provider anxiety contributes to less effective SS for recipients and that health costs may accompany providing and receiving support under nonoptimal conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Post-treatment pain in teeth with primary infections

    OpenAIRE

    Jesus Djalma Pécora; Cynthia Rodrigues De Araújo Estrela; Orlando Aguirre Guedes; Aldo Brugnera Junior; Carlos Estrela

    2008-01-01

    Objective: The purpose of this assay was to evaluate longitudinal studies about the pain after endodontic treatment, with primary infection, using a systematic review. Methods: A MEDLINE search strategy was developed to identify articles using the following uniterms: endodontic(s) and pulpal pain, endodontic(s) and periapical pain, endodontic(s) and symptom, endodontic(s) and flare-ups, endodontic(s) pain and post-treatment, endodontic(s) and inter-appointment/interappointment. The search inc...

  12. Providing support to nursing students in the clinical environment: a nursing standard requirement.

    Science.gov (United States)

    Anderson, Carina; Moxham, Lorna; Broadbent, Marc

    2016-10-01

    This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.

  13. Collaborative learning: A next step in the training of peer support providers.

    Science.gov (United States)

    Cronise, Rita

    2016-09-01

    This column explores how peer support provider training is enhanced through collaborative learning. Collaborative learning is an approach that draws upon the "real life" experiences of individual learners and encompasses opportunities to explore varying perspectives and collectively construct solutions that enrich the practice of all participants. This description draws upon published articles and examples of collaborative learning in training and communities of practice of peer support providers. Similar to person-centered practices that enhance the recovery experience of individuals receiving services, collaborative learning enhances the experience of peer support providers as they explore relevant "real world" issues, offer unique contributions, and work together toward improving practice. Three examples of collaborative learning approaches are provided that have resulted in successful collaborative learning opportunities for peer support providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Beune, Erik J. A. J.; Baim-Lance, Abigail M.; Bruessing, Raynold C.; Essink-Bot, Marie-Louise

    2015-01-01

    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study

  15. Maintaining Long-Distance Friendships: Communication Practices for Seeking and Providing Social Support across Geographic Divides

    Science.gov (United States)

    Lobburi, Patipan

    2012-01-01

    People seek and provide support through their personal social network, especially when they must cope with stress, deal with an emergency, or need help. Coping with a new culture or new environment is a stressful situation that sojourner students must face. Support through friendship plays an important role in facing such new situations. Focusing…

  16. Children's Support Services: Providing a System of Care for Urban Preschoolers with Significant Behavioral Challenges

    Science.gov (United States)

    Tewhey, Karen

    2006-01-01

    In this article, the author features the Children's Support Services (CSS) project in Lowell, Massachusetts, which is an interagency, multidisciplinary program that provides young children and their families a range of child development, mental health, and family support services. The CSS project, which was begun in September 2000, addresses the…

  17. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer.

    Science.gov (United States)

    Ussher, Jane; Kirsten, Laura; Butow, Phyllis; Sandoval, Mirjana

    2006-05-01

    This qualitative study examined the questions of what cancer support groups provide that other supportive relationships do not, and what the self perceived consequences are of support group attendance. Nine representative Australian cancer peer support groups, consisting of a total of 93 interviewees, 75 women, and 18 men, with a mean age of 62, took part in participant observation and focus group interviews, with the data analysed using positioning theory. Support groups were positioned by participants as providing a unique sense of community, unconditional acceptance, and information about cancer and its treatment, in contrast to the isolation, rejection, and lack of knowledge about cancer frequently experienced outside the group. Groups were also positioned as occasionally emotionally challenging, in contrast to the experience of normalising support from family and friends. Increased empowerment and agency were positioned as the most significant consequences of group support, consisting of increased confidence and a sense of control in relation to self, living with cancer, and interactions with others, in particular the medical profession. The support group was also positioned as facilitating positive relationships with family and friends because of relieving their burden of care, by providing a safe space for the expression of emotion. No difference was found between professionally led and peer led support groups, suggesting that it is not the professional background of the leader which is of importance, but whether the group provides a supportive environment, mutuality, and a sense of belonging, and whether it meets the perceived needs of those attending. It is suggested that future research should examine the construction and experience of social support in those who drop out of, or who do not attend, cancer support groups, in order to provide further insight into the contrast between social support within groups and support in other contexts.

  18. Support Needs for Canadian Health Providers Responding to Disaster: New Insights from a Grounded Theory Approach.

    Science.gov (United States)

    Fahim, Christine; O'Sullivan, Tracey L; Lane, Dan

    2015-07-01

    An earlier descriptive study exploring the various supports available to Canadian health and social service providers who deployed to the 2010 earthquake disaster in Haiti, indicated that when systems are compromised, professionals are at physical, emotional and mental risk during overseas deployment. While these risks are generally well-identified, there is little literature that explores the effectiveness of the supports in place to mitigate this risk. This study provides evidence to inform policy development regarding future disaster relief, and the effectiveness of supports available to responders assisting with international disaster response. This study follows Strauss and Corbin's 1990 structured approach to grounded theory to develop a framework for effective disaster support systems. N=21 interviews with Canadian health and social service providers, who deployed to Haiti in response to the 2010 earthquake, were conducted and analyzed. Resulting data were transcribed, coded and analysed for emergent themes. Three themes were identified in the data and were used to develop the evolving theory. The interview data indicate that the experiences of responders are determined based on an interaction between the individual's 'lens' or personal expectations, as well as the supports that an organization is able to provide. Therefore, organizations should consider the following factors: experience, expectations, and supports, to tailor a successful support initiative that caters to the needs of the volunteer workforce.

  19. Support provided by municipalities for families: Experience of families with children with special needs in Latvia

    Directory of Open Access Journals (Sweden)

    Millere J.

    2012-10-01

    Full Text Available For families that are not capable to obtain necessary supplies to meet their needs, State’s social policy guidelines determine support for improving the quality of life for these families. However, it is concluded, that neither the state nor municipality’ provided support for families with children with special needs, does not meet the needs of families, because state social policy is not focused on the assessment of the family needs, as well as often families do not receive the support due to lack of necessary information and disinterest by social service workers, which in turn reflects the problems in social policy delivery mechanisms. The most necessary support that families need is concerned with lodging and financial security, lack of assistants/care at home, as well as – emotional support.

  20. In-vivo job development training among peer providers of homeless veterans supported employment programs.

    Science.gov (United States)

    Gao, Ni; Dolce, Joni; Rio, John; Heitzmann, Carma; Loving, Samantha

    2016-06-01

    This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Perspectives of the Breast Cancer Survivorship Continuum: Diagnosis through 30 Months Post-Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer M. Hulett

    2015-05-01

    Full Text Available This study explored breast cancer survivors’ perspectives regarding their experiences of the survivorship continuum from diagnosis through 30 months post-treatment. The sample included women (N = 379 with newly-diagnosed breast cancer undergoing treatment at a Midwestern university-affiliated cancer center. Semi-structured interviews were conducted using the Lymphedema and Breast Cancer Questionnaire at time of diagnosis, post-operatively, quarterly during the first year, and then semi-annually thereafter through 30 months post-treatment. A mixed-methodology was used to analyze participants’ comments. Themes central to long-term survivorship experiences included social support, positive worldviews, breast cancer and lymphedema health literacy, religious/spiritual beliefs, self-empowerment, and recovery expectations. These themes were consistent with a psychoneuroimmunological model of health in which psychosocial variables mediate stress and influence health outcomes. Qualitative data showed that social support and positive worldviews were the two themes with the most significant impact on long-term breast cancer survivorship experiences. Survivors expressed a need to advance their health care literacy in order to share ownership of breast cancer and lymphedema treatment decisions. Since breast cancer is an immune-mediated disease, long-term survivorship planning should address psychosocial factors that influence the long-term psychological distress associated with immune dysfunction.

  2. Macintosh support is provided at the level of the Service Desk

    CERN Multimedia

    2011-01-01

    Since September 2010 the Apple laptops & desktops with Mac OS are recognized and supported at CERN by the IT department. Therefore, the “Macintosh support” procedure now follows the same ITIL*) schema as for all IT services, i.e.: All CERN users must address any request for support on Macintosh PCs to the Service Desk. The Service Desk will move on questions or problems they cannot solve to “IT 2nd level” support people, provided by the “computing support” contract managed by IT department. Mac OS being officially supported by the IT department, a 3rd level support is provided by CERN IT staff; they may give specialized expert assistance, within the scope described at the ITUM-2 presentation, for all incidents or requests which can be neither resolved nor fulfilled by the Service Desk (1st level) and the 2nd level support people. Therefore, users who have problems related to Mac OS should simply fill-in the appropriate form from th...

  3. Patients’ and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-01-01

    Objective To explore patients’ and nurses’ views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. Design In-depth interviews analysed thematically. Participants 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Setting Cardiac services based in the South West of England and the East Midlands, UK. Results Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients’ accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual’s mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Conclusions Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. Trial registration number ISCTRN34701576. PMID:28864707

  4. Hospice providers' key approaches to support informal caregivers in managing medications for patients in private residences.

    Science.gov (United States)

    Lau, Denys T; Joyce, Brian; Clayman, Marla L; Dy, Sydney; Ehrlich-Jones, Linda; Emanuel, Linda; Hauser, Joshua; Paice, Judith; Shega, Joseph W

    2012-06-01

    Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in

  5. Providing a Full Circle of Support to Teachers in an Inclusive Elementary School

    Science.gov (United States)

    Waldron, Nancy L.; Redd, Lacy

    2011-01-01

    Providing a full circle of support to teachers in an inclusive elementary school, the Newberry Elementary School (NES) principal and staff have worked for 5 years to ensure the inclusion of students with disabilities in general education classrooms. The authors would like to share their perceptions of how this full circle (the multiple systems) of…

  6. The Implementation of a Behavioural Support Programme: Teachers' Perceptions of the Programme and Themselves as Providers

    Science.gov (United States)

    Ingemarson, Maria; Bodin, Maria; Rubenson, Birgitta; Guldbrandsson, Karin

    2016-01-01

    Purpose: The purpose of this paper is to investigate how teachers received and perceived the school programme Prevention in School (PS), a positive behavioural support programme; how did the teachers perceive the programme characteristics and themselves as providers; and how did this affect programme implementation? Design/methodology/approach:…

  7. Addressing Needs of Military Families during Deployment: Military Service Providers' Perceptions of Integrating Support Services

    Science.gov (United States)

    Hayden, Seth Christian Walter

    2011-01-01

    Service providers are increasingly recognizing the need to develop effective methods for delivering supporting services to military families during deployment. Research suggests that military families experience increased levels of stress during the cycle of deployment. Bronfenbrenner (1979) conceptualized the family operating within the context…

  8. Factors Predicting Oncology Care Providers' Behavioral Intention to Adopt Clinical Decision Support Systems

    Science.gov (United States)

    Wolfenden, Andrew

    2012-01-01

    The purpose of this quantitative correlation study was to examine the predictors of user behavioral intention on the decision of oncology care providers to adopt or reject the clinical decision support system. The Unified Theory of Acceptance and Use of Technology (UTAUT) formed the foundation of the research model and survey instrument. The…

  9. Post-Treatment Hemodynamics of a Basilar Aneurysm and Bifurcation

    Energy Technology Data Exchange (ETDEWEB)

    Ortega, J; Hartman, J; Rodriguez, J; Maitland, D

    2008-01-16

    Aneurysm re-growth and rupture can sometimes unexpectedly occur following treatment procedures that were initially considered to be successful at the time of treatment and post-operative angiography. In some cases, this can be attributed to surgical clip slippage or endovascular coil compaction. However, there are other cases in which the treatment devices function properly. In these instances, the subsequent complications are due to other factors, perhaps one of which is the post-treatment hemodynamic stress. To investigate whether or not a treatment procedure can subject the parent artery to harmful hemodynamic stresses, computational fluid dynamics simulations are performed on a patient-specific basilar aneurysm and bifurcation before and after a virtual endovascular treatment. The simulations demonstrate that the treatment procedure produces a substantial increase in the wall shear stress. Analysis of the post-treatment flow field indicates that the increase in wall shear stress is due to the impingement of the basilar artery flow upon the aneurysm filling material and to the close proximity of a vortex tube to the artery wall. Calculation of the time-averaged wall shear stress shows that there is a region of the artery exposed to a level of wall shear stress that can cause severe damage to endothelial cells. The results of this study demonstrate that it is possible for a treatment procedure, which successfully excludes the aneurysm from the vascular system and leaves no aneurysm neck remnant, to elevate the hemodynamic stresses to levels that are injurious to the immediately adjacent vessel wall.

  10. Family carers providing support to a person dying in the home setting: A narrative literature review.

    Science.gov (United States)

    Morris, Sara M; King, Claire; Turner, Mary; Payne, Sheila

    2015-06-01

    This study is based on people dying at home relying on the care of unpaid family carers. There is growing recognition of the central role that family carers play and the burdens that they bear, but knowledge gaps remain around how to best support them. The aim of this study is to review the literature relating to the perspectives of family carers providing support to a person dying at home. A narrative literature review was chosen to provide an overview and synthesis of findings. The following search terms were used: caregiver, carer, 'terminal care', 'supportive care', 'end of life care', 'palliative care', 'domiciliary care' AND home AND death OR dying. During April-May 2013, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Pubmed, Cochrane Reviews and Citation Indexes were searched. Inclusion criteria were as follows: English language, empirical studies and literature reviews, adult carers, perspectives of family carers, articles focusing on family carers providing end-of-life care in the home and those published between 2000 and 2013. A total of 28 studies were included. The overarching themes were family carers' views on the impact of the home as a setting for end-of-life care, support that made a home death possible, family carer's views on deficits and gaps in support and transformations to the social and emotional space of the home. Many studies focus on the support needs of people caring for a dying family member at home, but few studies have considered how the home space is affected. Given the increasing tendency for home deaths, greater understanding of the interplay of factors affecting family carers may help improve community services. © The Author(s) 2015.

  11. What support do nurses need to provide palliative care for people with dementia?

    Science.gov (United States)

    Champion, Elizabeth

    2017-08-31

    The aim of this project was to identify the support required by registered nurses and unregistered healthcare support workers to provide palliative care for people with dementia in an acute hospital in England. A quantitative approach was taken and participants were asked to fill in a questionnaire. Data were collated and analysed to identify support needs and any emerging themes. Respondents were confident in identifying the different stages of dementia. There was less confidence in identifying a patient with dementia for palliative care referral compared with a patient without dementia. Further needs were identified by respondents in supporting the family/carer of the person with dementia and being aware of available support to facilitate palliative care for people with dementia and support for end of life care (EoLC) planning. The findings suggest that further work is required in relation to dementia and EoLC. Practical and educational collaboration with EoLC/palliative care practitioners and dementia leads would be beneficial.

  12. Decision support system of e-book provider selection for library using Simple Additive Weighting

    Science.gov (United States)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  13. Characteristics of Adults Seeking Health Care Provider Support Facilitated by Mobile Technology: Secondary Data Analysis.

    Science.gov (United States)

    Bosak, Kelly; Park, Shin Hye

    2017-12-21

    Mobile health technology is rapidly evolving with the potential to transform health care. Self-management of health facilitated by mobile technology can maximize long-term health trajectories of adults. Little is known about the characteristics of adults seeking Web-based support from health care providers facilitated by mobile technology. This study aimed to examine the following: (1) the characteristics of adults who seek human support from health care providers for health concerns using mobile technology rather than from family members and friends or others with similar health conditions and (2) the use of mobile health technology among adults with chronic health conditions. Findings of this study were interpreted in the context of the Efficiency Model of Support. We first described characteristics of adults seeking Web-based support from health care providers. Using chi-square tests for categorical variables and t test for the continuous variable of age, we compared adults seeking Web-based and conventional support by demographics. The primary aim was analyzed using multivariate logistic regression to examine whether chronic health conditions and demographic factors (eg, sex, income, employment status, race, ethnicity, education, and age) were associated with seeking Web-based support from health care providers. The sample included adults (N=1453), the majority of whom were female 57.60% (837/1453), white 75.02% (1090/1453), and non-Hispanic 89.13% (1295/1453). The age of the participants ranged from 18 to 92 years (mean 48.6, standard deviation [SD] 16.8). The majority 76.05% (1105/1453) of participants reported college or higher level of education. A disparity was found in access to health care providers via mobile technology based on socioeconomic status. Adults with annual income of US $30,000 to US $100,000 were 1.72 times more likely to use Web-based methods to contact a health care provider, and adults with an annual income above US $100,000 were 2.41 to

  14. Rural health professionals' perspectives on providing grief and loss support in cancer care.

    Science.gov (United States)

    Breen, L J; O'Connor, M

    2013-11-01

    Research demonstrates considerable inequalities in service delivery and health outcomes for people with cancer living outside large metropolitan cities. Semi-structured interviews with 11 professionals providing grief and loss support for people with cancer and their families in rural, regional, and remote areas Western Australia revealed the challenges they faced in delivering such support. The data are presented in four themes - Inequity of regional versus metropolitan services, Strain of the 'Jack of all trades' role, Constraints to accessing professional development, and Challenges in delivering post-bereavement services. These challenges are likely to be of growing concern given that populations are declining in rural areas as Australia becomes increasingly urban. The findings have implications in enhancing the loss and grief support services available in rural, regional, and remote Western Australia, including those grieving the death of a loved one through cancer. © 2013 John Wiley & Sons Ltd.

  15. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study.

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-09-01

    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © 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.

  16. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

    CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8...3 (2005), 220- 230. [5] F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior

  17. The "specter" of cancer: exploring secondary trauma for health professionals providing cancer support and counseling.

    Science.gov (United States)

    Breen, Lauren J; O'Connor, Moira; Hewitt, Lauren Y; Lobb, Elizabeth A

    2014-02-01

    Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in "high-death" contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants' reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Caregiver and health care provider preferences of nutritional support in a hematopoietic stem cell transplant unit.

    Science.gov (United States)

    Williams-Hooker, Ruth; Adams, Marissa; Havrilla, David A; Leung, Wing; Roach, Robin R; Mosby, Terezie T

    2015-08-01

    Many pediatric oncology patients undergoing hematopoietic stem cell transplantation (HSCT) require nutritional support (NS) because of their inability to consume adequate caloric intake enough calories orally. Although NS can be provided either enteraly (EN) or parenteraly (PN), EN is the preferred method of NS as long as if the gastrointestinal tract is functioning. In this qualitative study, we determined the type of NS preferences and the reservations of caregivers of pediatric HSCT patients undergoing hematopoietic stem cell transplantation (HSCT) as well as those of health care (HC) providers working on the HSCT unit. A survey was developed and completed anonymously by HC providers and caregivers. The hypothesis was that HC providers and caregivers would prefer PN because it is convenient to use in patients who already have a central line in place. Most caregivers preferred PN to EN, while most HC providers preferred EN to PN. The barrier between EN initiation and caregivers' approval was the caregivers' perception that EN was invasive and painful, most common obstacle for initiation of EN among caregivers was that it hurts/is invasive, while the barrier with HC providers was vomiting and/abdominal pain associated with EN. If caregivers were better educated about NS and the advantages/disadvantages of the different forms of NS, their preferences may change. There have been policy changes at St. Jude have been implemented since this study, and an outpatient dietitian now provides education to caregivers about NS during the pre-evaluation for HSCT. © 2015 Wiley Periodicals, Inc.

  19. Asset Management Planning – providing the evidence to support robust and risk-based investment decisions

    Directory of Open Access Journals (Sweden)

    Mitchell Chrissy

    2016-01-01

    Full Text Available Over the last decade the UK’s joint Flood and Coastal Erosion Risk Management Research and Development programme has been developing methods to support a move to a risk-based approach to flood defence asset management. Looking to ensure investment is less ‘find and fix’ and made to those assets where the biggest risk reduction can be made for the money available. In addition, providing the capability to articulate the benefits of investing in these assets quantitatively and transparently. This paper describes how the Asset Performance Tools (APT project [1] is delivering practical methods, prototype tools and supporting guidance which, together with related initiatives such as the Environment Agency’s Creating Asset Management Capacity (CAMC strategic programme [2] and the ‘State of the Nation’ (SoN [3] supportive datasets, will enable a risk-based, ‘predict and protect’ approach to asset management. A key advance is the ability to bring in local knowledge to make national generic datasets locally relevant. The paper also highlights existing outputs that can already be used to support a more proactive approach to asset management. It will summarise the ongoing work which will further develop and fine tune performance assessment and investment decision processes within an integrated conceptual framework aligned with ISO55000, deliverable via CAMC and whose concepts can be used by all risk management authorities.

  20. Training veterans to provide peer support in a weight-management program: MOVE!

    Science.gov (United States)

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J; Kinsinger, Linda

    2013-11-07

    The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. We developed an MI peer ounselor training program for volunteer veterans, the "Buddies" program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion.

  1. The Oncology Family App: Providing Information and Support for Families Caring for Their Child With Cancer.

    Science.gov (United States)

    Slater, Penelope J; Fielden, Philippa E; Bradford, Natalie K

    2017-11-01

    The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured "Statewide Hospital Contacts," including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; "When to Call" describing symptoms to look out for in a deteriorating child; "Blood Results Table"; and "Information" listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were "Blood Results Table," "When to Call," and "Statewide Hospital Contacts," but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.

  2. A world-wide databridge supported by a commercial cloud provider

    Science.gov (United States)

    Tat Cheung, Kwong; Field, Laurence; Furano, Fabrizio

    2017-10-01

    Volunteer computing has the potential to provide significant additional computing capacity for the LHC experiments. One of the challenges with exploiting volunteer computing is to support a global community of volunteers that provides heterogeneous resources. However, high energy physics applications require more data input and output than the CPU intensive applications that are typically used by other volunteer computing projects. While the so-called databridge has already been successfully proposed as a method to span the untrusted and trusted domains of volunteer computing and Grid computing respective, globally transferring data between potentially poor-performing residential networks and CERN could be unreliable, leading to wasted resources usage. The expectation is that by placing a storage endpoint that is part of a wider, flexible geographical databridge deployment closer to the volunteers, the transfer success rate and the overall performance can be improved. This contribution investigates the provision of a globally distributed databridge implemented upon a commercial cloud provider.

  3. Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support.

    Science.gov (United States)

    Bratt, Marilyn Meyer

    2009-09-01

    Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.

  4. Post treatment of antibiotic wastewater by adsorption on activated carbon

    Science.gov (United States)

    Mullai, P.; Rajesh, V.

    2018-02-01

    The most common method of treating industrial wastewater involves biomethanation in anaerobic digesters. This biological treatment process is ineffective in color removal and it requires post-treatment methods. The color is the first contaminant in wastewater which affects the water bodies in several ways. As the anaerobically digested antibiotic wastewater was found with color, an attempt was made to remove color using granulated activated carbon as an adsorbent. Experiments were carried out in batch reactors to find out the color removal efficiency of the wastewater at four different dosages such as 25, 50, 75 and 100 mg of adsorbent material at each of the four different initial concentrations of effluent like 1956, 1450, 1251 and 1040 mg COD/L. The steady state values of color removal efficiencies were 96.6, 97.64, 98.64 and 99.63%, respectively, using 100 mg of activated carbon under shaking condition at the end of the 120th min. The effect of contact time on the percentage of color removal was also studied. It was observed that the adsorption of effluent obtained equilibrium at 120 minutes. The equilibrium data fitted well with the Langmuir and Freundlich isotherms.

  5. FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Morgen, K; Martin, R; Stone, R D; Grafman, J; Kadom, N; McFarland, H F; Marques, A

    2001-12-11

    To determine patterns of abnormalities on cerebral MRI that may characterize subgroups of patients with post-treatment Lyme disease syndrome (PTLDS) and to help identify pathomechanisms of disease. The authors analyzed the distribution of cerebral lesions in a cohort of 27 patients with PTLDS. A subgroup of eight patients with PTLDS was further studied using whole-brain magnetization transfer ratio measures to identify abnormalities not seen on T2-weighted images. Four patients had focal neurologic deficits, relapsing-remitting disease, and lesions in a distribution typical of MS. Twenty-three patients presented with nonfocal symptoms such as fatigue, subjective memory deficits, and mood disturbance. Twelve of these patients had normal MRI, including the more sensitive fluid-attenuated inversion recovery sequence, 10 had primarily punctate and subcortical lesions, and one patient had multiple periventricular lesions. In a portion of patients with post-treatment Lyme disease syndrome, white-matter hyperintensities tend to occur in subcortical arteriolar watershed areas and are not specific. Magnetization transfer ratio analysis did not provide evidence for structural abnormalities of the brain parenchyma in patients with nonfocal disease.

  6. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Science.gov (United States)

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal

  7. Advanced Life Support Providers Have Poor Knowledge of When to Administer Resuscitation Drugs

    DEFF Research Database (Denmark)

    Johnsen, Josephine; Glerup Lauridsen, Kasper; Løfgren, Bo

    2017-01-01

    Background: Advanced life support (ALS) including resuscitation drugs improves return of spontaneous circulation after cardiac arrest. Resuscitation drugs are recommended to be administered at predefined time-points depending on whether the cardiac rhythm is shockable or non-shockable. Timing...... to administer drugs during shockable rhythm only. Similar, only one third knew when to administer drugs during non-shockable rhythm only. Knowledge on when to administer drugs in case of rhythm transition was poor (Figure 1).Conclusion: Advanced life support providers have poor knowledge of when to administer...... resuscitation drugs. Future studies should address methods to improve learning and skill retention of resuscitation drug administration.Author Disclosures: J. Johnsen: None. K.G. Lauridsen: None. B. Løfgren: None....

  8. Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

    Science.gov (United States)

    Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Wu, Amina; Lam, Annie

    2016-12-01

    The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.

  9. Primary care provider preferences for working with a collaborative support team

    Directory of Open Access Journals (Sweden)

    Flores Jennifer A

    2007-05-01

    Full Text Available Abstract Background Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team. Results A majority of PCPs identified email (95% and telephone calls (68% as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76% and make initial treatment changes (71% without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p Conclusion The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences.

  10. Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Morris, Dustin R

    2015-08-01

    A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

  11. Evaluation of Basic Life Support Training Program Provided for Nurses in A University Hospital

    Directory of Open Access Journals (Sweden)

    Banu Terzi

    2017-06-01

    Full Text Available Aims: This study was conducted to assess the efficiency of the basic life support (BLS training program provided for nurses in a university hospital. To evaluate the efficiency of the BLS training program provided for nurses in a university hospital. Methods: In this a quasi-experimental study, a total of 404 nurses who received BLS training were enrolled. The study was performed in two stages. In stage one, the participant nurses were given a pre-test that consisted of 25 questions, four points each, before the training on the first day of the 2-day BLS training. The post-test was conducted in addition to practical exams on manikins to determine nurses’ practice skills on BLS. Results: There was a statistically significant difference between the nurses with previous BLS training and the difference between their pre- and post-test results (p<0.05, and high statistically significant difference was found between the nurses with previous advanced life support (ALS training and the difference between their pre- and post-test results (p<0.001. Conclusion: Nurses should receive BLS training in hospitals and the training should be repeated on a regular basis. The BLS training that the nurses received in this study was effective and increased their knowledge level on BLS

  12. Effects of Providing Peer Support on Diabetes Management in People With Type 2 Diabetes.

    Science.gov (United States)

    Yin, Junmei; Wong, Rebecca; Au, Shimen; Chung, Harriet; Lau, Maggie; Lin, Laihar; Tsang, Chiuchi; Lau, Kampiu; Ozaki, Risa; So, Wingyee; Ko, Gary; Luk, Andrea; Yeung, Roseanne; Chan, Juliana C N

    2015-08-01

    We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes. In response to our invitation, 79 patients with fair glycemic control (HbA1c peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months. At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison). Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years. © 2015 Annals of Family Medicine, Inc.

  13. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    Directory of Open Access Journals (Sweden)

    Chaya Greenberger

    2016-07-01

    Full Text Available Background There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. Objective This manuscript examines if and when a relative’s presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one’s relative in hospital for the provision of emotional support. Methods Discourse of the halachic issues in the context of the scientific literature. Results Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient’s and the professionals’ perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient’s perception of the emotional need for a relative’s presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient’s life. In certain cases, the latter contingency is unnecessary. Conclusions Emotional support has an impact on the patient’s health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  14. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    Science.gov (United States)

    Greenberger, Chaya; Mor, Pnina

    2016-07-28

    There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. This manuscript examines if and when a relative's presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support. Discourse of the halachic issues in the context of the scientific literature. Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient's and the professionals' perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient's perception of the emotional need for a relative's presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient's life. In certain cases, the latter contingency is unnecessary. Emotional support has an impact on the patient's health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  15. Lipid-anchored Synaptobrevin Provides Little or No Support for Exocytosis or Liposome Fusion.

    Science.gov (United States)

    Chang, Che-Wei; Chiang, Chung-Wei; Gaffaney, Jon D; Chapman, Edwin R; Jackson, Meyer B

    2016-02-05

    SNARE proteins catalyze many forms of biological membrane fusion, including Ca(2+)-triggered exocytosis. Although fusion mediated by SNAREs generally involves proteins anchored to each fusing membrane by a transmembrane domain (TMD), the role of TMDs remains unclear, and previous studies diverge on whether SNAREs can drive fusion without a TMD. This issue is important because it relates to the question of the structure and composition of the initial fusion pore, as well as the question of whether SNAREs mediate fusion solely by creating close proximity between two membranes versus a more active role in transmitting force to the membrane to deform and reorganize lipid bilayer structure. To test the role of membrane attachment, we generated four variants of the synaptic v-SNARE synaptobrevin-2 (syb2) anchored to the membrane by lipid instead of protein. These constructs were tested for functional efficacy in three different systems as follows: Ca(2+)-triggered dense core vesicle exocytosis, spontaneous synaptic vesicle exocytosis, and Ca(2+)-synaptotagmin-enhanced SNARE-mediated liposome fusion. Lipid-anchoring motifs harboring one or two lipid acylation sites completely failed to support fusion in any of these assays. Only the lipid-anchoring motif from cysteine string protein-α, which harbors many lipid acylation sites, provided support for fusion but at levels well below that achieved with wild type syb2. Thus, lipid-anchored syb2 provides little or no support for exocytosis, and anchoring syb2 to a membrane by a TMD greatly improves its function. The low activity seen with syb2-cysteine string protein-α may reflect a slower alternative mode of SNARE-mediated membrane fusion. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  16. Optimization of Bicomponent Electrospun Fibers for Therapeutic Use: Post-Treatments to Improve Chemical and Biological Stability

    Directory of Open Access Journals (Sweden)

    Antonio Papa

    2017-10-01

    Full Text Available Bicomponent electrospun nanofibers based on the combination of synthetic (i.e., aliphatic polyesters such as polycaprolactone (PCL and natural proteins (i.e., gelatin have been extensively investigated as temporary platforms to instruct cells by the release of molecular/pharmaceutical signals for the regeneration of several tissues. Here, water soluble proteins (i.e., gelatin, strictly embedded to PCL, act as carriers of bioactive molecules, thus improving bioavailability and supporting cell activities during in vitro regeneration. However, these proteins are rapidly digested by enzymes, locally produced by many different cell types, both in vitro and in vivo, with significant drawbacks in the control of molecular release. Hence, we have investigated three post-processing strategies based on the use of different crosslinking agents—(1-ethyl-3-(3-dimethylaminopropylcarbodiimide hydrochloride (EDC, glyceraldehyde (GC, and 1,4-butanediol diglycidyl ether (BDDGE—to delay the dissolution time of gelatin macromolecules from bicomponent fibers. All of the qualitative (i.e., SEM, TGA and quantitative (i.e., Trinitrobenzene sulfonate (TNBS and bicinchoninic acid (BCA assays morphological/chemical analyses as well as biocompatibility assays indicate that EDC crosslinking improves the chemical stability of bicomponent fibers at 37 °C and provides a more efficient encapsulation and controlled sustained release of drug, thus resulting in the best post-treatment to design bio-inspired fibrous platforms for the extended in vitro release of drugs.

  17. Optimization of Bicomponent Electrospun Fibers for Therapeutic Use: Post-Treatments to Improve Chemical and Biological Stability.

    Science.gov (United States)

    Papa, Antonio; Guarino, Vincenzo; Cirillo, Valentina; Oliviero, Olimpia; Ambrosio, Luigi

    2017-10-16

    Bicomponent electrospun nanofibers based on the combination of synthetic (i.e., aliphatic polyesters such as polycaprolactone (PCL)) and natural proteins (i.e., gelatin) have been extensively investigated as temporary platforms to instruct cells by the release of molecular/pharmaceutical signals for the regeneration of several tissues. Here, water soluble proteins (i.e., gelatin), strictly embedded to PCL, act as carriers of bioactive molecules, thus improving bioavailability and supporting cell activities during in vitro regeneration. However, these proteins are rapidly digested by enzymes, locally produced by many different cell types, both in vitro and in vivo, with significant drawbacks in the control of molecular release. Hence, we have investigated three post-processing strategies based on the use of different crosslinking agents-(1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride) (EDC), glyceraldehyde (GC), and 1,4-butanediol diglycidyl ether (BDDGE)-to delay the dissolution time of gelatin macromolecules from bicomponent fibers. All of the qualitative (i.e., SEM, TGA) and quantitative (i.e., Trinitrobenzene sulfonate (TNBS) and bicinchoninic acid (BCA) assays) morphological/chemical analyses as well as biocompatibility assays indicate that EDC crosslinking improves the chemical stability of bicomponent fibers at 37 °C and provides a more efficient encapsulation and controlled sustained release of drug, thus resulting in the best post-treatment to design bio-inspired fibrous platforms for the extended in vitro release of drugs.

  18. Chronic kidney disease and support provided by home care services: a systematic review.

    Science.gov (United States)

    Aydede, Sema K; Komenda, Paul; Djurdjev, Ognjenka; Levin, Adeera

    2014-07-18

    Chronic diseases, such as chronic kidney disease (CKD), are growing in incidence and prevalence, in part due to an aging population. Support provided through home care services may be useful in attaining a more efficient and higher quality care for CKD patients. A systematic review was performed to identify studies examining home care interventions among adult CKD patients incorporating all outcomes. Studies examining home care services as an alternative to acute, post-acute or hospice care and those for long-term maintenance in patients' homes were included. Studies with only a home training intervention and those without an applied research component were excluded. Seventeen studies (10 cohort, 4 non-comparative, 2 cross-sectional, 1 randomized) examined the support provided by home care services in 15,058 CKD patients. Fourteen studies included peritoneal dialysis (PD), two incorporated hemodialysis (HD) and one included both PD and HD patients in their treatment groups. Sixteen studies focused on the dialysis phase of care in their study samples and one study included information from both the dialysis and pre-dialysis phases of care. Study settings included nine single hospital/dialysis centers and three regional/metropolitan areas and five were at the national level. Studies primarily focused on nurse assisted home care patients and mostly examined PD related clinical outcomes. In PD studies with comparators, peritonitis risks and technique survival rates were similar across home care assisted patients and comparators. The risk of mortality, however, was higher for home care assisted PD patients. While most studies adjusted for age and comorbidities, information about multidimensional prognostic indices that take into account physical, psychological, cognitive, functional and social factors among CKD patients was not easily available. Most studies focused on nurse assisted home care patients on dialysis. The majority were single site studies incorporating

  19. Provider perceptions on HIV risk and prevention services within permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony

    2017-10-01

    Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH. The purpose of this study was to investigate how PSH providers approach HIV prevention and the challenges they perceive surrounding HIV prevention in PSH. Results serve as a critical first step toward addressing the acceptability and feasibility of providing HIV/STI prevention services to PSH residents. As part of a longitudinal mixed methods study examining HIV risk and prevention behavior among homeless unaccompanied adults moving into PSH in Los Angeles, we conducted eleven focus groups with a total of 60 frontline staff across 10 PSH agencies. Thirty-three percent of focus group participants were African American, 32% were Hispanic, and 55% were women. Results suggest that provider awareness and knowledge of PrEP is very limited, and provision of formal HIV prevention programing for residents is perceived as challenging. Informal, ad hoc conversations with residents about sexual risk and HIV prevention do occur when providers have rapport with clients and perceive risk. There are significant gaps in HIV prevention services through PSH but also opportunities to enhance providers' efforts to promote the health of residents through prevention.

  20. The relationship between women's experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India.

    Science.gov (United States)

    Diamond-Smith, Nadia; Sudhinaraset, May; Melo, Jason; Murthy, Nirmala

    2016-09-01

    a growing body of literature has highlighted the prevalence of mistreatment that women experience around the globe during childbirth, including verbal and physical abuse, neglect, lack of support, and disrespect. Much of this has been qualitative. Research around the world suggests that support during childbirth can improve health outcomes and behaviours, and improve experiences. Support can be instrumental, informational, or emotional, and can be provided by a variety of people including family (husbands, mothers) or health providers of various professional levels. This study explores women's reported experiences of mistreatment during childbirth quantitatively, and how these varied by specific types of support available and provided by specific individuals. participants were women age 16-30 who had delivered infants in a health facility in the previous five years and were living in slums of Lucknow India. Data were collected on their experiences of mistreatment, the types of support they received, and who provided that support. women who reported lack of support were more likely to report mistreatment. Lack of support in regards to discussions with providers and provider information were most strongly associated with a higher mistreatment score. Women who received any type of support from their husband or a health worker were significantly more likely to report lower mistreatment scores. Receiving informational support from a mother/mother-in-law or emotional support from a health worker was also associated with lower mistreatment scores. However, receiving emotional support from a friend/neighbour/other family member was associated with a higher mistreatment score. women rely on different people to provide different types of support during childbirth in this setting. Some of these individuals provide specific types of support that ultimately improve a woman's overall experience of her childbirth. Interventions aiming to reduce mistreatment to women during

  1. Providing Data Management Support to NASA Airborne Field Studies through Streamlined Usability Design

    Science.gov (United States)

    Beach, A. L., III; Northup, E. A.; Early, A. B.; Chen, G.

    2016-12-01

    Airborne field studies are an effective way to gain a detailed understanding of atmospheric processes for scientific research on climate change and air quality relevant issues. One major function of airborne project data management is to maintain seamless data access within the science team. This allows individual instrument principal investigators (PIs) to process and validate their own data, which requires analysis of data sets from other PIs (or instruments). The project's web platform streamlines data ingest, distribution processes, and data format validation. In May 2016, the NASA Langley Research Center (LaRC) Atmospheric Science Data Center (ASDC) developed a new data management capability to help support the Korea U.S.-Air Quality (KORUS-AQ) science team. This effort is aimed at providing direct NASA Distributed Active Archive Center (DAAC) support to an airborne field study. Working closely with the science team, the ASDC developed a scalable architecture that allows investigators to easily upload and distribute their data and documentation within a secure collaborative environment. The user interface leverages modern design elements to intuitively guide the PI through each step of the data management process. In addition, the new framework creates an abstraction layer between how the data files are stored and how the data itself is organized(i.e. grouping files by PI). This approach makes it easy for PIs to simply transfer their data to one directory, while the system itself can automatically group/sort data as needed. Moreover, the platform is "server agnostic" to a certain degree, making deployment and customization more straightforward as hardware needs change. This flexible design will improve development efficiency and can be leveraged for future field campaigns. This presentation will examine the KORUS-AQ data portal as a scalable solution that applies consistent and intuitive usability design practices to support ingest and management of airborne

  2. Could implantable cardioverter defibrillators provide a human model supporting the learned helplessness theory of depression?

    Science.gov (United States)

    Goodman, M; Hess, B

    1999-01-01

    Affective symptoms were examined retrospectively in 25 patients following placement of implantable cardioverter defibrillators (ICD) which can produce intermittent shocks without warning in response to cardiac ventricular arrhythmias. The number of ICD random, uncontrollable discharge shocks and pre-ICD history of psychological distress (i.e., depression and/or anxiety) were documented in all patients using a demographics questionnaire and a standardized behavioral/psychological symptoms questionnaire (i.e., Symptom Checklist-90 Revised). ICD patients were dichotomized into two groups: those without a history of psychological distress prior to ICD (n = 18) and those with a history of psychological distress prior to ICD (n = 7). In ICD patients without a prior history, results indicated that quantity of ICD discharge shocks was significantly predictive of current reported depression (r = 0.45, p = 0.03) and current reported anxiety (r = 0.51, p = 0.02). Conversely, in patients with a reported history of psychological distress, there was no significant relationship found between quantity of discharge shocks and current reported depression or anxiety. This study may provide evidence in support of a human model of learned helplessness in that it supports the notion that exposure to an unavoidable and inescapable aversive stimulus was found to be related to patients' reported depression. Further studies may wish to prospectively consider a larger sample as well as a more comprehensive assessment of premorbid psychological symptoms.

  3. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers.

    Science.gov (United States)

    Yang, Chih-Wei; Yen, Zui-Shen; McGowan, Jane E; Chen, Huiju Carrie; Chiang, Wen-Chu; Mancini, Mary E; Soar, Jasmeet; Lai, Mei-Shu; Ma, Matthew Huei-Ming

    2012-09-01

    Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Computer-Based Script Training for Aphasia: Emerging Themes from Post-Treatment Interviews

    Science.gov (United States)

    Cherney, Leora R.; Halper, Anita S.; Kaye, Rosalind C.

    2011-01-01

    This study presents results of post-treatment interviews following computer-based script training for persons with chronic aphasia. Each of the 23 participants received 9 weeks of AphasiaScripts training. Post-treatment interviews were conducted with the person with aphasia and/or a significant other person. The 23 interviews yielded 584 coded…

  5. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    Science.gov (United States)

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  6. Provider order entry with integrated decision support: from academia to industry.

    Science.gov (United States)

    Giuse, D A

    2003-01-01

    To describe the evolution of a provider order entry system with integrated decision support, from a research prototype to full implementation at one academic center, and finally to a commercial product. Describe the institutional environment and planning process in which the system originated. Highlight the historical evolution of the provider entry system, and analyze its system architecture and functionality. Describe the requirements for successful design and deployment both within a single health care organization and as part of a commercial product line. Over a period of eight years the system evolved from a research prototype to a fully integrated order entry system in routine use on most inpatient units of a large academic medical center. Around 12,000 orders are entered every day into the computer system; 70% of those are entered directly by the responsible physician. The system embeds best-of-care practice guidelines, and is used to reduce resource utilization by limiting unnecessary testing and suggesting more effective or less costly therapeutic replacements. The system was recently acquired by a large HIS software vendor and is being rapidly implemented at numerous customer sites. Large-scale development or deployment of complex health information systems requires considerable organizational agreement and resources, as well as close attention to iterative system design that explicitly includes constant feedback from the user community. The transformation of such a system from a single-site success to a widely deployed product requires convergence of resources and needs.

  7. Primary Care Providers' Use of a Child Psychiatry Telephone Support Program.

    Science.gov (United States)

    Van Cleave, Jeanne; Holifield, Chloe; Perrin, James M

    2017-11-29

    The Massachusetts Child Psychiatry Access Project (MCPAP) provides telephone support from mental health specialists to primary care providers (PCPs). Understanding PCPs' use may inform implementation of similar programs. We sought to examine PCPs' decision-making process to use or not use MCPAP when encountering mental health problems. We analyzed data regarding calls from PCPs to MCPAP from October 1, 2010, to July 31, 2011, and interviewed 14 PCPs with frequent use (≥7 calls) and infrequent use (≤4 calls). PCPs were asked about recent patients with mental health problems, and they were asked to describe reasons for calling or not calling MCPAP. Frequent callers were asked what sustained use; infrequent callers were asked about alternative management strategies. Comparisons were made between these groups in qualitative analysis. PCPs (n = 993) made 6526 calls (mean = 6.6; median = 3). Factors influencing calling included: MCPAP's guidance is timely and tailored to individual scope of practice; MCPAP's ability to arrange therapy referrals exceeds PCPs' ability; providing a plan at point of care relieves anxious families; and MCPAP's assistance helps accommodate families' preference to keep mental health in primary care. Some infrequent callers had gained skills through MCPAP before 2010 and now called only for complex cases. Other reasons for infrequent calling: PCPs have other consultation sources, have fear of being asked to manage more than they are comfortable, or have misperceptions of MCPAP's offerings. MCPAP enhanced PCPs' ability to deliver mental health care consistent with families' preferences. PCPs applied knowledge gained from calls to subsequent patients. Promoting MCPAP components through outreach and tailoring guidance to PCPs' scope of practice may entice greater use. Copyright © 2018. Published by Elsevier Inc.

  8. Attrition of advanced trauma life support (ATLS) skills among ATLS instructors and providers in Mexico.

    Science.gov (United States)

    Azcona, Luis Am; Gutierrez, Guillermo E O; Fernandez, Cesar J P; Natera, Octavio M; Ruiz-Speare, Octavio; Ali, Jameel

    2002-09-01

    Mexico has had the Advanced Trauma Life Support (ATLS) program since 1986. We assessed the attrition of ATLS skills among ATLS providers and instructors in this country. Three groups (S, 16 students [new medical graduates enrolled for an ATLS course]; P, 33 providers; and I, 26 instructors [who had completed courses previously]) were evaluated. Group S read the manual before pretesting. Groups P and I were subdivided based on the length of time since the course had been completed: P1, less than 2 years (n = 22); P2, more than 2 years (n = 11); I1, less than 2 years (n = 16); and I2, more than 2 years (n = 10). Multiple-choice and psychomotor testing using ATLS scoring criteria were used. Affect was assessed post-ATLS for motivational factors, interactivity, and attitude toward trauma care. Multiple-choice test scores (means +/- SD) out of a maximum of 40 were as follows: S, 24.3 +/- 2.6; P1, 24.0 +/- 5.7; P2, 21.3 +/- 8.0; I1, 23.2 +/- 8.2; and I2, 24.0 +/- 7.2. Group S all passed the post-ATLS multiple-choice test (with correct answer percentages of 60.3% +/- 6.6% pre-ATLS versus 88.8% +/- 5.6% post-ATLS). An ATLS passing score of 80% correct answers was achieved in 2 of 33 for group P and 8 of 26 for group I (p ATLS group than in the P and I groups (p ATLS attitude to trauma care. Reading the manual alone yields similar cognitive but inferior psychomotor performance compared with subjects who completed the course previously. The majority of previous providers and instructors did not obtain a passing score (80%) in the multiple-choice test, but all the new providers passed the post-ATLS multiple-choice test, suggesting major attrition of cognitive skills but maintenance of psychomotor skills. Instructors had superior cognitive performance versus providers with worsening performance over time, but clinical skills performance was maintained at an equally high level by all groups. A very positive attitude toward ATLS prevailed among all participants.

  9. Interleukin 1 genetic tests provide no support for reduction of preventive dental care.

    Science.gov (United States)

    Diehl, Scott R; Kuo, Fengshen; Hart, Thomas C

    2015-03-01

    It has been proposed that the PST and PerioPredict genetic tests that are based on polymorphisms in interleukin 1 (IL-1) genes identify a subset of patients who experience fewer tooth extractions if provided with 2 annual preventive visits. Economic analyses indicate rationing preventive care to only "high-risk" genotypes, smokers, patients with diabetes, or combinations of these risk factors would reduce the cost of dental care by $4.8 billion annually in the United States. Data presented in the study that claimed clinical utility for the PST and PerioPredict tests were obtained for reanalysis using logistic regression to assess whether the PST genetic test, smoking, diabetes, or number of preventive visits were risk factors for tooth extraction during a span of 16 years. Consistency of risk classification by the PST (version 1) and PerioPredict (version 2) genetic tests was evaluated in different ethnic groups from the 1000 Genomes database. Multivariate analyses revealed association of tooth extraction with diabetes (P preventive visits (P = .004), but no support for the PST genetic test (P = .96) nor indication that the benefit of 2 preventive visits was affected by this genetic test (P = .58). Classification of risk was highly inconsistent between the PST (version 1) and PerioPredict (version 2) genetic tests. Two annual preventive visits were supported as beneficial for all patients, and there was no evidence that the IL-1 PST genetic test has any effect on tooth extraction risk or influences the benefits of 2 annual preventive visits. Neither IL-1 PST nor PerioPredict genetic tests are useful for rationing preventive dental care. Further research is needed to identify genetic biomarkers with robust clinical validity and clinical utility to effectively personalize the practice of dentistry. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  10. EDP Sciences and A&A: partnering to providing services to support the scientific community

    Science.gov (United States)

    Henri, Agnes

    2015-08-01

    Scholarly publishing is no longer about simply producing and packaging articles and sending out to subscribers. To be successful, as well as being global and digital, Publishers and their journals need to be fully engaged with their stakeholders (authors, readers, funders, libraries etc), and constantly developing new products and services to support their needs in the ever-changing environment that we work in.Astronomy & Astrophysics (A&A) is a high quality, major international Journal that belongs to the astronomical communities of a consortium of European and South American countries supported by ESO who sponsor the journal. EDP Sciences is a non-profit publisher belonging to several learned societies and is appointed by ESO to publish the journal.Over the last decade, as well as publishing the results of worldwide astronomical and astrophysical research, A&A and EDP Sciences have worked in partnership to develop a wide range of services for the authors and readers of A&A:- A specialist language editing service: to provide a clear and excellent level of English ensuring full understanding of the high-quality science.- A flexible and progressive Open Access Policy including Gold and Green options and strong links with arXiv.- Enriched articles: authors are able to enhance their articles using a wide range of rich media such as 3D models, videos and animations.Multiple publishing formats: allowing readers to browse articles on multiple devices including eReaders and Kindles.- “Scientific Writing for Young Astronomers”: In 2008 EDP Sciences and A&A set up the Scientific Writing for Young Astronomers (SWYA) School with the objective to teach early PhD Students how write correct and efficient scientific papers for different mediums (journals, proceedings, thesis manuscripts, etc.).

  11. Principals Supporting Teachers in Providing Language Instruction to English Learners in Elementary School

    Science.gov (United States)

    Munguia, Celia

    2017-01-01

    The purpose of the study was to examine the systems of support that principals establish at their school sites to support teachers with the academic achievement of the English learner population. Two schools from a single district were selected. Specific strategies, structures, and processes that support teachers and principals of English learners…

  12. Testing of tunnel support : dynamic load testing of rockbolt elements to provide data for safer support design.

    CSIR Research Space (South Africa)

    Ortlepp, WD

    1998-06-01

    Full Text Available forward has been accomplished in that it is now possible to use the same rational procedure for the design of tunnel support as is classically employed for the design of structures or machine components in more rigorous and precise engineering disciplines...

  13. Design and process evaluation of an informative website tailored to breast cancer survivors’ and intimate partners’ post-treatment care needs

    Science.gov (United States)

    2012-01-01

    Background On-line provision of information during the transition phase after treatment carries great promise in meeting shortcomings in post-treatment care for breast cancer survivors and their partners. The objectives of this study are to describe the development and process evaluation of a tailored informative website and to assess which characteristics of survivors and partners, participating in the feasibility study, are related to visiting the website. Methods The development process included quantitative and qualitative assessments of survivors’ and partners’ care needs and preferences. Participants’ use and evaluation of the website were explored by conducting baseline and post-measurements. During the intervening 10–12 weeks 57 survivors and 28 partners were granted access to the website. Results Fifty-seven percent (n=21) of survivors who took part in the post-measurement indicated that they had visited the website. Compared to non-visitors (n=16), they were more likely to have a partner and a higher income, reported higher levels of self-esteem and had completed treatment for a longer period of time. Partners who consulted the on-line information (42%, n=8) were younger and reported lower levels of social support compared to partners who did not visit the website (n=11). Visitors generally evaluated the content and lay-out positively, yet some believed the information was incomplete and impersonal. Conclusions The website reached only about half of survivors and partners, yet was mostly well-received. Besides other ways of providing information and support, a website containing clear-cut and tailored information could be a useful tool in post-treatment care provision. PMID:23034161

  14. Computer-Supported Feedback Message Tailoring for Healthcare Providers in Malawi: Proof-of-Concept

    Science.gov (United States)

    Landis-Lewis, Zach; Douglas, Gerald P; Hochheiser, Harry; Kam, Matthew; Gadabu, Oliver; Bwanali, Mwatha; Jacobson, Rebecca S

    2015-01-01

    Although performance feedback has the potential to help clinicians improve the quality and safety of care, healthcare organizations generally lack knowledge about how this guidance is best provided. In low-resource settings, tools for theory-informed feedback tailoring may enhance limited clinical supervision resources. Our objectives were to establish proof-of-concept for computer-supported feedback message tailoring in Malawi, Africa. We conducted this research in five stages: clinical performance measurement, modeling the influence of feedback on antiretroviral therapy (ART) performance, creating a rule-based message tailoring process, generating tailored messages for recipients, and finally analysis of performance and message tailoring data. We retrospectively generated tailored messages for 7,448 monthly performance reports from 11 ART clinics. We found that tailored feedback could be routinely generated for four guideline-based performance indicators, with 35% of reports having messages prioritized to optimize the effect of feedback. This research establishes proof-of-concept for a novel approach to improving the use of clinical performance feedback in low-resource settings and suggests possible directions for prospective evaluations comparing alternative designs of feedback messages. PMID:26958217

  15. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    Directory of Open Access Journals (Sweden)

    Michael Schuckers

    2017-01-01

    Full Text Available The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks” can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics department, or part of a learning commons, or a stand-alone center. There are hundreds of these centers in the U.S. The new handbook, which is the outgrowth of a 2013 NSF-sponsored, national workshop attended by 23 QMaSC directors from all quarters of the U.S., is available open access on the USF Scholar Commons and in hard copy from Amazon.com. This editorial by the handbook’s editors provides background and overview of the 20 detailed chapters on center leadership and management; community interactions; staffing, hiring and training; center assessment; and starting a center; and then a collection of ten case studies from research universities, four-year state colleges, liberal arts colleges, and a community college. The editorial ends by pointing out the need and potential benefits of a professional organization for QMaSC directors.

  16. The Effect of Providing Life Support on Nurses' Decision Making Regarding Life Support for Themselves and Family Members in Japan.

    Science.gov (United States)

    Shaku, Fumio; Tsutsumi, Madoka

    2016-12-01

    Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.

  17. Monolayer-crystal streptavidin support films provide an internal standard of cryo-EM image quality

    Energy Technology Data Exchange (ETDEWEB)

    Han, Bong-Gyoon [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Watson, Zoe [Univ. of California, Berkeley, CA (United States); Cate, Jamie H. D. [Univ. of California, Berkeley, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Glaeser, Robert M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-03-01

    Analysis of images of biotinylated Escherichia coli 70S ribosome particles, bound to streptavidin affinity grids, demonstrates that the image-quality of particles can be predicted by the image-quality of the monolayer crystalline support film. Also, the quality of the Thon rings is a good predictor of the image-quality of particles, but only when images of the streptavidin crystals extend to relatively high resolution. When the estimated resolution of streptavidin was 5 Å or worse, for example, the ribosomal density map obtained from 22,697 particles went to only 9.5 Å, while the resolution of the map reached 4.0 Å for the same number of particles, when the estimated resolution of streptavidin crystal was 4 Å or better. It thus is easy to tell which images in a data set ought to be retained for further work, based on the highest resolution seen for Bragg peaks in the computed Fourier transforms of the streptavidin component. The refined density map obtained from 57,826 particles obtained in this way extended to 3.6 Å, a marked improvement over the value of 3.9 Å obtained previously from a subset of 52,433 particles obtained from the same initial data set of 101,213 particles after 3-D classification. These results are consistent with the hypothesis that interaction with the air-water interface can damage particles when the sample becomes too thin. Finally, streptavidin monolayer crystals appear to provide a good indication of when that is the case.

  18. Migrants and Mobile Technology Use: Gaps in the Support Provided by Current Tools

    Science.gov (United States)

    Epp, Carrie Demmans

    2017-01-01

    Our current understanding of how migrants use mobile tools to support their communication and language learning is inadequate. This study, therefore, explores the learner-initiated use of technologies to support their comprehension, production, and acquisition of English following migration to Canada. Information about migrant use of technologies…

  19. Providing Students with Interdisciplinary Support to Improve Their Organic Chemistry Posters

    Science.gov (United States)

    Widanski, Bozena; Thompson, Jo Ann; Foran-Mulcahy, Katie; Abafo, Amy

    2016-01-01

    A two-semester-long interdisciplinary support effort to improve student posters in organic chemistry lab is described. In the first semester, students' literature search report is supported by a workshop conducted by an Instruction Librarian. During the subsequent semester, a second workshop is presented by the Instruction Librarian, an English…

  20. The performance implications of outsourcing customer support to service providers in emerging versus established economies

    NARCIS (Netherlands)

    Raassens, N.; Wuyts, S.H.K.; Geyskens, I.

    Recent discussions in the business press query the contribution of customer-support outsourcing to firm performance. Despite the controversy surrounding its performance implications, customer-support outsourcing is still on the rise, especially to emerging markets. Against this backdrop, we study

  1. A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

    2017-01-01

    We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

  2. PTC test bed upgrades to provide ACSES testing support capabilities at transportation technology center.

    Science.gov (United States)

    2015-06-01

    FRA Task Order 314 upgraded the Positive Train Control (PTC) Test Bed at the Transportation Technology Center to support : testing of PTC systems, components, and related equipment associated with the Advanced Civil Speed Enforcement System : (ACSES)...

  3. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    National Research Council Canada - National Science Library

    Greenberger, Chaya; Mor, Pnina

    2016-01-01

    .... It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support...

  4. Support options provided and required for modeling with DynaLearn - A case study

    NARCIS (Netherlands)

    Or-Bach, R.; Bredeweg, B.

    2013-01-01

    Science educators strongly advocate the importance of scientific modeling within science education. Although widely advocated for students, modeling is a complex task involving integration of topics, "languages" and abstraction levels. Thus support for the modeling task and for developing modeling

  5. Spontaneously Breathing Extracorporeal Membrane Oxygenation Support Provides the Optimal Bridge to Lung Transplantation.

    Science.gov (United States)

    Schechter, Matthew Adam; Ganapathi, Asvin M; Englum, Brian R; Speicher, Paul J; Daneshmand, Mani A; Davis, R Duane; Hartwig, Matthew G

    2016-12-01

    Extracorporeal membrane oxygenation (ECMO) is being increasingly used as a bridge to lung transplantation. Small, single-institution series have described increased success using ECMO in spontaneously breathing patients compared with patients on ECMO with mechanical ventilation, but this strategy has not been evaluated on a large scale. Using the United Network for Organ Sharing database, all adult patients undergoing isolated lung transplantation from May 2005 through September 2013 were identified. Patients were categorized by their type of pretransplant support: no support, ECMO only, invasive mechanical ventilation (iMV) only, and ECMO + iMV. Kaplan-Meier survival analysis with log-rank testing was performed to compare survival based on type of preoperative support. A Cox regression model was used to determine whether type of preoperative support was independently associated with survival, using previously established predictors of survival as covariates. Approximately 12,403 primary adult pulmonary transplantations were included in this analysis. Sixty-five patients (0.52%) were on ECMO only, 612 (4.93%) required only iMV, 119 (0.96%) were on ECMO + iMV, and the remaining 11,607 (94.6%) required no invasive support before transplantation. One-year survival was decreased in all patients requiring support, regardless of type. However, mid-term survival was similar between patients on ECMO alone and those not on support but significantly worse with patients requiring iMV only or ECMO + iMV. In multivariable analysis, ECMO + iMV and iMV alone were independently associated with decreased survival compared with nonsupport patients, whereas ECMO alone was not significant. In patients with worsening pulmonary disease awaiting lung transplantation, those supported via ECMO with spontaneous breathing demonstrated improved survival compared with other bridging strategies.

  6. Language facilitates event memory in early childhood: Child comprehension, adult-provided linguistic support and delayed recall at 16 months.

    Science.gov (United States)

    Lukowski, Angela F; Phung, Janice N; Milojevich, Helen M

    2015-01-01

    Adult-provided supportive language facilitates memory for the past in preverbal and verbal children. Work conducted with 18-month-olds indicates that children benefit from supportive adult language when tested after a 4-week delay but not when tested immediately after sequence demonstration; moreover, findings reveal that supportive language provided only at test may be more facilitative of recall after a delay relative to supportive language provided only at encoding. In the present study, we examined whether child language comprehension abilities moderated the extent to which preverbal children benefitted from supportive language provided at encoding and test. The findings indicated that child language comprehension and supportive language provided at encoding were unassociated with performance at baseline or immediate imitation; however, the moderating effect of child language comprehension on adult-provided supportive language at encoding and test was observed after a 1-week delay. Correlations revealed continuous associations between general comprehension scores and recall performance after the 1-week delay on sequences presented in the most supportive condition at encoding. Taken together, the presented findings reveal that the complex interplay between language and cognition is established in early childhood, with foundational relations emerging before children are capable of verbally reporting on the past.

  7. Factors that influence evidence-based program sustainment for family support providers in child protection services in disadvantaged communities.

    Science.gov (United States)

    Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell

    2017-08-01

    This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective role of coworker support.

    Science.gov (United States)

    Winning, Adrien M; Merandi, Jenna M; Lewe, Dorcas; Stepney, Lois M C; Liao, Nancy N; Fortney, Christine A; Gerhardt, Cynthia A

    2017-07-26

    To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support. Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined. A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit. During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support. Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress. © 2017 John Wiley & Sons Ltd.

  9. Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Su; Kim, Kyu Bo; Chie, Eui Kyu; Kim, Yoon Jun; Yoon, Jung Hwan; Lee, Hyo Suk; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-03-15

    To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

  10. Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma.

    Science.gov (United States)

    Kim, Kyung Su; Kim, Kyubo; Chie, Eui Kyu; Kim, Yoon Jun; Yoon, Jung Hwan; Lee, Hyo-Suk; Ha, Sung W

    2015-03-01

    To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

  11. Does Vicarious Instigation Provide Support for Observational Learning Theories? A Critical Review.

    Science.gov (United States)

    Green, Gina; Osborne, J. Grayson

    1985-01-01

    Examines the theories of Aronfreed, Bandura, Berger, and Hygge. Also reviews experimental evidence published since 1962 which supports theories of observational learning of emotional behavior. While the theories posit that different conditions are necessary to vicarious instigation, most research does not test the theories in any direct way.…

  12. Potential For Plug-In Electric Vehicles To Provide Grid Support Services

    Energy Technology Data Exchange (ETDEWEB)

    Dias, F. G.; Luo, Y.; Mohanpurkar, M.; Hovsapian, R.; Scoffield, D.

    2017-04-01

    Since the modern-day introduction of plug-in electric vehicles (PEVs), scientists have proposed leveraging PEV battery packs as distributed energy resources for the electric grid. PEV charging can be controlled not only to provide energy for transportation but also to provide grid services and to facilitate the integration of renewable energy generation. With renewable generation increasing at an unprecedented rate, most of which is non-dispatchable and intermittent, the concept of using PEVs as controllable loads is appealing to electric utilities. This additional functionality could also provide value to PEV owners and drive PEV adoption. It has been widely proposed that PEVs can provide valuable grid services, such as load shifting to provide voltage regulation. The objective this work is to address the degree to which PEVs can provide grid services and mutually benefit the electric utilities, PEV owners, and auto manufacturers.

  13. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: a randomized trial.

    Science.gov (United States)

    Lancee, Jaap; van den Bout, Jan; Sorbi, Marjolijn J; van Straten, Annemieke

    2013-12-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants were randomized to an internet-delivered intervention for insomnia with (n = 129) or without support (n = 133). All participants received an internet-delivered cognitive behavioral treatment for insomnia. In addition, the participants in the support condition received weekly emails. Assessments were at baseline, post-treatment, and 6-month follow-up. Both groups effectively ameliorated insomnia complaints. Adding support led to significantly higher effects on most sleep measures (d = 0.3-0.5; p support significantly enhances the benefits of internet-delivered treatment for insomnia on several variables. It appears that motivational feedback increases the effect of the intervention and encourages more participants to complete the intervention, which in turn improves its effectiveness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Management of Apical Periodontitis : Healing of Post-treatment Periapical Lesions Present 1 Year after Endodontic Treatment

    NARCIS (Netherlands)

    Zhang, Ming-Ming; Liang, Yu-Hong; Gao, Xue-Jun; Jiang, Lan; van der Sluis, Luc; Wu, Min-Kai

    Introduction: Post-treatment periapical lesions present 1 year after treatment may heal during the second year or later. The aim of this study was to assess second-year volumetric changes in post-treatment periapical radiolucencies detected 1 year after treatment. Methods: Post-treatment periapical

  15. Photocatalytic post-treatment in waste water reclamation systems

    Science.gov (United States)

    Cooper, Gerald; Ratcliff, Matthew A.; Verostko, Charles E.

    1989-01-01

    A photocatalytic water purification process is described which effectively oxidizes organic impurities common to reclaimed waste waters and humidity condensates to carbon dioxide at ambient temperatures. With this process, total organic carbon concentrations below 500 ppb are readily achieved. The temperature dependence of the process is well described by the Arrhenius equation and an activation energy barrier of 3.5 Kcal/mole. The posttreatment approach for waste water reclamation described here shows potential for integration with closed-loop life support systems.

  16. Providing Staff Training and Programming to Support People with Disabilities: An Academic Library Case Study

    Science.gov (United States)

    Brannen, Michelle H.; Milewski, Steven; Mack, Thura

    2017-01-01

    This case study explores services academic libraries provide to students with disabilities and the impact these can have on the success and experience of these students. The study focuses on staff training and outreach programming. The authors examine the academic library literature surrounding these topics, provide examples of programming…

  17. Child Care Providers' Strategies for Supporting Healthy Eating: A Qualitative Approach

    Science.gov (United States)

    Lynch, Meghan; Batal, Malek

    2012-01-01

    Recent research has revealed child care settings and providers to be important influences on children's developing behaviors. Yet most research on children's nutritional development has focused on home settings and parents. Thus, through semistructured interviews with child care providers, this study aimed to develop a better understanding of the…

  18. A new hat for librarians: providing REDCap support to establish the library as a central data hub.

    Science.gov (United States)

    Read, Kevin; LaPolla, Fred Willie Zametkin

    2018-01-01

    REDCap, an electronic data capture tool, supports good research data management, but many researchers lack familiarity with the tool. While a REDCap administrator provided technical support and a clinical data management support unit provided study design support, a service gap existed. Librarians with REDCap expertise sought to increase and improve usage through outreach, workshops, and consultations. In collaboration with a REDCap administrator and the director of the clinical data management support unit, the role of the library was established in providing REDCap training and consultations. REDCap trainings were offered to the medical center during the library's quarterly data series, which served as a springboard for offering tailored REDCap support to researchers and research groups. Providing REDCap support has proved to be an effective way to associate the library with data-related activities in an academic medical center and identify new opportunities for offering data services in the library. By offering REDCap services, the library established strong partnerships with the Information Technology Department, Clinical Data Support Department, and Compliance Office by filling in training gaps, while simultaneously referring users back to these departments when additional expertise was required. These new partnerships continue to grow and serve to position the library as a central data hub in the institution.

  19. Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers

    NARCIS (Netherlands)

    Barker, Gerry J.; Epstein, Joel B.; Williams, Karen B.; Gorsky, Meir; Raber-Durlacher, Judith E.

    2005-01-01

    The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was

  20. The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations

    Science.gov (United States)

    Muglia, Victor O.

    2010-01-01

    The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…

  1. Reframing cooperation: Challenges in overcoming tensions between professional services and volunteer organizations providing parenting support in immigrant communities

    NARCIS (Netherlands)

    Ponzoni, E.

    2015-01-01

    Volunteer organizations can potentially partner with mainstream professional services to provide better parenting support to immigrant parents. This qualitative study of cooperation between professional agencies and volunteer organizations known as migrant volunteer and community organizations

  2. A Reference Architecture for Providing Tools as a Service to Support Global Software Development

    DEFF Research Database (Denmark)

    Chauhan, Aufeef

    2014-01-01

    -based solutions. The restricted ability of the organizations to have desired alignment of tools with software engineering and development processes results in administrative and managerial overhead that incur increased development cost and poor product quality. Moreover, stakeholders involved in the projects have......Global Software Development (GSD) teams encounter challenges that are associated with distribution of software development activities across multiple geographic regions. The limited support for performing collaborative development and engineering activities and lack of sufficient support...... specific constraints regarding availability and deployments of the tools. The artifacts and data produced or consumed by the tools need to be governed according to the constraints and corresponding quality of service (QoS) parameters. In this paper, we present the research agenda to leverage cloud...

  3. Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

    OpenAIRE

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J.; Kinsinger, Linda

    2013-01-01

    Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer cou...

  4. Providing effective support to “deep democracy”:  how can it realistically be done?

    Directory of Open Access Journals (Sweden)

    Jean Bossuyt

    2014-02-01

    Full Text Available Martin Dahinden’s article on “Democracy Promotion at the local level: Experiences, Perspectives and Policy of Swiss International Cooperation” comes at the right time. Democracy promotion is not a new topic on the agenda of the international (European community. Since the democratisation wave of the early 1990s that swept across the developing world, a wide range of donor-supported programmes, mobilising substantial funds, have sought to build institutions and nurture democratic values in hu...

  5. Providing support for problem-based learning in dentistry: the Manchester experience.

    Science.gov (United States)

    Hoad-Reddick, Gillian; Theaker, Elizabeth

    2003-02-01

    The introduction of problem-based learning (PBL) into any programme demands a period of adjustment on the part of faculty. Similarly, students new to PBL take time to adapt to what is, for the majority of them, an unfamiliar mode of learning. At Manchester, closed loop PBL is used throughout the first and second years of the dental programme; the method is interdisciplinary; there are no subject boundaries. Dental students work in groups of between 10 and 15, facilitated by a tutor from the Department of Biological Sciences, to research topics and share information in a mutually supportive environment. Each week a different problem forms the focus for learning. In this paper, we seek to describe the measures introduced in response to student feedback collected via routine meetings with the senior tutor, after meetings with their academic or personal tutors and through discussion at the staff students' committee, which we at Manchester have taken to facilitate the process of adaptation to PBL. Changes have been made in the areas of recruitment, pre-admission interviewing, induction (development of an induction booklet and communication skills module) and tutorial support (overhaul of personal tutor system and introduction of peer-assisted study (PAS) and personal and academic development programmes (PADPs)). Feedback on these changes, gathered via the routes described above, has been positive and continues to be central to our processes of development in these areas. Although the various ways in which PBL has been implemented worldwide may place limits on the transferability of our methods, this paper serves to illustrate some of the means available to support students in the transition to self-directed learning. The latter is not only an essential component of PBL but also something we should be seeking to foster in all students, no matter what philosophy and method of course delivery are utilized.

  6. A programmable rules engine to provide clinical decision support using HTML forms.

    Science.gov (United States)

    Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

    1999-01-01

    The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

  7. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    OpenAIRE

    Michael Schuckers; Mary B. O'Neill; Grace Coulombe

    2017-01-01

    The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks”) can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics departm...

  8. Workshop for Early Career Geoscience Faculty: Providing resources and support for new faculty to succeed

    Science.gov (United States)

    Hill, T. M.; Beane, R. J.; Macdonald, H.; Manduca, C. A.; Tewksbury, B. J.; Allen-King, R. M.; Yuretich, R.; Richardson, R. M.; Ormand, C. J.

    2015-12-01

    A vital strategy to educate future geoscientists is to support faculty at the beginning of their careers, thus catalyzing a career-long impact on the early-career faculty and on their future students. New faculty members are at a pivotal stage in their careers as they step from being research-focused graduate students and post-doctoral scholars, under the guidance of advisors, towards launching independent careers as professors. New faculty commonly, and not unexpectedly, feel overwhelmed as they face challenges to establish themselves in a new environment, prepare new courses, begin new research, and develop a network of support. The workshop for Early Career Geoscience Faculty: Teaching, Research, and Managing Your Career has been offered annually in the U.S. since 1999. The workshop is currently offered through the National Association of Geoscience Teachers On the Cutting Edge professional development program with support from the NSF, AGU and GSA. This five-day workshop, with associated web resources, offers guidance for incorporating evidence-based teaching practices, developing a research program, and managing professional responsibilities in balance with personal lives. The workshop design includes plenary and concurrent sessions, individual consultations, and personalized feedback from workshop participants and leaders. Since 1999, more than 850 U.S. faculty have attended the Early Career Geoscience Faculty workshop. Participants span a wide range of geoscience disciplines, and are in faculty positions at two-year colleges, four-year colleges, comprehensive universities and research universities. The percentages of women (~50%) and underrepresented participants (~8%) are higher than in the general geoscience faculty population. Multiple participants each year are starting positions after receiving all or part of their education outside the U.S. Collectively, participants report that they are better prepared to move forward with their careers as a result of

  9. The Anterior Thalamus Provides A Subcortical Circuit Supporting Memory And Spatial Navigation

    Directory of Open Access Journals (Sweden)

    Shane M O‘Mara

    2013-08-01

    Full Text Available The anterior thalamic nuclei, a central component of Papez’ circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the anterior thalamic nuclei (anteromedial, anteroventral, anterodorsal are the particular structures of interest. The extensive direct and indirect hippocampal-anterior thalamic interconnections and the presence of theta-modulated cells in both sites further support the hypothesis that these structures constitute a neuronal network crucial for memory and cognition. The major tool in understanding how the brain processes information is the analysis of neuronal output at each hierarchical level along the pathway of signal propagation coupled with neuroanatomical studies. Here, we discuss the electrophysiological properties of cells in the anterior thalamic nuclei with an emphasis on their role in spatial navigation. In addition, we describe neuroanatomical and functional relationships between the anterior thalamic nuclei and hippocampal formation.

  10. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  11. Superhydrophobic Post Treatment and Coating Extenders for Improved Asset Sustainability

    Science.gov (United States)

    Trigwell, Steven; Montgomery, Eliza L.; Calle, Luz M.

    2015-01-01

    Launch structures, hardware, and ground support equipment, at NASA's John F. Kennedy Space Center in Florida, are exposed to a highly corrosive natural coastal marine environment. In addition, during launches, rocket exhaust deposition is also highly corrosive. Superhydrophobic coatings are being considered for additional corrosion protection on existing structures to enhance corrosion resistance and add an additional layer of protection against harsh environmental elements. These coatings have come into their own recently, and are now being investigated as corrosion protective coatings due to their water repelling capability. These coatings can be used on existing coatings, newly coated materials, or used on bare substrates. The coatings are not suitable for permanent corrosion protection, but can be used where additional corrosion control is desired or only when temporary corrosion control is needed, such as in hardware sitting on a launch pad for 30-45 days prior to a launch. In this study, superhydrophobic coatings were applied on various coated and uncoated substrates and exposed to the spaceport environment for various times up to 60 days. This paper highlights the current results of the superhydrophobic coatings performance evaluated by X-ray photoelectron spectroscopy, and contact angle measurements.

  12. Predictors of Quality and Commitment in Family Child Care: Provider Education, Personal Resources, and Support.

    Science.gov (United States)

    Weaver, Ruth Harding

    2002-01-01

    Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…

  13. Beyond the Clinic: Providing Services, Supports, and Connections to Help Children and Their Families Thrive

    Science.gov (United States)

    Nolan, Kevin J., Jr.

    2013-01-01

    As one of the premier pediatric hospitals in the United States, Boston Children's Hospital serves a wide range of children and provides top quality medical care, including a program for deaf and hard of hearing children that extends services beyond the medical scope. Within this program is a unique and particularly critical position--that of…

  14. Providing Social Enterprises with Better Access to Public Procurement : The Development of Supportive Legal Frameworks

    NARCIS (Netherlands)

    Argyrou, A.

    2017-01-01

    This article discusses the issue of social enterprises gaining access to public procurement processes and contracts at the EU and national level. It primarily examines the opportunities for social enterprises to access public procurement contracts provided for in the Public Procurement Directive

  15. Views on Logistics, Candid Voices, Providing Responsive Logistics Support: Applying LEAN Thinking to Logistics

    Science.gov (United States)

    1999-10-01

    repair, production, transportation, etc.) must provide customers with what they need when they need it. It must also minimize the cost to the customer . What...repair, produce or purchase things based on forecasted demands. However, in order to minimize the cost to the customer , the logistics system must repair

  16. Providing a Supportive Alternative Education Environment for At-Risk Students

    Science.gov (United States)

    McGee, John J.; Lin, Fan-Yu

    2017-01-01

    Many factors cause student disengagement from school that subsequently result in high dropout rates. Alternative education (AE) programs provide a different pathway for at-risk youths who do not meet the goals, standards, and requirements of traditional educational settings. However, educational agencies have vastly different interpretations…

  17. Parenting During Residency: Providing Support for Dr Mom and Dr Dad.

    Science.gov (United States)

    Morris, Laura; Cronk, Nikole J; Washington, Karla T

    2016-02-01

    Parenting during family medicine residency is increasingly common. Relatively little is known about how the competing demands of work and family life affect residents. We conducted an exploratory qualitative study of parenting family medicine residents at one program in the Midwest utilizing focus groups to understand residents' perceptions of the positive and negative characteristics of their roles as physicians and parents. We used consensus coding to identify themes in the data and then developed a model to illustrate the relationships among the identified themes. Competing demands on their time require parenting family medicine residents to often make difficult choices, which result in both positive and negative outcomes for residents, their families, and their residency experience. Parenting family medicine residents experience numerous conflicts in their concurrent roles of learner, physician, and parent. Parenting-friendly residency training programs would likely offer valuable support for these individuals during this stressful life period.

  18. Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

    Science.gov (United States)

    Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

    2016-01-01

    This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

  19. Use of an Online Community to Provide Support to Caregivers of People With Dementia

    OpenAIRE

    Pagán-Ortiz, Marta E.; Dharma E. Cortés; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, since linguistically and culturally appropriate information is often not available. In response to these needs, we developed a website for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and ...

  20. Pre-treatment and post-treatment changes in platelet indices in patients with immune thrombocytopenia.

    Science.gov (United States)

    Korkmaz, Serdal; Uslu, Ali U; Aydin, Bahattin; Dogan, Ozgur; Sencan, Mehmet

    2013-06-01

    To investigate if there is a correlation between pre- and post-treatment mean platelet volume (MPV), platelet size deviation width (PDW), and platecrit (PCT) values and to investigate whether we can use them as laboratory parameters to estimate the relapses of immune thrombocytopenia (ITP) patients. Patients with ITP diagnosed at the Hematology Clinic, School of Medicine, Cumhuriyet University, Sivas, Turkey between January 2005 and December 2011 were evaluated by a retrospective review of our patients' records. Eighty-one patients with ITP were collected. The first relapse was termed as the hospitalization day before second-line therapy, and the second relapse was termed as the hospitalization day before alternate second-line therapy. We provided the following data of ITP patients at diagnosis, before and after first relapses, and before and after second relapses: presenting symptoms, platelet count, MPV, PDW, and PCT values. We obtained significant statistical differences between MPV values after initial treatment and before second-line therapy (first relapse) (p=0.005), between MPV values after splenectomy and before immunosuppressive or immune modulator therapy (second relapse) (p=0.028), and also, between PCT values after splenectomy and before second relapse (p=0.043). Mean platelet volume is gradually increasing before first and second relapses, and again normal values are being obtained after appropriate therapies. We conclude that MPV is a useful parameter as a predictor of relapses.

  1. Distinct cerebrospinal fluid proteomes differentiate post-treatment lyme disease from chronic fatigue syndrome.

    Science.gov (United States)

    Schutzer, Steven E; Angel, Thomas E; Liu, Tao; Schepmoes, Athena A; Clauss, Therese R; Adkins, Joshua N; Camp, David G; Holland, Bart K; Bergquist, Jonas; Coyle, Patricia K; Smith, Richard D; Fallon, Brian A; Natelson, Benjamin H

    2011-02-23

    Neurologic Post Treatment Lyme disease (nPTLS) and Chronic Fatigue (CFS) are syndromes of unknown etiology. They share features of fatigue and cognitive dysfunction, making it difficult to differentiate them. Unresolved is whether nPTLS is a subset of CFS. Pooled cerebrospinal fluid (CSF) samples from nPTLS patients, CFS patients, and healthy volunteers were comprehensively analyzed using high-resolution mass spectrometry (MS), coupled with immunoaffinity depletion methods to reduce protein-masking by abundant proteins. Individual patient and healthy control CSF samples were analyzed directly employing a MS-based label-free quantitative proteomics approach. We found that both groups, and individuals within the groups, could be distinguished from each other and normals based on their specific CSF proteins (psyndromes. nPTLS and CFS have distinguishing CSF protein complements. Each condition has a number of CSF proteins that can be useful in providing candidates for future validation studies and insights on the respective mechanisms of pathogenesis. Distinguishing nPTLS and CFS permits more focused study of each condition, and can lead to novel diagnostics and therapeutic interventions.

  2. Distinct cerebrospinal fluid proteomes differentiate post-treatment lyme disease from chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Steven E Schutzer

    Full Text Available BACKGROUND: Neurologic Post Treatment Lyme disease (nPTLS and Chronic Fatigue (CFS are syndromes of unknown etiology. They share features of fatigue and cognitive dysfunction, making it difficult to differentiate them. Unresolved is whether nPTLS is a subset of CFS. METHODS AND PRINCIPAL FINDINGS: Pooled cerebrospinal fluid (CSF samples from nPTLS patients, CFS patients, and healthy volunteers were comprehensively analyzed using high-resolution mass spectrometry (MS, coupled with immunoaffinity depletion methods to reduce protein-masking by abundant proteins. Individual patient and healthy control CSF samples were analyzed directly employing a MS-based label-free quantitative proteomics approach. We found that both groups, and individuals within the groups, could be distinguished from each other and normals based on their specific CSF proteins (p<0.01. CFS (n = 43 had 2,783 non-redundant proteins, nPTLS (n = 25 contained 2,768 proteins, and healthy normals had 2,630 proteins. Preliminary pathway analysis demonstrated that the data could be useful for hypothesis generation on the pathogenetic mechanisms underlying these two related syndromes. CONCLUSIONS: nPTLS and CFS have distinguishing CSF protein complements. Each condition has a number of CSF proteins that can be useful in providing candidates for future validation studies and insights on the respective mechanisms of pathogenesis. Distinguishing nPTLS and CFS permits more focused study of each condition, and can lead to novel diagnostics and therapeutic interventions.

  3. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    Directory of Open Access Journals (Sweden)

    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  4. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a

  5. Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

    Science.gov (United States)

    Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

    2017-10-13

    Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

  6. FINDER, A system providing complex decision support for commercial transport replanning operations

    Science.gov (United States)

    Bittermann, Vincent; Deker, Guy; Sassus, Pierre; Mielnik, Jean-Christophe; Jud, Jean-Marie

    1994-03-01

    Decision-aid systems, likely to appear in future aircraft generations, could play a central role in the cockpit thanks to the broad spectrum of functionalities and decision support facilities they will offer to the crew. As part of such systems, the exploratory FINDER mock-up is a knowledge based system (KBS) designed to help crew members continually optimize their flight plan by suggesting solutions considering exhaustive information related to flight context, either on pilot request or upon external information occurrence. The successful evaluation by Air France pilots of that first mock-up dedicated to diversion procedure on pilot request has led to the current development of an enhanced system with nominal enroute operations and real-time capabilities. Nominal enroute operations concern the optimization with respect to an evolutive constraining of favoring environment (due to weather, traffic or regulated areas, and ETOPS constraints). This study paves the way for a future flight assistant system concept which is already under investigation and may take place in SEXTANT Avionique's future development steps.

  7. Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Sandberg, Jonas; Ekstedt, Mirjam; Kenne Sarenmalm, Elisabeth; Christiansen, Mats; Öhlén, Joakim

    2016-07-01

    Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people. Interpretive description guided the research process, and data were generated from repeated reflective conversations with staff in groups, individually, and in pairs. The findings disclose a person-centered approach to palliative care, grounded in the understanding of the person's health/illness and health literacy, and how this is related to and determinant on life as a homeless individual. Four patterns shape this approach: building trustful and family-like relationships, re-dignifying the person, re-considering communication about illness and dying, and re-defining flexible and pragmatic care solutions. © The Author(s) 2015.

  8. Providing Evidence-Based, Intelligent Support for Flood Resilient Planning and Policy: The PEARL Knowledge Base

    Directory of Open Access Journals (Sweden)

    George Karavokiros

    2016-09-01

    Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.

  9. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Bazzano AN

    2016-11-01

    Full Text Available Alessandra N Bazzano,1 Lisa Littrell,1 Amelia Brandt,1 Shelley Thibeau,2 Kamala Thriemer,3 Katherine P Theall1 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 2Ochsner Health System, New Orleans, LA, USA; 3MLT EpiConsult, Jingili, NT, Australia Background: Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers’ perceptions, experiences, and practices in relation to galactagogue recommendation. Method: A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants. Results: More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either ‘always’ (8.5% or ‘most of the time’ (14.9% and ‘sometimes’ (46.8%. More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues. Discussion: Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety

  10. Use of an online community to provide support to caregivers of people with dementia.

    Science.gov (United States)

    Pagán-Ortiz, Marta E; Cortés, Dharma E; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.

  11. Mechanical Harvesting Effectively Controls Young Typha spp. Invasion and Unmanned Aerial Vehicle Data Enhances Post-treatment Monitoring

    Directory of Open Access Journals (Sweden)

    Shane C. Lishawa

    2017-04-01

    Full Text Available The ecological impacts of invasive plants increase dramatically with time since invasion. Targeting young populations for treatment is therefore an economically and ecologically effective management approach, especially when linked to post-treatment monitoring to evaluate the efficacy of management. However, collecting detailed field-based post-treatment data is prohibitively expensive, typically resulting in inadequate documentation of the ecological effects of invasive plant management. Alternative approaches, such as remote detection with unmanned aerial vehicles (UAV, provide an opportunity to advance the science and practice of restoration ecology. In this study, we sought to determine the plant community response to different mechanical removal treatments to a dominant invasive wetland macrophyte (Typha spp. along an age-gradient within a Great Lakes coastal wetland. We assessed the post-treatment responses with both intensive field vegetation and UAV data. Prior to treatment, the oldest Typha stands had the lowest plant diversity, lowest native sedge (Carex spp. cover, and the greatest Typha cover. Following treatment, plots that were mechanically harvested below the surface of the water differed from unharvested control and above-water harvested plots for several plant community measures, including lower Typha dominance, lower native plant cover, and greater floating and submerged aquatic species cover. Repeated-measures analysis revealed that above-water cutting increased plant diversity and aquatic species cover across all ages, and maintained native Carex spp. cover in the youngest portions of Typha stands. UAV data revealed significant post-treatment differences in normalized difference vegetation index (NDVI scores, blue band reflectance, and vegetation height, and these remotely collected measures corresponded to field observations. Our findings suggest that both mechanically harvesting the above-water biomass of young Typha stands

  12. Scientific support, soil information and education provided by the Austrian Soil Science Society

    Science.gov (United States)

    Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie

    2015-04-01

    The Austrian Soil Science Society (ASSS), founded in 1954, is a non-profit organisation aiming at furthering all branches of soil science in Austria. The ASSS provides information on the current state of soil research in Austria and abroad. It organizes annual conferences for scientists from soil and related sciences to exchange their recent studies and offers a journal for scientific publications. Annually, ASSS awards the Kubiena Research Prize for excellent scientific studies provided by young scientists. In order to conserve and improve soil science in the field, excursions are organized, also in cooperation with other scientific organisations. Due to well-established contacts with soil scientists and soil science societies in many countries, the ASSS is able to provide its members with information about the most recent developments in the field of soil science. This contributes to a broadening of the current scientific knowledge on soils. The ASSS also co-operates in the organisation of excursions and meetings with neighbouring countries. Several members of the ASSS teach soil science at various Austrian universities. More detail on said conferences, excursions, publications and awards will be given in the presentation. Beside its own scientific journal, published once or twice a year, and special editions such as guidebooks for soil classification, the ASSS runs a website providing information on the Society, its activities, meetings, publications, awards and projects. Together with the Environment Agency Austria the ASSS runs a soil platform on the internet. It is accessible for the public and thus informs society about soil issues. This platform offers a calendar with national and international soil events, contacts of soil related organisations and networks, information on national projects and publications. The society has access to products, information material and information on educational courses. Last but not least information on specific soil

  13. Preventing HIV by providing support for orphan girls to stay in school: does religion matter?

    Science.gov (United States)

    Hallfors, Denise D; Cho, Hyunsan; Iritani, Bonita J; Mapfumo, John; Mpofu, Elias; Luseno, Winnie K; January, James

    2013-01-01

    The paper examines the influence of religion on attitudes, behaviors, and HIV infection among rural adolescent women in Zimbabwe. We analyzed data from a 2007 to 2010 randomized controlled trial in rural eastern Zimbabwe testing whether school support can prevent HIV risk behaviors and related attitudes among rural adolescent orphan girls; supplementary data from the 2006 Zimbabwe Demographic and Health Survey (ZDHS) were also analyzed. The present study design is largely cross-sectional, using the most recent available survey data from the clinical trial to examine the association between religious affiliation and religiosity on school dropout, marriage, and related attitudes, controlling for intervention condition, age and orphan type. The ZDHS data examined the effect of religious denomination on marriage and HIV status among young rural women, controlling for age. Apostolic Church affiliation greatly increased the likelihood of early marriage compared to reference Methodist Church affiliation (odds ratio = 4.5). Greater religiosity independently reduced the likelihood of school dropout, increased gender equity attitudes and disagreement with early sex, and marginally reduced early marriage. Young rural Apostolic women in the ZDHS were nearly four times as likely to marry as teenagers compared to Protestants, and marriage doubled the likelihood of HIV infection. Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV infection for young married women and their infants in high prevalence areas, further study is urgently needed to confirm this emerging public health problem

  14. Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support

    DEFF Research Database (Denmark)

    Byrne, J. L.; Davies, Melanie J; Willaing, I.

    2017-01-01

    : The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management......Aims: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Methods: A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17...... in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different...

  15. Ketosteroid isomerase provides further support for the idea that enzymes work by electrostatic preorganization.

    Science.gov (United States)

    Kamerlin, Shina C L; Sharma, Pankaz K; Chu, Zhen T; Warshel, Arieh

    2010-03-02

    One of the best systems for exploring the origin of enzyme catalysis has been the reaction of ketosteroid isomerase (KSI). Studies of the binding of phenolates to KSI have been taken as proof that the electrostatic preorganization effect only makes a minor contribution to the binding of the real, multiring, transition state (TS). However, our simulation study has determined that the difference between the phenolates and the TS arises from the fact that the nonpolar state of the phenolate can rotate freely relative to the oxyanion hole and thus loses the preorganization contribution. A recent study explored the reactivity of both small and multiring systems and concluded that their similar reactivity contradicts our preorganization idea. Herein, we establish that the available experiments in fact provide what is perhaps the best proof and clarification of the preorganization idea and its crucial role in enzyme catalysis. First, we analyze the binding energy and the pK(a) of equilenin and identify direct experimental evidence for our prediction about the differential electrostatic stabilization of the large TS and the small phenolates. Subsequently, we show that the similar reactivity of the small and large systems is also due to an electrostatic preorganization effect but that this effect only appears in the intermediate state because the TS is not free to rotate. This establishes the electrostatic origin of enzyme catalysis. We also clarify the crucial importance of having a well-defined physical concept when examining catalytic effects and the need for quantitative tools for analyzing such effects.

  16. Kelp transcriptomes provide robust support for interfamilial relationships and revision of the little known Arthrothamnaceae (Laminariales).

    Science.gov (United States)

    Jackson, Chris; Salomaki, Eric D; Lane, Christopher E; Saunders, Gary W

    2017-02-01

    If ever there were "charismatic megaflora" of the sea, the Laminariales (kelp) would undoubtedly meet that designation. From the Northeast Pacific kelp forests to the less diverse, but nonetheless dense, kelp beds ranging from the Arctic to the cold temperate waters of the Southern Hemisphere, kelp provide habitat structure and food for a variety of productive marine systems. Consequently, kelp are well represented in the literature, however, understanding their evolution has proven challenging. We used a 152-gene phylogenomics approach to better resolve the phylogeny of the "derived" kelp families (viz., Agaraceae, Alariaceae, Laminariaceae, and Lessoniaceae). The formerly unresolved Egregia menziesii firmly joined a significantly expanded Arthrothamnaceae including Arthrothamnus, Cymathaere, Ecklonia, Macrocystis, Nereocystis, Pelagophycus, Postelsia, Pseudolessonia, Saccharina, and Streptophyllopsis, which rendered both the Laminariaceae and Lessoniaceae monogeneric. A published eight-gene alignment, the most marker-rich prior to this study, was expanded and analyzed to facilitate inclusion of Aureophycus. Although the topology was unchanged at the family level between the transcriptome data set relative to eight-gene analyses, the superior resolving power of the former was clearly established. © 2016 Phycological Society of America.

  17. An enabling system for echocardiography providing adaptive support through behavioral analysis.

    Science.gov (United States)

    Trochim, S; Weidenbach, M; Pieper, S; Wick, C; Berlage, T

    2001-01-01

    Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality. Especially for beginners, the most critical point during an echocardiographic examination is the steering of the ultrasound probe to navigate between different cardiological standard planes (sensorimotor skill) without loosing orientation. These transitions or "standard trajectories" can roughly be described by specific movement patterns. We propose an enabling system based on an Augmented Reality simulator for two-dimensional echocardiography imitating this apprenticeship [1]-[3]. During a simulated ultrasound examination the system monitors the activities of the trainee and analyzes the motion pattern of the ultrasound probe. The simulator reacts by mapping the motion patterns onto cognitive orientation demands and providing adaptive feedback in the form of context sensitive help (animations). It partly takes the role of the critical teacher.

  18. Catchment structure that supports organic matter providing a natural control on rising river nutrient concentrations

    Science.gov (United States)

    Stutter, Marc; Ibiyemi, Adekunle; Wang, Chen

    2017-04-01

    The connectivity of sources of pollution in catchments has been well studied and brings concepts such as pollution hotspots and critical source areas. However, consideration of the placement of other structures combating rising pollution impacts has been less considered. One such area that is receiving developing focus is the layout of riparian management and buffer strips. However, there are wider aspects of connectivity and landscape structure that can bring benefits to delivery and in-stream processing of pollution. These include wetlands, forests and the distribution of soils of differing connectivity of organic matter varying in bioavailability. Organic matter is a great modulator of catchment processes from controlling the potential of land use (e.g. constraints of soil organic matter and wetness on agricultural use), to the amount and form of nutrients leached from soils, to controls of dissolved organic matter on in-stream biology that responds to nutrient concentrations. As the fundamental control of ecosystem energy available for many heterotrophic processes it mediates uptake, recycling and speciation of N, P at many stages of the catchment from soils to waters; as such DOM can be considered as a nature-based solution exerting a background level of control on inorganic nutrients. This poster explores the role of different structural aspects of catchments that provide beneficial organic matter inputs to rivers. At the fine scale the lability of riparian soil and leaf litter DOC are considered. At a riparian management scale the local changes in buffer strip soil C and DOC relative to field soils are considered. At the largest scale spatial data are explored for riparian structure, forests, wetlands and soils differing in delivery and forms of C across major Scottish rivers and used as co-variates to explain differences in in-stream processing of nutrients.

  19. Does minimally invasive transsacral fixation provide anterior column support in adult scoliosis?

    Science.gov (United States)

    Anand, Neel; Baron, Eli M; Khandehroo, Babak

    2014-06-01

    Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction. We determined (1) the fusion rate of long-segment arthrodeses, (2) heath-related quality-of-life (HRQOL) outcomes (VAS pain score, Oswestry Disability Index [ODI], SF-36), and (3) the common complications and their frequency in adult patients with scoliosis undergoing transsacral fixation without supplemental pelvic fixation. Between April 2007 and May 2011, 92 patients had fusion of three or more segments extending to the sacrum for spinal deformity. Transsacral L5-S1 fusion without supplemental pelvic fixation was performed in 56 patients. Of these, 46 with complete data points and a minimum of 2 years of followup (mean, 48 months; range, 24-72 months; 18% of patients lost to followup) were included in this study. Nineteen of the 46 (41%) had fusions extending above the thoracolumbar junction, with one patient having fusion into the proximal thoracic spine (T3-S1). General indications for the use of transsacral fixation were situations where the fusion needed to be extended to the sacrum, such as spondylolisthesis, prior laminectomy, stenosis, oblique take-off, and disc degeneration at L5-S1. Contraindications included anatomic variations in the sacrum, vascular anomalies, prior intrapelvic surgery, and rectal fistulas or abscesses. Fusion rates were assessed by full-length radiographs and CT scanning. HRQOL data, including VAS pain score, ODI, and SF-36 scores, were assessed at all pre- and postoperative visits. Intraoperative and postoperative complications were noted. Forty-one of 46 patients (89%) developed a solid fusion at L5-S1. There were significant improvements in all HRQOL parameters. Eight

  20. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  1. Parents' experiences of family functioning, health and social support provided by nurses--a pilot study in paediatric intensive care.

    Science.gov (United States)

    Hakio, Nora; Rantanen, Anja; Åstedt-Kurki, Päivi; Suominen, Tarja

    2015-02-01

    The objective of this study was to describe parents' experiences of family functioning, health and social support provided by nursing personnel, while their child was in intensive care, and to determine how social support was associated with family functioning and family health. Cross-sectional study. The data were collected by a self-administered questionnaire from 31 parents of critically ill children from 2010 to 2011. The data were analysed statistically. The parents considered their family functioning, health and social support provided by the nursing personnel to be good. The sub-area of family functioning that rated the lowest was strengths of family, whereas the lowest rated sub-area of family health was ill-being. Child's previous hospital treatments were associated with family health. Parents, whose child had already been in hospital care, reported more well-being and less ill-being than parents with children hospitalised for the first time. Parents' education was associated with family functioning, family health and social support given by the nurses. Weak positive correlation was also found between social support given by nurses and family health experienced by parents. There is a need to discuss how nursing care can further support parental resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  3. A pilot study examining the impact of care provider support program on resiliency, coping, and compassion fatigue in military health care providers.

    Science.gov (United States)

    Weidlich, Christopher P; Ugarriza, Doris N

    2015-03-01

    The Care Provider Support Program (CPSP) was created as a way to improve the resiliency of military health care providers. The purpose of this pilot study was to update what is currently known about the resiliency, coping, and compassion fatigue of military and civilian registered nurses, licensed practical nurses (LPNs), and medics who treat wounded Soldiers and whether these factors can be improved over a sustained period of time. A prospective cohort pilot study was implemented to investigate the long-term effects of CPSP training on military and civilian nurses, LPNs, and medics (n = 93) at an Army Medical Center utilizing the Connor-Davidson Resilience Scale, the Ways of Coping Questionnaire, and Professional Quality of Life Questionnaire. Twenty-eight participants returned follow-up questionnaires. CPSP was significant in reducing burnout as measured by the Professional Quality of Life questionnaire, leading to decreased compassion fatigue. CPSP training did not affect resiliency scores on the Connor-Davidson resilience scale or coping scores as measured by the Ways of Coping Questionnaire. on the basis of the results of this study, CPSP training was effective in reducing burnout, which often leads to decreased compassion fatigue in a group of military and civilian registered nurses, LPNs, and medics. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  4. Innovations in basic life support education for healthcare providers: improving competence in cardiopulmonary resuscitation through self-directed learning.

    Science.gov (United States)

    Cason, Carolyn L; Kardong-Edgren, Suzan; Cazzell, Mary; Behan, Deborah; Mancini, Mary Elizabeth

    2009-01-01

    Providing cardiopulmonary resuscitation is an essential competency for nurses. Nurse educators involved in staff development and continuing education spend numerous hours offering basic life support courses and conducting performance improvement activities such as mock codes. This study provides evidence that cardiopulmonary resuscitation performance skills using self-directed learning methods are as good as or, on a number of parameters, better than those achieved with a more resource- and time-intensive traditional approach.

  5. Perceptions of Supported Employment Providers: What Students with Developmental Disabilities, Families, and Educators Need to Know for Transition Planning

    Science.gov (United States)

    Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.

    2011-01-01

    The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…

  6. Support given to lecturers when providing mobile centric services in teaching and learning: a policy analysis perspective

    CSIR Research Space (South Africa)

    Chipangura, B

    2015-05-01

    Full Text Available The objective of this study is to examine the status of Higher Education Institutions (HEIs) policies in supporting lecturers when providing mobile centric services to students. The research was undertaken as a single case study within the Open...

  7. Emotional Literacy Support Assistants' Views on Supervision Provided by Educational Psychologists: What EPs Can Learn from Group Supervision

    Science.gov (United States)

    Osborne, Cara; Burton, Sheila

    2014-01-01

    The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…

  8. Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

    Science.gov (United States)

    Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie

    2012-01-01

    Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four

  9. Rapid and Checkable Electrical Post-Treatment Method for Organic Photovoltaic Devices

    Science.gov (United States)

    Park, Sangheon; Seo, Yu-Seong; Shin, Won Suk; Moon, Sang-Jin; Hwang, Jungseek

    2016-01-01

    Post-treatment processes improve the performance of organic photovoltaic devices by changing the microscopic morphology and configuration of the vertical phase separation in the active layer. Thermal annealing and solvent vapor (or chemical) treatment processes have been extensively used to improve the performance of bulk-heterojunction (BHJ) organic photovoltaic (OPV) devices. In this work we introduce a new post-treatment process which we apply only electrical voltage to the BHJ-OPV devices. We used the commercially available P3HT [Poly(3-hexylthiophene)] and PC61BM (Phenyl-C61-Butyric acid Methyl ester) photovoltaic materials as donor and acceptor, respectively. We monitored the voltage and current applied to the device to check for when the post-treatment process had been completed. This electrical treatment process is simpler and faster than other post-treatment methods, and the performance of the electrically treated solar cell is comparable to that of a reference (thermally annealed) device. Our results indicate that the proposed treatment process can be used efficiently to fabricate high-performance BHJ-OPV devices. PMID:26932767

  10. Agricultural potential of anaerobically digested industrial orange waste with and without aerobic post-treatment.

    Science.gov (United States)

    Kaparaju, Prasad; Rintala, Jukka; Oikari, Aimo

    2012-01-01

    The potential of anaerobically digested orange waste with (AAD) and without (AD) aerobic post-treatment for use in agriculture was evaluated through chemical analyses, short-term phytotoxicity and long-term plant assays. Chemical analyses showed that AD contained ammonia and organic acids, and aerobic post-treatment did not significantly remove these phytotoxins. The N:P2O5:K2O ratio in AD was 1:0.26:0.96 and aerobic post-treatment did not change the composition in AAD except for K2O (1:0.26:1.24). Heavy metal contents in AD and AAD were more or less the same and were below the upper limit recommended for non-sewage sludge application on agricultural soils. Short-term phytotoxicity tests showed that seed germination and root elongation of Chinese cabbage and ryegrass were severely inhibited at digestate concentrations of 60-100%. Germination index values were well below the score of 50% required to indicate the phytotoxic-free nature of compost. Long-term plant assays showed that AD and AAD, when supplemented with a base fertilizer, resulted in higher plant growth, and fresh weight and dry matter production than AD without base fertilizer. The results thus indicate that aerobic post-treatment did not have any significant beneficial effect on reducing phytotoxicity, and AD could be used as such on agricultural soils, especially with high P.

  11. Fate of oestrogens during anaerobic blackwater treatment with micro-aerobic post-treatment

    NARCIS (Netherlands)

    Mes, de T.Z.D.; Kujawa-Roeleveld, K.; Zeeman, G.; Lettinga, G.

    2007-01-01

    The fate of oestrone (E1), 17b-oestradiol (E2) and 17a-ethynyloestradiol (EE2) was investigated in a concentrated blackwater treatment system consisting of an UASB septic tank, with micro-aerobic post-treatment. In UASB septic tank effluent a (natural) total concentration of 4.02 mg/L E1 and 18.69

  12. Fate of oestrogens during anaerobic blackwater treatment with micro-aerobic post-treatment.

    Science.gov (United States)

    de Mes, T Z D; Kujawa-Roeleveld, K; Zeeman, G; Lettinga, G

    2007-01-01

    The fate of oestrone (E1), 17beta-oestradiol (E2) and 17alpha-ethynyloestradiol (EE2) was investigated in a concentrated blackwater treatment system consisting of an UASB septic tank, with micro-aerobic post-treatment. In UASB septic tank effluent a (natural) total concentration of 4.02 microg/L E1 and 18.69 microg/L E2, comprising the sum of conjugated (>70% for E1 and >80% for E2) and unconjugated forms, was measured. During post-treatment the unconjugated oestrogens were removed to below 1 microg/L. A percentage of 77% of the measured unconjugated E1 and 82% of E2 was associated with particles >1.2 microm in the final effluent implying high sorption affinity of both compounds. When spiking the UASB septic tank effluent with E1, E2, EE2 and the sulphate conjugate of E2, removal in the micro-aerobic post-treatment was >99% for both E2 and EE2 and 83% for E1. The lower removal value for E1 was a result of (slow) deconjugation during the treatment, and in the final effluent still 40% of E1 and 99% of E2 was present in conjugated form. The latter was the result of incomplete deconjugation of the spiked E2(3S) in the post-treatment system.

  13. Pre- and post-treatment enhance the protein enrichment from milling and air classification of legumes

    NARCIS (Netherlands)

    Pelgrom, P.J.M.; Wang, J.; Boom, R.M.; Schutyser, M.A.I.

    2015-01-01

    Air classification is a milder and more sustainable method to obtain protein-enriched fractions than commonly used wet fractionation. The protein content of air-classified fractions is generally lower than obtained with wet methods, therefore we applied pre- and post-treatments to increase the

  14. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  15. Effective post treatment for preparing highly conductive carbon nanotube/reduced graphite oxide hybrid films.

    Science.gov (United States)

    Wang, Ranran; Sun, Jing; Gao, Lian; Xu, Chaohe; Zhang, Jing; Liu, Yangqiao

    2011-03-01

    SWCNT-reduced graphite oxide hybrid films were prepared by a filtration method. An efficient post-treatment procedure was designed to reduce GO and remove dispersants simultaneously. The sheet resistance decreased significantly after treatment, by a factor of 4-13 times. Films with excellent performance (95.6%, 655 Ω per square) were obtained and had great potential applications.

  16. Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

    2013-06-01

    The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of post-treatment. Twenty (28%) patients had either residual symptoms or functional impact, but not both, and did not meet criteria for PTLDS. This operationalized definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Providing Informal Care in Terminal Illness: An Analysis of Preferences for Support Using a Discrete Choice Experiment.

    Science.gov (United States)

    Hall, Jane; Kenny, Patricia; Hossain, Ishrat; Street, Deborah J; Knox, Stephanie A

    2014-08-01

    The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P situation. The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers. © The Author(s) 2013.

  18. Safety and stability of nightguard vital bleaching: 9 to 12 years post-treatment.

    Science.gov (United States)

    Ritter, André V; Leonard, Ralph H; St Georges, Annie J; Caplan, Daniel J; Haywood, Van B

    2002-01-01

    The purposes of this retrospective case series study were to evaluate safety issues and determine participants' perceptions of a nightguard vital bleaching (NGVB) technique approximately 10 years post-treatment (average, 118 mo; range, 108-144 mo). The study sample included 30 (79%) of 38 participants who had completed a previous NGVB study using a 10% carbamide peroxide solution (Proxigel or Gly-Oxide) in a custom tray for 6 weeks. Participants were asked whether there had been any change in the shade of their teeth post-treatment and, if so, to quantify the change on a verbal scale. In addition, 19 participants had gingival index and tooth vitality evaluated clinically, external cervical root anatomy evaluated radiographically, and enamel surface changes evaluated microscopically. Thirty-five (92%) of the original 38 participants had successful lightening of their teeth. At approximately 10 years post-treatment (average, 118 mo; range, 108-144 mo), external cervical resorption was not diagnosed and gingival index and tooth vitality findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post-NGVB side effects at approximately 10 years. Scanning electron microscopic observations did not reveal substantial differences between treated and nontreated surfaces. Color stability, as perceived by 43% of the participants, may last approximately 10 years (average, 118 mo; range, 108-144 mo) post-treatment. Nightguard vital bleaching using 10% carbamide peroxide is safe and effective, with no noticeable side effects, at approximately 10 years (average, 118 mo; range, 108-144 mo) post-treatment. Color stability, as perceived by 43% of the participants, may last 108 to 144 months post-whitening.

  19. Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria.

    Science.gov (United States)

    Sieverding, Maia; Liu, Jenny; Beyeler, Naomi

    2015-10-01

    The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-05-10

    Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. proportion of mothers exclusively breastfeeding at eight weeks after discharge. proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be

  1. Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

    Science.gov (United States)

    Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

    2015-02-01

    When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

  2. Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

    Science.gov (United States)

    James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

    2011-02-01

    To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Providing support to surrogate decision-makers for people living with dementia: Healthcare professional, organisational and community responsibilities.

    Science.gov (United States)

    Shanley, Christopher; Fetherstonhaugh, Deirdre; McAuliffe, Linda; Bauer, Michael; Beattie, Elizabeth

    2017-09-01

    The prevalence of dementia will continue to increase with the ageing of the population. Many people living with dementia will reach a stage where surrogate decision-makers-mostly family carers-will need to make a range of decisions on their behalf. The aim of this study was to learn from surrogate decision-makers how they can be most effectively supported in this role. The study employed a qualitative design using semi-structured face-to-face or telephone interviews with a purposive sample of 34 surrogate decision-makers of people living with dementia. Transcripts of participant interviews were reviewed using a thematic approach to analysis. Four main themes were identified from this analysis: needing greater community awareness of dementia and its impact; intervening early in cognitive decline; relying on health professionals for ongoing support; and seeking and using support from wherever is relevant for each person. Based on this analysis and a review of the literature, we propose a wholistic set of recommendations for the support of surrogate decision-makers. Healthcare professionals need to help family carers understand the likely trajectory of dementia, including the significance of surrogate decision-making. They can support the person living with dementia and their surrogates to undertake advance care planning and they can act as empathic guides during this process. Health and community care organisations need to provide a "key worker" model wherever possible so that the person living with dementia and their surrogate decision-maker do not have to seek support from multiple staff members or organisations. Carer support programmes can routinely include information and resources about surrogate decision-making. Community and government organisations can help people prepare for the possibility of becoming surrogate decision-makers by promoting a greater public awareness and understanding of both dementia and advance care planning. © 2017 John Wiley & Sons Ltd.

  4. Adapting the Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course for emergency care education in Rwanda

    Directory of Open Access Journals (Sweden)

    William E. Cayley Jr

    2011-02-01

    Full Text Available The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.

  5. Electrospun Collagen/Silk Tissue Engineering Scaffolds: Fiber Fabrication, Post-Treatment Optimization, and Application in Neural Differentiation of Stem Cells

    Science.gov (United States)

    Zhu, Bofan

    Biocompatible scaffolds mimicking the locally aligned fibrous structure of native extracellular matrix (ECM) are in high demand in tissue engineering. In this thesis research, unidirectionally aligned fibers were generated via a home-built electrospinning system. Collagen type I, as a major ECM component, was chosen in this study due to its support of cell proliferation and promotion of neuroectodermal commitment in stem cell differentiation. Synthetic dragline silk proteins, as biopolymers with remarkable tensile strength and superior elasticity, were also used as a model material. Good alignment, controllable fiber size and morphology, as well as a desirable deposition density of fibers were achieved via the optimization of solution and electrospinning parameters. The incorporation of silk proteins into collagen was found to significantly enhance mechanical properties and stability of electrospun fibers. Glutaraldehyde (GA) vapor post-treatment was demonstrated as a simple and effective way to tune the properties of collagen/silk fibers without changing their chemical composition. With 6-12 hours GA treatment, electrospun collagen/silk fibers were not only biocompatible, but could also effectively induce the polarization and neural commitment of stem cells, which were optimized on collagen rich fibers due to the unique combination of biochemical and biophysical cues imposed to cells. Taken together, electrospun collagen rich composite fibers are mechanically strong, stable and provide excellent cell adhesion. The unidirectionally aligned fibers can accelerate neural differentiation of stem cells, representing a promising therapy for neural tissue degenerative diseases and nerve injuries.

  6. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support.

    Science.gov (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L

    2017-01-01

    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  7. What do healthcare providers know about nutrition support? A survey of the knowledge, attitudes, and practice of pharmacists and doctors toward nutrition support in Malaysia.

    Science.gov (United States)

    Karim, Sarah A; Ibrahim, Baharudin; Tangiisuran, Balamurugan; Davies, J Graham

    2015-05-01

    Malnutrition is one of the health problems that can be prevented by appropriate nutrition care provided by healthcare providers. However, this practice is still lacking possibly because of the providers' inadequate knowledge. The aim of this study was to evaluate the self-reported knowledge, attitudes, and practices of pharmacists and doctors toward nutrition support in a tertiary care hospital setting. A validated questionnaire was distributed to all the doctors and pharmacists working in a tertiary hospital in Penang, Malaysia. Seven individuals including academics, general surgeons, and pharmacists performed the face and content validity. The questionnaire was piloted using 24 healthcare providers at a different hospital. Of 400 surveyed, 158 doctors and 72 pharmacists from various grades completed the questionnaire. More doctors (31.6%) than pharmacists (15.3%) reported adequate knowledge to perform patients' nutrition screening. However, in the knowledge assessment, pharmacists had a higher mean score (6.07 ± 1.77) than the doctors did (4.59 ± 1.87; P doctors have ambivalent attitudes toward nutrition support. Only 31.3% stated that they perform nutrition screening on admission, and half of them performed nutrition assessment during hospitalization. Inappropriate nutrition care might be due to the lack of guidelines and insufficient knowledge among doctors and pharmacists. Special nutrition training and education for both pharmacists and doctors should be established. © 2014 American Society for Parenteral and Enteral Nutrition.

  8. Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge: The Going Home Toolkit.

    Science.gov (United States)

    Wallace, Andrea; Papke, Todd; Davisson, Erica; Spooner, Kara; Gassman, Laura

    Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge. Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based. Opinions about what an assessment of social support would seek to accomplish, what is currently done and by whom, and the preferred format for delivery were elicited during a series of individual and group interviews. During phase two, feasibility was assessed with three inpatient nurses over 3 clinical days. Field notes were analyzed throughout the project using rapid data analysis techniques. Health care providers endorsed the creation of an assessment and stated that target users would include all members of the discharge team (e.g., clinical nurses, case managers, discharge coordinators, hospitalists, and specialty care). They identified the need for a patient-family resource (vs. a traditional provider-facing assessment). Participants stated that, although both the information collected and the interview process would meet a need to increase patient engagement in inpatient settings, competing clinical demands would require a tool that was easily completed by patients and family and seen as directly informing clinical activities. To this end, although focusing on the eventual development of an electronic tool seemed valuable, a hard-copy resource was considered more feasible for patient use at the present time. The preliminary test of the resulting hard-copy "Going Home Toolkit" demonstrated potential feasibility and usefulness during clinical practice. There is need for not only assessing patients

  9. A train the trainer program for healthcare professionals tasked with providing psychosocial support to breast cancer survivors.

    Science.gov (United States)

    Park, Eunyoung; Yoon, Junghee; Choi, Eun-Kyung; Kim, Im Ryung; Kang, Danbee; Lee, Se-Kyung; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Visser, Adriaan; Cho, Juhee

    2018-01-06

    The objective of this study is to develop, implement, and evaluate a training program for healthcare providers to improve ability to provide psychosocial support to breast cancer survivors in Korea. Based on a needs assessment survey and in-depth interviews with breast cancer survivors, a multidisciplinary team developed two-day intensive training program as well as education materials and counseling notes. Participants' overall satisfaction was evaluated after the training. The training program included a total of 16 lectures held over the course of seven sessions. Forty-one nurses and 3 social workers participated in the training program. Mean age was 37.5(± 6.4) years, and on average, they had 11.1 (± 5.6) years of experience. Participants' overall satisfaction was good as following: program contents (4.04), trainee guidebook (3.82), location and environment (4.10), and program organization (4.19). Among the participants, 31 (70.4%) received certification after submitting real consultation cases after the training. Two day intensive training can provide a comprehensive and coordinated education to healthcare professionals for implementing survivorship care with an emphasis on psychosocial support. Furthermore, the program should resume as a periodic continuing education course for healthcare providers. Similar education for graduate students in oncology nursing would be beneficial.

  10. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

    Science.gov (United States)

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

    2016-01-01

    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  11. A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

    Science.gov (United States)

    Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

    2016-09-01

    Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.

  12. Changing current practice in urological cancer care: Providing better information, advice and related support on work engagement.

    Science.gov (United States)

    MacLennan, S J; Murdoch, S E; Cox, T

    2017-09-01

    There is a growing body of evidence on the importance of work following a diagnosis of cancer and the need to provide better information, advice and related support to patients on work engagement. The aim of this study was to better understand the nature of those needs and to identify better ways to meet these for those with a urological cancer. The focus was on the issues that were common to three key stakeholder groups. Semi-structured interviews were conducted with stakeholders in North East Scotland: 12 individuals with kidney, bladder or prostate cancer, 10 healthcare providers and 10 managers from large organisations. Five key themes emerged from the Framework Analysis: perceived importance of work engagement; decision-making: treatment, work and cancer; roles and responsibilities; education and training; information, advice and support resources. The data confirmed that work engagement is important to those with urological cancer. It also made clear that the current provision of information and advice could be improved. Any such interventions should involve all three key stakeholder groups with greater clarity on their respective roles and responsibilities. Finally, any new system would be best integrated with existing care provision and supported by adequate education and training of those involved. © 2017 John Wiley & Sons Ltd.

  13. Translating sustainability from strategy to operations: how can decision support mod-els help logistics service providers to attain strategic as well as operational goals?

    NARCIS (Netherlands)

    Reinder Pieters; Stef Weijers; Hans-Heinrich Glöckner

    2010-01-01

    Decision Support Models could help Logistic Service Providers as a means to make transportation more sustainable. When researching this hypothesis, we discovered that Logistic Service Providers were reluctant to use Decision Support Models when making transportation more sustainable.

  14. Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS)

    DEFF Research Database (Denmark)

    Petersen, Pelle B; Mikkelsen, Kim Lyngby; Lauritzen, Jes B

    2017-01-01

    OBJECTIVES: Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional...... pain syndrome (CRPS) following orthopedic treatment. The present study aimed to identify factors associated with post-treatment development of CRPS. METHODS: Using the Danish Patient Compensation Association's database, we identified 647 patients claiming post-treatment CRPS between 1992 and 2015. Age......, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral...

  15. Influence of Post-treatment Methods on Pressure Change of Filter Bag

    Directory of Open Access Journals (Sweden)

    Yihua Yin

    2016-01-01

    Full Text Available The PPS needle-punched non-woven filters with different post-treatments were studied by filter testing system. The pressure drop was measured at various filtration velocity, dust deposition time and the temperature during the experiment; and the effect of dust-cleaning as the consequence of pressure of filter bag was measured. The results showed that post-treatments transformed the surfaces of filters, and the dust formation differed greatly. Excessively high filtration velocity decreased the peak pressure in the process of dust-cleaning. The pressure of filter bag was increased as the dust layers were thickened. The higher temperature in filtration rose the peak pressure of filter bag, but decreased the rate of rising.

  16. Assessment of electrochemical and chemical coagulation as post-treatment for the effluents of a UASB reactor treating cellulose pulp mill wastewater.

    Science.gov (United States)

    Buzzini, A P; Motheo, A J; Pires, E C

    2005-01-01

    This paper presents results from exploratory experiments to test the technical feasibility of electrolytic treatment and coagulation followed by flocculation and sedimentation as post-treatment for the effluent of an UASB reactor treating simulated wastewater from an unbleached Kraft pulp mill. The electrolytic treatment provided up to 67% removal of the remaining COD and 98% of color removal. To achieve these efficiencies the energy consumption ranged from 14 Wh x l(-1) to 20 Wh x l(-1). The coagulation-flocculation treatment followed by settling required 350-400 mg x l(-1) of aluminium sulfate. The addition of a high molecular weight cationic polymer enhanced both COD and color removal. Both post-treatment processes are technically feasible.

  17. Genetic Variants in Cyclooxygenase-2 Contribute to Post-treatment Pain among Endodontic Patients.

    Science.gov (United States)

    Applebaum, Elizabeth; Nackley, Andrea G; Bair, Eric; Maixner, William; Khan, Asma A

    2015-08-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) have a well-established analgesic efficacy for inflammatory pain. These drugs exert their effect by inhibiting the enzyme cyclooxygenase (COX) and are commonly used for the management of pain after endodontic treatment. There are 2 distinct isoforms of COX: COX-1, which is constitutively expressed, and COX-2, which is primarily induced by inflammation. Previous studies have shown that functional human genetic variants of the COX-2 gene may explain individual variations in acute pain. The present study extends this work by examining the potential contribution of the 2 COX isoforms to pain after endodontic treatment. Ninety-four patients treated by endodontic residents at the University of North Carolina School of Dentistry were enrolled into a prospective cohort study. Data on potential predictors of post-treatment pain were collected, and all patients submitted saliva samples for genetic analysis. Nonsurgical root canal therapy was performed, and participants recorded pain levels for 5 days after. In this study, 63% of patients experienced at least mild pain after root canal therapy, and 24% experienced moderate to severe pain. The presence of pretreatment pain was correlated with higher post-treatment pain (P = .01). Elevated heart rate (P = .02) and higher diastolic blood pressure (P = .024) were also correlated with decreased post-treatment pain. Finally, we identified genetic variants in COX-2 (haplotype composed of rs2383515 G, rs5277 G, rs5275 T, and rs2206593 A) associated with post-treatment pain after endodontic treatment (P = .025). Understanding the genetic basis of pain after endodontic treatment will advance its prevention and management. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome

    OpenAIRE

    Hanna AF; Abraham B; Hanna A; Smith AJ

    2017-01-01

    Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith Department of Pain Management, Florida Spine Institute, Clearwater, FL, USA Abstract: Post-treatment Lyme disease syndrome (PTLDS) is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapi...

  19. Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma.

    Science.gov (United States)

    Zhang, Zi; Brown, Justin C; O'Malley, Bert W; Troxel, Andrea B; Bauml, Joshua M; Rubnitz, Kaitlyn R; Grosso, Colleen M; Weinstein, Gregory S; Schmitz, Kathryn H

    2016-05-01

    Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy. This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed. Among 354 patients who met the inclusion criteria, 290 (82 %) survivors were available for inclusion by 24-month follow-up. More than 70 % OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 % confidence interval (CI), 2.46-10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12-18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 % CI, 0.16-7.87, p = 0.041). Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.

  20. Polymorphism of the CD14 and TLR4 genes and post-treatment apical periodontitis.

    Science.gov (United States)

    Rôças, Isabela N; Siqueira, José F; Del Aguila, Camila A; Provenzano, José C; Guilherme, Bianca P S; Gonçalves, Lucio S

    2014-02-01

    This study investigated the association of CD14 -260C>T and TLR4 +896A>G gene polymorphisms with post-treatment apical periodontitis in Brazilian individuals. The study population consisted of 41 patients with post-treatment apical periodontitis and 42 individuals with root canal-treated teeth exhibiting healed/healing periradicular tissues (controls). All teeth had apical periodontitis lesions at the time of treatment, which was completed at least 1 year previously. Saliva was collected from the participants; DNA was extracted and used for CD14 and TLR4 genotyping using the polymerase chain reaction-restriction fragment length polymorphism approach and a real-time polymerase chain reaction TaqMan assay (Applied Biosystems, Foster City, CA), respectively. No specific genotype or allele of the CD14 and TLR4 genes or any combination thereof was positively associated with post-treatment apical periodontitis (P > .05). Data from the present study suggest that polymorphisms in the CD14 and TLR4 genes do not influence the response to endodontic treatment of teeth with apical periodontitis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Morphology modification of perovskite film by a simple post-treatment process in perovskite solar cell

    Energy Technology Data Exchange (ETDEWEB)

    Song, J.; Yang, Y.; Zhao, Y.L., E-mail: sdyulong@cumt.edu.cn; Che, M.; Zhu, L.; Gu, X.Q.; Qiang, Y.H., E-mail: yhqiang@cumt.edu.cn

    2017-03-15

    Highlights: • Perovskite films were post-treated by DMF/CBZ, DMSO/CBZ, or GBL/CBZ blend solvents. • This process could repair pinholes and enhance coverage in perovskite film. • This technique could modify charge transfer process at TiO{sub 2}/perovskite interface. - Abstract: A homogenous perovskite thin film with high coverage is a determining factor for high performance perovskite solar cells. Unlike previous pre-treatments aiming at perovskite precursor, we proposed a simple method to modify the morphology of perovskite films by post-treatment process using mixed solvents of N,N-dimethylformamide (DMF), dimethyl sulfoxide (DMSO), or 1,4-butyrolactone (GBL) with chlorobenzene (CBZ) in this paper. As good solvent of perovskite, DMF, DMSO, and GBL could dissolve the formed perovskite film. Meanwhile, CBZ, anti-solvent of perovskite film, could decrease the dissolving capacity of these good solvents. Therefore, the perovskite film coverage might be improved by the partial dissolution and recrystallization after solvent post-treatment process. Electrochemical impedance spectrometry (EIS) and time-resolved photoluminescence (TRPL) indicated that this post-treatment process could enhance charge transfer at TiO{sub 2}/perovskite interface. Finally, the conversion efficiency increased from 10.10% to 11.82%, 11.68%, and 10.66% using perovskite films post-treated by DMF/CBZ, DMSO/CBZ, and GBL/CBZ blend solvents, respectively.

  2. Post-treatment and reuse of secondary effluents using natural ltreatment systems: the Indian practices.

    Science.gov (United States)

    Kumar, D; Asolekar, S R; Sharma, S K

    2015-10-01

    Paper summarizes the results of India-wide survey of natural treatment systems (NTSs) for wastewater treatment and reuse. The quality of treated wastewater from different types of NTSs was analyzed for various physico-chemical and bacteriological parameters, and needs for post-treatment were identified. Currently, about 1838 million liters per day (MLD) of wastewater is being treated using NTSs, of which the contributions of polishing ponds, waste stabilization ponds, duckweed ponds, constructed wetlands, and Karnal technology were found to be 53.39, 45.15, 0.13, 0.55, and 0.78%, respectively. Among the NTSs studied, constructed wetland was found most efficient in removal of pollutants including nitrogen, phosphorus, total coliform, and fecal coliform in the range of 76, 61, 99.956, and 99.923%, respectively. Of all types of NTSs, only constructed wetland was found to meet the total coliform count requirements (irrigation; effluents from 48 systems are being discharged into river or lake, and remaining 38 systems have not found any designated use of treated effluent. The chlorination was the only post-treatment, which is being practiced at only three wastewater treatment facilities. During post-treatment, 1-2 ppm of chlorine is applied to the secondary effluent irrespective of its quality. The treated effluents from different NTSs contain fecal bacteria in the magnitude of 10(3) to 10(5), which may cause the severe health impacts through contamination of groundwater as well as surface water resources.

  3. Promoting Military Cultural Awareness in an Off-post Community of Behavioral Health and Social Support Service Providers

    Directory of Open Access Journals (Sweden)

    Christi Duette Luby

    2012-03-01

    Full Text Available Due to U.S. military Base Realignment and Closure (BRAC efforts and ongoing Overseas Contingency Operations, the number of military servicemembers and veterans seeking civilian-based services has increased. As the military presence grows in previously underrepresented areas, the need for culturally competent providers will also increase both on and off military installations. The purpose of this article is to promote military cultural awareness, while suggesting ways to enhance existing community behavioral health and social support services. It builds on a review of the extant literature and findings from a community assessment to introduce civilian providers to some specific issues affecting servicemembers and their families. A framework describes ways to increase military cultural competence and build community capacity to enhance civilian-based services. In addition, two appendices list some common military terminology and multiple training resources available through military organizations and websites.

  4. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  5. Support and services provided by public health regional surveillance teams to Local Health Departments in North Carolina.

    Science.gov (United States)

    Horney, Jennifer A; Markiewicz, Milissa; Meyer, Anne Marie; Macdonald, Pia D M

    2011-01-01

    Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.

  6. Community, intervention and provider support influences on implementation: reflections from a South African illustration of safety, peace and health promotion

    Science.gov (United States)

    2014-01-01

    Background The development, implementation and evaluation of community interventions are important for reducing child violence and injuries in low- to middle-income contexts, with successful implementation critical to effective intervention outcomes. The assessment of implementation processes is required to identify the factors that influence effective implementation. This article draws on a child safety, peace and health initiative to examine key factors that enabled or hindered its implementation, in a context characterised by limited resources. Methods A case study approach was employed. The research team was made up of six researchers and intervention coordinators, who led the development and implementation of the Ukuphepha Child Study in South Africa, and who are also the authors of this article. The study used author observations, reflections and discussions of the factors perceived to influence the implementation of the intervention. The authors engaged in an in-depth and iterative dialogic process aimed at abstracting the experiences of the intervention, with a recursive cycle of reflection and dialogue. Data were analysed utilising inductive content analysis, and categorised using classification frameworks for understanding implementation. Results The study highlights key factors that enabled or hindered implementation. These included the community context and concomitant community engagement processes; intervention compatibility and adaptability issues; community service provider perceptions of intervention relevance and expectations; and the intervention support system, characterised by training and mentorship support. Conclusions This evaluation illustrated the complexity of intervention implementation. The study approach sought to support intervention fidelity by fostering and maintaining community endorsement and support, a prerequisite for the unfolding implementation of the intervention. PMID:25081088

  7. A Pilot Study to Examine the Feasibility and Potential Effectiveness of Using Smartphones to Provide Recovery Support for Adolescents.

    Science.gov (United States)

    Dennis, Michael L; Scott, Christy K; Funk, Rodney R; Nicholson, Lisa

    2015-01-01

    Smartphone applications can potentially provide recovery monitoring and support in real-time, real-life contexts. Study aims included determining feasibility of (a) adolescents completing ecological momentary assessments (EMAs) and utilizing phone-based ecological momentary interventions (EMIs); and (b) using EMA and EMI data to predict substance use in the subsequent week. Twenty-nine adolescents were recruited at discharge from residential treatment, regardless of their discharge status or length of stay. During the 6-week pilot, youth were prompted to complete an EMA at 6 random times per day and were provided access to a suite of recovery support EMI. Youth completed 87% of the 5580 EMAs. Based on use in the next 7 days, EMA observations were classified into 3 risk groups: "Current Use" in the past 30 minutes (3% of observations), "Unrecognized Risk" (42%), or "Recognized Risk" (55%). All youth had observations in 2 or more risk groups and 38% in all 3. Youth accessed an EMI on average 162 times each week. Participants were 31% female, 48% African American, 21% Caucasian, 7% Hispanic, and 24% Mixed/Other; average age was 16.6 years. During the 90 days prior to entering treatment, youth reported using alcohol (38%), marijuana (41%), and other drugs (7%). When compared with the "Recognized Risk" group's use in the following week (31%), both the "Unrecognized Risk" (50%, odds ratio [OR]=2.08) and "Current Use" (96%, OR=50.30) groups reported significantly higher rates of use in the next week. When an EMI was accessed 2 or more times within the hour following an EMA, the rate of using during the next week was significantly lower than when EMIs were not accessed (32% vs. 43%, OR=0.62). Results demonstrate the feasibility of using smartphones for recovery monitoring and support with adolescents, with potential to reduce use.

  8. Decolorization and COD reduction of UASB pretreated poultry manure wastewater by electrocoagulation process: A post-treatment study

    Energy Technology Data Exchange (ETDEWEB)

    Yetilmezsoy, Kaan [Department of Environmental Engineering, Yildiz Technical University, 34349 Yildiz, Besiktas, Istanbul (Turkey)], E-mail: yetilmez@yildiz.edu.tr; Ilhan, Fatih; Sapci-Zengin, Zehra; Sakar, Suleyman; Gonullu, M. Talha [Department of Environmental Engineering, Yildiz Technical University, 34349 Yildiz, Besiktas, Istanbul (Turkey)

    2009-02-15

    The performance of electrocoagulation (EC) technique for decolorization and chemical oxygen demand (COD) reduction of anaerobically pretreated poultry manure wastewater was investigated in a laboratory batch study. Two identical 15.7-L up-flow anaerobic sludge blanket (UASB) reactors were first run under various organic and hydraulic loading conditions for 216 days. Effects of operating parameters such as type of sacrificial electrode material, time of electrolysis, current density, initial pH, and electrolyte concentration were further studied to optimize conditions for the post-treatment of UASB pretreated poultry manure wastewater. Preliminary tests conducted with two types of sacrificial electrodes (Al and Fe) resulted that Al electrodes were found to be more effective for both COD and color removals than Fe electrodes. The subsequent EC tests performed with Al electrodes showed that optimal operating conditions were determined to be an initial pH of 5.0, a current density of 15 mA/cm{sup 2}, and an electrolysis time of 20 min. The results indicated that under the optimal conditions, about 90% of COD and 92% of residual color could be effectively removed from the UASB effluent with the further contribution of the EC technology used as a post-treatment unit. In this study, the possible acute toxicity of the EC effluent was also evaluated by a static bioassay test procedure using guppy fish (Lebistes reticulatus). Findings of this study clearly indicated that incorporation of a toxicological test into conventional physicochemical analyses provided a better evaluation of final discharge characteristics.

  9. A qualitative synthesis of trials promoting physical activity behaviour change among post-treatment breast cancer survivors.

    Science.gov (United States)

    Short, Camille E; James, Erica L; Stacey, Fiona; Plotnikoff, Ronald C

    2013-12-01

    Health outcome trials have provided strong evidence that participating in regular physical activity can improve the quality of life and health of post-treatment breast cancer survivors. Focus is now needed on how to promote changes in physical activity behaviour among this group. This systematic review examines the efficacy of behavioural interventions for promoting physical activity among post-treatment breast cancer survivors. Behavioural intervention studies published up until July 2012 were identified through a systematic search of two databases: MEDLINE and CINAHL, and by searching reference lists of relevant publications and scanning citation libraries of project staff. Eight out of the ten identified studies reported positive intervention effects on aerobic physical activity behaviour, ranging from during the intervention period to 6 months post-intervention. Only two studies reported intervention effect sizes. The identification of factors related to efficacy was not possible because of the limited number and heterogeneity of studies included, as well as the lack of effect sizes reported. Nonetheless, an examination of the eight studies that did yield significant intervention effects suggests that 12-week interventions employing behaviour change techniques (e.g., self-monitoring and goal setting) derived from a variety of theories and delivered in a variety of settings (i.e., one-on-one, group or home) can be effective at changing the aerobic physical activity behaviour of breast cancer survivors in the mid- to long terms. Behavioural interventions do hold promise for effectively changing physical activity behaviour among breast cancer survivors. However, future research is needed to address the lack of studies exploring long-term intervention effects, mediators of intervention effects and interventions promoting resistance-training activity, and to address issues impacting on validity, such as the limited use of objective physical activity measures and

  10. Long-term treatment effects of the FR-2 appliance: a prospective evalution 7 years post-treatment.

    Science.gov (United States)

    Angelieri, Fernanda; Franchi, Lorenzo; Cevidanes, Lucia H S; Scanavini, Marco A; McNamara, James A

    2014-04-01

    To examine the long-term effects induced by treatment with the function regulator (FR-2) appliance 7 years post-treatment compared with untreated class II subjects. The FR-2 sample was collected prospectively and comprised 17 subjects (10 boys and 7 girls, mean age 10.8 years) who were treated with the FR-2 appliance for 1.7 years and re-evaluated 7.1 years after treatment. The step-by-step mandibular advancement was performed gradually (increments up to 3-4 mm), until a 'super class I' molar relationship was obtained. The control group consisted of 17 class II subjects (9 boys and 8 girls, mean age 11.3 years) with class II malocclusion, excessive overjet, and class II molar relationship, matched to the treated group as to ages at all times, gender distribution, and stages of skeletal maturity (evaluated by the cervical vertebral maturation method). The lateral cephalograms were analysed at T1 (initial), T2 (final), and T3 (7.1 years post-treatment). The compatibility between the groups and the comparisons of their changes at T1-T2, T2-T3, and T1-T3 intervals were examined by independent sample t-tests (P < 0.05). FR-2 treatment provided a significant improvement in the maxillomandibular relationship due to an increase in mandibular length compared with controls, which remained stable over time. Also overjet, overbite, and molar relationship corrections demonstrated stability. Among dentoalveolar changes, only the increased mesial movement of the mandibular molars in the FR-2 group demonstrated stability. Correction of class II malocclusion remained stable 7 years after FR-2 treatment mainly due to the stability of the skeletal changes.

  11. Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.

    Science.gov (United States)

    Reich, Richard R; Lengacher, Cecile A; Alinat, Carissa B; Kip, Kevin E; Paterson, Carly; Ramesar, Sophia; Han, Heather S; Ismail-Khan, Roohi; Johnson-Mallard, Versie; Moscoso, Manolete; Budhrani-Shani, Pinky; Shivers, Steve; Cox, Charles E; Goodman, Matthew; Park, Jong

    2017-01-01

    Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters. The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program. Three hundred twenty-two Stage 0-III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models of factor analysis and structural equation modeling. Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed. Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training. Name and URL of Registry: ClinicalTrials.gov. Registration number: NCT01177124. Copyright © 2016. Published by Elsevier Inc.

  12. High-fat diet reduces neuroprotection of isoflurane post-treatment: Role of carboxyl-terminal modulator protein-Akt signaling.

    Science.gov (United States)

    Yu, Hai; Deng, Jiao; Zuo, Zhiyi

    2014-11-01

    High-fat diet (HFD) contributes to the increased prevalence of obesity and hyperlipidemia in young adults, a possible cause for their recent increase in stroke. Isoflurane post-treatment provides neuroprotection. Isoflurane post-treatment induced neuroprotection in HFD-fed mice was determined. Six-week old CD-1 male mice were fed HFD or regular diet (RD) for 5 or 10 weeks. Their hippocampal slices (400 µm) were subjected to oxygen-glucose deprivation (OGD). Some slices were exposed to isoflurane for 30 min immediately after OGD. Some mice had a 90-min middle cerebral arterial occlusion and were post-treated with 2% isoflurane for 30 min. OGD time-dependently induced cell injury. This injury was dose-dependently reduced by isoflurane. The effect was apparent at 1% or 2% isoflurane in RD-fed mice but required 3% isoflurane in HFD-fed mice. HFD influenced the isoflurane effects in DG. OGD increased carboxyl-terminal modulator protein (CTMP), an Akt inhibitor, and decreased Akt signaling. Isoflurane reduced these effects. LY294002, an Akt activation inhibitor, attenuated the isoflurane effects. HFD increased CTMP and reduced Akt signaling. Isoflurane improved neurological outcome in the RD-fed mice but not in the HFD-fed mice. HFD attenuated isoflurane post-treatment-induced neuroprotection possibly because of decreased prosurvival Akt signaling. © 2014 The Obesity Society.

  13. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    Science.gov (United States)

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Background It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between

  14. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Science.gov (United States)

    Burgos, Jose L.; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Segovia, Luis A.; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings. PMID:26088189

  15. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Directory of Open Access Journals (Sweden)

    Jose L. Burgos

    2015-06-01

    Full Text Available Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons. By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP, a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion: The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings.

  16. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States-Mexico border region.

    Science.gov (United States)

    Burgos, Jose L; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C; Segovia, Luis A; Strathdee, Steffanie A; Olivares-Nevarez, Jose A; Ojeda, Victoria D

    2015-01-01

    The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US-Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. The HFiT-UIP might serve as a model for other educational partnerships across the US-Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students' desires to learn about Latino, border, and global health within resource-limited settings.

  17. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Science.gov (United States)

    Paxton, Avery B; Pickering, Emily A; Adler, Alyssa M; Taylor, J Christopher; Peterson, Charles H

    2017-01-01

    Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH), special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of reefs on the seafloor

  18. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Directory of Open Access Journals (Sweden)

    Avery B Paxton

    Full Text Available Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH, special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of

  19. Opinions of Artistically Talented Eminent Adults on Supports Provided by the State for Gifted Children in the Arts

    Directory of Open Access Journals (Sweden)

    Faruk Levent

    2017-12-01

    Full Text Available The purpose of the study was to examine opinions of artists in music about state supports for students talented in music. Participants had state sup-ports in music when they were young. A phenomenological study was undertaken to interview the participants. They were interviewed face to face. Data was coded and content-analyzed and categorized by themes. The findings showed that all of the participants expressed that policies related to the education of gifted children in the field of arts in Turkey did not work anymore, losing functionality and effects and special services to be provided for artistically gifted students depended upon individuals who were in charge, showing that the policies were no longer useful. In addition, the participants stated that policies and practices have changed constantly as a result of changes in perceptions of educational politics and decision makers. Therefore, it is reasonable to claim that the greatest challenge in the education of students highly talented in the arts is the lack of a consistent and sustainable national policy

  20. Communication architecture for AAL. Supporting patient care by health care providers in AAL-enhanced living quarters.

    Science.gov (United States)

    Nitzsche, T; Thiele, S; Häber, A; Winter, A

    2014-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Concepts of Ambient Assisted Living (AAL) support a long-term health monitoring and further medical and other services for multi-morbid patients with chronic diseases. In Germany many AAL and telemedical applications exist. Synergy effects by common agreements for essential application components and standards are not achieved. It is necessary to define a communication architecture which is based on common definitions of communication scenarios, application components and communication standards. The development of a communication architecture requires different steps. To gain a reference model for the problem area different AAL and telemedicine projects were compared and relevant data elements were generalized. The derived reference model defines standardized communication links. As a result the authors present an approach towards a reference architecture for AAL-communication. The focus of the architecture lays on the communication layer. The necessary application components are identified and a communication based on standards and their extensions is highlighted. The exchange of patient individual events supported by an event classification model, raw and aggregated data from the personal home area over a telemedicine center to health care providers is possible.

  1. [Six years of Advanced Trauma Life Support (ATLS) in Germany: the 100th provider course in Hamburg].

    Science.gov (United States)

    Münzberg, M; Mahlke, L; Bouillon, B; Paffrath, T; Matthes, G; Wölfl, C G

    2010-07-01

    With over 1 million certified physicians in more than 50 countries worldwide, the Advanced Trauma Life Support (ATLS) concept is one of the most successful international education programs. The concept is simple, priority-orientated (ABCDE scheme) and assesses the situation of the trauma patient on the basis of vital signs to treat the life-threatening injuries immediately. With over 100 ATLS provider courses and 10 instruction courses accomplished in less than 6 years, no other land in the world has successfully established this concept in such a short time as Germany. Meanwhile nearly 1,600 colleagues have been trained and certified. Evaluation of the first 100 ATLS courses in Germany supports this concept. The total evaluation of all courses is 1.36 (1.06-1.8, n=100). The individual parts of the course were marked as followed: presentations 1.6 (1.0-2.81, n=100), practical skills stations 1.46 (1.0-2.4, n=100) and surgical skills stations 1.38 (1.0-2.38, n=100). In 2009 a total of 47 ATLS courses were accomplished which will clearly increase in 2010. Other ATLS formats, such as ATCN (Advanced Trauma Care for Nurses) and refresher courses are planned for the beginning of 2010.

  2. Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study.

    Science.gov (United States)

    Vandrevala, T; Samsi, K; Rose, C; Adenrele, C; Barnes, C; Manthorpe, J

    2017-02-01

    The aim of the current exploratory study was to investigate the impact on care home staff when working with people with dementia at the end of life and to explore how they cope with this aspect of their work. With UK policy encouraging death in the place of residence, rather than hospital, more people with dementia are dying in care homes. A qualitative approach was employed; 20 care home staff working in five English care homes were interviewed. Thematic Analysis was used to analyse the data. Care home staff found the external demands on them and difficulties associated with interacting with people with dementia sometimes challenging, stressful and anxiety-provoking, particularly as residents approached end of life. Emotional aspects of caring for dying residents were sometimes heightened by close attachments with residents and their families. Staff were able to recognise these unmet needs and identified a need for further training and emotional support to manage these stressors. This study revealed rich and complex understandings of the practice dimensions of caring for people with dementia at the end of life and the impact these have on staff. There is a need to develop effective psychosocial interventions that focus on emotional support for care home staff. There will be challenges in providing this in employment settings that are generally low paid, low status, have high turnover and are reliant on temporary or migrant staff, where training is not rewarded, mandatory or culturally valued. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Providing Logistics Support to CDC-Deployed Staff for the Ebola Response in Liberia, Guinea, and Sierra Leone.

    Science.gov (United States)

    Dopson, Stephanie A; Rodriguez, Rockie; Rouse, Edward N

    2015-11-01

    The first Ebola cases in West Africa were reported by the Guinea Ministry of Health on March 23, 2014, and by June it became the largest recorded Ebola outbreak. Centers for Disease Control and Prevention field teams were deployed to West Africa, including in-country logistics staff who were critical for ensuring the movement of staff, equipment, and supplies to locations where public health knowledge and experience were applied to meet mission-related requirements. The logistics role was critical to creating the support for epidemiologists, medical doctors, laboratory staff, and health communicators involved in health promotion activities to successfully respond to the epidemic, both in the capital cities and in remote villages. Logistics personnel worked to procure equipment, such as portable video projectors, and have health promotion materials printed. Logistics staff also coordinated delivery of communication and health promotion materials to the embassy and provided assistance with distribution to various partners. © 2015 Society for Public Health Education.

  4. Gingival labial recessions and the post-treatment proclination of mandibular incisors.

    Science.gov (United States)

    Renkema, Anne-Marie; Navratilova, Zuzanna; Mazurova, Katerina; Katsaros, Christos; Fudalej, Piotr S

    2015-10-01

    A prerequisite for development of gingival recession is the presence of alveolar bone dehiscence. Proclination of mandibular incisors can result in thinning of the alveolus and dehiscence formation. To assess an association between proclination of mandibular incisor and development of gingival recession. One hundred and seventeen subjects who met the following inclusion criteria were selected: 1. age 11-14 years at start of orthodontic treatment (TS), 2. bonded retainer placed immediately after treatment (T0), 3. dental casts and lateral cephalograms available pre-treatment (TS), post-treatment (T0), and 5 years post-treatment (T5), and 4. post-treatment (T0) lower incisor inclination (Inc_Incl) 100.5°. Two groups were formed: non-proclined (N = 57; mean Inc_Incl = 90.8°) and proclined (N = 60; mean Inc_Incl = 105.2°). Clinical crown heights of mandibular incisors and the presence of gingival recession sites in this region were assessed on plaster models. Fisher's exact tests, t-tests, and regression models were computed for analysis of inter-group differences. The mean increase of clinical crown heights (from T0 to T5) of mandibular incisors ranged from 0.75 to 0.83mm in the non-proclined and proclined groups, respectively (P = 0.273). At T5, gingival recession sites were present in 12.3% and 11.7% patients from the non-proclined and proclined groups, respectively. The difference was also not significant (P = 0.851). The proclination of mandibular incisors did not increase a risk of development of gingival recession during five-year observation in comparison non-proclined teeth. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  5. Influence of post-treatment strategies on the properties of activated chars from broiler manure.

    Science.gov (United States)

    Lima, Isabel M; Boykin, Debbie L; Thomas Klasson, K; Uchimiya, Minori

    2014-01-01

    There are a myriad of carbonaceous precursors that can be used advantageously to produce activated carbons or chars, due to their low cost, availability and intrinsic properties. Because of the nature of the raw material, production of granular activated chars from broiler manure results in a significant ash fraction. This study was conducted to determine the influence of several pre- and post-treatment strategies in various physicochemical and adsorptive properties of the resulting activated chars. Pelletized samples of broiler litter and cake were pyrolyzed at 700 °C for 1h followed by a 45 min steam activation at 800 °C at different water flow rates from 1 to 5 mL min(-1). For each activation strategy, samples were either water-rinsed or acid-washed and rinsed or used as is (no acid wash/rinse). Activated char's physicochemical and adsorptive properties towards copper ions were selectively affected by both pre- and post-treatments. Percent ash reduction after either rinsing or acid washing ranged from 1.1 to 15.1% but washed activated chars were still alkaline with pH ranging from 8.4 to 9.1. Acid washing or water rinsing had no significant effect in the ability of the activated char to adsorb copper ions, however it significantly affected surface area, pH, ash content and carbon content. Instead, manure type (litter versus cake) and the activation water flow rate were determining factors in copper ion adsorption which ranged from 38 mg g(-1) to 104 mg g(-1) of activated char. Moreover, strong positive correlations were found between copper uptake and concentration of certain elements in the activated char such as phosphorous, sulfur, calcium and sodium. Rinsing could suffice as a post treatment strategy for ash reduction since no significant differences in the carbon properties were observed between rinsed and acid wash treatments. Published by Elsevier Ltd.

  6. Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Hanna, Ashraf F; Abraham, Bishoy; Hanna, Andrew; Smith, Adam J

    2017-01-01

    Post-treatment Lyme disease syndrome (PTLDS) is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA) and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption.

  7. Investigation of fiber splitting in side-by-side bicomponent meltblown nonwoven webs through post treatment

    Science.gov (United States)

    Liu, Yanbo

    Investigation of Bicomponent (Bico) fiber splitting mechanism and hence finding proper ways to achieve fiber splitting in Side-by-side Bicompoent (Bico) meltblown (MB) nonwoven (NW) webs were carried out in this research. Based on the fiber splitting mechanism, incompatible polymer pairs were chosen and appropriate post-treating methods as well as the post-treating agent(s) were selected to facilitate fiber splitting in S/S Bico MB nonwoven webs. Several post treatments were used to split S/S MB NW fibers in this research, including hydroentanglement (HE), heat-stretching (HST), NaOH and benzoic acid treatment. In each post treatment method, fiber splitting was observed with SEM and/or laser-source microscope. Fiber diameter, web structure and web properties were examined before and after the fiber splitting inducing treatment. HE has been applied to S/S Bico MB NW webs with Bico pairs of PA6/PE, PA6/PP and PA6/PET. Fiber splitting was observed after HE treatment, but web uniformity decreased and web properties deteriorated due to the damage from high-pressure water jets. HST post treatment was applied to S/S Bico MB NW webs with Bico pairs of PA6/PE and PA6/PP along machine direction. No fiber splitting was resulted from this post treatment; however, the treated webs gained elasticity in cross machine direction. The S/S Bico MB NW webs of 25PE/75PET, and 50PBT/50PP were treated with NaOH solution at bath ratio of 1/20 and temperature of 100°C using different NaOH treatments. Fiber splitting was observed after NaOH treatment, but fibers and webs were damaged, web properties thus deteriorated after the treatment. Benzoic acid (BA) has been employed to split S/S Bico MB webs composed of 50PET/50PA6 and 50PP/50PA6. Degree of fiber splitting was evaluated using both fiber splitting ratio and initial dye adsorption ratio/initial dyeing ratio in this research. It was found that benzoic acid treatment could result in S/S Bico MB fiber splitting at appropriate treating

  8. Post-treatment of Fly Ash by Ozone in a Fixed Bed Reactor

    DEFF Research Database (Denmark)

    Pedersen, Kim Hougaard; Melia, M. C.; Jensen, Anker Degn

    2009-01-01

    The residual carbon in fly ash produced from pulverized coal combustion can adsorb the air-entraining admixtures (AEAs) added to enhance air entrainment in concrete. This behavior of the ash can be suppressed by exposing the fly ash to oxidizing species, which oxidizes the carbon surface and thus...... prevents the AEA to be adsorbed. In the present work, two fly ashes have been ozonated in a fixed bed reactor and the results showed that ozonation is a potential post-treatment method that can lower the AEA requirements of a fly ash up to 6 times. The kinetics of the carbon oxidation by ozone was found...

  9. Fate of inorganic contaminants post treatment of acid mine drainage by cryptocrystalline magnesite: Complimenting experimental results with a geochemical model

    CSIR Research Space (South Africa)

    Masindi, V

    2016-03-01

    Full Text Available This study assessed the fate of inorganic contaminants post treatment of acid mine drainage by cryptocrystalline magnesite. To accomplish that, neutralization and metal attenuation were evaluated and complemented with simulations using geochemical...

  10. Integrated nitrogen removal biofilter system with ceramic membrane for advanced post-treatment of municipal wastewater.

    Science.gov (United States)

    Son, Dong-Jin; Yun, Chan-Young; Kim, Woo-Yeol; Zhang, Xing-Ya; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2016-12-01

    The pre-denitrification biofilm process for nitrogen removal was combined with ceramic membrane with pore sizes of 0.05-0.1 µm as a system for advanced post-treatment of municipal wastewater. The system was operated under an empty bed hydraulic retention time of 7.8 h, recirculation ratio of 3, and transmembrane pressure of 0.47 bar. The system showed average removals of organics, total nitrogen, and solids as high as 93%, 80%, and 100%, respectively. Rapid nitrification could be achieved and denitrification was performed in the anoxic filter without external carbon supplements. The residual particulate organics and nitrogen in effluent from biofilm process could be also removed successfully through membrane filtration and the removal of total coliform was noticeably improved after membrane filtration. Thus, a system composed of the pre-denitrification biofilm process with ceramic membrane would be a compact and flexible option for advanced post-treatment of municipal wastewater.

  11. Impact of post-treatment on the characteristics of electrospun poly (vinyl alcohol)/chitosan nanofibers

    Energy Technology Data Exchange (ETDEWEB)

    Susanto, H., E-mail: heru.susanto@undip.ac.id [Department of Chemical Engineering, Faculty of Engineering, Diponegoro University Jl. Prof. Soedarto-Tembalang, Semarang (Indonesia); Samsudin, A. M.; Faz, M. W.; Rani, M. P. H.

    2016-04-19

    Electrospun nanofibers have many advantages such as high porosity, easy to be fabricated in various size and high ratio of surface area to volume. This paper presents the preparation of electrospun PVA/Chitosan nanofibers and more specifically focuses on the effect of post-treatment on the permeability and morphology of electrospun PVA/chitosan nanofibers. The mixtures of various concentrations of PVA (6,7,8 wt%)and 2 wt%.chitosan solution (with the ratio of 3:1)were used in electrospun with a constant rate of 0.7 ml/hour. The post-treatment was conducted by immersing in a ethanol or glutaraldehyde solution to performed crosslink structure. The electrospun PVA/Chitosan nanofiber was characterized by scanning electron microscopy (SEM) and fourier transform infrared (FTIR) spectroscopy. The results revealed that the viscosity of the mixture solution is directly proportional to its concentration. Increasing the viscosity increased the diameter of fiber but also made the larger beads formation. FTIR measurement exhibited the existence of relevant functional groups of both PVA and chitosan in the composites.The crosslinked structure was found for the electrospun PVA/Chitosan nanofibers treated with glutaraldehyde solution.

  12. Correlates of resistance training in post-treatment breast cancer survivors.

    Science.gov (United States)

    Short, Camille E; James, Erica L; Vandelanotte, Corneel; Courneya, Kerry S; Duncan, Mitch J; Rebar, Amanda; Plotnikoff, Ronald C

    2014-10-01

    To explore demographic, health, social-cognitive and behavioural correlates of resistance training among post-treatment breast cancer survivors. A sample of 330 post-treatment breast cancer survivors recruited from across Australia completed a mailed questionnaire. A multivariate logistical regression model was used to test associations between independent variables and meeting the resistance training guidelines. Less than a quarter of the participants were meeting the resistance training guidelines of at least two sessions of resistance training per week. Higher task self-efficacy for resistance training (p resistance training guidelines, with a one unit increase in task self-efficacy and goal setting, increasing the odds of meeting the resistance training guidelines by a factor of approximately 1.2 (odds ratio (OR) task self-efficacy = 1.23, 95 % confidence interval (CI) = 1.05-1.43; goal-setting OR = 1.20, 95 % CI = 1.04-1.38). No other variables significantly predicted meeting the resistance training guidelines in the multivariate analysis. Strategies targeting task self-efficacy and goal-setting behaviours are likely to be important intervention components in resistance training interventions for breast cancer survivors. The findings of this study will be useful for informing the development of evidence-based interventions aiming to promote resistance training among this group.

  13. Submerged aerated bio-filter (SAB)--a post treatment option for UASB effluent treating sewage.

    Science.gov (United States)

    Sudhir, Padigala; Gaur, Rubia Zahid; Khan, Abid Ali; Kazmi, A A; Mehrotra, Indu

    2013-07-01

    This paper presents exploratory results of the performance of submerged aerated bio-filter (SAB-1.5 L) for the post treatment of UASB effluent treating sewage in order to bring the effluent quality in compliance with discharge standards. The study was carried out in three stages with varied dissolved oxygen (DO) levels of 0 to 2.0, 2.0 to 4.0, 4.0 to 6.0 and > 6.0 mg/L. The hydraulic retention time (HRT) and hydraulic loading rate (HLR) were maintained 0.67 h & 0.1 m3/ m2 x h respectively in all stage of study. The performance in terms of BOD removal efficiency was increased with increase in DO levels. Results revealed that the average BOD and SS removal efficiencies in phases 3 and 4 were 51.3 and 59.5% and 58.8 and 67.5% respectively. Significant ammonical nitrogen (NH4-N) removal of 60% was observed in phase 4. The BOD and SS in phases 3 and 4 were reduced to well below the effluent disposal standards. The SAB at DO ≥ 4 mg/L can be considered a viable alternative for the post treatment of effluent from UASB treating domestic wastewater.

  14. Characteristics of activated carbon produced from biosludge and its use in wastewater post-treatment.

    Science.gov (United States)

    Pikkov, L; Kallas, J; Rüütmann, T; Rikmann, E

    2001-02-01

    Experimental research into the bench-scale production of activated carbon from waste-activated sludge from water purification, sawdust, peat, and their mixtures, by carbonisation and activation was undertaken. The research work was carried out to determine possible methods of production of cheap activated carbon from local raw materials and to use it in water purification technology. Along with the samples produced, several commercial activated carbons (namely RB-1, F 100, CA (adsorbent from military gas masks), BAY (product of the USSR)) were tested to compare adsorption properties in the adsorption of phenols, xylidines, amines, methylene blue and molasses. It has been found that the activated carbon produced from waste biosludge was of higher quality than that produced from either sawdust or peat, and performed similarly to RB-1 and F100 in adsorption tests. It was also determined that the activated carbon produced from biosludge could possibly be used in the post-treatment of wastewater. Residual sludge from the biological treatment of the wastewater from the purification of oil-shale in the chemical processing industry could cover up to 80% of the need for activated carbon. Some of this activated carbon could be used in the post-treatment of the same water, adsorbing polyalcaline phenols from the initial content of 4 mg l-1 to the demanded level of 1 mg l-1.

  15. Enhanced Performance of Thin Film Composite Forward Osmosis Membrane by Chemical Post-Treatment

    Science.gov (United States)

    Liu, Zheng; Chen, Jiangrong; Cao, Zhen; Wang, Jian; Guo, Chungang

    2018-01-01

    Forward osmosis is an attractive technique in water purification and desalination fields. Enhancement of the forward osmosis membrane performance is essential to the application of this technique. In this study, an optimized chemical post-treatment approach which was used to improve RO membrane performance was employed for enhancing water flux of thin film composite forward osmosis membrane. Home-made polysulfide-based forward osmosis membrane was prepared and nitric acid, sulfuric acid, ethanol, 2-propanol were employed as post-treatment solutions. After a short-term treatment, all the membrane samples manifested water flux enhancement compared with their untreated counterparts. Over 50% increase of water flux had been obtained by ethanol solution treatment. The swelling, changes of hydrophobicity and solvency in both active layer and substrate were verified as the major causes for the enhancement of the water flux. It is noted that the treatment time and solution concentration should be controlled to get both appropriate water flux and reverse salt flux. The results obtained in this study will be useful for further FO membrane development and application.

  16. Protein Based Molecular Markers Provide Reliable Means to Understand Prokaryotic Phylogeny and Support Darwinian Mode of Evolution

    Directory of Open Access Journals (Sweden)

    Vaibhav eBhandari

    2012-07-01

    Full Text Available The analyses of genome sequences have led to the proposal that lateral gene transfers (LGTs among prokaryotes are so widespread that they disguise the interrelationships among these organisms. This has led to questioning whether the Darwinian model of evolution is applicable to the prokaryotic organisms. In this review, we discuss the usefulness of taxon-specific molecular markers such as conserved signature indels (CSIs and conserved signature proteins (CSPs for understanding the evolutionary relationships among prokaryotes and to assess the influence of LGTs on prokaryotic evolution. The analyses of genomic sequences have identified large numbers of CSIs and CSPs that are unique properties of different groups of prokaryotes ranging from phylum to genus levels. The species distribution patterns of these molecular signatures strongly support a tree-like vertical inheritance of the genes containing these molecular signatures that is consistent with phylogenetic trees. Recent detailed studies in this regard on Thermotogae and Archaea, which are reviewed here, have identified large numbers of CSIs and CSPs that are specific for the species from these two taxa and a number of their major clades. The genetic changes responsible for these CSIs (and CSPs initially likely occurred in the common ancestors of these taxa and then vertically transferred to various descendants. Although some CSIs and CSPs in unrelated groups of prokaryotes were identified, their small numbers and random occurrence has no apparent influence on the consistent tree-like branching pattern emerging from other markers. These results provide evidence that although LGT is an important evolutionary force, it does not mask the tree-like branching pattern of prokaryotes or understanding of their evolutionary relationships. The identified CSIs and CSPs also provide novel and highly specific means for identification of different groups of microbes and for taxonomical and biochemical

  17. Dying at home: a qualitative study of family carers' views of support provided by GPs community staff.

    Science.gov (United States)

    Seamark, David; Blake, Susan; Brearley, Sarah G; Milligan, Christine; Thomas, Carol; Turner, Mary; Wang, Xu; Payne, Sheila

    2014-12-01

    Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. To elicit family carers' views about the community support that made death at home possible. Qualitative study in East Devon, North Lancashire, and Cumbria. Participants were bereaved family carers who had provided care at the end of life for patients dying at home. Semi-structured interviews were conducted 6-24 months after the death. Fifty-nine bereaved family carers were interviewed (54% response rate; 69% female). Two-thirds of the patients died from cancer with median time of home care being 5 months and for non-cancer patients the median time for home care was 30 months. An overarching theme was of continuity of care that divided into personal, organisational, and informational continuity. Large numbers and changes in care staff diluted personal continuity and failure of the GPs to visit was viewed negatively. Family carers had low expectations of informational continuity, finding information often did not transfer between secondary and primary care and other care agencies. Organisational continuity when present provided comfort and reassurance, and a sense of control. The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience. © British Journal of General Practice 2014.

  18. Management of Apical Periodontitis: Healing of Post-treatment Periapical Lesions Present 1 Year after Endodontic Treatment.

    Science.gov (United States)

    Zhang, Ming-Ming; Liang, Yu-Hong; Gao, Xue-Jun; Jiang, Lan; van der Sluis, Luc; Wu, Min-Kai

    2015-07-01

    Post-treatment periapical lesions present 1 year after treatment may heal during the second year or later. The aim of this study was to assess second-year volumetric changes in post-treatment periapical radiolucencies detected 1 year after treatment. Post-treatment periapical radiolucencies were detected on cone-beam computed tomographic (CBCT) scans obtained from 93 single-rooted teeth 1 year after endodontic treatment. The outcome of these teeth was evaluated 2 years after treatment. Two examiners independently measured the volume of the radiolucencies on CBCT images twice. A Wilcoxon signed rank test was used to assess the 1- and 2-year post-treatment volumes. The intraclass correlation coefficients for the CBCT volumetric measurements were 0.971 and 0.998 for the 2 examiners, and the interexaminer correlation coefficient was 0.998. Of the 93 teeth with post-treatment radiolucencies at 1 year, 61were examined at the second-year evaluation. The overall size of the radiolucencies significantly decreased during the second year (P = .01); the volume decreased in 38 teeth (63%), remained unchanged in 20 (33%), and increased in 2 (3%). The volume of post-treatment periapical radiolucencies detected 1 year after treatment was significantly reduced after the second year in 63% of teeth. Copyright © 2015. Published by Elsevier Inc.

  19. Extracellular matrix inspired surface functionalization with heparin, fibronectin and VEGF provides an anticoagulant and endothelialization supporting microenvironment

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xue [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Liu, Tao [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Yuan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Zhang, Kun [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); School of Life Science, Zhengzhou University, Zhengzhou (China); Maitz, Manfred F. [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials, Hohe Str. 06, 01069 Dresden (Germany); Pan, Changjiang [Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Junying, E-mail: chenjy@263.net [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Huang, Nan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China)

    2014-11-30

    Highlights: • Surface modification with fibronectin, heparin and VEGF could selectively anticoagulant and promote endothelialization. • The bioactivity of biomolecules was more efficiently maintained via specific intermolecular interaction. • Poly-l-lysine interlayer was more feasible and the degradation product had no harm to human body. - Abstract: The biocompatibility of currently used coronary artery stent is still far from perfect, which closely related to insufficient endothelialization and thrombus formation. In this study, heparin, fibronectin and VEGF were immobilized on Ti surface to construct a multifunctional microenvironment with favorable properties to inhibit thrombosis formation and promote endothelialization simultaneously. The microenvironment on Ti surface was characterized in detail and demonstrated that the Hep/Fn/VEGF biofunctional coating was constructed successfully on Ti surface. The influence of surface properties such as chemical composition, roughness, hydrophilicity, and binding density of biomolecules on the performances of hemocompatibility and cytocompatibility was evaluated and discussed. Modified surface significantly enhanced the AT III binding density and prolonged the clotting time. In vitro platelet adhesion and activation assays further proved that the modified surface presented favorable anti-coagulant property. In addition, the proliferation of endothelial progenitor cells (EPCs) and endothelial cells (ECs) on the Hep/Fn/VEGF biofunctional coating was significantly promoted. In conclusion, the Hep/Fn/VEGF biofunctional coating was successfully constructed with desirable anticoagulant and endothelialization supporting properties. This work may provide a promising approach for biofunctional surface modification of coronary artery stent to acquire a desired multifunctional microenvironment.

  20. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Science.gov (United States)

    Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

    2008-01-01

    Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032

  1. Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.

    Science.gov (United States)

    Ranji, Sumant R; Rennke, Stephanie; Wachter, Robert M

    2014-09-01

    Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear. We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings. We included systematic and narrative reviews published since 2008 and controlled clinical trials published since 2012. We included five systematic reviews, one narrative review and two controlled trials. The existing literature consists mostly of studies of homegrown systems conducted in the inpatient setting. CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, and often leads to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects. CPOE+CDSS does not appear to reliably prevent clinical ADEs. Despite more widespread implementation over the past decade, it remains a work in progress. 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.

  2. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Directory of Open Access Journals (Sweden)

    Millson Peggy

    2008-06-01

    Full Text Available Abstract Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  3. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

    Directory of Open Access Journals (Sweden)

    Sommerfeld David H

    2009-12-01

    Full Text Available Abstract Background The goal of this study is to extend research on evidence-based practice (EBP implementation by examining the impact of organizational type (public versus private and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170. Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in

  4. Zoe's Story: Exploring the Complexity of "Help-Providing" and "Help-Receiving" Relationships on the "Front-Line" of Family Support

    Science.gov (United States)

    Leese, Maggie

    2013-01-01

    The subject of engaging mothers in appropriate family support continues to be debated and this paper explores the complex factors that influenced one mother's willingness to accept support. In addition, it captures how her family support worker built and sustained a "help-providing" and "help-receiving" relationship despite the…

  5. Predator diversity and abundance provide little support for the enemies hypothesis in forests of high tree diversity.

    Directory of Open Access Journals (Sweden)

    Andreas Schuldt

    Full Text Available Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity--and thus information on the relevance of experimental findings--for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25-69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis--derived from studies in less diverse ecosystems--of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species

  6. Predator Diversity and Abundance Provide Little Support for the Enemies Hypothesis in Forests of High Tree Diversity

    Science.gov (United States)

    Schuldt, Andreas; Both, Sabine; Bruelheide, Helge; Härdtle, Werner; Schmid, Bernhard; Zhou, Hongzhang; Assmann, Thorsten

    2011-01-01

    Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity—and thus information on the relevance of experimental findings—for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25–69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes) of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis—derived from studies in less diverse ecosystems—of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species-rich forest

  7. [Effect of post-treatment with dry extract from vicia truncatula on NADPH-GSH dependent system of rat liver during chronic alcohol intoxication].

    Science.gov (United States)

    Dorkina, E G

    2010-04-01

    Experiments on white female rats showed that chronic ethanol consumption leads to activation of the NADPH - GSH dependent system of the liver, which provides protection against ethanol-induced oxidative stress. Post-treatment administration of dry extract from Vicia truncatula Fish ex Bieb. (300 mg/kg body weight) on the background of 40% ethanol increased this adaptive reaction without depletion in the system, in contrast to what was observed in rats treated with carsil. These results suggest a significant hepatoprotective effect of the dry extract during the chronic alcohol-induced injury of the liver.

  8. Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome

    Directory of Open Access Journals (Sweden)

    Hanna AF

    2017-08-01

    Full Text Available Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith Department of Pain Management, Florida Spine Institute, Clearwater, FL, USA Abstract: Post-treatment Lyme disease syndrome (PTLDS is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption. Keywords: chronic Lyme, late Lyme, pain, analgesic, suicidality, depression

  9. The hybrid assisted limb (HAL) for Care Support, a motion assisting robot providing exoskeletal lumbar support, can potentially reduce lumbar load in repetitive snow-shoveling movements.

    Science.gov (United States)

    Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-12-15

    An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    National Research Council Canada - National Science Library

    Jones, Ray B; O'Connor, Anita; Brelsford, Jade; Parsons, Neil; Skirton, Heather

    2012-01-01

    .... Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients...

  11. Feasibility and potential value of lipofilling in post-treatment oropharyngeal dysfunction.

    Science.gov (United States)

    Kraaijenga, Sophie A C; Lapid, Oren; van der Molen, Lisette; Hilgers, Frans J M; Smeele, Ludwig E; van den Brekel, Michiel W M

    2016-12-01

    Head and neck cancer (HNC) patients may develop oropharyngeal dysfunction as result of volume loss or muscle atrophy of the tongue or pharyngeal musculature following treatment with surgery and/or chemoradiotherapy. If intensive swallowing therapy offers no further improvement, and the functional problems persist, transplantation of autologous adipose tissue (lipofilling) might restore functional outcomes by compensating the existing tissue defects or tissue loss. Case series. In this prospective pilot feasibility study, the application of lipofilling was studied in seven HNC patients with chronic dysphagia. The procedure was carried out under general anesthesia in several sessions using the Coleman technique. Swallowing outcomes were evaluated with standard videofluoroscopy (VFS) for obtaining objective Penetration Aspiration Scale (PAS) and residue scores. Subjective Functional Oral Intake Scale scores and Swallowing Quality of Life Questionnaire were also completed. Magnetic resonance imaging was used to evaluate the post-treatment injected fat. Five patients completed the intended three lipofilling sessions, whereas two completed two injections. One patient dropped out of the study after two injections because of progressive dysphagia requiring total laryngectomy. Four of the six remaining patients showed improved PAS scores on post-treatment VFS assessments, with two patients no longer showing aspiration for a specific consistency. Two patients were no longer feeding tube dependent. Patient-reported swallowing and oral intake improved in four out of six patients. Based on the results, the lipofilling technique seems safe and, in selected cases, of potential value for improving swallowing function in this small therapy-refractory HNC patient cohort. 4 Laryngoscope, 126:2672-2678, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Hepatic preneoplasia induction in male Wistar rats: histological studies up to five months post treatment

    Directory of Open Access Journals (Sweden)

    Gerardo Bruno Pisani

    Full Text Available Background: Liver preneoplasia development in rats can be mimicked by an initiation-promotion model that induces the appearance of altered hepatocyte foci (FAH. Aims: We compare two initiation-promotion models to evaluate the presence of FAH or additional hepatic pathologies in which other organs were affected up to five month post treatment. Material and methods: FAH were induced in male adult Wistar rats with two doses of dietylnitrosamine (DEN, 150 mg/kg bw followed by 4 doses per week (3 weeks of 2-acetylaminofluorene (2-AAF, 20 mg/kg bw or with one dose of DEN (200 mg/kg bw followed by 2 doses per week (3 weeks of 2-AAF. DEN 150, DEN 200 and control rats (received the vehicle of the drugs groups were compared. Rats were euthanized immediately after the last dose of 2-AAF, at 3, 4 and 5 months (n = 3 for euthanasia times per group. Samples of livers, lungs, kidneys, pancreatic tissue and small bowel were processed for histological and immunohistochemical analysis. Results: FAH persisted for 5 months in all livers of the DEN groups. Three months after withdrawal of 2-AAF, one rat from DEN 150 group developed fibrosis and 5 months after 2-AAF removal another rat from the same group presented a microscopic hyperplastic nodule. Only the lungs had damages compatible with lesions induced by gavage-related reflux in DEN groups. Conclusion: We concluded that up to five month post treatments, FAH persisted in all the livers from DEN groups; livers from DEN 200 group showed no other hepatic lesions besides FAH, and only the lungs suffered pathological alterations in both treated groups.

  13. Proton Radiotherapy for Prostate Cancer Is Not Associated With Post-Treatment Testosterone Suppression

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, R. Charles, E-mail: rnichols@floridaproton.org [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Morris, Christopher G.; Hoppe, Bradford S.; Henderson, Randal H.; Marcus, Robert B.; Mendenhall, William M.; Li Zuofeng [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Williams, Christopher R.; Costa, Joseph A. [Division of Urology, University of Florida Shands Hospital, Jacksonville, FL (United States); Mendenhall, Nancy P. [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States); University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

    2012-03-01

    Purpose: Three independent studies of photon (x-ray) radiotherapy (RT) for prostate cancer have demonstrated evidence of testosterone suppression after treatment. The present study was undertaken to determine whether this would also be the case with conformal protons. Methods and Materials: Between August 2006 and October 2007, 171 patients with low- and intermediate-risk prostate cancer were enrolled and underwent treatment according to University of Florida Proton Therapy Institute institutional review board-approved PR01 and PR02 protocols. Of the 171 patients, 18 were excluded because they had received androgen deprivation therapy either before (n = 17) or after (n = 1) RT. The pretreatment serum testosterone level was available for 150 of the remaining 153 patients. These 150 patients were included in the present study. The post-treatment levels were compared with the pretreatment levels. Results: The median baseline pretreatment serum testosterone level was 357.9 ng/dL. The median post-treatment testosterone value was 375.5 ng/dL at treatment completion (p = .1935) and 369.9 ng/dL (p = .1336), 348.7 ng/dL (p = .7317), 353.4 ng/dL (p = .6996), and 340.9 ng/dL (p = .1669) at 6, 12, 18, and 24 months after proton therapy, respectively. Conclusions: Conformal proton therapy to the prostate, as delivered using University of Florida Proton Therapy Institute PR01 and PR02 protocols, did not appear to significantly affect the serum testosterone levels within 24 months after RT.

  14. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support.

    Science.gov (United States)

    Denno, Donna M; Hoopes, Andrea J; Chandra-Mouli, Venkatraman

    2015-01-01

    Access to youth friendly health services is vital for ensuring sexual and reproductive health (SRH) and well-being of adolescents. This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of sexual and reproductive health services (SRHS) in low- and middle-income countries. We examined four SRHS intervention types: (1) facility based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Outcomes assessed across the four questions included uptake of SRHS or sexual and reproductive health commodities and sexual and reproductive health biologic outcomes. There is limited evidence to support the effectiveness of initiatives that simply provide adolescent friendliness training for health workers. Data are most ample (10 initiatives demonstrating weak but positive effects and one randomized controlled trial demonstrating strong positive results on some outcome measures) for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media. We found a paucity of evidence on out-of-facility-based strategies, except for those delivered through mixed-use youth centers that demonstrated that SRHS in these centers are neither well used nor effective at improving SRH outcomes. There was an absence of studies or evaluations examining outcomes among vulnerable or marginalized adolescents. Findings from 17 of 21 initiatives assessing demand-generation activities demonstrated at least some association with adolescent SRHS use. Of 15 studies on parental and other community gatekeepers' approval of SRHS for adolescents, which assessed SRHS/commodity uptake and/or biologic outcomes, 11 showed positive results. Packages of interventions that train health workers, improve facility adolescent friendliness

  15. You can't always give what you want: the challenge of providing social support to low self-esteem individuals.

    Science.gov (United States)

    Marigold, Denise C; Cavallo, Justin V; Holmes, John G; Wood, Joanne V

    2014-07-01

    It can be challenging for support providers to facilitate effective social support interactions even when they have the best intentions. In the current article, we examine some reasons for this difficulty, with a focus on support recipients' self-esteem as a crucial variable. We predicted that recipients' receptiveness to support would be influenced by both support strategy and recipient self-esteem and that receptiveness in turn would impact providers' perceived caregiving efficacy and relationship quality. Study 1 (hypothetical scenarios), Study 2 (confederate interaction), and Study 3 (reports of recently received support) showed that individuals with low self-esteem (LSEs) are less receptive than are individuals with high self-esteem (HSEs) to support that positively reframes their experience but are equally receptive to support that validates their negative feelings. In Study 4, providers demonstrated some knowledge that positive reframing would be less helpful to LSEs than to HSEs but indicated equal intention to give such support. Study 5 showed that, in a real interaction, friends were indeed equally likely to offer positive reframing to both LSEs and HSEs but were less likely to offer validation to LSEs. LSEs were less accepting of such support, and in turn providers felt worse about the interaction, about themselves, and about their friendship more broadly. Study 6 confirmed that recipients' receptivity to support directly influenced providers' experience of a support interaction as well as their self- and relationship evaluations. The findings illustrate how well-meaning support attempts that do not match recipients' particular preferences may be detrimental to both members of the dyad.

  16. Effects of Physico-Chemical Post-Treatments on the Semi-Continuous Anaerobic Digestion of Sewage Sludge

    Directory of Open Access Journals (Sweden)

    Xinbo Tian

    2017-07-01

    Full Text Available Sludge production in wastewater treatment plants is increasing worldwide due to the increasing population. This work investigated the effects of ultrasonic (ULS, ultrasonic-ozone (ULS-Ozone and ultrasonic + alkaline (ULS+ALK post-treatments on the anaerobic digestion of sewage sludge in semi-continuous anaerobic reactors. Three conditions were tested with different hydraulic retention times (HRT, 10 or 20 days and sludge recycle ratios (R = QR/Qin (%: 50 or 100%. Biogas yield increased by 17.8% when ULS+ALK post-treatment was applied to the effluent of a reactor operating at 20 days HRT and at a 100% recycle ratio. Operation at 10 days HRT also improved the biogas yield (277 mL CH4/g VSadded (VS: volatile solids versus 249 mL CH4/g VSadded in the control. The tested post-treatment methods showed 4–7% decrease in effluent VS. The post-treatment resulted in a decrease in the cellular ATP (Adenosine tri-phosphate concentration indicating stress imposed on microorganisms in the reactor. Nevertheless, this did not prevent higher biogas production. Based on the results, the post-treatment of digested sludge or treating the sludge between two digesters is an interesting alternative to pre-treatments.

  17. A case of recurrent depressive disorder presenting with Alice in Wonderland syndrome: psychopathology and pre- and post-treatment FDG-PET findings.

    Science.gov (United States)

    Yokoyama, Tatsushi; Okamura, Tsuyoshi; Takahashi, Miwako; Momose, Toshimitsu; Kondo, Shinsuke

    2017-04-27

    Alice in Wonderland syndrome (AIWS) is a rare neuropsychiatric syndrome that typically manifests in distortion of extrapersonal visual image, altered perception of one's body image, and a disturbed sense of the passage of distance and time. Several conditions have been reported to contribute to AIWS, although its biological basis is still unknown. Here, we present the first case demonstrating a clear concurrence of recurrent depressive disorder and AIWS. The clinical manifestations and pre- and post-treatment fluorodeoxyglucose positron-emission tomographic (FDG-PET) images provide insights into the psychopathological and biological basis of AIWS. We describe a 63-year-old Japanese male who developed two distinct episodes of major depression concurrent with AIWS. In addition to typical AIWS perceptual symptoms, he complained of losing the ability to intuitively grasp the seriousness of news and the value of money, which implies disturbance of high-order cognition related to estimating magnitude and worth. Both depression and AIWS remitted after treatment in each episode. Pre-treatment FDG-PET images showed significant hypometabolism in the frontal cortex and hypermetabolism in the occipital and parietal cortex. Post-treatment images showed improvement of these abnormalities. The clinical co-occurrence of depressive episodes and presentation of AIWS can be interpreted to mean that they have certain functional disturbances in common. In view of incapacity, indifference, devitalization, altered perception of one's body image, and disturbed sense of time and space, the features of AIWS analogous to those of psychotic depression imply a common psychopathological basis. These high-order brain dysfunctions are possibly associated with the metabolic abnormalities in visual and parietotemporal association cortices that we observed on the pre- and post-treatment FDG-PET images in this case, while the hypometabolism in the frontal cortex is probably associated with depressive

  18. External support to local institutions: providing political leverage to weaker groups, or sustaining traditional relations of power?

    DEFF Research Database (Denmark)

    Nygaard, Ivan

    2008-01-01

    economic resources. The study thus enhances our understanding of mechanisms for access to local donor-supported institutions. Il existe tout un pan de la littérature qui montre que les institutions appuyées par les bailleurs de fonds en Afrique Subsaharienne (ASS) sont accaparées par les élites locales...

  19. Water Vapor Adsorption on Biomass Based Carbons under Post-Combustion CO2 Capture Conditions: Effect of Post-Treatment

    Directory of Open Access Journals (Sweden)

    Nausika Querejeta

    2016-05-01

    Full Text Available The effect of post-treatment upon the H2O adsorption performance of biomass-based carbons was studied under post-combustion CO2 capture conditions. Oxygen surface functionalities were partially replaced through heat treatment, acid washing, and wet impregnation with amines. The surface chemistry of the final carbon is strongly affected by the type of post-treatment: acid treatment introduces a greater amount of oxygen whereas it is substantially reduced after thermal treatment. The porous texture of the carbons is also influenced by post-treatment: the wider pore volume is somewhat reduced, while narrow microporosity remains unaltered only after acid treatment. Despite heat treatment leading to a reduction in the number of oxygen surface groups, water vapor adsorption was enhanced in the higher pressure range. On the other hand acid treatment and wet impregnation with amines reduce the total water vapor uptake thus being more suitable for post-combustion CO2 capture applications.

  20. Water Vapor Adsorption on Biomass Based Carbons under Post-Combustion CO2 Capture Conditions: Effect of Post-Treatment

    Science.gov (United States)

    Querejeta, Nausika; Plaza, Marta G.; Rubiera, Fernando; Pevida, Covadonga

    2016-01-01

    The effect of post-treatment upon the H2O adsorption performance of biomass-based carbons was studied under post-combustion CO2 capture conditions. Oxygen surface functionalities were partially replaced through heat treatment, acid washing, and wet impregnation with amines. The surface chemistry of the final carbon is strongly affected by the type of post-treatment: acid treatment introduces a greater amount of oxygen whereas it is substantially reduced after thermal treatment. The porous texture of the carbons is also influenced by post-treatment: the wider pore volume is somewhat reduced, while narrow microporosity remains unaltered only after acid treatment. Despite heat treatment leading to a reduction in the number of oxygen surface groups, water vapor adsorption was enhanced in the higher pressure range. On the other hand acid treatment and wet impregnation with amines reduce the total water vapor uptake thus being more suitable for post-combustion CO2 capture applications. PMID:28773488

  1. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

    OpenAIRE

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-01-01

    Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mo...

  2. Neuroimaging findings of the post-treatment effects of radiation and chemotherapy of malignant primary glial neoplasms.

    Science.gov (United States)

    Mamlouk, M D; Handwerker, J; Ospina, J; Hasso, A N

    2013-08-01

    Post-treatment radiation and chemotherapy of malignant primary glial neoplasms present a wide spectrum of tumor appearances and treatment-related entities. Radiologic findings of these post-treatment effects overlap, making it difficult to distinguish treatment response and failure. The purposes of this article are to illustrate and contrast the imaging appearances of recurrent tumor from necrosis and to discuss other radiologic effects of cancer treatments. It is critical for radiologists to recognize these treatment-related effects to help direct clinical management.

  3. Post-treatment vascular leakage and inflammatory responses around brain cysts in porcine neurocysticercosis.

    Directory of Open Access Journals (Sweden)

    Siddhartha Mahanty

    2015-03-01

    Full Text Available Cysticidal treatment of neurocysticercosis, an infection of humans and pig brains with Taenia solium, results in an early inflammatory response directed to cysts causing seizures and focal neurological manifestations. Treatment-induced pericystic inflammation and its association with blood brain barrier (BBB dysfunction, as determined by Evans blue (EB extravasation, was studied in infected untreated and anthelmintic-treated pigs. We compared the magnitude and extent of the pericystic inflammation, presence of EB-stained capsules, the level of damage to the parasite, expression of genes for proinflammatory and regulatory cytokines, chemokines, and tissue remodeling by quantitative PCR assays between treated and untreated infected pigs and between EB-stained (blue and non stained (clear cysts. Inflammatory scores were higher in pericystic tissues from EB-stained cysts compared to clear cysts from untreated pigs and also from anthelmintic-treated pigs 48 hr and 120 hr after treatment. The degree of inflammation correlated with the severity of cyst wall damage and both increased significantly at 120 hours. Expression levels of the proinflammatory genes for IL-6, IFN-γ, TNF-α were higher in EB-stained cysts compared to clear cysts and unaffected brain tissues, and were generally highest at 120 hr. Additionally, expression of some markers of immunoregulatory activity (IL-10, IL-2Rα were decreased in EB-stained capsules. An increase in other markers for regulatory T cells (CTLA4, FoxP3 was found, as well as significant increases in expression of two metalloproteases, MMP1 and MMP2 at 48 hr and 120 hr post-treatment. We conclude that the increase in severity of the inflammation caused by treatment is accompanied by both a proinflammatory and a complex regulatory response, largely limited to pericystic tissues with compromised vascular integrity. Because treatment induced inflammation occurs in porcine NCC similar to that in human cases, this model

  4. Post-treatment vascular leakage and inflammatory responses around brain cysts in porcine neurocysticercosis.

    Science.gov (United States)

    Mahanty, Siddhartha; Orrego, Miguel Angel; Mayta, Holger; Marzal, Miguel; Cangalaya, Carla; Paredes, Adriana; Gonzales-Gustavson, Eloy; Arroyo, Gianfranco; Gonzalez, Armando E; Guerra-Giraldez, Cristina; García, Hector H; Nash, Theodore E

    2015-03-01

    Cysticidal treatment of neurocysticercosis, an infection of humans and pig brains with Taenia solium, results in an early inflammatory response directed to cysts causing seizures and focal neurological manifestations. Treatment-induced pericystic inflammation and its association with blood brain barrier (BBB) dysfunction, as determined by Evans blue (EB) extravasation, was studied in infected untreated and anthelmintic-treated pigs. We compared the magnitude and extent of the pericystic inflammation, presence of EB-stained capsules, the level of damage to the parasite, expression of genes for proinflammatory and regulatory cytokines, chemokines, and tissue remodeling by quantitative PCR assays between treated and untreated infected pigs and between EB-stained (blue) and non stained (clear) cysts. Inflammatory scores were higher in pericystic tissues from EB-stained cysts compared to clear cysts from untreated pigs and also from anthelmintic-treated pigs 48 hr and 120 hr after treatment. The degree of inflammation correlated with the severity of cyst wall damage and both increased significantly at 120 hours. Expression levels of the proinflammatory genes for IL-6, IFN-γ, TNF-α were higher in EB-stained cysts compared to clear cysts and unaffected brain tissues, and were generally highest at 120 hr. Additionally, expression of some markers of immunoregulatory activity (IL-10, IL-2Rα) were decreased in EB-stained capsules. An increase in other markers for regulatory T cells (CTLA4, FoxP3) was found, as well as significant increases in expression of two metalloproteases, MMP1 and MMP2 at 48 hr and 120 hr post-treatment. We conclude that the increase in severity of the inflammation caused by treatment is accompanied by both a proinflammatory and a complex regulatory response, largely limited to pericystic tissues with compromised vascular integrity. Because treatment induced inflammation occurs in porcine NCC similar to that in human cases, this model can be used to

  5. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    OpenAIRE

    Jose L. Burgos; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Luis A. Segovia; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity.Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program...

  6. Rhetoric or reality? What nurse practitioners do to provide self-management support in outpatient clinics: an ethnographic study.

    Science.gov (United States)

    Ter Maten-Speksnijder, Ada J; Dwarswaard, Jolanda; Meurs, Pauline L; van Staa, AnneLoes

    2016-11-01

    To describe how nurse practitioners enact their role in outpatient consultations, and how this compares to their perception of their responsibility for patients with chronic conditions. Nurse practitioners working with patients with chronic conditions seek to support them in self-managing their diseases. An ethnographic study. Episodic participant observations (in total 48 hours) were carried out combined with formal interviews. The study population consisted of a purposive sample of nurse practitioners working in five outpatient clinics related to chronic care in one university medical centre in the Netherlands. Two different types of clinics were selected, namely (1) for patients with episodic flare-ups and (2) for patients with diseases requiring life-saving procedures. The nurse practitioners perceived the monitoring of patients' treatment as their main professional responsibility. Four monitoring strategies could be distinguished: 'assessing health conditions', 'connecting with patients', 'prioritising treatment in daily living' and 'educating patients'. While nurse practitioners considered building a relationship with their patients of utmost importance, their consultations were mostly based on a conventional medical model of medical history taking. Little attention was paid to the social, psychological and behavioural dimensions of illness. Nurse practitioners in this study seemed quite successful in their extension into medical territory, but moving patients' illness perceptions to the background was not conducive to self-management support. By their medical subspecialty expertise, nurse practitioners have a major role in the longitudinal process of the management of chronic diseases' treatment. Supporting patients to reduce the impact of the disease and its complications requires nurse practitioners to develop new coaching strategies designed to meet patients' individual needs. © 2016 John Wiley & Sons Ltd.

  7. Neuroanatomic overlap between intelligence and cognitive factors: morphometry methods provide support for the key role of the frontal lobes.

    Science.gov (United States)

    Colom, Roberto; Burgaleta, Miguel; Román, Francisco J; Karama, Sherif; Alvarez-Linera, Juan; Abad, Francisco J; Martínez, Kenia; Quiroga, Ma Ángeles; Haier, Richard J

    2013-05-15

    Evidence from neuroimaging studies suggests that intelligence differences may be supported by a parieto-frontal network. Research shows that this network is also relevant for cognitive functions such as working memory and attention. However, previous studies have not explicitly analyzed the commonality of brain areas between a broad array of intelligence factors and cognitive functions tested in the same sample. Here fluid, crystallized, and spatial intelligence, along with working memory, executive updating, attention, and processing speed were each measured by three diverse tests or tasks. These twenty-one measures were completed by a group of one hundred and four healthy young adults. Three cortical measures (cortical gray matter volume, cortical surface area, and cortical thickness) were regressed against psychological latent scores obtained from a confirmatory factor analysis for removing test and task specific variance. For cortical gray matter volume and cortical surface area, the main overlapping clusters were observed in the middle frontal gyrus and involved fluid intelligence and working memory. Crystallized intelligence showed an overlapping cluster with fluid intelligence and working memory in the middle frontal gyrus. The inferior frontal gyrus showed overlap for crystallized intelligence, spatial intelligence, attention, and processing speed. The fusiform gyrus in temporal cortex showed overlap for spatial intelligence and attention. Parietal and occipital areas did not show any overlap across intelligence and cognitive factors. Taken together, these findings underscore that structural features of gray matter in the frontal lobes support those aspects of intelligence related to basic cognitive processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  9. The Application of the DMC Strategy and Experience to Provide Additional Support to a European Global Monitoring System Programme

    Science.gov (United States)

    Cutter, M. A.; Giwa, S. C.; Graham, K. L.; Hodgson, D. J.; Mackin, S.; Sweeting, M. N.; Vanotti, M.; Regan, A.

    2008-08-01

    Surrey Satellite Technology Ltd has reviewed the ability of small satellites to provide additional capability to the presently defined Global Monitoring for Environment and Security (GMES) space segment, allowing the broadest set of user requirements to be met. User- focused services have been compared with the instruments defined for the currently proposed Sentinels. SSTL has developed the Disaster Monitoring Constellation (DMC) of small satellites at a very low cost, which provide land-focused data products in the visible wavebands with daily access capability. The study undertaken by SSTL for the European Space Agency analysed the DMC operational concept in a GMES context, reviewing a range of possible services with different payload configurations on small satellite platforms. One concept was selected and an appropriate payload definition derived. The chosen mission concept was based on the provision of near time operational oceanography information using a constellation of small satellites. The aim is to provide sea surface height, significant wave height and wind speed.

  10. THE INFLUENCE OF IMPLEMENTING THE STRATEGIC POLICY IN CREATING BUSINESS CLIMATE, BUSINESS ENVIRONMENT AND PROVIDING SUPPORT FACILITIES TOWARDS BUSINESS EMPOWERMENT ON SMALL MEDIUM CRAFT ENTERPRISES IN AMBON INDONESIA

    Directory of Open Access Journals (Sweden)

    Josef Papilaya

    2015-04-01

    Full Text Available This study aims at analyzing and explaining whether there was the influence of implementing the strategic policy in creating business climate, business environment and providing support facilities towards empowerment on small and medium enterprises as well as whether there is synchronously influence of implementing the strategic policy in creating business climate, business environment and providing support facilities for business empowerment on small and medium scale enterprises through a survey in the city of Ambon. The results show, that there is a positive and significant effect of implementing the strategic policy in creating business climate to empower small and medium enterprises. There is a positive and significant effect on the business environment toward the empowerment of small and medium enterprises, there is a positive and significant effect of providing support facilities toward the empowerment of small and medium enterprises, and there is a positive and significant simultaneously effect in business climate, business environment and support facilities for business towards the empowerment of small business in Ambon city. Empowerment programs are conducted to maintain a conducive business climate, including: 1. the innovation promotion, 2. enhancing human resources through training development; 3. providing financial support, 4. giving support to the marketing strategy, 5. opening the business partnership. While the supporting facilities granted to small and medium enterprises including: 1. giving the fishing boat for the Fishermen, 2. providing the workshop (machine shop service facilities to small crafts business Enterprises, 3. establish vendors for small enterprises, 4. provide the area for street vendors, 5. provide tents for merchants culinary who work at night. Providing the assistance to encourage the business climate and create conducive business environment.

  11. FISHing for gutta-percha-adhered biofilms in purulent post-treatment apical periodontitis.

    Science.gov (United States)

    Zehnder, M; Rechenberg, D-K; Thurnheer, T; Lüthi-Schaller, H; Belibasakis, G N

    2017-06-01

    This study investigated the possibility of depicting individual taxa in clinically relevant biofilms using fluorescent in situ hybridization (FISH). Gutta-percha samples were collected from the apical aspect of root canals associated with a chronic apical abscess (test samples, n = 8). Corresponding control samples were obtained from previously filled root canals with apparently normal periapical tissues (n = 3). The transport medium was investigated for detached biofilm fragments using FISH staining and conventional epifluorescence microscopy. Gutta-percha samples were stained by multiplex FISH, and inspected using confocal laser scanning microscopy. FISH of the transport medium confirmed the presence of the main species formerly identified by conventional methods in post-treatment purulent endodontic infections, most prominently Fusobacterium spp., Bacteroidetes and Prevotellaceae. Treponemes were identified in five of eight cases associated with purulent infections, but Enterococcus faecalis and Staphylococcus spp. were not identified. The biofilms on gutta-percha from root canals associated with apical periodontitis showed dense aggregates of variable composition. Control samples contained few, if any, bacteria in the transport medium, and featured no biofilms on the respective gutta-percha specimens. The current study revealed some direct, visual in situ information on the nature of biofilms associated with purulent periapical infections in man. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Determinants of health information-seeking behavior: implications for post-treatment cancer patients.

    Science.gov (United States)

    Jung, Minsoo

    2014-01-01

    Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post- treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

  13. Recovery among Adolescents: Models for Post-Treatment Gains in Drug Abuse Treatments

    Science.gov (United States)

    Joe, George W.; Knight, Danica Kalling; Becan, Jennifer E.; Flynn, Patrick M.

    2013-01-01

    Recovery among adolescents undergoing substance abuse treatment was modeled in terms of pre-treatment motivation, therapeutic relationships, psychological functioning, treatment retention, legal pressures, DSM diagnoses, and client demographics. To address between program differences, a within-covariance matrix, based on 547 youth, was used. Applicability of the results across treatment modalities was also examined. The data were from the NIDA-sponsored DATOS Adolescent study. Results from structural equation models (estimated using Mplus) indicated that higher pre-treatment motivation predicted stronger counselor and in-treatment peer relationships, better counselor relationships and retention predicted less illegal drug use at follow-up, and DSM diagnosis was important in the treatment process. Overall, illegal drug use at follow-up was associated with post-treatment alcohol consumption, cigarette use, condom nonuse, psychological distress, criminality, and school non-attendance. The results document the importance of motivation and therapeutic relationships on recovery, even when taking into account the relative effects of legal pressures, DSM diagnoses, and demographics. PMID:24238715

  14. Controlled trials of antibiotic treatment in patients with post-treatment chronic Lyme disease.

    Science.gov (United States)

    Klempner, Mark S

    2002-01-01

    Some patients have persistence of profound fatigue, myalgias, arthralgias without arthritis, dysesthesia/paresthesia, and mood and memory disturbances after standard courses of antibiotic treatment for Lyme disease. This constellation of symptoms has been variously referred to as "chronic Lyme disease," "post-Lyme disease syndrome," and "post-treatment chronic Lyme disease." Persistent symptoms have been reported in patients who are seropositive for IgG antibodies against Borrelia burgdorferi as well as in patients who are seronegative. The cause or causes of persistent symptoms in these patients have not been clearly defined and are controversial. Because of the temporal association of these symptoms with infection with B. burgdorferi, some patients have been treated with prolonged courses of antibiotics. Case reports and uncontrolled trials have reported the efficacy of prolonged antibiotic therapy, often with relapse of the symptoms after discontinuation of therapy. To date, only one randomized, placebo-controlled, double-blind trial of antibiotic therapy for these patients has been published. An abstract of a second placebo-controlled trial of antibiotic therapy in a smaller cohort has also been presented. This paper will describe this patient population in detail and will review the clinical, microbiological, and selected biochemical and immunologic parameters and their responses to antibiotic treatment in the setting of a controlled trial.

  15. Correlates of perceived health-related quality of life in post-treatment Lyme encephalopathy.

    Science.gov (United States)

    Chandra, Avinash M; Keilp, John G; Fallon, Brian A

    2013-01-01

    Marked functional impairment has been reported by patients with post-treatment Lyme disease syndrome (PTLDS). We sought to identify the clinical features that contribute most strongly to the impaired health status associated with PTLDS. Enrolled patients had a well-documented history of Lyme disease, prior treatment with at least 3 weeks with intravenous ceftriaxone, a positive IgG Western blot, and objective problems with memory. An index score to capture aggregate cognitive functioning, Short-Form 36 physical and mental component summary scores, and scores on other clinical and demographic measures were examined. Multiple linear regressions were performed to determine significant predictors of perceptions of impaired life functioning as delineated by the Short-Form 36. Fatigue was the most important contributor to perceived impairments in overall physical functioning, and fatigue and depression significantly predicted perceived impairments in overall mental functioning. Because fatigue and depression contribute prominently to reports of impaired physical functioning and mental functioning among patients with PTLDS, clinicians should assess patients for these symptoms and consider targeting these symptoms in the selection of treatment interventions. Future controlled studies should examine the effectiveness of such agents for patients with PTLDS. © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  16. Audiologic manifestations of patients with post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Shotland, Lawrence I; Mastrioanni, Mary Ann; Choo, Daniel L; Szymko-Bennett, Yvonne M; Dally, Leonard G; Pikus, Anita T; Sledjeski, Kathryn; Marques, Adriana

    2003-12-01

    The purpose of this study was to characterize auditory function in patients diagnosed with post-treatment Lyme disease syndrome (PTLDS). Eighteen patients with PTLDS were evaluated and compared to a normal population. Evaluations consisted of pure tone and speech thresholds, word recognition (WRS), acoustic immittance battery, auditory brain stem response (ABR), and loudness discomfort level (LDL). Both seropositive and seronegative patients were evaluated. Audiologists were blinded to patient status. Forty four percent of the patients had one or more abnormal pure tone thresholds compared to gender- and age-adjusted norms. Thirty-one percent showed abnormally reduced LDLs, and 17% had abnormal acoustic reflexes at one or more frequencies. This paper catalogs previously unstudied long-term auditory system sequelae resulting from PTLDS. Our most significant finding was the dramatically reduced loudness tolerance in the presence of either normal or minimally impaired hearing. The clinician is encouraged to consider PTLDS when confronted with these or similar findings in patients having history of Borrelia burgdorferi infection and continued complaints.

  17. Expanded Polyfunctional T Cell Response to Mycobacterial Antigens in TB Disease and Contraction Post-Treatment

    Science.gov (United States)

    Young, James M.; Adetifa, Ifedayo M. O.; Ota, Martin O. C.; Sutherland, Jayne S.

    2010-01-01

    Background T cells producing multiple factors have been shown to be required for protection from disease progression in HIV but we have recently shown this not to be the case in TB. Subjects with active disease had a greater proportion of polyfunctional cells responding to ESAT-6/CFP-10 stimulation than their infected but non-diseased household contacts (HHC). We therefore wanted to assess this profile in subjects who had successfully completed standard TB chemotherapy. Methods We performed a cross-sectional study using PBMC from TB cases (pre- and post-treatment) and HHC. Samples were stimulated overnight with TB antigens (ESAT-6/CFP-10 and PPD) and their CD4+ and CD8+ T cells were assessed for production of CD107a, IFN-γ, IL-2 and TNF-α and the complexity of the responses was determined using SPICE and PESTLE software. Results and Conclusions We found that an increase in complexity (i.e., production of more than 1 factor simultaneously) of the T cell profile was associated with TB disease and that this was significantly reduced following TB treatment. This implies that T cells are able to respond adequately to TB antigens with active disease (at least initially) but the ability of this response to protect the host from disease progression is hampered, presumably due to immune evasion strategies by the bacteria. These findings have implications for the development of new diagnostics and vaccine strategies. PMID:20574540

  18. Post-treatment of sanitary landfill leachate by coagulation-flocculation using chitosan as primary coagulant.

    Science.gov (United States)

    Nascimento, Inara Oliveira do Carmo; Guedes, Ana Rosa Pinto; Perelo, Louisa Wessels; Queiroz, Luciano Matos

    2016-01-01

    Chitosan was chosen as an alternative primary coagulant in a complementary coagulation-flocculation treatment of sanitary landfill leachate with the aim of removing recalcitrant organic matter. In order to optimize the process conditions, central composite design and response surface methodology were applied. To evaluate the performance of the process using chitosan, we also carried out tests with aluminium sulphate (Al(2) (SO(4))(3).14 H(2)O) as coagulant. In addition, acute toxicity tests were carried using the duckweed Lemna minor and the guppy fish Poecilia reticulata as test organisms. The analytic hierarchy process was employed for selecting the most appropriate coagulant. Mean values of true colour removal efficiency of 80% and turbidity removal efficiency of 91.4% were reached at chitosan dosages of 960 mg L(-1) at pH 8.5. The acute toxicity tests showed that organisms were sensitive to all samples, mainly after coagulation-flocculation using chitosan. CE(50) for L. minor was not determined because there was no inhibition of the average growth rate and biomass production; LC(50) for P. reticulata was 23% (v v(-1)). Multi-criteria analysis showed that alum was the most appropriate coagulant. Therefore, chitosan as primary coagulant was not considered to be a viable alternative in the post-treatment of landfill leachate.

  19. Lyme disease and post-treatment Lyme disease syndrome: the neglected disease in our own backyard.

    Science.gov (United States)

    Crowder, L A; Yedlin, V A; Weinstein, E R; Kortte, K B; Aucott, J N

    2014-09-01

    A survey was developed to assess experience and opinions about Lyme disease and post-treatment Lyme disease syndrome (PTLDS) among faculties in public health. No previous surveys of public health faculties have been found in the literature. This is a cross sectional study of public health school faculty members designed to measure knowledge and experience with Lyme disease and PTLDS using an internet survey instrument. Participants were recruited using all the publicly available e-mail addresses of faculty members in all the 50 accredited Schools of Public Health in the United States. A 15% response rate was seen for the survey. 50% of respondents were from Lyme endemic states. Less than 5% of faculty members consider themselves expert in Lyme or PTLDS. Many faculty members had known someone with Lyme disease or PTLDS, but few had been diagnosed themselves. Most believe that PTLDS can be severe and chronic, is not easy to treat, and does not resolve on its own, but were uncertain about its aetiology. Most respondents also felt that the incidence of Lyme disease will increase and that more education is needed. The need for further understanding and communication presents an opportunity for public health research and education in Lyme disease and the sequelae of PTLDS. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Video self-modeling as a post-treatment fluency recovery strategy for adults.

    Science.gov (United States)

    Harasym, Jessica; Langevin, Marilyn; Kully, Deborah

    2015-06-01

    This multiple-baseline across subjects study investigated the effectiveness of video self-modeling (VSM) in reducing stuttering and bringing about improvements in associated self-report measures. Participants' viewing practices and perceptions of the utility of VSM also were explored. Three adult males who had previously completed speech restructuring treatment viewed VSM recordings twice per week for 6 weeks. Weekly speech data, treatment viewing logs, and pre- and post-treatment self-report measures were obtained. An exit interview also was conducted. Two participants showed a decreasing trend in stuttering frequency. All participants appeared to engage in fewer avoidance behaviors and had less expectations to stutter. All participants perceived that, in different ways, the VSM treatment had benefited them and all participants had unique viewing practices. Given the increasing availability and ease in using portable audio-visual technology, VSM appears to offer an economical and clinically useful tool for clients who are motivated to use the technology to recover fluency. Readers will be able to describe: (a) the tenets of video-self modeling; (b) the main components of video-self modeling as a fluency recovery treatment as used in this study; and (c) speech and self-report outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    Directory of Open Access Journals (Sweden)

    Jones Ray B

    2012-03-01

    Full Text Available Abstract Background Better use of e-health services by patients could improve outcomes and reduce costs but there are concerns about inequalities of access. Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients more. This pilot study explored the feasibility and cost of recruiting patients for an e-health intervention in one primary care trust. Methods The sample comprised 46 practices with total patient population of 250,000. We approached all practices using various methods, seeking collaboration to recruit patients via methods agreed with each practice. A detailed research diary was kept of time spent recruiting practices and patients. Researcher time was used to estimate costs. Patients who consented to participate were offered email support for their use of the Internet for health. Results Eighteen practices agreed to take part; we recruited 27 patients, most (23/27 from five practices. Practices agreed to recruit patients for an e-health intervention via waiting room leaflets (16, posters (16, practice nurses (15, doctors giving patients leaflets (5, a study website link (7, inclusion in planned mailshots (2, and a special mailshot to patients selected from practice computers (1. After low recruitment response we also recruited directly in five practices through research assistants giving leaflets to patients in waiting rooms. Ten practices recruited no patients. Those practices that were more difficult to recruit were less likely to recruit patients. Leaving leaflets for practice staff to distribute and placing posters in the practice were not effective in recruiting patients. Leaflets handed out by practice nurses and website links were more successful. The practice with lowest costs per patient recruited (£70 used a special mailshot to selected patients. Conclusion Recruitment via

  2. [Dietary training for school food service providers in support of the Acuerdo Nacional para la Salud Alimentaria].

    Science.gov (United States)

    Muñoz-Dávila, Carolina; Rangel-Peniche, Diana Beatriz

    2015-01-01

    To address the problem of overweight and obesity in Mexico, in 2010 the Acuerdo Nacional para la Salud Alimentaria was published. At school level, food service providers were considered essential to comply with certain commitments. The goal of this intervention was to train school food service providers in school eating establishments (SEE) as to the criteria in the general guidelines for the sale and distribution of food in schools of basic education. 13 SEE in San Luis Potosi participated. Based on an initial diagnosis, a class-workshop of 5 sessions was designed. Knowledge regarding food was evaluated at the beginning and end of the sessions. The percentage of adherence regarding general hygiene and food preparation and distribution was obtained at the beginning, one month, and two months post-intervention. School food service providers had little knowledge on the objectives of the Acuerdo in food groups and combination, as well as reading labels; there were significant changes in the last two after intervention. The initial percentage of overall hygiene compliance was 60 %, with an increase of almost 20 % post-training. The preparation and distribution of food did not show significant changes. School food service providers acquired knowledge about the guidelines that a SEE comply with, without putting them into practice, given the economic impact that it implies.

  3. Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

    Science.gov (United States)

    Riggie, Jennifer

    2013-01-01

    The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

  4. Which Cognitive Processes Support Learning during Small-Group Discussion? The Role of Providing Explanations and Listening to Others

    Science.gov (United States)

    van Blankenstein, Floris M.; Dolmans, Diana H. J. M.; van der Vleuten, Cees P. M.; Schmidt, Henk G.

    2011-01-01

    Seventy students participated in an experiment to measure the effects of either providing explanations or listening during small group discussions on recall of related subject-matter studied after the discussion. They watched a video of a small group discussing a problem. In the first experimental condition, the video was stopped at various points…

  5. Enhancing Context Analysis with Intelligence in Providing e-Health Services: Less Infrastructure Dependency in Supporting Cardio-Vascular Patients

    NARCIS (Netherlands)

    Verbraeck, A.; Widya, I.A.; Shishkov, Boris; Cordeiro, J.; Ranchordas, A.

    2009-01-01

    In Europe, we observe an increasing number of people with health problems, who could theoretically receive care outside of a hospital when their condition could be properly monitored. Not being able to provide this monitoring leads to an increasing pressure on an already overcrowded hospital system

  6. The PTSD Practitioner Registry: An Innovative Tracking, Dissemination, and Support Tool for Providers in Military and Nonmilitary settings

    Science.gov (United States)

    2017-10-01

    engineering, and the academic world on areas such as:  improving public knowledge, attitudes, skills, and abilities;  changing behavior, practices...previously reported in writing , provide the following additional information or state, “Nothing to Report,” if applicable: Changes in approach...Describe partner organizations – academic institutions, other nonprofits, industrial or commercial firms, state or local governments, schools or

  7. A Context-Aware Ubiquitous Learning Approach for Providing Instant Learning Support in Personal Computer Assembly Activities

    Science.gov (United States)

    Hsu, Ching-Kun; Hwang, Gwo-Jen

    2014-01-01

    Personal computer assembly courses have been recognized as being essential in helping students understand computer structure as well as the functionality of each computer component. In this study, a context-aware ubiquitous learning approach is proposed for providing instant assistance to individual students in the learning activity of a…

  8. Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

    Science.gov (United States)

    Rabbetts, Lyn

    2017-06-02

    A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

  9. The Impact of Learning Style on Healthcare Providers' Preference for Voice Advisory Manikins versus Live Instructors in Basic Life Support Training

    Science.gov (United States)

    DiGiovanni, Lisa Marie

    2013-01-01

    The American Heart Association's HeartCode[TM] Healthcare Provider (HCP) Basic Life Support (BLS) e-learning program with voice-advisory manikins was implemented in an acute care hospital as the only teaching method offered for BLS certification. On course evaluations, healthcare provider staff commented that the VAM technology for skills practice…

  10. Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity.

    Science.gov (United States)

    Lamore, Kristopher; Kaci, Sandra S; Czernichow, Sébastien; Bretault, Marion; Bouillot, Jean-Luc; Naudé, Anne-Jeanne; Gribe-Ouaknine, Sandra; Carette, Claire; Flahault, Cécile

    2017-03-01

    Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health. CSO coordinators were contacted by e-mail to collect general information on the centers (e.g., number of bariatric operations). Secondly, psychologists and psychiatrists of each center completed an anonymous questionnaire assessing their professional practices and their organization of care pathways. The vast majority of CSO coordinators (81%, n = 26/32) answered our survey. These results show significant differences and shortages in terms of the psychology/psychiatry resources available. Most of the psychologists (n = 26/31) and psychiatrists (n = 10/10) stated that they systematically meet new patients only before surgery (56%) or both before and after the operation (30%); however, some psychologists and psychiatrists (14%) do not systematically meet all the patients (before and/or after surgery). Nevertheless, all the professionals provide psychology assessments, and about 75% of them offer a psychological follow-up, indicating a similarity regarding the practices of psychologists and psychiatrists. Our results highlight the place of psychological/psychiatric evaluations in French CSOs and emphasize the absence of mental health providers in several of these services. Post-operative psychological follow-up is not usually provided. It would be appropriate to create clear recommendations for post-operative psychological or psychiatric long-term follow-up.

  11. Development of a National Consensus for Tactical Emergency Medical Support (TEMS) Training Programs--Operators and Medical Providers.

    Science.gov (United States)

    Schwartz, Richard; Lerner, Brooke; Llwewllyn, Craig; Pennardt, Andre; Wedmore, Ian; Callaway, David; Wightman, John; Casillas, Raymond; Eastman, Alex; Gerold, Kevin; Giebner, Stephen; Davidson, Robert; Kamin, Richard; Piazza, Gina; Bollard, Glenn; Carmona, Phillip; Sonstrom, Ben; Seifarth, William; Nicely, Barbara; Croushorn, John; Carmona, Richard

    2014-01-01

    Tactical teams are at high risk of sustaining injuries. Caring for these casualties in the field involves unique requirements beyond what is provided by traditional civilian emergency medical services (EMS) systems. Despite this need, the training objectives and competencies are not uniformly agreed to or taught. An expert panel was convened that included members from the Departments of Defense, Homeland Security, Justice, and Health and Human Services, as well as federal, state, and local law-enforcement officers who were recruited through requests to stakeholder agencies and open invitations to individuals involved in Tactical Emergency Medical Services (TEMS) or its oversight. Two face-to-face meetings took place. Using a modified Delphi technique, previously published TEMS competencies were reviewed and updated. The original 17 competency domains were modified and the most significant changes were the addition of Tactical Emergency Casualty Care (TECC), Tactical Familiarization, Legal Aspects of TEMS, and Mass Casualty Triage to the competency domains. Additionally, enabling and terminal learning objectives were developed for each competency domain. This project has developed a minimum set of medical competencies and learning objectives for both tactical medical providers and operators. This work should serve as a platform for ensuring minimum knowledge among providers, which will serve enhance team interoperability and improve the health and safety of tactical teams and the public. 2014.

  12. The benefit of meeting a stranger: experiences with emotional support provided by nurses among Danish-born and migrant cancer patients.

    Science.gov (United States)

    Kristiansen, M; Tjørnhøj-Thomsen, T; Krasnik, A

    2010-07-01

    Research among cancer patients has shown that emotional support in informal relationships may be difficult to access because of a fear or lack of knowledge about cancer. Consequently, formal relationships with healthcare professionals may be important sources of support. This study explores needs for and experiences with emotional support provided by nurses as well as prerequisites for the provision of support among Danish-born and migrant cancer patients. We conducted narrative interviews with 18 adult Danish-born and migrant cancer patients. Patients were recruited from a variety of places in a purposive strategic sampling process. Analysis was inspired by phenomenological methods and Simmel's theoretical concept of "the stranger". Both Danish-born and migrant patients perceived the support delivered by healthcare professionals as available, empathic and valuable. Prerequisites for providing emotional support were 1) setting aside time for the patient to feel safe and able to verbalise emotional concerns, 2) continuity in relationships with healthcare professionals, and 3) nurses' ability to understand the patient's emotional reactions without creating additional distress. Being positioned as a stranger to the patient gives nurses a unique position from which to provide emotional support during cancer treatment. Thus, formal relationships with healthcare professionals are of great importance for many cancer patients.

  13. Twenty -year post-treatment assessment of class II division 1 malocclusion treated with non-extraction approach

    Directory of Open Access Journals (Sweden)

    Ashok Karad

    2013-01-01

    This article describes twenty-year post-treatment assessment of a class II division 1 malocclusion case, treated in the late mixed dentition stage, with the non-extraction treatment approach - molar-inserted headgear along with a fixed appliance therapy.

  14. The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2008-01-01

    In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. The......, and associated with personality factors or domains not captured by standard questionnaires....

  15. Sustainable treatment of rubber latex processing wastewater : the UASB-system combined with aerobic post-treatment

    NARCIS (Netherlands)

    Viet Nguyen Trung,

    1999-01-01

    The main objective of this PhD-thesis is to assess the applicability of UASB-process for treating RLP wastewater and the feasibility of some adequate post-treatment processes for the effluent of the anaerobic treatment process.

    The studies were carried out in The Netherlands during

  16. Low-temperature post-treatment of anaerobically treated-sewage in anaerobic filter with cationic-polymer addition

    NARCIS (Netherlands)

    Elmitwalli, T.A.; Raimundo, R.; Kujawa-Roeleveld, K.; Zeeman, G.

    2006-01-01

    The post-treatment of domestic sewage pretreated in a 6m3 UASB was investigated in two high-rate anaerobic filter (AF) reactors operated in parallel. The difference between the two AF reactors was only the addition of cationic polymer to the second reactor (AF + P). The reactors were operated at low

  17. Post-treatment Method for the Synthesis of Monodisperse Binary FePt-Fe3O4 Nanoparticles

    Science.gov (United States)

    Liu, Zhilu; Wu, Chun; Niu, Liang; Yang, Ganting; Wang, Kai; Pei, Wenli; Wang, Qiang

    2017-09-01

    To obtain the optimal 1:1 composition of FePt alloy nanomaterials by polyol synthesis, the iron precursor (iron pentacarbonyl, Fe(CO)5) must be used in excess, because the Fe(CO)5 exists in the vapor phase at the typical temperatures used for FePt synthesis and cannot be consumed completely. Fabrication of Fe3O4 nanoparticles by consuming the excess iron precursor was an effective strategy to make full use of the iron precursor. In this paper, a facile post-treatment method was applied to consume the excess iron, which was oxidized to Fe3O4 after post-treatment at 150 and 200 °C, and a monodisperse binary FePt-Fe3O4 nanoparticle system was generated. The post-treatment method did not affect the crystal structure, grain size, or composition of the FePt nanoparticles. However, the content and grain size of the fcc-Fe3O4 nanoparticles can be increased simply by increasing the post-treatment temperature from 150 to 200 °C.

  18. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda.

    Science.gov (United States)

    Janssen, Ralf; Budd, Graham E

    2010-07-05

    Antisense transcripts of Ultrabithorax (aUbx) in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs) of the bithoraxoid (bxd) locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly.Bicistronic transcription of Ubx and Antennapedia (Antp) has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods.Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  19. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda

    Directory of Open Access Journals (Sweden)

    Janssen Ralf

    2010-07-01

    Full Text Available Abstract Antisense transcripts of Ultrabithorax (aUbx in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs of the bithoraxoid (bxd locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly. Bicistronic transcription of Ubx and Antennapedia (Antp has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods. Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  20. Providing support at time of death from cancer: results of a 5-year post-bereavement group study.

    Science.gov (United States)

    Clark, Paul G; Brethwaite, Drucilla S; Gnesdiloff, Sabine

    2011-01-01

    Despite advances in the quality and availability of hospice and palliative care for people with end stage cancers, research addressing the psychosocial needs of family members and concerned others during the dying process has been limited primarily to caregivers. In addition, many of these studies focused on the recently bereaved. In this study, the authors sought to broaden that perspective by examining the psychosocial needs of secondary survivors, a term that applies to caregivers, family members, and others who felt a caring bond with a dying person. A qualitative exploration of needs expressed by secondary survivors following the conclusion of a structured 8-week psychoeducational grief group experience revealed that secondary cancer survivors experience a sense of isolation and powerlessness that is often unrecognized by physicians, nurses, oncology social workers, or other health care professionals. Furthermore, these secondary survivors needed support that extends well beyond activities that are traditionally associated with the physical and emotional care of the dying. Social work intervention strategies directed toward helping secondary survivors assert personal needs, develop greater proximity with the health care team, and prepare for the processes associated with end-of-life may be helpful later during bereavement.

  1. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

    Directory of Open Access Journals (Sweden)

    Jones Christopher M

    2012-08-01

    Full Text Available Abstract Introduction Effective delivery of cardiopulmonary resuscitation (CPR and prompt defibrillation following sudden cardiac arrest (SCA is vital. Updated guidelines for adult basic life support (BLS were published in 2010 by the European Resuscitation Council (ERC in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p  Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

  2. Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications

    Science.gov (United States)

    Grilo, C. M.; White, M. A.; Wilson, G. T.; Gueorguieva, R.; Masheb, R. M.

    2011-01-01

    Background We examined rapid response in obese patients with binge-eating disorder (BED) in a clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method Altogether, 90 participants were randomly assigned to CBT or BWL. Assessments were performed at baseline, throughout and post-treatment and at 6- and 12-month follow-ups. Rapid response, defined as ≥70% reduction in binge eating by week four, was determined by receiver operating characteristic curves and used to predict outcomes. Results Rapid response characterized 57% of participants (67% of CBT, 47% of BWL) and was unrelated to most baseline variables. Rapid response predicted greater improvements across outcomes but had different prognostic significance and distinct time courses for CBT versus BWL. Patients receiving CBT did comparably well regardless of rapid response in terms of reduced binge eating and eating disorder psychopathology but did not achieve weight loss. Among patients receiving BWL, those without rapid response failed to improve further. However, those with rapid response were significantly more likely to achieve binge-eating remission (62% v. 13%) and greater reductions in binge-eating frequency, eating disorder psychopathology and weight loss. Conclusions Rapid response to treatment in BED has prognostic significance through 12-month follow-up, provides evidence for treatment specificity and has clinical implications for stepped-care treatment models for BED. Rapid responders who receive BWL benefit in terms of both binge eating and short-term weight loss. Collectively, these findings suggest that BWL might be a candidate for initial intervention in stepped-care models with an evaluation of progress after 1 month to identify non-rapid responders who could be advised to consider a switch to a specialized treatment. PMID:21923964

  3. DC microgrids with energy storage systems and demand response for providing support to frequency regulation of electrical power systems

    DEFF Research Database (Denmark)

    Basic, Hrvoje; Dragicevic, Tomislav; Pandzic, Hrvoje

    2017-01-01

    Frequency regulation of electric power systems efficiency depends on response time and on power reserves for frequency regulation. As integration of non-dispatchable renewable generation in the power system results with increased need for power reserves from fast responding power units, the idea...... of using aggregated DC microgrids in frequency regulation is presented. Model proposed in this work is based on using battery energy storage, combined with demand response for achieving efficient usage of battery energy storage. It is shown that large number of DC microgrids can provide sufficient....

  4. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti

    2017-09-01

    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  5. Post-treatment prostate biopsies in the era of three-dimensional conformal radiotherapy: what can they teach us?

    Science.gov (United States)

    Zapatero, Almudena; Mínguez, Ricardo; Nieto, Santiago; Martín de Vidales, Carmen; García-Vicente, Feliciano

    2009-04-01

    The ability to discriminate between therapeutic success and failure after radiotherapy (RT) for prostate cancer (PCa) remains a clinical challenge. Post-treatment biopsies would seem ideal for evaluating innovations such as dose escalation protocols or combination treatments involving brachytherapy or hormones. Correlate post-treatment biopsy results with prostate-specific antigen (PSA) and clinical outcome in PCa patients treated with three-dimensional conformal radiotherapy (3DCRT) in a dose-escalation study. This study included 160 patients with clinical stage T1c to T3b PCa treated between 1995 and 2005 in Hospital Universitario la Princesa with 3DCRT who consented to and underwent a transrectal ultrasound (TRUS)-guided prostate biopsy 24-36 mo after RT. The median follow-up was 78 mo (range 27-171 mo). The median radiation dose was 74 gray (Gy; range 66.0-84.1). Risk-adapted short-term androgen deprivation (STAD) and long-term androgen deprivation (LTAD) were associated in 25 and 106 patients, respectively. Right and left systematic biopsies were carried out by the same urologist and were examined by a genitourinary pathologist. Biochemical disease-free survival (bDFS) according to American Society for Therapeutic Radiology and Oncology (ASTRO) 1997 and Phoenix definition criteria as well as histologic control using post-treatment prostate biopsies. Twenty-one percent of patients (34 of 160) had post-treatment-positive biopsies (PB). The 5-yr bDFS according to the Phoenix definition was 87%, 65%, and 92% for the whole series (PB and negative biopsies [NB] patients, respectively [pprobability of bDFS, confirming that PSA control can be an adequate surrogate for local control, as assessed by post-treatment biopsies.

  6. The need for social support provided by the non-profit cancer societies throughout different phases in the cancer trajectory and its integration into public healthcare.

    Science.gov (United States)

    Yli-Uotila, Tiina; Kaunonen, Marja; Pylkkänen, Liisa; Suominen, Tarja

    2016-04-01

    To describe the phases of the cancer trajectory when social support, in the form of electronic counselling services, as provided by the non-profit cancer societies, is needed, as well as how these services are integrated into the cancer care in public healthcare. In this descriptive qualitative study a purposive sample of patients with cancer (n = 12) were interviewed. The data were content analysed inductively. Social support was needed when emotional well-being was weakened, when the body broke, when the care pathway induced unawareness, and when empowerment needed strengthening. There was no need for social support when well-being was considered in balance. The electronic counselling services were integrated into cancer care by supporting the patient with cancer emotionally, developing the informational expertise of the patient with cancer, expanding the opportunities for support, and supporting public healthcare. Integration required improvements to the actions of the patients and various actors involved in the healthcare system. There was no integration due to the health status of the patient and the sufficiency of the primary support sources. The received social support was not integrated into the actual cancer treatment process of the patient with cancer in the public healthcare system. The phases of support needed in the cancer trajectory as defined by the patient differ from the traditional biomedical phases of treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Discrepancies Between the Supports Needed for Discharge of Patients With Terminal Cancer to Family Caregivers and What Supports Were Actually Provided in Japan: Assessment of Palliative Care Unit Nurses.

    Science.gov (United States)

    Oosono, Yasufumi; Yokoyama, Kazuhito; Itoh, Hiroaki; Enomoto, Miyuki; Ishiwata, Miki

    2017-01-01

    Even if patients with terminal cancer hope to spend the rest of their lives at home, they are often unable to leave the hospital early due to their family caregivers' anxiety. This study aimed to investigate in Japan the discrepancies between the supports needed by and actually provided by palliative care unit nurses (PCUNs) to the family caregivers for discharge of patients with terminal cancer. In this cross-sectional study, self-administered questionnaires including 6-point Likert-type scales assessing the reasons for difficulties in transition to home-based care were distributed to 1227 PCUNs. Using paired t tests, the differences between the scores on perceived importance and actual supports to family caregivers were examined. The supports actually provided were classified by factor analysis. The relationships between the PCUNs' characteristics and mean scores on the supports in each category were examined using multiple regression analysis. A total of 1023 (83.4%) completed questionnaires were returned. Scores on the actually provided supports for discharge to family caregivers were consistently and significantly lower than the corresponding scores on perceived importance for all 57 items ( P care, receiving necessary training, cooperating with palliative care staff, and cooperating with local service providers were significantly associated with higher levels of actual supply of supports to family caregivers. Our findings suggest that PCUNs need to be encouraged to provide further support to family caregivers for the discharge of patients with terminal cancer.

  8. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online.

    Science.gov (United States)

    van Veen, Merel Rebecca; Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-09-08

    Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors' questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be

  9. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions.

    Science.gov (United States)

    Baker, Michael G; Zhang, Jane; Blakely, Tony; Crane, Julian; Saville-Smith, Kay; Howden-Chapman, Philippa

    2016-02-16

    Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5% of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96%) of applicant and tenant household members with their National Health Index (NHI) number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44% containing one or more smokers compared with 33% for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52%) and tenants (38%) compared with New Zealanders as whole (10%). This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low incomes and high levels of exposure to household crowding and environmental

  10. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

    Science.gov (United States)

    Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-01-01

    Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

  11. A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

    Science.gov (United States)

    Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

    2015-01-01

    Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes.

    Science.gov (United States)

    Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B

    2015-11-01

    To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  13. Project quality assurance plan for research and development services provided by Oak Ridge National Laboratory in support of the Hanford Grout Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Spence, R.D.; Gilliam, T.M.

    1991-11-01

    This Project Quality Assurance Plan (PQAP) is being published to provide the sponsor with referenceable documentation for work conducted in support of the Hanford WHC Grout Disposal Program. This plan, which meets NQA-1 requirements, is being applied to work performed at Oak Ridge National Laboratory (ORNL) during FY 1991 in support of this program. It should also be noted that with minor revisions, this plan should be applicable to other projects involving research and development that must comply with NQA-1 requirements.

  14. Update of the Swiss guidelines on post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Nemeth, Johannes; Bernasconi, Enos; Heininger, Ulrich; Abbas, Mohamed; Nadal, David; Strahm, Carol; Erb, Stefan; Zimmerli, Stefan; Furrer, Hansjakob; Delaloye, Julie; Kuntzer, Thierry; Altpeter, Ekkehard; Sturzenegger, Mathias; Weber, Rainer; For The Swiss Society For Infectious Diseases And The Swiss Society For Neurology

    2016-01-01

    Lyme borreliosis is caused by Borrelia burgdorferi sensu lato infection, which responds well to antibiotic therapy in the overwhelming majority of cases. However, despite adequate antibiotic treatment some patients report persisting symptoms which are commonly summarised as post-treatment Lyme disease syndrome (PTLDS). In 2005, the Swiss Society of Infectious Diseases published a case definition for PTLDS. We aimed to review the scientific literature with a special emphasis on the last 10 years, questioning whether the definitions from 2005 are still valid in the light of current knowledge. Furthermore, we describe the clinical history of infection with Borrelia burgdorferi sensu lato, the estimated prevalence of PTLDS, the possible pathogenesis of PTLDS, and treatment options with an emphasis on clinical studies. In summary, we were unable to find a scientific reason for modification of the PTLDS definitions published in 2005. Thus, the diagnostic criteria remain unchanged, namely documented clinical and laboratory evidence of previous infection with B. burgdorferi, a completed course of appropriate antibiotic therapy, symptoms including fatigue, arthralgia, myalgia, cognitive dysfunction or radicular pain persisting for >6 months, a plausible timely association between documented B. burgdorferi infection and onset of symptoms (i.e., persistent or recurrent symptoms that began within 6 months of completion of a recommended antibiotic therapy for early or late Lyme borreliosis), and exclusion of other somatic or psychiatric causes of symptoms. The main therapeutic options remain cognitive behavioural therapy and low-impact aerobic exercise programmes. Growing and unequivocal evidence confirms that prolonged or repeated antibiotic therapy for PTLDS is not beneficial, but potentially harmful and therefore contraindicated. The Guidelines of the Swiss Society of Infectious Diseases offer an evidence based, diagnostic and therapeutic framework for physicians caring for

  15. X-ray computed tomography in the post treatment evaluation of carcinoma of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hiroshi

    1988-12-01

    The diagnostic value of X-ray computed tomography scan for early detection of recurrence and/or metastasis were analyzed as an index of a sensitivity, a specificity, a positive predictive value, a negative predictive value and an accuracy among one hundred and thirty-one patients with carcinoma of the cervix as part of post-treatment evaluation during a period from 1980 to 1987. The diagnostic points of CT scan was the following criteria which including (1) parametrial involvement, (2) enlargement of uterine cervix, (3) invasion to vaginal wall, (4) bladder and/or rectal invasion, (5) pyometra, (6) enlargement of pelvic and/or paraaortic lymph nodes, (7) laterality of pelvic muscle, (8) intrapelvic abnormal shadow or ascites retension, (9) hydronephrosis, and (10) distant metastasis. (1) Among the patients treated with surgery, accuracy of each diagnostic point for early detection of recurrence was as follows: (8) 73%, (6) 60%, (9) 47%, (10) 47%, (3) 40%, (1) 33%, (4) 27%, (7) 27%, respectively. (2) Among the patients reated with radiotherapy, accuracy of each diagnostic point for early detection of recurrence was as follws: (1) 65%, (8) 64%, (5) 63%, (4) 61%, (10) 58%, (6) 55%, (9) 53%, (2) 42%, (3) 41%, (7) 41%, respectively. (3) Among the patients treated with surgery and radiotherapy, accuracy of each diagnostic point for early detection of recurrence was as follows: (8) 76%, (10) 76%, (9) 57%, (6) 52%, (1) 48%, (4) 43%, (7) 33%, (3) 19%, respectively. In conclusion, CT findings such as paraaortic lymphadenopathy and invasion to vaginal wall including distant metastasis were most important for early detection of recurrence during the follow-up study.

  16. Comparison of Pre and Post-Treatment Orexin A Levels in Patients with Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Muhammed Erdal

    2010-01-01

    Full Text Available Aim: Subclinical hypothyroidism is a clinical condition mostly observed in women, the prevalence of which increases by age. Sleepiness and appetite problems are observed in subclinical hypothyroidism. Orexins play a role in the physiological regulations like the stabilization of cardiovascular functions and the sleep-alert cycle. Similarities in the physiological regulation areas of orexins and the clinical findings of hypothyroidism were influential in the planning of this research. Additionally, homosisteine, which is influential on the cardiovascular system and the plasma level of which changes by eating (as is the case with orexins, was also analyzed. Besides, the change in the lipid profiles of the patients was also observed. Material and Methods: Nineteen pre-menopausal female patients (mean age=39.58±12.58, mean BMI= 26.7±4.9 included in this study. Following 12 hours fasting blood samples were taken from brachial vein. All patients were given 50µg/day L-T4 TSH levels were examined in every 4-6 weeks to adjust the L-T4 doses. When euthyroidism was ensured, a re-evaluation was made 4 months later. Results:  Pre-treatment plasma orexin A levels of 19 patients with pre-menopausal subclinical hypothyroidism increased significantly following a treatment of l-tiroxin for 4 months (pre-treatment orexin level median=1.20 mg/dl (mean: 1.33±0.28 post-treatment median=1.82 mg/dl (mean: 1.70±0.42 p=0.007. A significant change in the level of plasma total homosisteine and lipid profile was not detected. Conclusions: Advanced studies are needed to study the physiological effects of orexin levels in cases with subclinical hypothyroidism and the possible benefits in treatment.

  17. Pulmonary actinomycosis: CT studies of diagnostic and post-treatment findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Jung; Song, Sun Wha; Bo, Seal Hwang; Park, Hyun Jin; Kim, Hyeon Sook; Kim, Ki Jun; Kim, Horrim; Park, Seog Hee [College of Medicine, the Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2008-05-15

    To investigate the value of the computed tomography (CT) in the study of diagnostic and post-treatment findings of pulmonary actinomycosis. Clinical data and CT findings were retrospectively analyzed in 10 patients with histopathologically confirmed pulmonary actinomycosis. We analyzed the initial CT findings in search of patterns and distributions which suggest possible lung abnormalities and found the pleura, chest wall, and lymphadenopathy to be involved as part of the indicators of lung abnormalities. We analyzed follow-up CT findings for changes in the lungs after antibiotic therapy and recurrence after surgery. Of the 10 patients analyzed by CT for lung lesions, seven had been diagnosed with alcoholism and nine were male. The initial CTs (n = 10) indicated that all the pulmonary lesions were solitary without chest wall involvement. However, a transfissural extension was observed in 20% of the study population (n = 2). Furthermore, peripheral lung distribution and adjacent pleural thickening was observed in 70% of the study population (n = 7). Within the consolidation (n = 6) or mass (n = 4), a central low density with peripheral enhancement was seen in 70% of the study population (n = 7). A follow-up CT of the seven cases following antiobiotic therapy revealed that four cases showed minimal improvement or aggravation of their lung lesions, whereas three cases showed resolution or improvement. The improvement of the central low density was related to the improvement of consolidation or mass. Furthermore the presence of fibrosis was observed after the resolution of pulmonary lesions (n = 2). No relationship was found between the duration and response of antibiotic therapy. A follow-up CT (n = 4) subsequent to a lung resection revealed the onset of chest wall actinomycosis and a thickened pleura in one case. The results of this study highlight the value of the CT in pulmonary actinomycosis in order to diagnose and evaluate antibiotic responses, complications, or

  18. A model to identify mathematics topics in MXit lingo to provide tutors quick access to supporting documentation

    Directory of Open Access Journals (Sweden)

    Laurie Butgereit

    2011-11-01

    Full Text Available Dr MathTM is a mobile, online tutoring system where learners can use MXitTM on their mobile phones to receive help with their mathematics homework from volunteer tutors. These conversations between learners and Dr Math are held in MXit lingo. MXit lingo is a heavily abbreviated, English-like language that is evolving between users of mobile phones that communicate using MXit. The Dr Math project has been running since January 2007 and uses volunteer tutors who are mostly university students who readily understand and use MXit lingo. However, due to the large number of simultaneous conversations that the tutors are often involved in and the diversity of topics discussed, it would often be beneficial to provide assistance regarding the mathematics topic to the tutors. This article explains how the μ model identifies the mathematics topic in the conversation. The model identifies appropriate mathematics topics in just over 75% of conversations in a corpus of conversations identified to be about mathematics topics in the school curriculum.

  19. Becoming successful entrepreneurs. Bangladesh. ADB supports pioneering family-based approach to provide micro-credit and skills training.

    Science.gov (United States)

    Molitor, C

    1996-01-01

    The Thana Resource Development and Employment Project (TRDEP), built upon the successful experience of the Grameen Bank and other nongovernmental organizations, is a comprehensive poverty alleviation scheme implemented by the government of Bangladesh and targeted to the poorest segment of Bangladeshi society. The project provides soft loans to landless poor for income-generating activities involving non-crop livelihoods and trades. The loans are granted at an 18% interest rate including a 2% charge which goes into a risk fund. The poorest of poor are eligible to receive loans as long as each borrowing unit is a self-help group comprised of five members of one family and each member of the group assumes the responsibility of paying each other member's loan. Each member of a borrowing group may receive loans in the amount of Taka 3000-5000 (US$75-125). The loans are then repayable in 50 equal installments over the course of 1 year. One member's default disqualifies all other group members from receiving future credit until the default is cleared. TRDEP borrowers have started small, successful entrepreneurial activities with their loans as capital.

  20. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

    Science.gov (United States)

    Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

    2017-10-01

    Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

  1. Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine.

    Science.gov (United States)

    Abu Farha, Nader H; Khatib, Mohammed T; Salameh, Husam; Zyoud, Sa'ed H

    2017-01-01

    Post-treatment pain has been suggested as an important indicator for health-related quality of life (HRQOL) in patients with breast cancer. Therefore, this study was performed to examine the association between pain and its impact on HRQOL among breast cancer patients in Palestine. Also, this study aimed to determine the QOL profile for breast cancer patients and stated the factors associated with QOL. A correlational cross-sectional study was conducted from May 2016 to November 2016 at Al-Watani Hospital and An-Najah National University Hospital in the Nablus district in Palestine. The five-level EuroQol five-dimensional instrument (EQ-5D-5L) was used to examine HRQOL. Pain severity and interference were assessed using the Brief Pain Inventory (BPI). Multiple linear regression analysis was performed to determine the most important variables related with HRQOL. One hundred and seventy patients were involved in this study. Overall, all participants were female, with a mean ± SD for age of 51.71 ± 11.11 years. The reported HRQOL of this study was measured by using the median EQ-5D-5L index score, which was 0.67 (interquartile range: 0.51-0.84). There were moderate negative correlations between EQ-5D-5L index score and pain severity score (r = - 0.58, p value < 0.001), and pain interference score (r = - 0.604, p-value < 0.001). Furthermore, univariate analysis showed that age, marital status, employment status, income, current condition of cancer, and post-treatment pain were associated with quality of life (p-value < 0.05). Regression analysis revealed that patients with high income (p-value = 0.003), patients with lower pain severity score (p-value < 0.001), and lower pain interference score (p-value = 0.018) were independently associated with high QOL. This is the first study to present important data regarding QOL by using the EQ-5D-5L instruments that may help healthcare providers to identify patients at risk of low QOL. Healthcare

  2. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Mohn, J; Graue, M; Assmus, J

    2015-01-01

    AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...

  3. Review of inputs provided to Jason Associates Corporation in support of RWEV-REP-001, the Analysis of Postclosure Groundwater Impacts report.

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Charles R.; Weck, Philippe F.; Vaughn, Palmer; Arnold, Bill Walter

    2014-04-01

    Report RWEV-REP-001, Analysis of Postclosure Groundwater Impacts for a Geologic Repository for the Disposal of Spent Nuclear Fuel and High Level Radioactive Waste at Yucca Mountain, Nye County, Nevada was issued by the DOE in 2009 and is currently being updated. Sandia National Laboratories (SNL) provided support for the original document, performing calculations and extracting data from the Yucca Mountain Performance Assessment Model that were used as inputs to the contaminant transport and dose calculations by Jason Associates Corporation, the primary developers of the DOE report. The inputs from SNL were documented in LSA-AR-037, Inputs to Jason Associates Corporation in Support of the Postclosure Repository Supplemental Environmental Impact Statement. To support the updating of the original Groundwater Impacts document, SNL has reviewed the inputs provided in LSA-AR-037 to verify that they are current and appropriate for use. The results of that assessment are documented here.

  4. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists

    NARCIS (Netherlands)

    Timmers, L.; Boons, C.C.; Verbrugghe, M.; Bemt, B.J.F van den; Hecke, A. Van; Hugtenburg, J.G.

    2017-01-01

    BACKGROUND: Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the

  5. Association of pre- and post-treatment expectations with improvements after acupuncture in patients with migraine.

    Science.gov (United States)

    Zheng, Hui; Huang, Wenjing; Li, Juan; Zheng, Qianhua; Li, Ying; Chang, Xiaorong; Sun, Guojie; Liang, Fanrong

    2015-04-01

    To study whether a higher expectation of acupuncture measured at baseline and after acupuncture is associated with better outcome improvements in patients with migraine. We performed a secondary analysis of a previous published trial in which 476 patients with migraine were randomly allocated to three real acupuncture groups and one sham acupuncture control group. All the participants received 20 sessions of acupuncture over a 4-week period. The primary outcome was the number of days with a migraine attack (NDMA) assessed at 5-8 weeks after randomisation. The secondary outcomes were visual analogue scale, headache intensity and quality of life assessed at 4, 8 and 16 weeks after randomisation. Expectations of the acupuncture effect were assessed at baseline and at the end of treatment and categorised into five levels, with 0% the lowest and 100% the highest. Outcome improvement was first compared among the participants with different expectation levels using an analysis of variance model. The association between expectations of treatment and outcome improvement was then calculated using a logistic regression model. Patients with 100% baseline expectations did not report significantly fewer NDMA than those with 0% baseline expectations after adjusting for the covariates (at 5-8 weeks, 1.7 vs 3.9 days, p=0.987). High baseline expectations had no significant impact on improvement of the primary outcome (100% vs 0%: OR 8.50, 95% CI 0.89 to 191.65, p=0.682). However, patients with 100% post-treatment expectations reported fewer NDMA than those with 0% expectations (primary outcome: 1.3 vs 5.0 days, pvs 0%: OR 68.87, 95% CI 6.26 to 1449.73, p=0.002). Similar results were found when analysing the impact of expectation on the secondary outcomes. A high level of expectation after acupuncture treatment rather than at baseline was associated with better long-term outcome improvements in patients with migraine. NCT00599586. Published by the BMJ Publishing Group

  6. Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Johannsen, Maja; O Connor, Maja; OToole, Mia Skytte

    2016-01-01

    PURPOSE: To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer. METHODS: A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3...

  7. A family outreach intervention for engaging young out-of-treatment drug users: pre- versus post-treatment comparison.

    Science.gov (United States)

    Santis, Rodrigo; Hidalgo, Carmen Gloria; Jaramillo, Andrea; Hayden, Viviana; Armijo, Ivan; Lasagna, Andrea

    2013-01-01

    Only a small fraction of drug users worldwide enter treatment each year. We evaluated the efficacy of a systemic family outreach intervention (SFOI) for young, untreated drug users, using a quasi-experimental design in which the experimental group (EG) received SFOI and the control group (CG) received traditional outreach work (OW). Both pre- and post-treatment, we administered the Addiction Severity Index-6 (ASI-6), the Family Environment Scale (FES), and tests of parental practices and risky behavior. Post-treatment, there was a fivefold improvement on the ASI-6 and a significant worsening on the conflict sub-scale of the FES in the EG as compared with the CG. SFOI was more efficacious than OW in reducing drug use in the drug user's home environment. The increased conflict in the EG might be explained by parents' increased awareness of abnormal behaviors and implementation of strategies to protect their children. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. The nature of parent support provided by parent mentors for families with deaf/hard-of-hearing children: voices from the start.

    Science.gov (United States)

    Narr, Rachel Friedman; Kemmery, Megan

    2015-01-01

    This study used a qualitative design to explore parent mentors' summaries of conversations with more than 1,000 individual families of deaf and hard-of-hearing (DHH) children receiving parent-to-parent support as part of an existing family support project. Approximately 35% of the families were Spanish speaking. Five parent mentors who have DHH children provided varied support primarily via the telephone to families with DHH children, frequently birth to age 3. The nature and types of support provided were examined and resulted in an in-depth analysis of the summary notes prepared by the parent mentors. The notes were coded using a mixed-methods software application. Three topics were the most prevalent within the conversations between parent mentors and family members: hearing-related topics, early intervention, and multiple disabilities. Several differences emerged between English-speaking and Spanish-speaking families receiving support. Implications and the significance of this study are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Effect of post-treatment conditions on the inactivation of helminth eggs (Ascaris suum) after the composting process.

    Science.gov (United States)

    Darimani, Hamidatu S; Ito, Ryusei; Maiga, Ynoussa; Sou, Mariam; Funamizu, Naoyuki; Maiga, Amadou H

    2016-01-01

    Safe and appropriate disposal of human waste is a basic requirement for sanitation and protection of public health. For proper sanitation and nutrient recovery, it is necessary to ensure effective treatment methods to complete pathogen destruction in excreta prior to reuse. Composting toilets convert faeces to a reusable resource such as fertilizer or humus for organic agriculture. A composting toilet for rural Burkina Faso was created by modifying a commercial model available in Japan to improve hygiene and increase food production. The toilet has shown to result in a degraded final product, but its effectiveness for pathogen destruction was unclear due to low temperatures generated from the toilet. This study aimed to sanitize compost withdrawn from the composting toilet for food production by setting post-treatment conditions. The inactivation kinetics of Ascaris suum eggs, selected as an indicator for helminth eggs, was determined during post-treatment at different temperatures (30°C, 40°C, 50°C and 60°C) with varying moisture contents (MC) (50%, 60% and 70%). The treatment of compost in a possible additional post-treatment after the composting process was tried in the laboratory test. Inactivation of A. suum eggs was fast with greater than two log reductions achieved within 2 h for temperature 50°C and 50% MC and greater than three log reductions for temperature 60°C and 50% MC within 3 h. Statistical analysis showed the significant impact of temperature and moisture on the inactivation rates of A. suum eggs. The post-treatment can efficiently increase helminth eggs destruction prior to reuse.

  10. Association Between Perceived Health Care Provider Support and Satisfaction with Insulin Pumps in Children with Type 1 Diabetes Mellitus: Opportunities for Pharmacists

    Directory of Open Access Journals (Sweden)

    Laura Brooke Jowers

    2015-01-01

    Full Text Available Purpose: The purpose of this pilot study was to describe parents’ perceived healthcare provider support for integrating technology, satisfaction with insulin pump use in their child with T1DM, and the relationship between parents’ perceived healthcare provider support and satisfaction with insulin pump use. Methods: A cross-sectional, correlational design was used to collect data for the present study. The study was conducted through an Internet survey among Mid-South parents who have a child with T1DM, 18 years old or younger using an insulin pump and/or continuous glucose monitoring (CGM. Frequencies, descriptive statistics, and correlation coefficients were calculated. Results: Most of the parents surveyed used an endocrinologist/pediatric endocrinologist as their primary diabetes healthcare provider and considered three to four healthcare professionals as part of the diabetes healthcare team who helped them utilize insulin pumps and advanced technologies. Parents (23.4% indicated a pharmacist was part of the healthcare team who helped them utilize technology. Parents appeared to perceive support for using insulin pumps; however, there is room for improvement. The more perceived support for integrating technology, the more satisfied the parents were with using insulin pumps (r=0.431, p=0.005. Conclusions: Results from this study suggest that parents and children need continued education, support and training to integrate insulin pumps into diabetes self-management. As more patients attempt to adopt insulin pumps and other advanced technologies, it will be important for pharmacists to support the adoption and integration of these technologies and be knowledgeable and helpful if asked about technology-related challenges.   Type: Student Project

  11. Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation.

    Science.gov (United States)

    Endo, M S; Martinho, F C; Zaia, A A; Ferraz, C C R; Almeida, J F A; Gomes, B P F A

    2012-10-01

    This clinical study was conducted to quantify cultivable bacteria and endotoxin in root canals with post-treatment apical periodontitis by correlating their levels with clinical features and to evaluate the effect of chemo-mechanical preparation (CMP) with 2 % chlorhexidine gel + 17 % EDTA on bacterial and endotoxin removal/elimination. Moreover, target strict Gram-negative anaerobic bacteria were investigated by polymerase chain reaction (PCR). Fifteen teeth with post-treatment apical periodontitis were sampled before (s1) and after (s2) CMP. Culture techniques determined the number of colony-forming units (CFU). PCR (16S rDNA) and limulus amebocyte lysate (LAL) assay were used for bacterial and endotoxin detection, respectively. Prevotella nigrescens (4/15), Prevotella intermedia (2/15), and Tannerella forsythia (2/15) were the most frequently detected species. Endotoxin was recovered in 100 % of the samples. At s1, bacteria and endotoxin were detected at a median value of 5.14 × 10(3) CFU/mL and 3.96 EU/mL, respectively. Higher levels of endotoxin were related to a larger size of radiolucent area (>5 mm) (p area in the periapical region. Moreover, CMP was effective in reducing both bacterial and endotoxin contents in post-treatment apical periodontitis.

  12. Influence of sealing post-treatments on the corrosion resistance of PEO coated AZ91 magnesium alloy

    Science.gov (United States)

    Mingo, B.; Arrabal, R.; Mohedano, M.; Llamazares, Y.; Matykina, E.; Yerokhin, A.; Pardo, A.

    2018-03-01

    The effect of three different post-treatments carried out on Plasma Electrolytic Oxidation (PEO) coated magnesium alloys are evaluated in terms of characterisation and corrosion resistance. Special interest is given to the role of a common additive (NaF) to the coating properties. The post-treatments are based on immersion sealing processes in aqueous solutions of inorganic salts (cerium and stannate based salts) and alcoholic solution of an organic acid (octodecylphosphate acid, ODP). Sealing mechanisms for each post-treatment are proposed. Cerium and stannate sealings are based on filling of the pores with the products of dissolution/precipitation reactions, while the ODP acid sealing is based on the formation of a thin layer of ODP over the coating through specific interactions between the polar part of the organic acid and the coating surface. All coatings are evaluated by salt fog test and analysed by electrochemical impedance spectroscopy. All sealings show a slight increase in the corrosion resistance of the coatings formed in the NaF-free electrolyte, but their positive influence is boosted in case of the coatings obtained in the NaF-containing electrolyte. This is related to the chemical and morphological changes at the coating surface induced by the presence of NaF in the electrolyte.

  13. Development of downflow hanging sponge (DHS) reactor as post treatment of existing combined anaerobic tank treating natural rubber processing wastewater.

    Science.gov (United States)

    Watari, Takahiro; Cuong Mai, Trung; Tanikawa, Daisuke; Hirakata, Yuga; Hatamoto, Masashi; Syutsubo, Kazuaki; Fukuda, Masao; Nguyen, Ngoc Bich; Yamaguchi, Takashi

    2017-01-01

    Conventional aerated tank technology is widely applied for post treatment of natural rubber processing wastewater in Southeast Asia; however, a long hydraulic retention time (HRT) is required and the effluent standards are exceeded. In this study, a downflow hanging sponge (DHS) reactor was installed as post treatment of anaerobic tank effluent in a natural rubber factory in South Vietnam and the process performance was evaluated. The DHS reactor demonstrated removal efficiencies of 64.2 ± 7.5% and 55.3 ± 19.2% for total chemical oxygen demand (COD) and total nitrogen, respectively, with an organic loading rate of 0.97 ± 0.03 kg-COD m-3 day-1 and a nitrogen loading rate of 0.57 ± 0.21 kg-N m-3 day-1. 16S rRNA gene sequencing analysis of the sludge retained in the DHS also corresponded to the result of reactor performance, and both nitrifying and denitrifying bacteria were detected in the sponge carrier. In addition, anammox bacteria was found in the retained sludge. The DHS reactor reduced the HRT of 30 days to 4.8 h compared with the existing algal tank. This result indicates that the DHS reactor could be an appropriate post treatment for the existing anaerobic tank for natural rubber processing wastewater treatment.

  14. Dying patients' need for emotional support and personalized care from physicians: perspectives of patients with terminal illness, families, and health care providers.

    Science.gov (United States)

    Wenrich, Marjorie D; Curtis, J Randall; Ambrozy, Donna A; Carline, Jan D; Shannon, Sarah E; Ramsey, Paul G

    2003-03-01

    This study addressed the emotional and personal needs of dying patients and the ways physicians help or hinder these needs. Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care workers, and physicians. Content analyses were performed based on grounded theory. Emotional support and personalization were 2 of the 12 domains identified as important in end-of-life care. Components of emotional support were compassion, responsiveness to emotional needs, maintaining hope and a positive attitude, and providing comfort through touch. Components of personalization were treating the whole person and not just the disease, making the patient feel unique and special, and considering the patient's social situation. Although the levels of emotional support and personalization varied, there was a minimal level, defined by compassion and treating the whole person and not just the disease, that physicians should strive to meet in caring for all dying patients. Participants also identified intermediate and advanced levels of physician behavior that provide emotional and personal support.

  15. Why patient summaries in electronic health records do not provide the cognitive support necessary for nurses' handoffs on medical and surgical units: insights from interviews and observations.

    Science.gov (United States)

    Staggers, Nancy; Clark, Lauren; Blaz, Jacquelyn W; Kapsandoy, Seraphine

    2011-09-01

    Patient care handoffs are cognitively intense activities, especially on medical and surgical units where nurses synthesize information across an average of four to five patients every shift. The objective of this study was to examine handoffs and nurses' use of computerized patient summary reports in an electronic health record after computerized provider order entry (CPOE) was installed. We observed and audio taped 93 patient handoffs on 25 occasions on 5 acute care units in 2 different facilities sharing a vendor's electronic health record. We found that the computerized patient summary report and the electronic health record were minimally used during the handoff and that the existing patient summary reports did not provide adequate cognitive support for nurses. The patient summary reports were incomplete, rigid and did not offer "at a glance" information, or help nurses encode information. We make recommendations about a redesign of patient summary reports and technology to support the cognitive needs of nurses during handoffs at the change of shift.

  16. Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

    Science.gov (United States)

    Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

    2017-11-21

    Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in

  17. Key components of a service model providing early childhood support for women attending opioid treatment clinics: an Australian state health service review.

    Science.gov (United States)

    Harvey, Susan R; Schmied, Virginia; Nicholls, Daniel; Dahlen, Hannah

    2012-09-01

    To report the findings of a service review--specifically the strategy to provide early childhood services 'on site' at opioid treatment clinics to address access difficulties. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4-15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n=58). Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. The provision of early childhood and parenting services on site, as part of a multidisciplinary 'one stop shop' approach to service delivery was a clear recommendation of the review. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients. © 2012 Blackwell Publishing Ltd.

  18. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-03-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt. © The Author(s) 2015.

  19. Symbiotic bacteria are responsible for diet-induced mating preference in Drosophila melanogaster, providing support for the hologenome concept of evolution.

    Science.gov (United States)

    Sharon, Gil; Segal, Daniel; Zilber-Rosenberg, Ilana; Rosenberg, Eugene

    2011-01-01

    Diet-induced mating preference in Drosophila melanogaster results from amplification of the commensal bacterium Lactobacillus plantarum, providing a new role for gut microbiota and support for the hologenome concept of evolution. When the flies were treated with antibiotics prior to changing their diet, mating preference did not occur. These data also indicate that other potentially beneficial bacteria could be irreversibly lost by antibiotic treatment and that their replacement could provide a health benefit. We suggest that D. melanogaster can be a useful model organism to study the activities of gut microbiota and their interaction with the immune system.

  20. A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School

    Science.gov (United States)

    Maxwell, Tim

    2013-01-01

    The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…

  1. Supporting students' scientific explanations: A case study investigating the synergy focusing on a teacher's practices when providing instruction and using mobile devices

    Science.gov (United States)

    Delen, Ibrahim

    Engage students in constructing scientific practices is a critical component of science instruction. Therefore a number of researchers have developed software programs to help students and teachers in this hard task. The Zydeco group, designed a mobile application called Zydeco, which enables students to collect data inside and outside the classroom, and then use the data to create scientific explanations by using claim-evidence-reasoning framework. Previous technologies designed to support scientific explanations focused on how these programs improve students' scientific explanations, but these programs ignored how scientific explanation technologies can support teacher practices. Thus, to increase our knowledge how different scaffolds can work together, this study aimed to portray the synergy between a teacher's instructional practices (part 1) and using supports within a mobile devices (part 2) to support students in constructing explanations. Synergy can be thought of as generic and content-specific scaffolds working together to enable students to accomplish challenging tasks, such as creating explanations that they would not normally be able to do without the scaffolds working together. Providing instruction (part 1) focused on understanding how the teacher scaffolds students' initial understanding of the claim-evidence-reasoning (CER) framework. The second component of examining synergy (part 2: using mobile devices) investigated how this teacher used mobile devices to provide feedback when students created explanations. The synergy between providing instruction and using mobile devices was investigated by analyzing a middle school teacher's practices in two different units (plants and water quality). Next, this study focused on describing how the level of synergy influenced the quality of students' scientific explanations. Finally, I investigated the role of focused teaching intervention sessions to inform teacher in relation to students' performance. In

  2. Effects of repeated high-dose methamphetamine and ceftriaxone post-treatments on tissue content of dopamine and serotonin as well as glutamate and glutamine.

    Science.gov (United States)

    Althobaiti, Yusuf S; Almalki, Atiah H; Das, Sujan C; Alshehri, Fahad S; Sari, Youssef

    2016-11-10

    Repeated exposure to high doses of methamphetamine (METH) is known to alter several neurotransmitters in certain brain regions. Little is known about the effects of ceftriaxone (CEF), a β-lactam antibiotic, known to upregulate glutamate transporter subtype 1, post-treatment on METH-induced depletion of dopamine and serotonin (5-HT) tissue content in brain reward regions. Moreover, the effects of METH and CEF post-treatment on glutamate and glutamine tissue content are not well understood. In this study, Wistar rats were used to investigate the effects of METH and CEF post-treatment on tissue content of dopamine/5-HT and glutamate/glutamine in the nucleus accumbens (NAc) and prefrontal cortex (PFC). Rats received either saline or METH (10mg/kg, i.p. every 2h×4) followed by either saline or CEF (200mg/kg, i.p, every day×3) post-treatment. METH induced a significant depletion of dopamine and 5-HT in the NAc and PFC. Importantly, dopamine tissue content was completely restored in the NAc following CEF post-treatment. Additionally, METH caused a significant decrease in glutamate and glutamine tissue content in PFC, and this effect was attenuated by CEF post-treatment. These findings demonstrate for the first time the attenuating effects of CEF post-treatment on METH induced alterations in the tissue contents of dopamine, glutamate, and glutamine. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Interventions to improve the self-management support health professionals provide for people with progressive neurological conditions: protocol for a realist synthesis.

    Science.gov (United States)

    Davies, Freya; Wood, Fiona; Bullock, Alison; Wallace, Carolyn; Edwards, Adrian

    2017-03-20

    Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances. A realist synthesis of the evidence is proposed. There are 2 priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to (1) self-management, (2) health professionals and (3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations. Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training. 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/.

  4. Using Patient-Generated Health Data From Mobile Technologies for Diabetes Self-Management Support: Provider Perspectives From an Academic Medical Center.

    Science.gov (United States)

    Nundy, Shantanu; Lu, Chen-Yuan E; Hogan, Patrick; Mishra, Anjuli; Peek, Monica E

    2014-01-01

    Mobile health and patient-generated health data are promising health IT tools for delivering self-management support in diabetes, but little is known about provider perspectives on how best to integrate these programs into routine care. We explored provider perceptions of a patient-generated health data report from a text-message-based diabetes self-management program. The report was designed to relay clinically relevant data obtained from participants' responses to self-assessment questions delivered over text message. Likert-type scale response surveys and in-depth interviews were conducted with primary care physicians and endocrinologists who pilot tested the patient-generated health data report in an actual clinical encounter. Interview guides were designed to assess providers' perceptions of the feasibility and utility of patient-generated health data in routine clinical practice. Interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Twelve providers successfully piloted the summary report in clinic. Although only a minority of providers felt the report changed the care they provided (3 of 12 or 25%), most were willing to use the summary report in a future clinical encounter (9 of 12 or 75%). Perceived benefits of patient-generated health data included agenda setting, assessment of self-care, and identification of patient barriers. Major themes discussed included patient selection, reliability of patient-generated health information, and integration into clinical workflow. Providers perceived multiple benefits of patient-generated health data in overcoming common barriers to self-management support in clinical practice and found the summary report feasible and usable in a clinical context. © 2014 Diabetes Technology Society.

  5. Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephanie K. Young

    2016-09-01

    Full Text Available Background: Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face. Objective: To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation. Methods: In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care. Results: The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity. Conclusions: Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the

  6. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  7. The Tulip GT® airway versus the facemask and Guedel airway: a randomised, controlled, cross-over study by Basic Life Support-trained airway providers in anaesthetised patients.

    Science.gov (United States)

    Shaikh, A; Robinson, P N; Hasan, M

    2016-03-01

    We performed a randomised, controlled, cross-over study of lung ventilation by Basic Life Support-trained providers using either the Tulip GT® airway or a facemask with a Guedel airway in 60 anaesthetised patients. Successful ventilation was achieved if the provider produced an end-tidal CO2 > 3.5 kPa and a tidal volume > 250 ml in two of the first three breaths, within 60 sec and within two attempts. Fifty-seven (95%) providers achieved successful ventilation using the Tulip GT compared with 35 (58%) using the facemask (p Tulip GT and facemask, the mean (SD) end-tidal CO2 was 5.0 (0.7) kPa vs 2.5 (1.5) kPa, tidal volume was 494 (175) ml vs 286 (186) ml and peak inspiratory pressure was 18.3 (3.4) cmH2 O vs 13.6 (7) cmH2 O respectively (all p Tulip GT airway. These results are similar to a previous manikin study using the same protocol, suggesting a close correlation between human and manikin studies for this airway device. We conclude that the Tulip GT should be considered as an adjunct to airway management both within and outside hospitals when ventilation is being undertaken by Basic Life Support-trained airway providers. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  8. HIV Care Providers' Attitudes regarding Mobile Phone Applications and Web-Based Dashboards to support Patient Self-Management and Care Coordination: Results from a Qualitative Feasibility Study.

    Science.gov (United States)

    Swendeman, Dallas; Farmer, Shu; Mindry, Deborah; Lee, Sung-Jae; Medich, Melissa

    2016-10-01

    In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination. Newly diagnosed and patients with co-morbidities were highest priorities for mobile application support. Facilitators included universal mobile phone ownership and use of smartphones or text messaging. Patient-level barriers included concerns about low motivation and financial instability for consistent use by some patients. Organizational barriers, cited primarily by physicians, included concerns about privacy protections, easy dashboard access, non-integrated electronic records, and competing burdens in limited appointment times. Psychosocial services providers were most supportive of the proposed mobile tools.

  9. Qualitative study to explore the health and well-being impacts on adults providing informal support to female domestic violence survivors.

    Science.gov (United States)

    Gregory, Alison; Feder, Gene; Taket, Ann; Williamson, Emma

    2017-03-24

    Domestic violence (DV) is hazardous to survivors' health, from injuries sustained and from resultant chronic physical and mental health problems. Support from friends and relatives is significant in the lives of DV survivors; research shows associations between positive support and the health, well-being and safety of survivors. Little is known about how people close to survivors are impacted. The aim of this study was exploratory, with the following research question: what are the health and well-being impacts on adults who provide informal support to female DV survivors? A qualitative study using semistructured interviews conducted face to face, by telephone or using Skype. A thematic analysis of the narratives was carried out. Community-based, across the UK. People were eligible to take part if they had had a close relationship (either as friend, colleague or family member) with a woman who had experienced DV, and were aged 16 or over during the time they knew the survivor. Participants were recruited via posters in community venues, social media and radio advertisement. 23 participants were recruited and interviewed; the majority were women, most were white and ages ranged from mid-20s to 80. Generated themes included: negative impacts on psychological and emotional well-being of informal supporters, and related physical health impacts. Some psychological impacts were over a limited period; others were chronic and had the potential to be severe and enduring. The impacts described suggested that those providing informal support to survivors may be experiencing secondary traumatic stress as they journey alongside the survivor. Friends and relatives of DV survivors experience substantial impact on their own health and well-being. There are no direct services to support this group. These findings have practical and policy implications, so that the needs of informal supporters are legitimised and met. Published by the BMJ Publishing Group Limited. For permission to

  10. Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation (IC-SMOKE) interventions: a systematic review protocol.

    Science.gov (United States)

    de Bruin, Marijn; Viechtbauer, Wolfgang; Eisma, Maarten C; Hartmann-Boyce, Jamie; West, Robert; Bull, Eleanor; Michie, Susan; Johnston, Marie

    2016-05-04

    Systematic reviews of behaviour change interventions for smoking cessation vary in scope, quality, and applicability. The current review aims to generate more accurate and useful findings by (1) a detailed analysis of intervention elements that change behaviour (i.e. behaviour change techniques (BCTs)) and potential moderators of behaviour change (i.e. other intervention and sample characteristics) and (2) assessing and controlling for variability in support provided to comparison groups in smoking cessation trials. A systematic review will be conducted of randomized controlled trials of behaviour change interventions for smoking cessation in adults (with or without pharmacological support), with a minimum follow-up of 6 months, published after 1995. Eligible articles will be identified through the Cochrane Tobacco Addiction Group Specialized Register. Study authors will be asked for detailed descriptions of smoking cessation support provided to intervention and comparison groups. All data will be independently coded by two researchers. The BCT taxonomy v1 (tailored to smoking cessation interventions) and template for intervention description and replication criteria will be used to code intervention characteristics. Data collection will further include sample and trial characteristics and outcome data (smoking cessation rates). Multilevel mixed-effects meta-regression models will be used to examine which BCTs and/or BCT clusters delivered to intervention and comparison groups explain smoking cessation rates in treatment arms (and effect sizes) and what key moderators of behaviour change are. Predicted effect sizes of each intervention will be computed assuming all interventions are compared against comparison groups receiving the same levels of behavioural support (i.e. low, medium, and high levels). Multi-disciplinary advisory board members (policymakers, health care providers, and (ex-)smokers) will provide strategic input throughout the project to ensure the

  11. E-cadherin and CD1a expression in gingival epithelium in periodontal health, disease and post-treatment.

    Science.gov (United States)

    Arun, Ramya; Hemalatha, R; Arun, K V; Kumar, Tss

    2010-01-01

    Epithelial integrity is important for maintenance of periodontal health. It is not fully known if non-surgical periodontal therapy is capable of recreating the epithelial barrier in its functional state. Sixty-five patients (31 males and 34 females) were included in the study. They were divided into group A (healthy gingiva 16 patients), group B (gingivitis 17 patients), group C (periodontitis 17 patients), and group D (post-treatment 15 patients). Gingival samples were collected and immunohistochemical study was done using E-cadherin and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison test for CD1a and Tukey's highly significant difference (HSD) test for E-cadherin. There was a statistically significant difference (P periodontitis group (0.700±0.483). Similarly, there was a statistically significant difference (P periodontitis group (29.07±3.08). However, the expression of E-cadherin (1.242±0.653) and CD1a in post-treatment samples (52.18±2.90) was lower with no statistically significant difference when compared to health. The significant reduction in E-cadherin and CD1a levels in periodontal disease when compared to health could possibly be a result of invasion by the periodontopathogens and its subsequent sequel. Although, the post-treatment samples showed significant improvement when compared to disease, the reduction in E-cadherin and CD1a levels when compared to gingival health suggests that the epithelial barrier was not yet fully established in its functional state.

  12. Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?

    Science.gov (United States)

    Aucott, John N; Rebman, Alison W; Crowder, Lauren A; Kortte, Kathleen B

    2013-02-01

    A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time. Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months. Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than “minimal” depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months. Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.

  13. Improving Nanofiber Membrane Characteristics and Membrane Distillation Performance of Heat-Pressed Membranes via Annealing Post-Treatment

    Directory of Open Access Journals (Sweden)

    Minwei Yao

    2017-01-01

    Full Text Available Electrospun membranes are gaining interest for use in membrane distillation (MD due to their high porosity and interconnected pore structure; however, they are still susceptible to wetting during MD operation because of their relatively low liquid entry pressure (LEP. In this study, post-treatment had been applied to improve the LEP, as well as its permeation and salt rejection efficiency. The post-treatment included two continuous procedures: heat-pressing and annealing. In this study, annealing was applied on the membranes that had been heat-pressed. It was found that annealing improved the MD performance as the average flux reached 35 L/m2·h or LMH (>10% improvement of the ones without annealing while still maintaining 99.99% salt rejection. Further tests on LEP, contact angle, and pore size distribution explain the improvement due to annealing well. Fourier transform infrared spectroscopy and X-ray diffraction analyses of the membranes showed that there was an increase in the crystallinity of the polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP membrane; also, peaks indicating the α phase of polyvinylidene fluoride (PVDF became noticeable after annealing, indicating some β and amorphous states of polymer were converted into the α phase. The changes were favorable for membrane distillation as the non-polar α phase of PVDF reduces the dipolar attraction force between the membrane and water molecules, and the increase in crystallinity would result in higher thermal stability. The present results indicate the positive effect of the heat-press followed by an annealing post-treatment on the membrane characteristics and MD performance.

  14. Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

    Science.gov (United States)

    Dean, M; Levis, A

    2016-12-01

    To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  15. A CONTEXT AWARE BASED PRE-HANDOFF SUPPORT APPROACH TO PROVIDE OPTIMAL QOS FOR STREAMING APPLICATIONS OVER VEHICULAR AD HOC NETWORKS – HOSA

    Directory of Open Access Journals (Sweden)

    K. RAMESH BABU

    2015-06-01

    Full Text Available Large variations in network Quality of Service (QoS such as bandwidth, latency, jitter, and reliability may occur during media transfer over vehicular ad hoc networks (VANET. Usage of VANET over mobile and wireless computing applications experience “bursty” QoS behavior during the execution over distributed network scenarios. Applications such as streaming media services need to adapt their functionalities to any change in network status. Moreover, an enhanced software platform is necessary to provide adaptive network management services to upper software components. HOSA, a handoff service broker based architecture for QoS adaptation over VANET supports in providing awareness. HOSA is structured as a middleware platform both to provide QoS awareness to streaming applications as well to manage dynamic ad hoc network resources with support over handoff in an adaptive fashion. HOSA is well analyzed over routing schemes such as TIBSCRPH, SIP and ABSRP where performance of HOSA was measured using throughput, traffic intensity and end to end delay. HOSA has been analyzed using JXTA development toolkit over C++ implemented classes to demonstrate its performance over varying node mobility established using vehicular mobility based conference application.

  16. Crosslinking of polybenzimidazolemembranes by divinylsulfone post-treatment for high-temperature proton exchange membrane fuel cell applications

    DEFF Research Database (Denmark)

    Aili, David; Li, Qingfeng; Christensen, Erik

    2011-01-01

    Phosphoric acid-doped polybenzimidazole (PBI) has been suggested as a promising electrolyte for proton exchangemembrane fuel cells operating at temperatures up to 200 ◦C. This paper describes the development of a crosslinking procedure for PBI membranes by post-treatment with divinylsulfone....... The crosslinking chemistry was studied and optimized on a low-molecularweight model system and the results were used to optimize the crosslinking conditions of PBI membranes. The crosslinked membraneswere characterized with respect to chemical and physiochemical properties, showing improved mechanical strength...

  17. Effect of post-treatment on photocatalytic oxidation activity of (111 oriented NaNbO3 film

    Directory of Open Access Journals (Sweden)

    Feng Zhang

    2015-10-01

    Full Text Available We investigate the impact of post-treatment on photocatalytic oxidation activity of (111 oriented NaNbO3 film prepared by pulse laser deposition. Some impurities such as Na2Nb4O11 and bigger particles appear in the treated samples. The activity of rhodamine B degradation with N2 purge increases with the amount of ⋅OH, the sample treated under H2/Ar(7% being the highest activity, followed by under air and untreated one; the opposite trend is observed when the system was without N2 purge.

  18. Thermal post-treatment alters nutrient release from a controlled-release fertilizer coated with a waterborne polymer

    OpenAIRE

    Zhou, Zijun; Du, Changwen; Li, Ting; Shen, Yazhen; Zhou, Jianmin

    2015-01-01

    Controlled-release fertilizers (CRF) use a controlled-release technology to enhance the nutrient use efficiency of crops. Many factors affect the release of nutrients from the waterborne polymer-coated CRF, but the effects of thermal post-treatments remain unclear. In this study, a waterborne polyacrylate-coated CRF was post-treated at different temperatures (30 °C, 60 °C, and 80 °C) and durations (2, 4, 8, 12, and 24 h) after being developed in the Wurster fluidized bed. To characterize the ...

  19. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

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    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  20. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  1. Post-treatment Method for the Synthesis of Monodisperse Binary FePt-Fe^sub 3^O^sub 4^ Nanoparticles

    National Research Council Canada - National Science Library

    Zhilu Liu; Chun Wu; Liang Niu; Ganting Yang; Kai Wang; Wenli Pei; Qiang Wang

    2017-01-01

    ... °C, and a monodisperse binary FePt-Fe3O4 nanoparticle system was generated. The post-treatment method did not affect the crystal structure, grain size, or composition of the FePt nanoparticle...

  2. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

    Science.gov (United States)

    Soekarjo, Damayanti; Zehner, Elizabeth

    2011-10-01

    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

  3. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists.

    Science.gov (United States)

    Timmers, Lonneke; Boons, Christel C L M; Verbrugghe, Mathieu; van den Bemt, Bart J F; Van Hecke, Ann; Hugtenburg, Jacqueline G

    2017-02-10

    Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence. A cross-sectional, observational study among HCPs in (haemato-)oncology settings in Belgium and the Netherlands was conducted in 2014 using a composite questionnaire. A total of 47 care activities were listed and categorised into eight domains. HCPs were also asked about their perceptions of adherence management on the items: insight into adherence, patients' communication, capability to influence, knowledge of consequences and insight into causes. Validated questionnaires were used to assess beliefs about medication (BMQ) and shared decision making (SDM-Q-doc). In total, 208 HCPs (29% male) participated; 107 from 51 Dutch and 101 from 26 Belgian hospitals. Though a wide range of activities were reported, certain domains concerning medication adherence management received less attention. Activities related to patient knowledge and adverse event management were reported most frequently, whereas activities aimed at patient's self-efficacy and medication adherence during ongoing use were frequently missed. The care provided differed between professions and by country. Belgian physicians reported more activities than Dutch physicians, whereas Dutch nurses and pharmacists reported more activities than Belgian colleagues. The perceptions of medication adherence management were related to the level of care provided by HCPs. SDM and BMQ outcomes were not related to the care provided. Enhancing the awareness and perceptions of medication adherence management of HCPs is likely to have a positive effect on care quality. Care can be improved by addressing medication adherence more directly e.g., by questioning patients about (expected) barriers and discussing

  4. The application of novel coagulant reagent (polyaluminium silicate chloride) for the post-treatment of landfill leachates.

    Science.gov (United States)

    Tzoupanos, N D; Zouboulis, A I; Zhao, Y-C

    2008-10-01

    Relatively "old" (stabilized) landfill leachates are a special category of wastewaters, which are difficult to treat further, mainly due to their bio-refractory organic content (humic substances). In this study, coagulation-flocculation was examined as post-treatment method for the biologically pre-treated stabilized leachates. The purpose was to examine the coagulation performance of alternative coagulant agents, i.e. the composite coagulant polyaluminium silicate chloride. Composite coagulants with different Al to Si molar ratio and different preparation methods were tested. Their efficiency was evaluated by monitoring from turbidity and phosphate content, other parameters strongly correlated with the presence of organic matter, such as UV absorbance at 254nm, COD and colour. The results suggest that the silica-based coagulants exhibit better coagulation performance, than the relevant conventional coagulant (alum) or simple pre-polymerized coagulants (PACl). Polyaluminium silicate chloride has greater tolerance against pH variation than alum or PACl, whereas this novel coagulant works better at pH values between 7 and 9. Coagulation-flocculation has proved to be an efficient post-treatment method for the biologically pre-treated leachates, promoting the removal of the refractory humic substances, while the treatment efficiency of coagulation can be improved by the application of the new coagulant agent.

  5. USE OF ARTIFICIAL AQUATIC FOOD-WEB FOR POST-TREATMENT OF DOMESTIC WASTEWATER IN COLD CLIMATE: A REVIEW

    Directory of Open Access Journals (Sweden)

    Aigars Lavrinovičs

    2017-11-01

    Full Text Available Eutrophication-promoting phosphorous loads originating from wastewater treatment plants are commonly controlled by chemical precipitation in the tertiary treatment phase. However, this approach is costly and generates additional waste. Therefore, inexpensive and sustainable methods for wastewater post-treatment are wanted. The artificial aquatic food-web that performs wastewater phycoremediation by algae and subsequent biomass harvest by filter-feeding organisms not only requires low energy consumption but also produces biomass for treatment process cost recovery. Still, the knowledge on its performance at different scales and under different climates are limited. In this review, the application possibilities of the artificial aquatic food-web for domestic wastewater post-treatment is discussed, focusing on its use in cold climate regions. Considering the reduced biological activity of aquatic organisms at low ambient temperature, possible solutions for its performance and prospect application at low temperatures are suggested. Finally, directions for future research regarding the practical use of artificial aquatic food-web are highlighted.

  6. Curcumin pretreatment and post-treatment both improve the antioxidative ability of neurons with oxygen-glucose deprivation

    Directory of Open Access Journals (Sweden)

    Jing-xian Wu

    2015-01-01

    Full Text Available Recent studies have shown that induced expression of endogenous antioxidative enzymes thr-ough activation of the antioxidant response element/nuclear factor erythroid 2-related factor 2 (Nrf2 pathway may be a neuroprotective strategy. In this study, rat cerebral cortical neurons cultured in vitro were pretreated with 10 μM curcumin or post-treated with 5 μM curcumin, respectively before or after being subjected to oxygen-glucose deprivation and reoxygenation for 24 hours. Both pretreatment and post-treatment resulted in a significant decrease of cell injury as indicated by propidium iodide/Hoechst 33258 staining, a prominent increase of Nrf2 protein expression as indicated by western blot analysis, and a remarkable increase of protein expression and enzyme activity in whole cell lysates of thioredoxin before ischemia, after ischemia, and after reoxygenation. In addition, post-treatment with curcumin inhibited early DNA/RNA oxidation as indicated by immunocytochemistry and increased nuclear Nrf2 protein by inducing nuclear accumulation of Nrf2. These findings suggest that curcumin activates the expression of thioredoxin, an antioxidant protein in the Nrf2 pathway, and protects neurons from death caused by oxygen-glucose deprivation in an in vitro model of ischemia/reperfusion. We speculate that pharmacologic stimulation of antioxidant gene expression may be a promising approach to neuroprotection after cerebral ischemia.

  7. A retrospective study of the clinical characteristics and post-treatment hearing outcome in idiopathic sudden sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Purushothaman Ganesan

    2017-02-01

    Full Text Available The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL. 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA (500, 1K, and 2K Hz, and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58% had complete recovery and 34 (28% had partial recovery. The average pre-treatment PTA was 78.3 ± 16.9 dB whereas post-treatment average was 47.0 ± 20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001. The factors such as presence of tinnitus (P=0.005 and initial milder hearing loss (P=0.005 were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.

  8. A Knowledge-Modeling Approach to Integrate Multiple Clinical Practice Guidelines to Provide Evidence-Based Clinical Decision Support for Managing Comorbid Conditions.

    Science.gov (United States)

    Abidi, Samina

    2017-10-26

    Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients. COMET exploits semantic web technologies to achieve (a) CPG knowledge synthesis to translate a paper-based CPG to disease-specific clinical pathways (CP) that include specialized co-morbidity management procedures based on input from domain experts; (b) CPG knowledge modeling to computerize the disease-specific CP using a Comorbidity CPG ontology; (c) CPG knowledge integration by aligning multiple ontologically-modeled CP to develop a unified comorbid CPG knowledge model; and (e) CPG knowledge execution using reasoning engines to derive CPG-mediated recommendations for managing patients with comorbidities. We present a web-accessible COMET CDSS that provides family physicians with CPG-mediated comorbidity decision support to manage Atrial Fibrillation and Chronic Heart Failure. We present our qualitative and quantitative analysis of the knowledge content and usability of COMET CDSS.

  9. Post-treatment follow-up study of abdominal cystic echinococcosis in tibetan communities of northwest Sichuan Province, China.

    Directory of Open Access Journals (Sweden)

    Tiaoying Li

    2011-10-01

    cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB. However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i presenting as initial elevation followed by subsequent decline, or (ii a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases.This was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole.

  10. Somebody to lean on: Social relationships predict post-treatment depression severity in adults.

    Science.gov (United States)

    Hallgren, Mats; Lundin, Andreas; Tee, Fwo Yi; Burström, Bo; Forsell, Yvonne

    2017-03-01

    Supportive social relationships can help protect against depression, but few studies have examined how social relationships influence the response to depression treatment. We examined longitudinal associations between the availability of social relationships and depression severity following a 12-week intervention. In total, 946 adults aged 18-71 years with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12 weeks. The interventions included internet-based cognitive behavioural therapy (ICBT), 'usual care' (CBT or supportive counselling) and exercise. The primary outcome was the change in depression severity. The availability of social relationships were self-rated and based on the Interview Schedule for Social Interaction (ISSI). Prospective associations were explored using and logistic regression models. Participants with greater access to supportive social relationships reported larger improvements in depression compared to those with 'low' availability of relationships (β= -3.95, 95% CI= -5.49, -2.41, pdepression. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  11. Programas e intervenciones de apoyo a los cuidadores informales en España Supporting programs and interventions for informal care providers in Spain

    Directory of Open Access Journals (Sweden)

    Mª Pilar Torres Egea

    2008-03-01

    Full Text Available Cuidar a personas con dependencia es una responsabilidad que implica a los familiares más directos. El cuidado individualizado suele recaer en una persona a quien se identifica como el cuidador principal. La sobrecarga que genera el cuidado continuado hace preciso que este cuidador reciba un soporte de los profesionales del ámbito sanitario y/o social. Desde el sector formal se realizan diversos programas e intervenciones, individuales o grupales, para dar soporte a los cuidadores de personas con dependencia. El presente trabajo analiza las publicaciones científicas, aparecidas en los últimos diez años, que tratan sobre diferentes programas e intervenciones de soporte a los cuidadores informales, y que surgen de la preocupación de diferentes profesionales por la calidad de vida y la salud de los cuidadores.Taking care of dependent people is a task the performance of which involves the family members. Individualized care burden is normally borne on only one person, who is identified as the main caregiver. The burden that these care activities generate makes necessary that care provider receives professional assistance from healthcare and social experts. From the formal area some programs and interventions, from both individuals and groups, are conducted to support care providers for dependent people. This work analyzes scientific publications, appeared in the last ten years, which focus on some programs and interventions to support non-professional caregivers and which arise out of some professionals worries for care providers health and quality of life.

  12. Acti-Tape™ (elastic therapeutic tape as compared with a knee guard in providing support to the knee joint: an open-label, randomized, crossover study

    Directory of Open Access Journals (Sweden)

    Hui HK

    2014-04-01

    Full Text Available Hoong Keong Hui,1 Narayan J Karne,2 Navneet Sonawane31Nutriworks Ltd, Kowloon, Hong Kong; 2Karne Hospital, Pune, India; 3Vedic Lifesciences Pvt Ltd, Mumbai, IndiaStudy design: Randomized, open-label, crossover, controlled study.Background: Elastic taping methods are used to provide support to the musculoskeletal system in athletes. Acti-Tape™ (an elastic therapeutic tape has been marketed for the last 2–3 years and has shown good results in providing support to the joints. This pilot study was planned to collect data on the clinical outcomes and to assess if a single tape application of Acti-Tape over the knee joint could provide benefits similar to a traditionally used knee guard.Methods: Thirteen subjects aged 30–65 years visiting an orthopedic center in Pune, India who were suffering from osteoarthritis were randomly assigned to either Acti-Tape (n=6 or a knee guard (n=7 in the first intervention period (6 days and were crossed over to the other group in the second intervention period (6 days after a washout of 1 day. Main outcome measures were change from day 0 to day 6 in pain visual analog score (VAS; timed up and go (TUG, medial step down (MSD, and unilateral anterior reach (UAR tests; and subject's preference.Results: Data for all the 13 subjects were pooled and analyzed by Student's t-test as treatment-by-period interaction was not significant by analysis of variance (P>0.05. The changes (mean ± standard deviation after using Acti-Tape and a knee guard, respectively, were pain VAS, –10±5.4 versus (vs –11.5±5.83; TUG, –0.62±1.33 vs –0.46±1.56; UAR, 0.15±1.07 vs 0.75±0.44; and MSD, 1.08±095 vs 0.85±1.14. These were statistically significant with both devices for pain VAS, UAR, and MSD, but not for TUG. Between the treatments however, no statistically significant difference was seen. Eleven of 13 (85% subjects preferred Acti-Tape for future use (P<0.05 by McNemar’s χ2 test. No safety concerns were reported by the

  13. Racial disparities in birth care: Exploring the perceived role of African-American women providing midwifery care and birth support in the United States.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Hamilton, Lydia J

    2017-02-01

    Midwifery care has been linked to positive birth outcomes. Despite the broad racial disparities in maternal and infant outcomes in the United States (US), little is known about the role of minority women in either providing or receiving this type of care. A vibrant community of minority women, who self-identify as providing these services, exists online. In this exploratory study we ask how they describe their role; view their practice; and position themselves in the broader discussions of racial health disparities in the US. Using an internet mediated qualitative design we analyse online narratives from self-described African-American nurse-midwives, lay midwives and birth assistants; we found 28 unique websites. We collected and analysed narrative material from each site. We used a thematic analysis approach to identify recurrent and emergent themes in relation to the study question. Narratives identified a strong link to the past, as providers viewed their practice in a historical perspective linking African roots, to the diaspora, and to current African-American struggles. Providers engaged both in direct clinical work, and in activist roles. Advocacy efforts sought to expand numbers of minority birth care workers and to extend the benefits of woman-centred birth care to underserved communities. Results demonstrate the continued existence and important role of diverse types of African-American birth care providers in minority communities in the US. Recognition, support, and increasing the number of midwives of colour is important in tackling racial inequalities in health. Further research should explore minority access to woman-centred care. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. Supporting Emergency Medical Care Teams with an Integrated Status Display Providing Real-Time Access to Medical Best Practices, Workflow Tracking, and Patient Data.

    Science.gov (United States)

    Wu, PoLiang; Nam, Min-Young; Choi, Jeonghwan; Kirlik, Alex; Sha, Lui; Berlin, Richard B

    2017-10-17

    The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design. We then developed a medical Best Practice Guidance (BPG) system for reducing medical teams' cognitive load, thus fostering real-time adherence to best practices. We evaluated the resulting system with physicians and nurses using a professional patient simulator used for medical training and certification. The evaluation results point to a reduction of cognitive load and enhanced adherence to medical best practices.

  15. Post-treatment of reclaimed waste water based on an electrochemical advanced oxidation process

    Science.gov (United States)

    Verostko, Charles E.; Murphy, Oliver J.; Hitchens, G. D.; Salinas, Carlos E.; Rogers, Tom D.

    1992-01-01

    The purification of reclaimed water is essential to water reclamation technology life-support systems in lunar/Mars habitats. An electrochemical UV reactor is being developed which generates oxidants, operates at low temperatures, and requires no chemical expendables. The reactor is the basis for an advanced oxidation process in which electrochemically generated ozone and hydrogen peroxide are used in combination with ultraviolet light irradiation to produce hydroxyl radicals. Results from this process are presented which demonstrate concept feasibility for removal of organic impurities and disinfection of water for potable and hygiene reuse. Power, size requirements, Faradaic efficiency, and process reaction kinetics are discussed. At the completion of this development effort the reactor system will be installed in JSC's regenerative water recovery test facility for evaluation to compare this technique with other candidate processes.

  16. Do student nurses feel a lack of comfort in providing support for Lesbian, Gay, Bisexual or Questioning adolescents: what factors influence their comfort level?

    Science.gov (United States)

    Richardson, Brian P; Ondracek, Anton E; Anderson, Dee

    2017-05-01

    The aim of this study was to find out if student nurses feel comfortable in caring by providing support for Lesbian, Gay, Bisexual or Questioning adolescents and what factors influence their level of comfort. Research indicates that nurses and nursing students experience varying levels of comfort when caring for adults who are Lesbian, Gay, Bisexual or Questioning: adult patients feel that nurse's attitudes change towards them once they disclose their sexuality. There has been minimal research to date on nursing attitudes to working with adolescents who are Lesbian, Gay, Bisexual or Questioning. Both quantitative and qualitative methods were used in this descriptive study. Questionnaires were completed by 152 nursing students and nine took part in semi-structured focus groups. A two-way ANOVA was used to analyse the questionnaires. Thematic analysis was used to identify the themes arising from the focus groups. Data were collected between August 2013 - July 2014. The results and findings of the study were that student nurse's felt discomfort in providing support; due to a lack of knowledge of Lesbian, Gay or Bisexual sexuality, personal and religious beliefs and the perceptions of others. However, all students indicated they had a positive attitude towards Lesbian, Gay, Bisexual and Questioning adolescents. More needs to be done to raise self-awareness and improve the level of knowledge in relation to Lesbian, Gay and Bisexual issues amongst student nurses. Educational institutions and practice areas need to recognize this fact and reflect this in their educational programmes. © 2016 John Wiley & Sons Ltd.

  17. Parent Perceptions of How Nurse Encounters Can Provide Caring Support for the Family in Early Acute Care Following Children’s Severe Traumatic Brain Injury

    Science.gov (United States)

    Roscigno, Cecelia I.

    2016-01-01

    Objective A child’s severe traumatic brain injury (TBI) creates a family crisis requiring extensive cultural, informational, psychological, and environmental support. Nurses need to understand parents’ expectations of caring in early acute care so they can tailor their attitudes, beliefs, and behaviors appropriately to accommodate the family’s needs. Methods In a previous qualitative study of 42 parents or caregivers from 37 families of children with moderate to severe TBI, parents of children with severe TBI (n = 25) described their appraisals of nurse caring and uncaring behaviors in early acute care. Swanson’s theory of caring was used to categorize parents’ descriptions in order to inform nursing early acute care practices and family-centered care. Results Caring nurse encounters included: (a) involving parents in the care of their child and reflecting on all socio-cultural factors shaping family resources and responses (knowing); (b) respecting that family grief can be co-mingled with resilience, and that parents are typically competent to be involved in decision-making (maintaining belief); (d) actively listening and engaging parents in order to fully understand family values and needs (being with); (e) decreasing parents’ workload to get information, emotional support, and providing a safe cultural, psychological, and physical environment for the family (doing for), and; (f) providing anticipatory guidance to navigate the early acute care system and giving assistance to learn and adjust to their situation (enabling). Conclusion Application of Swanson’s caring theory is prescriptive in helping individual nurses and early acute care systems to meet important family needs following children’s severe TBI. PMID:26871242

  18. E-cadherin and CD1a expression in gingival epithelium in periodontal health, disease and post-treatment

    Directory of Open Access Journals (Sweden)

    Arun Ramya

    2010-01-01

    Full Text Available Background: Epithelial integrity is important for maintenance of periodontal health. It is not fully known if non-surgical periodontal therapy is capable of recreating the epithelial barrier in its functional state. Patients and Methods: Sixty-five patients (31 males and 34 females were included in the study. They were divided into group A (healthy gingiva 16 patients, group B (gingivitis 17 patients, group C (periodontitis 17 patients, and group D (post-treatment 15 patients. Gingival samples were collected and immunohistochemical study was done using E-cadherin and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA, followed by Tukey-Kramer multiple comparison test for CD1a and Tukey′s highly significant difference (HSD test for E-cadherin. Result: There was a statistically significant difference (P < 0.001 in the expression of E-cadherin between healthy (1.846±0.555, gingivitis (1.100±0.994, and periodontitis group (0.700±0.483. Similarly, there was a statistically significant difference (P < 0.001 in the expression of CD1a between healthy (75.70±3.09, gingivitis (42.53±3.09, and periodontitis group (29.07±3.08. However, the expression of E-cadherin (1.242±0.653 and CD1a in post-treatment samples (52.18±2.90 was lower with no statistically significant difference when compared to health. Discussion: The significant reduction in E-cadherin and CD1a levels in periodontal disease when compared to health could possibly be a result of invasion by the periodontopathogens and its subsequent sequel. Although, the post-treatment samples showed significant improvement when compared to disease, the reduction in E-cadherin and CD1a levels when compared to gingival health suggests that the epithelial barrier was not yet fully established in its functional state.

  19. Protection afforded by pre- or post-treatment with 4-phenylbutyrate against liver injury induced by acetaminophen overdose in mice.

    Science.gov (United States)

    Shimizu, Daisuke; Ishitsuka, Yoichi; Miyata, Keishi; Tomishima, Yoshiro; Kondo, Yuki; Irikura, Mitsuru; Iwawaki, Takao; Oike, Yuichi; Irie, Tetsumi

    2014-09-01

    Acetaminophen (paracetamol, N-acetyl-p-aminophenol; APAP) is a widely used analgesic/antipyretic drug with few adverse effects at therapeutic doses; suicidal or unintentional overdose of APAP frequently induces severe hepatotoxicity. To explore a new and effective antidote for APAP hepatotoxicity, this study examined the effects of sodium 4-phenylbutyrate (4-PBA) on liver injury induced by APAP overdose in mice. Liver injury was induced in C57BL/6 male mice by intraperitoneal injection of APAP (400mg/kg). The effects of 4-PBA (100-200mg/kg) treatment at 1h before the APAP injection were evaluated with serum alanine aminotransferase (ALT) and blood ammonia levels, hepatic pathological changes, including histopathology, DNA damage, nitrotyrosine formation, and mRNA or protein expression involved in the development of hepatotoxicity, such as X-box binding protein-1 (XBP1), c-Jun N-terminal kinase (JNK), C/EBP homologous protein (CHOP) and B-cell lymphoma 2 interacting mediator of cell death (Bim). In addition, glutathione depletion and CYP2E1 protein expression, which are measures of the metabolic conversion of APAP to a toxic metabolite, were examined. Furthermore, we examined the effects of post-treatment with 4-PBA against APAP-induced hepatotoxicity in mice. When administered at 1h before APAP injection, 4-PBA significantly prevented the increase in serum ALT and blood ammonia levels, centrilobular necrosis of hepatocytes, DNA fragmentation, and nitrotyrosine formation induced by APAP in mice. 4-PBA also inhibited hepatic Xbp1 mRNA splicing and JNK phosphorylation induced by APAP, but did not suppress CHOP and Bim mRNA and protein expression. In addition, 4-PBA had little effect on hepatic glutathione depletion and CYP2E1 expression, parameters of toxic APAP metabolite production. Post-treatment with 4-PBA administration at 1 or 2h after APAP injection also attenuated the increase in serum ALT and blood ammonia levels and hepatic pathological changes in APAP

  20. Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Wanyenze Rhoda K

    2013-02-01

    Full Text Available Abstract Background Some people living with HIV/AIDS (PLHIV want to have children while others want to prevent pregnancies; this calls for comprehensive services to address both needs. This study explored decisions to have or not to have children and contraceptive preferences among PLHIV at two clinics in Uganda. Methods This was a qualitative cross-sectional study. We conducted seventeen focus group discussions and 14 in-depth interviews with sexually active adult men and women and adolescent girls and boys, and eight key informant interviews with providers. Overall, 106 individuals participated in the interviews; including 84 clients through focus group discussions. Qualitative latent content analysis technique was used, guided by key study questions and objectives. A coding system was developed before the transcripts were examined. Codes were grouped into categories and then themes and subthemes further identified. Results In terms of contraceptive preferences, clients had a wide range of preferences; whereas some did not like condoms, pills and injectables, others preferred these methods. Fears of complications were raised mainly about pills and injectables while cost of the methods was a major issue for the injectables, implants and intrauterine devices. Other than HIV sero-discordance and ill health (which was cited as transient, the decision to have children or not was largely influenced by socio-cultural factors. All adult men, women and adolescents noted the need to have children, preferably more than one. The major reasons for wanting more children for those who already had some were; the sex of the children (wanting to have both girls and boys and especially boys, desire for large families, pressure from family, and getting new partners. Providers were supportive of the decision to have children, especially for those who did not have any child at all, but some clients cited negative experiences with providers and information gaps for

  1. ANAEROBIC EFFLUENT POST-TREATMENT APPLYING PHOTOLYTIC REACTOR PRIOR TO AGRICULTURAL USE IN BRAZILIAN'S SEMIARID REGION

    Directory of Open Access Journals (Sweden)

    José Tavares de Sousa

    2013-01-01

    Full Text Available This work applied a Compact System consisting of a Reactor Up flow Sludge Blanket (UASB in conjunction with s Submerged Anaerobic Filter containing polyurethane cubes as support media, followed by a Solar Photolytic R eactor. The compact anaerobic system produced a clarified effluent with low concentration of organic matter, especially dissolved (20 mg .VSS/L, and free of helminthes eggs. These low concentrations of suspended solids facilitated photolytic disinfection process producing a good quality final effluent, of which 90% of the samples were thoroughly disinfected, while the other fraction showed concentration of Thermotolerant Coliform (TTC at or below 100 CFU/100 mL and high concentrations of nutrients (48 mg . NH 4 + -N/L and 6,4mg PO 4 -3 - P/L enabling the use of irrigation for productive purposes. Another advantages of the compact anaerobic treatment consisted of low sludge production, and relatively simple operation without energy consumption. These advantages results in a significant reduction in operational costs of sewage treatment, and, indeed, an outlet for developing countries in tropical climate.

  2. ANAEROBIC EFFLUENT POST-TREATMENT APPLYING PHOTOLYTIC REACTOR PRIOR TO AGRICULTURAL USE IN BRAZILIAN'S SEMIARID REGION

    Directory of Open Access Journals (Sweden)

    José Tavares de Sousa

    2013-06-01

    Full Text Available This work applied a Compact System consisting of a Reactor Up flow Sludge Blanket (UASB in conjunction with s Submerged Anaerobic Filter containing polyurethane cubes as support media, followed by a Solar Photolytic Reactor. The compact anaerobic system produced a clarified effluent with low concentration of organic matter, especially dissolved (20 mg .VSS/L, and free of helminthes eggs. These low concentrations of suspended solids facilitated photolytic disinfection process producing a good quality final effluent, of which 90% of the samples were thoroughly disinfected, while the other fraction showed concentration of Thermotolerant Coliform (TTC at or below 100 CFU/100 mL and high concentrations of nutrients (48 mg . NH4+-N/L and 6,4mg PO4-3-P/L enabling the use of irrigation for productive purposes. Another advantages of the compact anaerobic treatment consisted of low sludge production, and relatively simple operation without energy consumption. These advantages results in a significant reduction in operational costs of sewage treatment, and, indeed, an outlet for developing countries in tropical climate.

  3. Chemical post-treatment and thermoelectric properties of poly(3,4-ethylenedioxylthiophene):poly(styrenesulfonate) thin films

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Jinji, E-mail: jinji.luo@zfm.tu-chemnitz.de; Blaudeck, Thomas [Center for Microtechnologies, Technische Universität Chemnitz, Reichenhainer Str. 70, Chemnitz D-09107 (Germany); Billep, Detlef; Otto, Thomas [Fraunhofer Institute for Electro Nano Systems (ENAS), Technologie-Campus 3, Chemnitz D-09107 (Germany); Sheremet, Evgeniya; Rodriguez, Raul D.; Zahn, Dietrich R. T. [Semiconductor Physics, Technische Universität Chemnitz, Reichenhainer Str. 70, Chemnitz D-09107 (Germany); Toader, Marius; Hietschold, Michael [Solid Surfaces Analysis, Technische Universität Chemnitz, Reichenhainer Str. 70, Chemnitz D-09107 (Germany); Gessner, Thomas [Center for Microtechnologies, Technische Universität Chemnitz, Reichenhainer Str. 70, Chemnitz D-09107 (Germany); Fraunhofer Institute for Electro Nano Systems (ENAS), Technologie-Campus 3, Chemnitz D-09107 (Germany)

    2014-02-07

    We report on the modification of the thermoelectric properties of poly(3,4-ethylenedioxylthiophene):poly(styrenesulfonate) (PEDOT:PSS) thin films by means of a simple post treatment of the solid thin films realized by drop-coating. We show that the organic polar solvents, dimethyl sulfoxide and ethylene glycol as secondary dopants for PEDOT:PSS, only affect the film morphology for which a high electrical conductivity is observed. In contrast, ethanolamine (MEA) and ammonia solutions are reduction agents that improve the density of PEDOT chains in the reduced forms (polaron and neutral states), resulting in the trade-off between Seebeck coefficient and electrical conductivity. Furthermore, we show that the nature of amines determines the reduction degree: the nitrogen lone pair electrons in MEA are easier to be donated than those in ammonia solution and will therefore neutralize the PEDOT chains.

  4. The effect of progressive resistance training on lean body mass in post-treatment cancer patients - A systematic review

    DEFF Research Database (Denmark)

    Lønbro, Simon

    2014-01-01

    resistance training on lean body mass in post-treatment cancer patients. A comprehensive literature search was conducted and ultimately 12 studies were included. Methodological quality of the included studies was evaluated using the PEDro scale and the effect of progressive resistance training was reported...... as the range of mean changes among RCTs and non-RCTs. Six RCTs and six non-RCTs were included in the study. In the RCTs the change in lean body mass in the progressive resistance training groups relative to control groups ranged from -0.4% to 3.9%, and in four of six trials the training effect...... was significantly larger than the change in the control groups. In the six non-RCTs, the mean change in lean body mass over time ranged from -0.01 to 11.8% which was significant in two of the trials. The included studies reported no or very limited adverse events following progressive resistance training. Based...

  5. A Novel Process Configuration for Anaerobic Digestion of Source-Sorted Household Waste Using Hyper-Thermophilic Post-Treatment

    DEFF Research Database (Denmark)

    Hartmann, H.; Ahring, Birgitte Kiær

    2005-01-01

    A novel reactor configuration was investigated for anaerobic digestion (AD) of the organic fraction of municipal solid waste (OFMSW). An anaerobic hyper-thermophilic (68°C) reactor R68 was implemented as a post–treatment step for the effluent of a thermophilic reactor R1 (55°C) in order to enhance......). A single-stage thermophilic (55°C) reactor R2 was used as control. VS reduction and biogas yield of the combined system was 78 – 89% and 640 – 790 ml/g-VS, respectively. While the VS reduction in the combined system was up to 7% higher than in the single-stage treatment, no increase in methane yield......-thermophilic post-treatment. 7% of the ammonia load was removed in the hyper-thermophilic reactor with a flow of headspace gas through the reactor equivalent to four times the biogas flow produced in reactor R1....

  6. Post-treatment changes of tumour perfusion parameters can help to predict survival in patients with high-grade astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Sanz-Requena, Roberto; Marti-Bonmati, Luis [Hospital Quironsalud Valencia, Radiology Department, Valencia (Spain); Hospital Universitari i Politecnic La Fe, Grupo de Investigacion Biomedica en Imagen, Valencia (Spain); Revert-Ventura, Antonio J.; Salame-Gamarra, Fares [Hospital de Manises, Radiology Department, Manises (Spain); Garcia-Marti, Gracian [Hospital Quironsalud Valencia, Radiology Department, Valencia (Spain); Hospital Universitari i Politecnic La Fe, Grupo de Investigacion Biomedica en Imagen, Valencia (Spain); CIBER-SAM, Instituto de Salud Carlos III, Madrid (Spain); Perez-Girbes, Alexandre [Hospital Universitari i Politecnic La Fe, Grupo de Investigacion Biomedica en Imagen, Valencia (Spain); Molla-Olmos, Enrique [Hospital La Ribera, Radiology Department, Alzira (Spain)

    2017-08-15

    Vascular characteristics of tumour and peritumoral volumes of high-grade gliomas change with treatment. This work evaluates the variations of T2*-weighted perfusion parameters as overall survival (OS) predictors. Forty-five patients with histologically confirmed high-grade astrocytoma (8 grade III and 37 grade IV) were included. All patients underwent pre- and post-treatment T2*-weighted contrast-enhanced magnetic resonance (MR) imaging. Tumour, peritumoral and control volumes were segmented. Relative variations of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), K{sup trans-T2*}, k{sub ep-T2*}, v{sub e-T2*} and v{sub p-T2*} were calculated. Differences regarding tumour grade and surgical resection extension were evaluated with ANOVA tests. For each parameter, two groups were defined by non-supervised clusterisation. Survival analysis were performed on these groups. For the tumour region, the 90th percentile increase or stagnation of CBV was associated with shorter survival, while a decrease related to longer survival (393 ± 189 vs 594 ± 294 days; log-rank p = 0.019; Cox hazard-ratio, 2.31; 95% confidence interval [CI], 1.12-4.74). K{sup trans-T2*} showed similar results (414 ± 177 vs 553 ± 312 days; log-rank p = 0.037; hazard-ratio, 2.19; 95% CI, 1.03-4.65). The peritumoral area values showed no relationship with OS. Post-treatment variations of the highest CBV and K{sup trans-T2*} values in the tumour volume are predictive factors of OS in patients with high-grade gliomas. (orig.)

  7. Post-Treatment of Secondary Wastewater Treatment Plant Effluent Using A Two-Stage Fluidized Bed Bioreactor System

    Directory of Open Access Journals (Sweden)

    Golam Hossein Safari

    2013-06-01

    Full Text Available The aim of this study was to investigate the performance of a two-stage fluidized bed reactor (FBR system for the post-treatment of secondary wastewater treatment plant effluents (Shahrak Gharb, Tehran, Iran. The proposed treatment scheme was evaluated using pilot-scale reactors (106-L of capacity filled with PVC as the fluidized bed (first stage and gravel for the filtration purpose (second stage. Aluminum sulfate (30 mg/L and chlorine (1 mg/L were used for the coagulation and disinfection of the effluent, respectively. To monitor the performance of the FBR system, variation of several parameters (biochemical oxygen demand (BOD5, chemical oxygen demand (COD, turbidity, total phosphorous, total coliform and fecal coliform were monitored in the effluent wastewater samples. The results showed that the proposed system could effectively reduce BOD5 and COD below 1.95 and 4.06 mg/L, respectively. Turbidity of the effluent could be achieved below 0.75 NTU, which was lower than those reported for the disinfection purpose. The total phosphorus was reduced to 0.52 mg/L, which was near the present phosphorous standard for the prevention of eutrophication process. Depending on both microorganism concentration and applied surface loading rates (5–10 m/h, about 35 to 75% and 67 to 97% of coliform were removed without and with the chlorine addition, respectively. Findings of this study clearly confirmed the efficiency of the FBR system for the post-treatment of the secondary wastewater treatment plant effluents without any solid problem during the chlorination.

  8. The post-treatment effects of enterobiasis on the occurrence of enuresis among children in Calabar, Nigeria.

    Science.gov (United States)

    Otu-Bassey, Iquo B; Useh, Monday F; Alaribe, Anyanwu A

    2011-04-01

    To investigate the relationship between enterobiasis and enuresis before and after albendazole therapy among 632 children, aged, 5-14 years, in Calabar, Nigeria. The scotch tape (cellotape) technique was used for the detection of eggs of Enterobius vermicularis (E. vermicularis) while questionnaire-based interviews were used for screening for anal itching and/or enuresis among study participants. All subjects found positive for Enterobius infection as confirmed by the presence of eggs and those with persistent anal itching (both enuretic and non-enuretic) were treated with 400 mg of albendazole given as a single dose. The treated subjects were re-assessed post-treatment to ascertain whether they were cured and also to determine their enuretic status (for the enuretics). The overall prevalences of Enterobius infection, anal itching, and enuresis prior to albendazole therapy were 6.8%, 42.9%, and 35.6% respectively. There was no statistically significant difference in the prevalence of these parameters by the socio-economic class of subjects (P = 0.462, P = 0.647, and P = 0.610, respectively). The pre-treatment prevalences of enuresis among Enterobius and anal itching-positive subjects were 53.5% and 49.8%, respectively versus 34.3% and 24.9%, respectively among their negative counterpart (P = 0.012 and P enuresis, thus giving a total resolution rate of 60%. Similarly, 64.2% resolution (25% cure and 32.8% reduction) of enuresis was observed amongst 120 anal itching-cured/enuretic children. Enuretic status of the Enterobius-/anal itching-uncured subjects, on the other hand, remained unchanged post-treatment. This study is suggestive of the involvement of E. vermicularis in the aetiology of enuresis in Calabar. Children presenting with, especially, uncomplicated enuresis should be screened for enterobiasis. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  9. Coagulant recovery from water treatment plant sludge and reuse in post-treatment of UASB reactor effluent treating municipal wastewater.

    Science.gov (United States)

    Nair, Abhilash T; Ahammed, M Mansoor

    2014-09-01

    In the present study, feasibility of recovering the coagulant from water treatment plant sludge with sulphuric acid and reusing it in post-treatment of upflow anaerobic sludge blanket (UASB) reactor effluent treating municipal wastewater were studied. The optimum conditions for coagulant recovery from water treatment plant sludge were investigated using response surface methodology (RSM). Sludge obtained from plants that use polyaluminium chloride (PACl) and alum coagulant was utilised for the study. Effect of three variables, pH, solid content and mixing time was studied using a Box-Behnken statistical experimental design. RSM model was developed based on the experimental aluminium recovery, and the response plots were developed. Results of the study showed significant effects of all the three variables and their interactions in the recovery process. The optimum aluminium recovery of 73.26 and 62.73 % from PACl sludge and alum sludge, respectively, was obtained at pH of 2.0, solid content of 0.5 % and mixing time of 30 min. The recovered coagulant solution had elevated concentrations of certain metals and chemical oxygen demand (COD) which raised concern about its reuse potential in water treatment. Hence, the coagulant recovered from PACl sludge was reused as coagulant for post-treatment of UASB reactor effluent treating municipal wastewater. The recovered coagulant gave 71 % COD, 80 % turbidity, 89 % phosphate, 77 % suspended solids and 99.5 % total coliform removal at 25 mg Al/L. Fresh PACl also gave similar performance but at higher dose of 40 mg Al/L. The results suggest that coagulant can be recovered from water treatment plant sludge and can be used to treat UASB reactor effluent treating municipal wastewater which can reduce the consumption of fresh coagulant in wastewater treatment.

  10. Sexuality issues in gynaecological oncology patients: post treatment symptoms and therapeutic options.

    Science.gov (United States)

    Iavazzo, C; Johnson, K; Savage, H; Gallagher, S; Datta, M; Winter-Roach, B A

    2015-03-01

    According to recent studies up to 80% of patients would like to receive more information about how cancer treatments can affect their sexual functioning. Moreover, 75 % of them would not feel comfortable being the first to bring up the subject. Our Gynaecological Advice Clinic was established in 2006 at the Christie Hospital and offers support to cancer patients who face sexuality issues. A previous evaluation established that the service sees approximately, 200 patients per year. The aims of this study are to evaluate the service by collecting data relating to levels of attendance, type and amount of clinical activity and to explore further patients' experiences and management. This is a retrospective study which was carried out in 2012-2013. Different models are used to evaluate our patients including history taking integrated therapy model, consultations to understand the normal anatomy and physiology with the use of diagrams and photographs, psycho-education and the international classification "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSMV). The treatment options advised include medications such as hormone replacement treatment, testosterone, antidepressant, local oestrogen, tibolone, aqueous cream, lubrication to introitus, diprobase, dermal cream and advice for massage to areas of discomfort. Moreover, the use of vaginal dilators, the role of pelvic floor exercises, vulval care and self examination are explained. The team works closely with the psycho-oncology department. The most frequently discussed topics that were covered during the consultation are analysed. 41 outpatient clinics were held between 2012 and 2013. 194 patients attended those clinics during the study period. Single and not group therapy was offered to all the participants. 216 patients were offered appointments while 194 patients actually attended (90%). Patients' age ranged from 24 to 91 years with a mean age of 59 years. 45% had endometrial and 32% cervical

  11. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    Science.gov (United States)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  12. Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

    Science.gov (United States)

    Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

    2014-07-01

    Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

  13. The Lower Sevier River Basin Crop Monitor and Forecast Decision Support System: Exploiting Landsat Imagery to Provide Continuous Information to Farmers and Water Managers

    Science.gov (United States)

    Torres-Rua, A. F.; Walker, W. R.; McKee, M.

    2013-12-01

    The last century has seen a large number of innovations in agriculture such as better policies for water control and management, upgraded water conveyance, irrigation, distribution, and monitoring systems, and better weather forecasting products. In spite of this, irrigation management and irrigation water deliveries by farmers/water managers is still based on factors like water share amounts, tradition, and past experience on irrigation. These factors are not necessarily related to the actual crop water use; they are followed because of the absence of related information provided in a timely manner at an affordable cost. Thus, it is necessary to develop means to deliver continuous and personalized information about crop water requirements to water users/managers at the field and irrigation system levels so managers at these levels can better quantify the required versus available water for irrigation during the irrigation season. This study presents a new decision support system (DSS) platform that addresses the absence of information on actual crop water requirements and crop performance by providing continuous updated farm-based crop water use along with other farm performance indicators such as crop yield and farm management to irrigators and water managers. This DSS exploits the periodicity of the Landsat Satellite Mission (8 to 16 days, depending on the period of interest) to provide remote monitoring at the individual field and irrigation system levels. The Landsat satellite images are converted into information about crop water use, yield performance and field management through application of state-of-the-art semi-physical and statistical algorithms that provide this information at a pixel basis that are ultimately aggregated to field and irrigation system levels. A version of the DSS has been implemented for the agricultural lands in the Lower Sevier River, Utah, and has been operational since the beginning of the 2013 irrigation season. The main goal of

  14. Development of a sixth-generation down-flow hanging sponge (DHS) reactor using rigid sponge media for post-treatment of UASB treating municipal sewage.

    Science.gov (United States)

    Onodera, Takashi; Tandukar, Madan; Sugiyana, Doni; Uemura, Shigeki; Ohashi, Akiyoshi; Harada, Hideki

    2014-01-01

    A sixth-generation down-flow hanging sponge reactor (DHS-G6), using rigid sponge media, was developed as a novel aerobic post-treatment unit for upflow anaerobic sludge blanket (UASB) treating municipal sewage. The rigid sponge media were manufactured by copolymerizing polyurethane with epoxy resin. The UASB and DHS system had a hydraulic retention time (HRT) of 10.6 h (8.6 h for UASB and 2 h for DHS) when operated at 10-28 °C. The system gave reasonable organic and nitrogen removal efficiencies. The final effluent had a total biochemical oxygen demand of only 12 mg/L and a total Kjeldahl nitrogen content of 6 mg/L. The DHS reactor gave particularly good nitrification performance, which was attributed to the new rigid sponge media. The sponge media helped to provide a sufficient HRT, and retained a high biomass concentration, extending the solids retention time. The DHS reactor maintained a high dissolved oxygen concentration under natural ventilation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Development of natural treatment system consisting of black soil and Kentucky bluegrass for the post-treatment of anaerobically digested strong wastewater.

    Science.gov (United States)

    Chen, Xiaochen; Fukushi, Kensuke

    2016-03-01

    To develop a sound post-treatment process for anaerobically-digested strong wastewater, a novel natural treatment system comprising two units is put forward. The first unit, a trickling filter, provides for further reduction of biochemical oxygen demand and adjustable nitrification. The subsequent soil-plant unit aims at removing and recovering the nutrients nitrogen (N), phosphorus (P) and potassium (K). As a lab-scale feasibility study, a soil column test was conducted, in which black soil and valuable Kentucky bluegrass were integrated to treat artificial nutrient-enriched wastewater. After a long-term operation, the nitrification function was well established in the top layers, despite the need for an improved denitrification process prior to discharge. P and K were retained by the soil through distinct mechanisms. Since they either partially or totally remained in plant-available forms in the soil, indirect nutrient reuse could be achieved. As for Kentucky bluegrass, it displayed better growth status when receiving wastewater, with direct recovery of 8%, 6% and 14% of input N, P and K, respectively. Furthermore, the indispensable role of Kentucky bluegrass for better treatment performance was proved, as it enhanced the cell-specific nitrification potential of the soil nitrifying microorganisms inhabiting the rhizosphere. After further upgrade, the proposed system is expected to become a new solution for strong wastewater pollution. Copyright © 2015. Published by Elsevier B.V.

  16. Ultrathin Polyamide Membranes Fabricated from Free-Standing Interfacial Polymerization: Synthesis, Modifications, and Post-treatment

    KAUST Repository

    Cui, Yue

    2016-12-21

    The thin film composite (TFC) membrane synthesized via interfacial polymerization is the workhorse of the prevalent membrane technologies such as nanofiltration (NF), reverse osmosis (RO), forward osmosis (FO), and pressure retarded osmosis (PRO) membranes. The polyamide selective layer usually possesses a high selectivity and permeability, making it the heart of this membrane technology. To further improve and understand its formation, with entirely excluding the effect of substrate, an ultrathin membrane which consists of only the polyamide selective layer has been fabricated via free-standing interfacial polymerization between M-phenylenediamine (MPD) and trimesoyl chloride (TMC) in this study. The influences of monomer concentration on polyamide layer formation is first examined. Different from previous studies which indicated that the variation of MPD concentration might affect the polyamide layer formation even when in excess, the MPD concentration when in excess does not affect membrane properties significantly, while increasing the TMC concentration gradually densifies the polyamide layer and enhances its transport resistance. Adding lithium bromide (LiBr) and sodium dodecyl sulfate (SDS) in MPD solutions is found to facilitate the reaction between the two phases and result in a significant improvement in water permeability. However, a high amount of additives leads to an augmentation in transport resistance. The N,N-dimethylformamide (DMF) treatment on the polyamide membrane shows pronounced improvements on water flux under FO tests and water permeability under RO tests without compromising reverse salt flux and salt rejection because the dense polyamide core stays intact. This study may offer a different perspective on membrane formation and intrinsic properties of the polyamide selective layer and provide useful insights for the development of next-generation TFC membranes.

  17. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

    Full Text Available Background: Computerized Provider Order Entry (CPOE and Clinical Decision Support System (CDSS help practitioners to choose evidence-based decisions, regarding patients’ needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. Objective: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing. Methods: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation, where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD, crude costs and product of costs-DDD (cost-DDD/100 bed-days. We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years. Results: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05. In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings. Conclusion: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

  18. The complete mitochondrial genome of the onychophoran Epiperipatus biolleyi reveals a unique transfer RNA set and provides further support for the ecdysozoa hypothesis.

    Science.gov (United States)

    Podsiadlowski, Lars; Braband, Anke; Mayer, Georg

    2008-01-01

    Onychophora (velvet worms) play a crucial role in current discussions on position of arthropods. The ongoing Articulata/Ecdysozoa debate is in need of additional ground pattern characters for Panarthropoda (Arthropoda, Tardigrada, and Onychophora). Hence, Onychophora is an important outgroup taxon in resolving the relationships among arthropods, irrespective of whether morphological or molecular data are used. To date, there has been a noticeable lack of mitochondrial genome data from onychophorans. Here, we present the first complete mitochondrial genome sequence of an onychophoran, Epiperipatus biolleyi (Peripatidae), which shows several characteristic features. Specifically, the gene order is considerably different from that in other arthropods and other bilaterians. In addition, there is a lack of 9 tRNA genes usually present in bilaterian mitochondrial genomes. All these missing tRNAs have anticodon sequences corresponding to 4-fold degenerate codons, whereas the persisting 13 tRNAs all have anticodons pairing with 2-fold degenerate codons. Sequence-based phylogenetic analysis of the mitochondrial protein-coding genes provides a robust support for a clade consisting of Onychophora, Priapulida, and Arthropoda, which confirms the Ecdysozoa hypothesis. However, resolution of the internal ecdysozoan relationships suffers from a cluster of long-branching taxa (including Nematoda and Platyhelminthes) and a lack of data from Tardigrada and further nemathelminth taxa in addition to nematodes and priapulids.

  19. DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.

    Directory of Open Access Journals (Sweden)

    Ann D King

    Full Text Available It is important to identify patients with head and neck squamous cell carcinoma (SCC who fail to respond to chemoradiotherapy so that they can undergo post-treatment salvage surgery while the disease is still operable. This study aimed to determine the diagnostic performance of dynamic contrast enhanced (DCE-MRI using a pharmacokinetic model for pre-treatment predictive imaging, as well as post-treatment diagnosis, of residual SCC at primary and nodal sites in the head and neck.Forty-nine patients with 83 SCC sites (primary and/or nodal underwent pre-treatment DCE-MRI, and 43 patients underwent post-treatment DCE-MRI, of which 33 SCC sites had a residual mass amenable to analysis. Pre-treatment, post-treatment and % change in the mean Ktrans, kep, ve and AUGC were obtained from SCC sites. Logistic regression was used to correlate DCE parameters at each SCC site with treatment response at the same site, based on clinical outcome at that site at a minimum of two years.None of the pre-treatment DCE-MRI parameters showed significant correlations with SCC site failure (SF (29/83 sites or site control (SC (54/83 sites. Post-treatment residual masses with SF (14/33 had significantly higher kep (p = 0.05, higher AUGC (p = 0.02, and lower % reduction in AUGC (p = 0.02, than residual masses with SC (19/33, with the % change in AUGC remaining significant on multivariate analysis.Pre-treatment DCE-MRI did not predict which SCC sites would fail treatment, but post-treatment DCE-MRI showed potential for identifying residual masses that had failed treatment.

  20. Effect of application rates and media types on nitrogen and surfactant removal in trickling filters applied to the post-treatment of effluents from UASB reactors

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, P. G. S. de; Taveres, F. v. F.; Chernicharo, C. A. I.

    2009-07-01

    Tricking filters are a very promising alternative for the post treatment of effluents from UASB reactors treating domestic sewage,especially in developing countries. Although a fair amount of information is already available regarding organic mater removal in this combined system, very little is known in relation to nitrogen and surfactant removal in trickling filters post-UASB reactors. Therefore, the purpose of this study was to evaluate and compare the effect evaluate and compare the effect of different application rates and packing media types on trickling filters applied to the post-treatment of effluents from UASB reactors, regarding the removal of ammonia nitrogen and surfactants. (Author)

  1. Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of a post-treatment communication

    Directory of Open Access Journals (Sweden)

    Mauro Cozzani

    2016-12-01

    Full Text Available Abstract Background Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients’ compliance over a period of 66 days. The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days. Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department, Gaslini Hospital, Genova, between July and October 2014 were randomly assigned to one of three trial arms. Before the bonding, all patients underwent a session of oral hygiene aimed at obtaining an plaque index of “zero.” At the following orthodontic appointment, the plaque index was calculated for each patient in order to assess oral hygiene compliance. The first group served as control and did not receive any post-procedure communication, the second group received a structured text message giving reassurance, and the third group received a structured telephone call. Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study. (The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014, and it is not registered in the trial’s register. Results Thirty patients were randomly assigned to the control group, 28 participants to the text message group, and 26 to the telephone group. Participants who received a post-treatment communication reported higher level of oral hygiene compliance than participants in the control group. The plaque index was 0.3 (interquartile range (Iqr, 0.60 and 0.75 (Iqr, 1.30, respectively, with a significant difference (P = 0.0205. Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to

  2. Providers with Limited Experience Perform Better in Advanced Life Support with Assistance Using an Interactive Device with an Automated External Defibrillator Linked to a Ventilator.

    Science.gov (United States)

    Busch, Christian Werner; Qalanawi, Mohammed; Kersten, Jan Felix; Kalwa, Tobias Johannes; Scotti, Norman Alexander; Reip, Wikhart; Doehn, Christoph; Maisch, Stefan; Nitzschke, Rainer

    2015-10-01

    Medical teams with limited experience in performing advanced life support (ALS) or with a low frequency of cardiopulmonary resuscitation (CPR) while on duty, often have difficulty complying with CPR guidelines. This study evaluated whether the quality of CPR of trained medical students, who served as an example of teams with limited experience in ALS, could be improved with device assistance. The primary outcome was the hands-off time (i.e., the percentage of the entire CPR time without chest compressions). The secondary outcome was seven time intervals, which should be as short as possible, and the quality of ventilations and chest compressions on the mannequin. We compared standard CPR equipment to an interactive device with visual and acoustic instructions for ALS workflow measures to guide briefly trained medical students through the ALS algorithm in a full-scale mannequin simulation study with a randomized crossover study design. The study equipment consisted of an automatic external defibrillator and ventilator that were electronically linked and communicating as a single system. Included were regular medical students in the third to sixth years of medical school of one class who provided written informed consent for voluntary participation and for the analysis of their CPR performance data. No exclusion criteria were applied. For statistical measures of evaluation we used an analysis of variance for crossover trials accounting for treatment effect, sequence effect, and carry-over effect, with adjustment for prior practical experience of the participants. Forty-two medical students participated in 21 CPR sessions, each using the standard and study equipment. Regarding the primary end point, the study equipment reduced the hands-off time from 40.1% (95% confidence interval [CI] 36.9-43.4%) to 35.6% (95% CI 32.4-38.9%, p = 0.031) compared with the standard equipment. Within the prespecified secondary end points, study equipment reduced the time interval until

  3. Post-treatment CIN

    DEFF Research Database (Denmark)

    Bais, Aagje G; Eijkemans, Marinus J C; Rebolj, Mateja

    2009-01-01

    cytology and presence of hrHPV (80 vs. 91%, relative risk 0.87 (95% CI 0.77-0.99)). Both methods showed no significant difference in sensitivity ((86 vs. 100%) RR 0.86 (95% CI 0.63-1.16)). Comparing different post hoc modifications in the strategy of combined testing showed similar test characteristics...

  4. The Nature of Parent Support Provided by Parent Mentors for Families with Deaf/Hard-of-Hearing Children: Voices from the Start

    Science.gov (United States)

    Friedman Narr, Rachel; Kemmery, Megan

    2015-01-01

    This study used a qualitative design to explore parent mentors' summaries of conversations with more than 1,000 individual families of deaf and hard-of-hearing (DHH) children receiving parent-to-parent support as part of an existing family support project. Approximately 35% of the families were Spanish speaking. Five parent mentors who have…

  5. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  6. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial.

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  7. Removing heavy metals using permeable pavement system with a titanate nano-fibrous adsorbent column as a post treatment.

    Science.gov (United States)

    Sounthararajah, Danious Pratheep; Loganathan, Paripurnanda; Kandasamy, Jayakumar; Vigneswaran, Saravanamuthu

    2017-02-01

    Permeable pavement systems (PPS) are a widely-used treatment measure in sustainable stormwater management and groundwater recharge. However, PPS are not very efficient in removing heavy metals from stormwater. A pilot scale study using zeolite or basalt as bed material in PPS removed 41-72%, 67-74%, 38-43%, 61-72%, 63-73% of Cd, Cu, Ni, Pb, and Zn, respectively, from synthetic stormwater (pH 6.5; Cd, Cu, Ni, Pb, and Zn concentrations of 0.04, 0.6, 0.06, 1.0, and 2.0 mg L-1, respectively) over a period of 80 h. The total volume of stormwater that passed through the PPS was equivalent to runoff in 10 years of rainfall in Sydney, Australia. The concentrations of metals in the PPS effluent failed fresh and marine water quality trigger values recommended in the Australian and New Zealand guidelines. An addition of a post-treatment of a horizontal filter column containing a titanate nano-fibrous (TNF) material with a weight  basalt; Pb > Cu > Cd, Ni, Zn. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Post-treatment haemolysis in severe imported malaria after intravenous artesunate: case report of three patients with hyperparasitaemia

    Directory of Open Access Journals (Sweden)

    Rolling Thierry

    2012-05-01

    Full Text Available Abstract Parenteral artesunate has been shown to be a superior treatment option compared to parenteral quinine in adults and children with severe malaria. Little evidence, however, is available on long-term safety. Recently, cases of late-onset haemolysis after parenteral treatment with artesunate have been reported in European travellers with imported Plasmodium falciparum malaria. Therefore, an extended follow-up of adult patients treated for severe imported malaria was started in August 2011 at the University Medical Center Hamburg-Eppendorf. Until January 2012, three patients with hyperparasitaemia (range: 14-21% were included for analysis. In all three patients, delayed haemolysis was detected in the second week after the first dose of intravenous artesunate. Reticulocyte production index remained inadequately low in the 7 – 14 days following the first dose of artesunate despite rapid parasite clearance. Post-treatment haemolysis after parenteral artesunate may be of clinical relevance in particular in imported severe malaria characterized by high parasite levels. Extended follow-up of at least 30 days including controls of haematological parameters after artesunate treatment seems to be indicated. Further investigations are needed to assess frequency and pathophysiological background of this complication.

  9. [Analysis of relationship between the detection of Enterococcus faecalis in post-treatment endodontic disease and clinical symptom or sign].

    Science.gov (United States)

    Niu, Wei-dong; Song, Qi-yi; Wang, Li-na; Zheng, Jian-bo; Shi, Chun; Li, Ji-yao; Zhou, Xue-dong

    2010-10-01

    To detect the Enterococcus faecalis (E. faecalis) in post-treatment endodontic disease, and to analyze the relationship between the occurrence of E. faecalis and clinical symptom. 108 teeth which need root canal retreatment were collected, and the clinical symptoms and physical signs were recorded. Bacterium samples from root canal were taken, and genome DNA from bacterial samples were extracted. The occurrence of E. faecalis by means of the polymerase chain reaction was investigated. The detection rate of E. faecalis in cases of root canal retreatment was 47.2%, while in cases with symptoms or signs, or cases with both symptoms and signs, the root canal E. faecalis detection rates were 52.6%, 57.9%, 62.5%. The detection rates of E. faecalis between cases with clinical symptom and without clinical symptom demonstrated statistical significance (P faecalis in cases with biting pain was 66.7%, clearly higher than those without biting pain (P faecalis in cases of root canal retreatment correlates with clinical symptoms.

  10. Direct methanol steam reforming to hydrogen over CuZnGaOx catalysts without CO post-treatment: mechanistic considerations.

    Science.gov (United States)

    Tong, Weiyi; Cheung, Kevin; West, Adam; Yu, Kai-Man; Tsang, Shik Chi Edman

    2013-05-21

    Utilization of hydrogen gas (and carbon dioxide) from methanol steam reforming reaction directly without CO post-treatment to supply proton exchange membrane fuel cells for mobile applications is an attractive option. CuZnGaOx based mixed oxides prepared by co-precipitation are found to be active as catalysts for the reforming reaction. It is also found that the use of lower temperature and a faster substrate flow rate with a shorter contact time with the catalyst bed can significantly reduce the CO level in the product gas stream. At 150 °C this class of oxides gives a decent methanol conversion but can also totally suppress the CO production at a short contact time, which is in a sharp contrast with conventional CuZnOx based catalysts that give a significant degree of CO formation. Characterization using Diffuse Reflectance Infrared Fourier Transform (DRIFT) analysis presented in this work clearly suggests the importance of the interface between copper metal-defective oxides for the catalysis. Mechanistic aspects of this reaction are therefore discussed in this paper.

  11. Optimizing processes of dispersant concentration and post-treatments for fabricating single-walled carbon nanotube transparent conducting films

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Jing; Wang, Wen-Yi; Chen, Li-Ting; Cui, Li-Jun; Hu, Xiao-Yan; Geng, Hong-Zhang, E-mail: genghz@tjpu.edu.cn

    2013-07-15

    This study evaluated the effect of sodium dodecyl benzene sulfonate (SDBS) as dispersant for the dispersion of purified single-walled carbon nanotubes (SWCNTs) in water in terms of dispersibility dependence on electrical conductivity of SWCNT transparent conducting film (TCF) performance. SWCNT TCFs were prepared by different proportions of CNTs/SDBS solution to find out the optimum SDBS concentration according to the film resistance of pristine and after post-treatment by nitric acid. TCFs fabricated with the aqueous solution by the ratio of CNTs/SDBS 1:5 gave the lowest sheet resistance and the highest transmittance. The TCFs were then further treated with thionyl chloride to improve their conductivity. Low sheet resistance (86 Ω/□, 80%T) was achieved. The dispersion condition of CNTs/SDBS aqueous solution was characterized by field-emission scanning electron microscopy, while the X-ray photoelectron spectroscopy and Raman spectroscopy confirmed the dispersion and doping mechanism treated with nitric acid and thionyl chloride.

  12. Optimizing processes of dispersant concentration and post-treatments for fabricating single-walled carbon nanotube transparent conducting films

    Science.gov (United States)

    Gao, Jing; Wang, Wen-Yi; Chen, Li-Ting; Cui, Li-Jun; Hu, Xiao-Yan; Geng, Hong-Zhang

    2013-07-01

    This study evaluated the effect of sodium dodecyl benzene sulfonate (SDBS) as dispersant for the dispersion of purified single-walled carbon nanotubes (SWCNTs) in water in terms of dispersibility dependence on electrical conductivity of SWCNT transparent conducting film (TCF) performance. SWCNT TCFs were prepared by different proportions of CNTs/SDBS solution to find out the optimum SDBS concentration according to the film resistance of pristine and after post-treatment by nitric acid. TCFs fabricated with the aqueous solution by the ratio of CNTs/SDBS 1:5 gave the lowest sheet resistance and the highest transmittance. The TCFs were then further treated with thionyl chloride to improve their conductivity. Low sheet resistance (86 Ω/□, 80%T) was achieved. The dispersion condition of CNTs/SDBS aqueous solution was characterized by field-emission scanning electron microscopy, while the X-ray photoelectron spectroscopy and Raman spectroscopy confirmed the dispersion and doping mechanism treated with nitric acid and thionyl chloride.

  13. Attachment style and respiratory sinus arrhythmia predict post-treatment quality of life in breast cancer survivors.

    Science.gov (United States)

    Fagundes, Christopher P; Jaremka, Lisa M; Malarkey, William B; Kiecolt-Glaser, Janice K

    2014-07-01

    Breast cancer is the most frequent malignant tumor among women in the industrialized world. The vast majority of these tumors can now be successfully treated. A subset of breast cancer survivors report quality of life (QOL) difficulties well after treatment is completed. The current study examined how individual differences in attachment style and self-regulatory capacity (as indexed by respiratory sinus arrhythmia (RSA)) were associated QOL among post-treatment breast cancer survivors. Women who had completed treatment for stage 0-IIIA breast cancer within the past 2 years participated in the study (N=96). RSA was assessed using electrocardiography data that was continuously measured non-invasively for 10 min. Attachment orientation was measured using a modified version of the Experiences in Close Relationships Scale and overall QOL by the Functional Assessment of Cancer Therapy-Breast scale. Breast cancer survivors with more attachment anxiety reported poorer QOL than those with less attachment anxiety. Women who were more avoidantly attached also reported poorer QOL compared with those who were less avoidantly attached. Furthermore, attachment avoidance interacted with RSA to predict QOL such that those with higher attachment avoidance were only vulnerable to poorer QOL if they also had lower self-regulatory capacity, as indexed by lower RSA. A better understanding of how attachment style and RSA contribute to breast cancer survivors QOL will help identify people at risk for QOL problems after treatment completion. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support

    National Research Council Canada - National Science Library

    Harris, Paul A; Taylor, Robert; Thielke, Robert; Payne, Jonathon; Gonzalez, Nathaniel; Conde, Jose G

    2009-01-01

    Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1...

  15. Do clinical decision-support reminders for medical providers improve isoniazid preventative therapy prescription rates among HIV-positive adults? Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Green, Eric P; Catalani, Caricia; Diero, Lameck; Carter, E Jane; Gardner, Adrian; Ndwiga, Charity; Keny, Aggrey; Owiti, Philip; Israelski, Dennis; Biondich, Paul

    2015-04-09

    This document describes a research protocol for a study designed to estimate the impact of implementing a reminder system for medical providers on the use of isoniazid preventative therapy (IPT) for adults living with HIV in western Kenya. People living with HIV have a 5% to 10% annual risk of developing active tuberculosis (TB) once infected with TB bacilli, compared to a 5% lifetime risk in HIV-negative people with latent TB infection. Moreover, people living with HIV have a 20-fold higher risk of dying from TB. A growing body of literature suggests that IPT reduces overall TB incidence and is therefore of considerable benefit to patients and the larger community. However, in 2009, of the estimated 33 million people living with HIV, only 1.7 million (5%) were screened for TB, and about 85,000 (0.2%) were offered IPT. This study will examine the use of clinical decision-support reminders to improve rates of initiation of preventative treatment in a TB/HIV co-morbid population living in a TB endemic area. This will be a pragmatic, parallel-group, cluster-randomized superiority trial with a 1:1 allocation to treatment ratio. For the trial, 20 public medical facilities that use clinical summary sheets generated from an electronic medical records system will participate as clusters. All HIV-positive adult patients who complete an initial encounter at a study cluster and at least one return encounter during the study period will be included in the study cohort. The primary endpoint will be IPT prescription at 3 months post the initial encounter. We will conduct both individual-level and cluster-level analyses. Due to the nature of the intervention, the trial will not be blinded. This study will contribute to the growing evidence base for the use of electronic health interventions in low-resource settings to promote high-quality clinical care, health system optimization and positive patient outcomes. Trial registration ClinicalTrials.gov NCT01934309, registered 29

  16. Informatics and Decisions support in Galway Bay (SmartBay) using ERDDAP, OGC Technologies and Third Party Data Sources to Provide Services to the Marine Community.

    Science.gov (United States)

    Delaney, Conor; Gaughan, Paul; Smyth, Damian

    2013-04-01

    The global marine sector generates and consumes vast quantities of operational and forecast data on a daily basis. One of the key challenges facing the sector relates to the management and transformation of that data into knowledge. The Irish Marine Institute (MI) generates oceanographic and environmental data on a regular and frequent basis. This data comes from operational ocean models run on the MI's high performance computer (HPC) and various environmental observation sensors systems. Some of the data published by the Marine Institute is brokered by the Environmental Research Division's Data Access Program (ERDDAP) data broker, which is a broker technology that uses technology based on OPeNDAP and Open Geospatial Consortium (OGC) standards. The broker provides a consistent web service interface to the data services of the Marine Institute; these services include wave, tide and weather sensors and numerical model output. An ERDDAP server publishes data in a number of standard and developer friendly ways, including some OGC formats. The data on the MI ERDDAP (http://erddap.marine.ie) server is published as OpenData. The marine work package of the FP7 funded ENVIROFI project (http://www.envirofi.eu/) has used the ERDDAP data broker as a core resource in the development of its Marine Asset management decision Support Tool (MAST) portal and phone App. Communication between MAST and ERDDAP is via a Uniform Resource Identifier (Linked Data). A key objective of the MAST prototype is to demonstrate the potential of next-generation dynamic web-based products and services and how they can be harnessed to facilitate growth of both the marine and IT sectors. The use case driving the project is the management of ocean energy assets in the marine environment. In particular the provision of information that aid in the decision making process surrounding maintenance at sea. This question is common to any offshore industry and solution proposed here is applicable to other users

  17. Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England.

    Science.gov (United States)

    Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

    2011-03-01

    Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of 'key' external advocates and leverage of additional resources by adoption of care pathway tools.

  18. SU-E-J-254: Evaluating the Role of Mid-Treatment and Post-Treatment FDG-PET/CT in Predicting Progression-Free Survival and Distant Metastasis of Anal Cancer Patients Treated with Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, H; Wang, J; Chuong, M; D’Souza, W; Choi, W; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Latifi, K; Hoffe, S; Moros, E [Moffitt Cancer Center, Tampa, FL (United States); Saeed, Nadia [Brwon University, Providence, RI (United States); Tan, S [Huazhong University of Science & Technology, Wuhan (China); Shridhar, R [Florida Hospital, Orlando, FL (United States)

    2015-06-15

    support vector machine model. Conclusion: Applying radiomics approach to either midtreatment or post-treatment PET/CT could achieve high accuracy in predicting anal cancer treatment outcomes. This work was supported in part by the National Cancer Institute Grant R01CA172638.

  19. Influence of various operating conditions on wastewater treatment in an AS-biofilm reactor and post-treatment using TiO2-based solar/UV photocatalysis.

    Science.gov (United States)

    Manu, D S; Thalla, Arun Kumar

    2018-01-09

    In the present study, the effect of carbon to nitrogen (C/N) ratio, suspended biomass concentration (X), hydraulic retention time (HRT) and dissolved oxygen (DO) on chemical oxygen demand (COD) and nutrient removal from wastewater was investigated in a lab-scale activated sludge (AS)-biofilm reactor. Furthermore, in order to improve the quality of the treated wastewater, photocatalysis by TiO 2 was investigated as a post-treatment technology, using solar and UV irradiations. The AS-biofilm reactor provided a substantial removal efficiency in terms of COD, ammonia nitrogen [Formula: see text], total nitrogen (TN) and total phosphorous when the system was maintained at C/N ratio 6.66, X in the range 2-2.5 g/L, HRT 10 h, DO in the range of 3.5-4.5 mg/L and organic loading rate (OLR) of 0.96 kg COD/m 3  d during Run 1. Similarly, when the reactor was maintained at C/N ratio 10, X in the range of 3-3.5 g/L, HRT 8 h, DO in the range of 3.5-4.5 mg/L and OLR of 1.8 kg COD/m 3  d during Run 2. The microstructure of suspended and attached biomass comprised a dense bacterial structure of cocci and bacillus microorganisms. The UV photocatalysis was found to be better than solar photocatalysis during the comparative analysis. The maximum removal efficiencies of COD, most probable number and phosphorous at optimum conditions in the case of UV and solar irradiations were 72%, 95%, 52% and 71%, 99%, 50%, respectively.

  20. Computational Toxicology as Implemented by the U.S. EPA: Providing High Throughput Decision Support Tools for Screening and Assessing Chemical Exposure, Hazard and Risk

    Science.gov (United States)

    Computational toxicology is the application of mathematical and computer models to help assess chemical hazards and risks to human health and the environment. Supported by advances in informatics, high-throughput screening (HTS) technologies, and systems biology, the U.S. Environ...

  1. Working together to promote diabetes control : A practical guide for diabetes health care providers in establishing a working alliance to achieve self-management support

    NARCIS (Netherlands)

    Jones, Allan; Vallis, Michael; Cooke, Debbie; Pouwer, F.

    2016-01-01

    The quality of the "patient-carer" relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the

  2. Virological Blips and Predictors of Post Treatment Viral Control After Stopping ART Started in Primary HIV Infection.

    Science.gov (United States)

    Fidler, Sarah; Olson, Ashley D; Bucher, Heiner C; Fox, Julie; Thornhill, John; Morrison, Charles; Muga, Roberto; Phillips, Andrew; Frater, John; Porter, Kholoud

    2017-02-01

    Few individuals commencing antiretroviral therapy (ART) in primary HIV infection (PHI) maintain undetectable viremia after treatment cessation. Associated factors remain unclear given the importance of the phenomenon to cure research. Using CASCADE data of seroconverters starting ART in PHI (≤6 months from seroconversion), we estimated proportions experiencing viral blips (>400 copies followed by HIV-RNA/mL without alteration of regimen) while on ART. We used Cox models to examine the association between time from ART stop to loss of control (2 consecutive measurements >1000 copies per milliliter) and magnitude and frequency of blips while on ART, time from seroconversion to ART, time on ART, adjusting for mean number of HIV-RNA measurements/year while on ART, and other confounders. Seven hundred seventy-eight seroconverters started ART in PHI with ≥3 HIV-RNA measurements. Median interquartile range (IQR) ART duration was 16.2 (8.0-35.9) months, within which we observed 13% with ≥1 blip. Of 228 who stopped ART, 119 rebounded; time to loss of control was associated with longer interval between seroconversion and ART initiation [hazard ratio (HR) = 1.16 per month; 1.04, 1.28], and blips while on ART (HR = 1.71 per blip; 95% confidence interval = 0.94 to 3.10). Longer time on ART (HR = 0.84 per additional month; 0.76, 0.92) was associated with lower risk of losing control. Of 228 stopping ART, 22 (10%) maintained post treatment control (PTC), ie, HIV-RNA HIV viral blips on therapy are associated with subsequent viral rebound on stopping ART among individuals treated in PHI. Longer duration on ART is associated with a greater chance of PTC.

  3. Molecular Remodeling of Left and Right Ventricular Myocardium in Chronic Anthracycline Cardiotoxicity and Post-Treatment Follow Up

    Science.gov (United States)

    Lenčová-Popelová, Olga; Jirkovský, Eduard; Mazurová, Yvona; Lenčo, Juraj; Adamcová, Michaela; Šimůnek, Tomáš; Geršl, Vladimír; Štěrba, Martin

    2014-01-01

    Chronic anthracycline cardiotoxicity is a serious clinical issue with well characterized functional and histopathological hallmarks. However, molecular determinants of the toxic damage and associated myocardial remodeling remain to be established. Furthermore, details on the different propensity of the left and right ventricle (LV and RV, respectively) to the cardiotoxicity development are unknown. Hence, the aim of the investigation was to study molecular changes associated with remodeling of the LV and RV in chronic anthracycline cardiotoxicity and post-treatment follow up. The cardiotoxicity was induced in rabbits with daunorubicin (3 mg/kg/week for 10 weeks) and animals were sacrificed either at the end of the treatment or after an additional 10 weeks. Daunorubicin induced severe and irreversible cardiotoxicity associated with LV dysfunction and typical morphological alterations, whereas the myocardium of the RV showed only mild changes. Both ventricles also showed different expression of ANP after daunorubicin treatment. Daunorubicin impaired the expression of several sarcomeric proteins in the LV, which was not the case of the RV. In particular, a significant drop was found in titin and thick filament proteins at both mRNA and protein level and this might be connected with persistent LV down-regulation of GATA-4. In addition, the LV was more affected by treatment-induced perturbations in calcium handling proteins. LV cardiomyocytes showed marked up-regulation of desmin after the treatment and vimentin was mainly induced in LV fibroblasts, whereas only weaker changes were observed in the RV. Remodeling of extracellular matrix was almost exclusively found in the LV with particular induction of collagen I and IV. Hence, the present study describes profound molecular remodeling of myocytes, non-myocyte cells and extracellular matrix in response to chronic anthracycline treatment with marked asymmetry between LV and RV. PMID:24804796

  4. Exploring Post-Treatment Reversion of Antimicrobial Resistance in Enteric Bacteria of Food Animals as a Resistance Mitigation Strategy.

    Science.gov (United States)

    Volkova, Victoriya V; KuKanich, Butch; Riviere, Jim E

    2016-11-01

    Antimicrobial drug use in food animals is associated with an elevation in relative abundance of bacteria resistant to the drug among the animal enteric bacteria. Some of these bacteria are potential foodborne pathogens. Evidence suggests that at least in the enteric nontype-specific Escherichia coli, after treatment the resistance abundance reverts to the background pre-treatment levels, without further interventions. We hypothesize that it is possible to define the distribution of the time period after treatment within which resistance to the administered drug, and possibly other drugs in case of coselection, in fecal bacteria of the treated animals returns to the background pre-treatment levels. Furthermore, it is possible that a novel resistance mitigation strategy for microbiological food safety could be developed based on this resistance reversion phenomenon. The strategy would be conceptually similar to existing antimicrobial drug withdrawal periods, which is a well-established and accepted mitigation strategy for avoiding violative drug residues in the edible products from the treated animals. For developing resistance-relevant withdrawals, a mathematical framework can be used to join the necessary pharmacological, microbiological, and animal production components to project the distributions of the post-treatment resistance reversion periods in the production animal populations for major antimicrobial drug classes in use. The framework can also help guide design of empirical studies into the resistance-relevant withdrawal periods and development of mitigation approaches to reduce the treatment-associated elevation of resistance in animal enteric bacteria. We outline this framework, schematically and through exemplar equations, and how its components could be formulated.

  5. High-VOC biochar-effectiveness of post-treatment measures and potential health risks related to handling and storage.

    Science.gov (United States)

    Buss, Wolfram; Mašek, Ondřej

    2016-10-01

    Biochar can contain volatile organic compounds (VOCs), formed and introduced during the pyrolysis process. In some pyrolysis units or under specific conditions during production, pyrolysis vapours can deposit on biochar in significant amounts resulting in high-VOC biochar. In this study, it was tested to which extent VOCs are released from such high-VOC biochars when openly stored, which post-treatment measures are most effective in reducing phytotoxic potential and whether the VOC emissions could exceed human health-related threshold values. It was shown that the initial VOC release of high-VOC biochars can exceed occupational exposure limit values and even after 2 months, the biochars still emitted VOCs exceeding air quality guideline values. Consequently, these specific high-VOC biochars pose health risks when handled or stored openly. Simple open-air storage turned out to be insufficient for VOC removal. Low temperature treatment, on the other hand, removed VOCs from the high-VOC biochars effectively and alleviated any human health risks and phytotoxic effects. In addition to the high-VOC biochars, a low-VOC biochar was tested which did not emit any VOCs and was even able to sorb VOCs from the VOC-rich biochar to a certain extent. Thermal treatment and blending with low-VOC biochar are methods which could be used in practise to treat high-VOC biochar, reducing VOC emissions. This study revealed significant new findings on the topic of VOCs in biochar which highlights the need to include VOCs in the list of priority contaminants in biochar.

  6. Decorin binding proteins of Borrelia burgdorferi promote arthritis development and joint specific post-treatment DNA persistence in mice.

    Directory of Open Access Journals (Sweden)

    Jemiina Salo

    Full Text Available Decorin binding proteins A and B (DbpA and B of Borrelia burgdorferi are of critical importance for the virulence of the spirochete. The objective of the present study was to further clarify the contribution of DbpA and B to development of arthritis and persistence of B. burgdorferi after antibiotic treatment in a murine model of Lyme borreliosis. With that goal, mice were infected with B. burgdorferi strains expressing either DbpA or DbpB, or both DbpA and B, or with a strain lacking the adhesins. Arthritis development was monitored up to 15 weeks after infection, and bacterial persistence was studied after ceftriaxone and immunosuppressive treatments. Mice infected with the B. burgdorferi strain expressing both DbpA and B developed an early and prominent joint swelling. In contrast, while strains that expressed DbpA or B alone, or the strain that was DbpA and B deficient, were able to colonize mouse joints, they caused only negligible joint manifestations. Ceftriaxone treatment at two or six weeks of infection totally abolished joint swelling, and all ceftriaxone treated mice were B. burgdorferi culture negative. Antibiotic treated mice, which were immunosuppressed by anti-TNF-alpha, remained culture negative. Importantly, among ceftriaxone treated mice, B. burgdorferi DNA was detected by PCR uniformly in joint samples of mice infected with DbpA and B expressing bacteria, while this was not observed in mice infected with the DbpA and B deficient strain. In conclusion, these results show that both DbpA and B adhesins are crucial for early and prominent arthritis development in mice. Also, post-treatment borrelial DNA persistence appears to be dependent on the expression of DbpA and B on B. burgdorferi surface. Results of the immunosuppression studies suggest that the persisting material in the joints of antibiotic treated mice is DNA or DNA containing remnants rather than live bacteria.

  7. Decorin binding proteins of Borrelia burgdorferi promote arthritis development and joint specific post-treatment DNA persistence in mice.

    Science.gov (United States)

    Salo, Jemiina; Jaatinen, Annukka; Söderström, Mirva; Viljanen, Matti K; Hytönen, Jukka

    2015-01-01

    Decorin binding proteins A and B (DbpA and B) of Borrelia burgdorferi are of critical importance for the virulence of the spirochete. The objective of the present study was to further clarify the contribution of DbpA and B to development of arthritis and persistence of B. burgdorferi after antibiotic treatment in a murine model of Lyme borreliosis. With that goal, mice were infected with B. burgdorferi strains expressing either DbpA or DbpB, or both DbpA and B, or with a strain lacking the adhesins. Arthritis development was monitored up to 15 weeks after infection, and bacterial persistence was studied after ceftriaxone and immunosuppressive treatments. Mice infected with the B. burgdorferi strain expressing both DbpA and B developed an early and prominent joint swelling. In contrast, while strains that expressed DbpA or B alone, or the strain that was DbpA and B deficient, were able to colonize mouse joints, they caused only negligible joint manifestations. Ceftriaxone treatment at two or six weeks of infection totally abolished joint swelling, and all ceftriaxone treated mice were B. burgdorferi culture negative. Antibiotic treated mice, which were immunosuppressed by anti-TNF-alpha, remained culture negative. Importantly, among ceftriaxone treated mice, B. burgdorferi DNA was detected by PCR uniformly in joint samples of mice infected with DbpA and B expressing bacteria, while this was not observed in mice infected with the DbpA and B deficient strain. In conclusion, these results show that both DbpA and B adhesins are crucial for early and prominent arthritis development in mice. Also, post-treatment borrelial DNA persistence appears to be dependent on the expression of DbpA and B on B. burgdorferi surface. Results of the immunosuppression studies suggest that the persisting material in the joints of antibiotic treated mice is DNA or DNA containing remnants rather than live bacteria.

  8. Work Function and Conductivity of Inkjet-Printed Silver Layers: Effect of Inks and Post-treatments

    Science.gov (United States)

    Mitra, Dana; Mitra, Kalyan Yoti; Dzhagan, Volodymyr; Pillai, Nikhil; Zahn, Dietrich R. T.; Baumann, Reinhard R.

    2017-12-01

    The electronic properties of a printed layer are influenced by a number of factors, including the nature of the ink (nanoparticle- or solution-based), ink composition (solvents, additives, concentration), and post-treatment technologies, especially sintering. One of the major challenges in the field of printed electronics is achieving the desired performance, for example, in terms of conductivity, resistivity, or work function (WF). This work investigates the dependence of sheet resistance and WF on various sintering methodologies. Four different silver nanoparticle inks were inkjet-printed on a flexible polymeric foil and post-treated by thermal sintering (in an oven) or novel sintering processes using infrared or intense pulsed light. The surfaces of the printed and sintered layers were investigated optically, and various inhomogeneities in the layer surface were observed, varying from a smooth to a highly rough appearance with ring-shaped drying structures. An analysis of the sheet resistance revealed notable variation among the various inks and sintering methodologies used. Here, for the very first time, WF is measured and evaluated as a function of sintering methodology and silver ink, and the respective layer formation characteristics realized with the inkjet printing technology. The WF values obtained by ultraviolet photoemission show a similar spread and allow unambiguous trends to be tracked with respect to the type of ink and sintering method used. The values of the WF obtained range from 3.7 eV to 4.3 eV, approaching the reported bulk values of 4.3-4.7 eV. The various silver inks resulted in different WFs when the same sintering method was used, while the same silver ink resulted in different WFs when various sintering methods were applied. Therefore, it is believed that the WF can be tuned over a broad range in a controlled manner to satisfy electronic device requirements.

  9. Alteration in Haematological and Liver Function Indices during Human Infection with Fasciola spp. Post Treatment with Triclabendazole

    Directory of Open Access Journals (Sweden)

    M.I. Edalatzadeh

    2006-07-01

    Full Text Available Introduction & Objective: Fascioliasis is a zoonotic parasitic disease, caused by the liver fluke, Fasciola spp.. Human is occasional host when ingesting the metacercaria by eating contaminated aquatic vegetable. In the two past decades, human fasciolasis was emerging as a problem of public health in the Guilan province; in Anzali city. Triclabendazole is a novel anti-helmenthic that during recent years has been used for fascioliasis treatment in this region. The aim of the present work is to study alteration in haematological and liver function indices during human infection with Fasciola spp. pre and post treatment with triclabendazoleMaterials & Methods: The present work is a longitudinal clinical trail. In this regard, fifty confirmed fasciolasis patients, were chosen for parasitological, hematological and biochemical examinations pre-therapy as well as 1 and 6 months post-therapy. Formalin-ether and modified Telemann methods were used for stool examination. For Fasciola antibody detection ELISA technique was employed. Hematological and biochemical tests were performed by standard methods. Results: Results indicated that, triclabendazole efficacy was 74% after usage as one dose of 20mg/kg and reached to 88% after repeating in the next month. Before triclabebdazole therapy the Hb and HCT of the patients were slightly found lower than normal ranges, meanwhile the ESR and eosinophil percentages were higher. However following receiving the drug, in the cured individuals, the indices returned to the normal ranges but in the non-cured individuals were not shifted to the normal. On the other hand liver function indices of the patients mostly were at normal ranges before and following drug therapy.Conclusion: In conclusion haematological indices could be valuable indicator for successful therapy of patients treated with triclabendazole.

  10. Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

    Science.gov (United States)

    Weitzner, Erica; McKenna, Donna; Nowakowski, John; Scavarda, Carol; Dornbush, Rhea; Bittker, Susan; Cooper, Denise; Nadelman, Robert B; Visintainer, Paul; Schwartz, Ira; Wormser, Gary P

    2015-12-15

    Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years. Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS. One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi. PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Molecular remodeling of left and right ventricular myocardium in chronic anthracycline cardiotoxicity and post-treatment follow up.

    Directory of Open Access Journals (Sweden)

    Olga Lenčová-Popelová

    Full Text Available Chronic anthracycline cardiotoxicity is a serious clinical issue with well characterized functional and histopathological hallmarks. However, molecular determinants of the toxic damage and associated myocardial remodeling remain to be established. Furthermore, details on the different propensity of the left and right ventricle (LV and RV, respectively to the cardiotoxicity development are unknown. Hence, the aim of the investigation was to study molecular changes associated with remodeling of the LV and RV in chronic anthracycline cardiotoxicity and post-treatment follow up. The cardiotoxicity was induced in rabbits with daunorubicin (3 mg/kg/week for 10 weeks and animals were sacrificed either at the end of the treatment or after an additional 10 weeks. Daunorubicin induced severe and irreversible cardiotoxicity associated with LV dysfunction and typical morphological alterations, whereas the myocardium of the RV showed only mild changes. Both ventricles also showed different expression of ANP after daunorubicin treatment. Daunorubicin impaired the expression of several sarcomeric proteins in the LV, which was not the case of the RV. In particular, a significant drop was found in titin and thick filament proteins at both mRNA and protein level and this might be connected with persistent LV down-regulation of GATA-4. In addition, the LV was more affected by treatment-induced perturbations in calcium handling proteins. LV cardiomyocytes showed marked up-regulation of desmin after the treatment and vimentin was mainly induced in LV fibroblasts, whereas only weaker changes were observed in the RV. Remodeling of extracellular matrix was almost exclusively found in the LV with particular induction of collagen I and IV. Hence, the present study describes profound molecular remodeling of myocytes, non-myocyte cells and extracellular matrix in response to chronic anthracycline treatment with marked asymmetry between LV and RV.

  12. The death of patients with terminal cancer: the distress experienced by their children and medical professionals who provide the children with support care.

    Science.gov (United States)

    Otani, Hiroyuki; Ozawa, Miwa; Morita, Tatsuya; Kawami, Ayako; Sharma, Sahana; Shiraishi, Keiko; Oshima, Akira

    2016-02-04

    Few studies have been conducted on the experiences of children of terminally ill patients or hospital-based medical professionals supporting such children. This study explored distress among individuals whose parents died of cancer in childhood and among hospital-based medical professionals supporting such children. A qualitative study. The sample was 12 adults whose parents had died of cancer in childhood and 20 hospital-based medical professionals supporting children of patients' with terminal cancer. In-depth interviews were conducted, focusing on the distress experienced by the participants. The data were analysed thematically. Among adults whose parents died of cancer in childhood, we identified themes related to the period before death (eg, concealing the parent's illness), the time of death (eg, alienation due to isolation from the parent), soon after death (eg, fear and shock evoked by the bizarre circumstances, regrets regarding the relationship with the deceased parent before death), several years thereafter (ie, distinctive reflection during adolescence, prompted by the parent's absence) and the present time (ie, unresolved feelings regarding losing the parent). We identified seven themes among the medical professionals (eg, lack of knowledge/experience with children, the family's attempts to shield the child from the reality of death, estrangement from the family once they leave the hospital). An important finding of the study is that the participants' grief reaction to their parents' deaths during childhood was prolonged. Moreover, hospital medical professionals may find it difficult to directly support affected children. Comprehensive support involving organisations (eg, local communities) may be necessary for children who have lost a parent. 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/

  13. How can information systems provide support to nurses’ hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections

    National Research Council Canada - National Science Library

    Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; da Silva, Miguel Mira; Lapão, Luís Velez

    2017-01-01

    .... To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time...

  14. A Retrospective Pre-Post Treatment Study of Occupational Therapy Intervention for Children with Sensory Processing Challenges

    Directory of Open Access Journals (Sweden)

    Sarah A. Schoen

    2018-01-01

    Full Text Available Background: This study investigated the impact of an intensive, short-term program that incorporates the principles of sensory integration and relationship-based therapies with extensive parent collaboration. The goals were to identify measures sensitive to change and explore the relation between sensory modulation characteristics and change in behavior after intervention. Method: A retrospective chart review examined routine clinical data pre-post intervention from 179 children identified with sensory processing challenges without comorbid autism. Change in measures of adaptive behavior, emotional functioning, sensory-related behaviors, and motor functioning were evaluated. Relations between sensory modulation and behavior were explored. Results: Improvements were noted from pretreatment to postreatment on all measures of adaptive behavior, problem behaviors, sensory-related functions, and measures of motor function. Sensory craving symptoms were associated with a significant reduction in externalizing and behavior problems after intervention. Conclusion: This study provides preliminary support for the effectiveness of a novel treatment approach.

  15. THE CHANGES OF PHYSICAL AND PSYCHOLOGICAL SEXUAL COMPLAINS IN WOMEN WITH POST TREATMENT CERVICAL CANCER AFTER SEXUAL NURSING INTERVENTION

    Directory of Open Access Journals (Sweden)

    Afiyanti Afiyanti

    2017-04-01

    Full Text Available Introduction: Despite increasing awareness related to sexual health for cervical cancer survivors, health care providers are passive in addressing their sexual issues. The objectives were to develop and investigate the effect of a sexual nursing intervention packet to mitigate sexual dysfunction among cervical cancer survivors. Method: A sample of 104 survivors were participated consecutively based on required inclusive criteria in this quasi-experimental study. The sexual nursing intervention packet focused on the physical, psychological, and care of relational aspects of sexual health elements. The packet consisted of 6 weekly 2-hour sessions. Results: The participants reported poor sexual satisfaction and sexual function. There were no statistically signi fi cant differences in sexual interest, sexual arousal, orgasm, and vaginal lubrication improvement following the intervention, although all the variables in the intervention group were improved clinically. The sexual nursing intervention packet was effective in increasing sexual satisfaction and decreasing dispareunia among cervical cancer survivors. Discussion: This study suggests that the quality of life in cervical cancer survivors could be improved with the sexual nursing intervention packet provided as part of supportive group care. This program may be more effective if delivered earlier and for a longer period. Implications for Practice: The sexual nursing intervention packet offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for cervical cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction following cancer treatment.

  16. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Tejpal [Tata Memorial Centre, Department of Radiation Oncology, Kharghar, Navi Mumbai (India); Tata Memorial Centre, Epidemiology Clinical Trials Unit-Clinical Research Secretariat, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Kharghar, Navi Mumbai (India); Master, Zubin; Murthy, Vedang [Tata Memorial Centre, Department of Radiation Oncology, Kharghar, Navi Mumbai (India); Kannan, Sadhana [Tata Memorial Centre, Epidemiology Clinical Trials Unit-Clinical Research Secretariat, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Kharghar, Navi Mumbai (India); Agarwal, Jai Prakash; Ghsoh-Laskar, Sarbani; Budrukkar, Ashwini [Tata Memorial Hospital, Department of Radiation Oncology, Mumbai (India); Rangarajan, Venkatesh [Tata Memorial Hospital, Bio-Imaging Unit, Mumbai (India)

    2011-11-15

    Our objective was to conduct a systematic review and meta-analysis of studies assessing the diagnostic performance of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) with or without computed tomography (CT) in post-treatment response assessment and/or surveillance imaging of head and neck squamous cell carcinoma (HNSCC). A systematic search of the indexed medical literature was done using appropriate keywords to identify relevant studies. Metrics of diagnostic test accuracy, viz. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were extracted from individual studies and combined using a random effects model to yield weighted mean pooled estimates with 95% confidence intervals (95% CI). The impact of timing of post-treatment scan, study quality and advancements in PET technology was explored through meta-regression. A total of 51 studies involving 2,335 patients were included in the meta-analysis. The weighted mean (95% CI) pooled sensitivity, specificity, PPV and NPV of post-treatment FDG PET(CT) for the primary site was 79.9% (73.7-85.2%), 87.5% (85.2-89.5%), 58.6% (52.6-64.5%) and 95.1% (93.5-96.5%), respectively. Similar estimates for the neck were 72.7% (66.6-78.2%), 87.6% (85.7-89.3%), 52.1% (46.6-57.6%) and 94.5% (93.1-95.7%), respectively. Scans done {>=}12 weeks after completion of definitive therapy had moderately higher diagnostic accuracy on meta-regression analysis using time as a covariate. The overall diagnostic performance of post-treatment FDG PET(CT) for response assessment and surveillance imaging of HNSCC is good, but its PPV is somewhat suboptimal. Its NPV remains exceptionally high and a negative post-treatment scan is highly suggestive of absence of viable disease that can guide therapeutic decision-making. Timing of post-treatment imaging has a significant, though moderate impact on diagnostic accuracy. (orig.)

  17. Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

    OpenAIRE

    Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

    2011-01-01

    Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for en...

  18. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  19. Conceptualizing RTI in 21st-Century Secondary Science Classrooms: Video Games' Potential to Provide Tiered Support and Progress Monitoring for Students with Learning Disabilities

    Science.gov (United States)

    Marino, Matthew T.; Beecher, Constance C.

    2010-01-01

    Secondary schools across the United States are adopting response to intervention (RTI) as a means to identify students with learning disabilities (LD) and provide tiered instructional interventions that benefit all students. The majority of current RTI research focuses on students with reading difficulties in elementary school classrooms.…

  20. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  1. Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

    Science.gov (United States)

    Liao, C C; Yeh, C J; Lee, S H; Liao, W C; Liao, M Y; Lee, M C

    2015-04-01

    To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the

  2. Improving the quality of paediatric malaria diagnosis and treatment by rural providers in Myanmar: an evaluation of a training and support intervention.

    Science.gov (United States)

    Aung, Tin; Longfield, Kim; Aye, Nyo Me; San, Aung Kyaw; Sutton, Thea S; Montagu, Dominic

    2015-10-09

    This study evaluates the effectiveness of a training programme for improving the diagnostic and treatment quality of the most complex service offered by Sun Primary Health (SPH) providers, paediatric malaria. The study further assesses whether any quality improvements were sustained over the following 12 months. The study took place in 13 townships in central Myanmar between January 2011 and October 2012. A total of 251 community health workers were recruited and trained in the provision of paediatric and adult malaria diagnosis and treatment; 197 were surveyed in all three rounds: baseline, 6 and 12 months. Townships were selected based on a lack of alterative sources of medical care, averaging 20 km from government or private professional health care treatment facilities. Seventy percent of recruits were assistant nurse midwives or had other basic health training; the rest had no health training experience. Recruits were evaluated on their ability to properly diagnosis and treat a simulated 5-year-old patient using a previously validated method known as Observed Simulated Patient. A trained observer scored SPH providers on a scale of 1-100, based on WHO and Myanmar MOH established best practices. During a pilot test, 20 established private physicians operating in malaria-endemic areas of Myanmar scored an average of 70/100. Average quality scores of newly recruited SPH providers prior to training (baseline) were 12/100. Six months after training, average quality scores were 48/100. This increase was statistically significant (p training, providers were retested and average quality scores were 45/100 (R3-R1, p training programme was able to improve the quality of paediatric malaria care significantly, and to maintain that improvement over time. Quality of care remains lower than that of trained physicians; however, SPH providers operate in rural areas where no trained physicians operate. More research is needed to establish acceptable and achievable levels of

  3. Three-Ply Al/Mg/Al Clad Sheets Fabricated by Twin-Roll Casting and Post-treatments (Homogenization, Warm Rolling, and Annealing)

    Science.gov (United States)

    Park, Jaeyeong; Song, Hyejin; Kim, Jung-Su; Sohn, Seok Su; Lee, Sunghak

    2017-01-01

    When thin Al alloy sheets are clad on to twin-roll-cast Mg alloy melt, inherent drawbacks of Mg alloys such as poor formability, corrosion resistance, and surface quality can be effectively complemented. In this study, three-ply Al/Mg/Al clad sheets were fabricated by twin-roll casting and post-treatments. Brittle interfacial layers composed of γ (Mg17Al12) and β (Mg2Al3) phases were inevitably formed, but their proper thickening during the post-treatments led to improvement of interfacial bonding and resultant tensile properties. In particular, warm rolling was an effective way to modify interfacial microstructures and tensile properties by minimizing deformation inhomogeneity and stress concentration.

  4. Social Pedagogy as a Model to Provide Support for Siblings of Children with Intellectual Disabilities: A Report of the Views of the Children and Young People Using a Sibling Support Group

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-01-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report…

  5. Hypofractionated passively scattered proton radiotherapy for low- and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression

    Energy Technology Data Exchange (ETDEWEB)

    Kil, Whoon Jong; Nichols, Romaine C. Jr. [Dept. of Radiation Oncology, Univ. of Florida, Gainesville (United States); Univ. of Florida Proton Therapy Inst., Jacksonville (United States)], e-mail: rnichols@floridaproton.org; And others

    2013-04-15

    Background: To investigate post-treatment changes in serum testosterone in low- and intermediate-risk prostate cancer patients treated with hypofractionated passively scattered proton radiotherapy. Material and methods: Between April 2008 and October 2011, 228 patients with low- and intermediate-risk prostate cancer were enrolled into an institutional review board-approved prospective protocol. Patients received doses ranging from 70 Cobalt Gray Equivalent (CGE) to 72.5 CGE at 2.5 CGE per fraction using passively scattered protons. Three patients were excluded for receiving androgen deprivation therapy (n = 2) or testosterone supplementation (n = 1) before radiation. Of the remaining 226 patients, pretreatment serum testosterone levels were available for 217. Of these patients, post-treatment serum testosterone levels were available for 207 in the final week of treatment, 165 at the six-month follow-up, and 116 at the 12-month follow-up. The post-treatment testosterone levels were compared with the pretreatment levels using Wilcoxon's signed-rank test for matched pairs. Results: The median pretreatment serum testosterone level was 367.7 ng/dl (12.8 nmol/l). The median changes in post-treatment testosterone value were as follows: +3.0 ng/dl (+0.1 nmol/l) at treatment completion; +6.0 ng/dl (+0.2 nmol/l) at six months after treatment; and +5.0 ng/dl (0.2 nmol/l) at 12 months after treatment. None of these changes were statistically significant. Conclusion: Patients with low- and intermediate-risk prostate cancer treated with hypofractionated passively scattered proton radiotherapy do not experience testosterone suppression. Our findings are consistent with physical measurements demonstrating that proton radiotherapy is associated with less scatter radiation exposure to tissues beyond the beam paths compared with intensity-modulated photon radiotherapy.

  6. Evaluation of microsurgery with SuperEBA as root-end filling material for treating post-treatment endodontic disease: a 2-year retrospective study.

    Science.gov (United States)

    Li, Hong; Zhai, Fei; Zhang, Ru; Hou, Benxiang

    2014-03-01

    This retrospective study assessed the effects of microsurgical treatment of post-treatment endodontic disease using SuperEBA (Bosworth, Skokie, IL) as the root-end filling material and evaluated the potential prognostic factors in relation to outcome. Data were collected from patients diagnosed with post-treatment endodontic disease who then underwent endodontic microsurgery between April 2007 and October 2010. The effect was evaluated 2 years after the operation. Surgical procedures were performed by a single endodontic specialist. After surgery, operation records were recorded including preoperative, intraoperative, and postoperative factors from the clinical and radiographic measures. For statistical analysis of the predisposing factors, the dependent variable was the dichotomous outcome (ie, success vs failure). Eighty-two patients with 101 treated teeth met the inclusion criteria. The recall rate was 87.2%. Of these microsurgically treated cases, the overall healing rate was 93.1%. At the 0.05 significance level, age, sex, tooth position, size of periapical radiolucency, biopsy result of periapical lesion, and presence of a sinus tract appeared to have no significant effects on the outcome (P > .05). Microsurgical endodontic treatment using SuperEBA as the root-end filling material is a favorable option for post-treatment endodontic disease. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. Prediction of post-treatment hypothyroidism using changes in thyroid volume after radioactive iodine therapy in adolescent patients with Graves' disease

    Directory of Open Access Journals (Sweden)

    Fukata Shuji

    2011-11-01

    Full Text Available Abstract Background The goal of iodine-131 therapy for pediatric Graves' disease is to induce hypothyroidism. However, changes in post-treatment thyroid volume have not been investigated in pediatric and/or adolescent patients. Objective The aim of this retrospective study was to examine whether changes in thyroid volume predict post-treatment hypothyroidism in adolescent Graves' disease patients. Patients and Methods We used ultrasonography to examine changes in thyroid volume, and also assessed thyroid functions, at 0, 1, 3, 5, 8 and 12 months after iodine-131 treatment in 49 adolescents ranging in age from 12 to 19 years retrospectively. Based on thyroid function outcome at 12 months, patients were divided into two groups: 29 patients with overt hypothyroidism requiring levothyroxine replacement and 20 without overt hypothyroidism. We compared changes in post-radioiodine thyroid volume between the two groups. Results About 90% of patients whose thyroid volume at 3 months after iodine-131 administration was less than 50% of the original volume were hypothyroid by one year after treatment (positive predictive value 88%, sensitivity 75.9%, specificity 85.0%. Conclusions We believe ultrasonographic measurement of thyroid volume at 3 months after iodine-131 to be clinically useful for predicting post-treatment hypothyroidism in adolescent Graves' disease patients.

  8. Temperature-Sensitive Cav1.2 Calcium Channels Support Intrinsic Firing of Pyramidal Neurons and Provide a Target for the Treatment of Febrile Seizures

    Science.gov (United States)

    Radzicki, Daniel; Yau, Hau-Jie; Pollema-Mays, Sarah L.; Mlsna, Lauren; Cho, Kangho; Koh, Sookyong

    2013-01-01

    Febrile seizures are associated with increased brain temperature and are often resistant to treatments with antiepileptic drugs, such as carbamazepine and phenytoin, which are sodium channel blockers. Although they are clearly correlated with the hyperthermic condition, the precise cellular mechanisms of febrile seizures remain unclear. We performed patch-clamp recordings from pyramidal cells in acute rat brain slices at temperatures up to 40°C and found that, at ≥37°C, L-type calcium channels are active at unexpectedly hyperpolarized potentials and drive intrinsic firing, which is also supported by a temperature-dependent, gadolinium-sensitive sodium conductance. Pharmacological data, RT-PCR, and the current persistence in Cav1.3 knock-out mice suggested a critical contribution of Cav1.2 subunits to the temperature-dependent intrinsic firing, which was blocked by nimodipine. Because intrinsic firing may play a critical role in febrile seizures, we tested the effect of nimodipine in an in vivo model of febrile seizures and found that this drug dramatically reduces both the incidence and duration of febrile seizures in rat pups, suggesting new possibilities of intervention for this important pathological condition. PMID:23761887

  9. Polyandrous females provide sons with more competitive sperm: Support for the sexy-sperm hypothesis in the rattlebox moth (Utetheisa ornatrix).

    Science.gov (United States)

    Egan, Andrea L; Hook, Kristin A; Reeve, H Kern; Iyengar, Vikram K

    2016-01-01

    Given the costs of multiple mating, why has female polyandry evolved? Utetheisa ornatrix moths are well suited for studying multiple mating in females because females are highly polyandrous over their life span, with each male mate transferring a substantial spermatophore with both genetic and nongenetic material. The accumulation of resources might explain the prevalence of polyandry in this species, but another, not mutually exclusive, possibility is that females mate multiply to increase the probability that their sons will inherit more-competitive sperm. This latter "sexy-sperm" hypothesis posits that female multiple mating and male sperm competitiveness coevolve via a Fisherian runaway process. We tested the sexy-sperm hypothesis by using competitive double matings to compare the sperm competition success of sons of polyandrous versus monandrous females. In accordance with sexy-sperm theory, we found that in 511 offspring across 17 families, the male whose polyandrous mother mated once with each of three different males sired significantly more of all total offspring (81%) than did the male whose monandrous mother was mated thrice to a single male. Interestingly, sons of polyandrous mothers had a significantly biased sex ratio of their brood toward sons, also in support of the hypothesis. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  10. Joint interpretation of seismic tomography and new magnetotelluric results provide evidence for support of high topography in the Southern Rocky Mountains and High Plains of eastern Colorado, USA

    Science.gov (United States)

    Feucht, D. W.; Sheehan, A. F.; Bedrosian, P.

    2015-12-01

    A recent magnetotelluric (MT) survey in central Colorado, USA, when interpreted alongside existing seismic tomography, reveals potential mechanisms of support for high topography both regionally and locally. Broadband and long period magnetotelluric data were collected at twenty-three sites along a 330 km E-W profile across the Southern Rocky Mountains and High Plains of central North America as part of the Deep RIFT Electrical Resistivity (DRIFTER) experiment. Remote-reference data processing yielded high quality MT data over a period range of 100 Hz to 10,000 seconds. A prominent feature of the regional geo-electric structure is the Denver Basin, which contains a thick package of highly conductive shales and porous sandstone aquifers. One-dimensional forward modeling was performed on stations within the Denver Basin to estimate depth to the base of this shallow conductor. Those estimates were then used to place a horizontal penalty cut in the model mesh of a regularized two-dimensional inversion. Two-dimensional modeling of the resistivity structure reveals two major anomalous regions in the lithosphere: 1) a high conductivity region in the crust under the tallest peaks of the Rocky Mountains and 2) a lateral step increase in lithospheric resistivity beneath the plains. The Rocky Mountain crustal anomaly coincides with low seismic wave speeds and enhanced heat flow and is thus interpreted as evidence of partial melt and/or high temperature fluids emplaced in the crust by tectonic activity along the Rio Grande Rift. The lateral variation in the mantle lithosphere, while co-located with a pronounced step increase in seismic velocity, appears to be a gradational boundary in resistivity across eastern Colorado and could indicate a small degree of compositional modification at the edge of the North American craton. These inferred conductivity mechanisms, namely crustal melt and modification of mantle lithosphere, likely contribute to high topography locally in the

  11. Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam.

    Science.gov (United States)

    Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah Oa; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

    2017-06-27

    A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of

  12. Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial.

    Science.gov (United States)

    Rangelov, Natalie; Della Bella, Sara; Marques-Vidal, Pedro; Suggs, L Suzanne

    2018-02-16

    The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children's food intake differed by intervention group. Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children's food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention. Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17). A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children's consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference. The trial was retrospectively registered in the

  13. Genome-wide and Ordered-Subset linkage analyses provide support for autism loci on 17q and 19p with evidence of phenotypic and interlocus genetic correlates

    Directory of Open Access Journals (Sweden)

    Folstein Susan E

    2005-01-01

    these milestones and it revealed significantly increased LOD* scores at 19p13. Conclusions Our results further support 19p13 as harboring an autism susceptibility locus, confirm other linkage findings at 17q11.2, and demonstrate the need to analyze more discreet trait-based subsets of complex phenotypes to improve ability to detect genetic effects.

  14. Valorization of lignin and cellulose in acid-steam-exploded corn stover by a moderate alkaline ethanol post-treatment based on an integrated biorefinery concept.

    Science.gov (United States)

    Yang, Sheng; Zhang, Yue; Yue, Wen; Wang, Wei; Wang, Yun-Yan; Yuan, Tong-Qi; Sun, Run-Cang

    2016-01-01

    Due to the unsustainable consumption of fossil resources, great efforts have been made to convert lignocellulose into bioethanol and commodity organic compounds through biological methods. The conversion of cellulose is impeded by the compactness of plant cell wall matrix and crystalline structure of the native cellulose. Therefore, appropriate pretreatment and even post-treatment are indispensable to overcome this problem. Additionally, an adequate utilization of coproduct lignin will be important for improving the economic viability of modern biorefinery industries. The effectiveness of moderate alkaline ethanol post-treatment on the bioconversion efficiency of cellulose in the acid-steam-exploded corn stover was investigated in this study. Results showed that an increase of the alcoholic sodium hydroxide (NaOH) concentration from 0.05 to 4% led to a decrease in the lignin content in the post-treated samples from 32.8 to 10.7%, while the cellulose digestibility consequently increased. The cellulose conversion of the 4% alcoholic NaOH integrally treated corn stover reached up to 99.3% after 72 h, which was significantly higher than that of the acid steam exploded corn stover without post-treatment (57.3%). In addition to the decrease in lignin content, an expansion of cellulose I lattice induced by the 4% alcoholic NaOH post-treatment played a significant role in promoting the enzymatic hydrolysis of corn stover. More importantly, the lignin fraction (AL) released during the 4% alcoholic NaOH post-treatment and the lignin-rich residue (EHR) remained after the enzymatic hydrolysis of the 4% alcoholic NaOH post-treated acid-steam-exploded corn stover were employed to synthesize lignin-phenol-formaldehyde (LPF) resins. The plywoods prepared with the resins exhibit satisfactory performances. An alkaline ethanol system with an appropriate NaOH concentration could improve the removal of lignin and modification of the crystalline structure of cellulose in acid

  15. Cost-effectiveness analysis of universal noninvasive testing for post-treatment confirmation of Helicobacter pylori eradication and the impact of patient adherence

    Directory of Open Access Journals (Sweden)

    Boklage SH

    2016-06-01

    Full Text Available Susan H Boklage,1 Allen W Mangel,2 Varun Ramamohan,2 Deirdre Mladsi,2 Tao Wang1 1Otsuka America Pharmaceutical, Inc, Princeton, NJ, 2RTI Health Solutions, Research Triangle Park, NC, USA Background: The treatment failure rate for Helicobacter pylori eradication therapy is ~20% due to poor patient compliance and increased antibiotic resistance. This analysis assessed the cost-effectiveness of universal post-treatment testing to confirm eradication of H. pylori infection in adults.Methods: Decision-analytic models evaluated the cost-effectiveness of universal post-treatment testing (urea breath test [UBT] or monoclonal fecal antigen test [mFAT] vs no testing (Model 1, and UBT vs mFAT after adjusting for patient adherence to testing (Model 2 in adults who previously received first-line antimicrobial therapy. Patients testing positive received second-line quadruple therapy; no further action was taken for those testing negative or with no testing (Model 1 or for those nonadherent to testing (Model 2. In addition to testing costs, excess lifetime costs and reduced quality-adjusted life-years (QALYs due to continuing H. pylori infection were considered in the model.Results: Expected total costs per patient were higher for post-treatment testing (UBT: US$325.76; mFAT: US$242.12 vs no testing (US$182.41 in Model 1 and for UBT (US$336.75 vs mFAT (US$326.24 in Model 2. Expected QALYs gained per patient were 0.71 and 0.72 for UBT and mFAT, respectively, vs no testing (Model 1, and the same was 0.37 for UBT vs mFAT (Model 2. The estimated incremental costs per QALY gained for post-treatment testing vs no testing were US$82.90–US$202.45 and, after adjusting for adherence, US$28.13 for UBT vs mFAT.Conclusion: Universal post-treatment testing was found to be cost-effective for confirming eradication of H. pylori infection following first-line therapy. Better adherence to UBT relative to mFAT was the key to its cost-effectiveness. Keywords: health

  16. Coupling alkaline pre-extraction with alkaline-oxidative post-treatment of corn stover to enhance enzymatic hydrolysis and fermentability

    Science.gov (United States)

    2014-01-01

    Background A two-stage chemical pretreatment of corn stover is investigated comprising an NaOH pre-extraction followed by an alkaline hydrogen peroxide (AHP) post-treatment. We propose that conventional one-stage AHP pretreatment can be improved using alkaline pre-extraction, which requires significantly less H2O2 and NaOH. To better understand the potential of this approach, this study investigates several components of this process including alkaline pre-extraction, alkaline and alkaline-oxidative post-treatment, fermentation, and the composition of alkali extracts. Results Mild NaOH pre-extraction of corn stover uses less than 0.1 g NaOH per g corn stover at 80°C. The resulting substrates were highly digestible by cellulolytic enzymes at relatively low enzyme loadings and had a strong susceptibility to drying-induced hydrolysis yield losses. Alkaline pre-extraction was highly selective for lignin removal over xylan removal; xylan removal was relatively minimal (~20%). During alkaline pre-extraction, up to 0.10 g of alkali was consumed per g of corn stover. AHP post-treatment at low oxidant loading (25 mg H2O2 per g pre-extracted biomass) increased glucose hydrolysis yields by 5%, which approached near-theoretical yields. ELISA screening of alkali pre-extraction liquors and the AHP post-treatment liquors demonstrated that xyloglucan and β-glucans likely remained tightly bound in the biomass whereas the majority of the soluble polymeric xylans were glucurono (arabino) xylans and potentially homoxylans. Pectic polysaccharides were depleted in the AHP post-treatment liquor relative to the alkaline pre-extraction liquor. Because the already-low inhibitor content was further decreased in the alkaline pre-extraction, the hydrolysates generated by this two-stage pretreatment were highly fermentable by Saccharomyces cerevisiae strains that were metabolically engineered and evolved for xylose fermentation. Conclusions This work demonstrates that this two

  17. Mobile phone messages to provide support to women during the home phase of medical abortion in South Africa: a randomised controlled trial.

    Science.gov (United States)

    Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon

    2014-09-01

    Home use of misoprostol for medical abortion is more convenient for many women than in-clinic use but requires management of abortion symptoms at home without provider backup. This study evaluated whether automated text messages to women undergoing medical abortion can reduce anxiety and emotional discomfort, and whether the messages can better prepare women for symptoms they experience. A multisite randomized controlled trial was conducted in which women undergoing early medical abortion were allocated to receive standard of care (SOC) only (n=235) or SOC+a messaging intervention (n=234). Consenting women were interviewed at the clinic after taking mifepristone and again at their follow-up clinic visit 2-3 weeks later; the intervention group received text messages over the duration of this period. Emotional outcomes were evaluated using the Hospital Anxiety and Depression Scale, Adler's 12-item emotional scale and the Impact of Event Scale-Revised. Preparedness for the abortion symptoms and overall satisfaction with the procedure were assessed using 4-point Likert-type scales. Between baseline and follow-up, anxiety decreased more (p=0.013), and less emotional stress was experienced (adjusted for baseline anxiety, p=0.015), in the intervention compared to the SOC group. Participants in the intervention group were also more likely to report that they felt very well prepared for the bleeding (peffects (p=0.027) they experienced. Acceptability and other negative emotions relating to the abortion did not differ between study groups. Ninety-nine percent of the intervention group stated that they would recommend the messages to a friend having the same procedure. Text messages to women following mifepristone administration for early medical abortion may assist them in managing symptoms and appear highly acceptable to recipients. This randomized controlled trial provides evidence for the effectiveness of text messages following mifepristone administration in

  18. Siberian Earth System Science Cluster - A web-based Geoportal to provide user-friendly Earth Observation Products for supporting NEESPI scientists

    Science.gov (United States)

    Eberle, J.; Gerlach, R.; Hese, S.; Schmullius, C.

    2012-04-01

    To provide earth observation products in the area of Siberia, the Siberian Earth System Science Cluster (SIB-ESS-C) was established as a spatial data infrastructure at the University of Jena (Germany), Department for Earth Observation. This spatial data infrastructure implements standards published by the Open Geospatial Consortium (OGC) and the International Organizsation for Standardization (ISO) for data discovery, data access, data processing and data analysis. The objective of SIB-ESS-C is to faciliate environmental research and Earth system science in Siberia. The region for this project covers the entire Asian part of the Russian Federation approximately between 58°E - 170°W and 48°N - 80°N. To provide discovery, access and analysis services a webportal was published for searching and visualisation of available data. This webportal is based on current web technologies like AJAX, Drupal Content Management System as backend software and a user-friendly surface with Drag-n-Drop and further mouse events. To have a wide range of regular updated earth observation products, some products from sensor MODIS at the satellites Aqua and Terra were processed. A direct connection to NASA archive servers makes it possible to download MODIS Level 3 and 4 products and integrate it in the SIB-ESS-C infrastructure. These data can be downloaded in a file format called Hierarchical Data Format (HDF). For visualisation and further analysis, this data is reprojected, converted to GeoTIFF and global products clipped to the project area. All these steps are implemented as an automatic process chain. If new MODIS data is available within the infrastructure this process chain is executed. With the link to a MODIS catalogue system, the system gets new data daily. With the implemented analysis processes, timeseries data can be analysed, for example to plot a trend or different time series against one another. Scientists working in this area and working with MODIS data can make use

  19. Why choose Random Forest to predict rare species distribution with few samples in large undersampled areas? Three Asian crane species models provide supporting evidence

    Directory of Open Access Journals (Sweden)

    Chunrong Mi

    2017-01-01

    Full Text Available Species distribution models (SDMs have become an essential tool in ecology, biogeography, evolution and, more recently, in conservation biology. How to generalize species distributions in large undersampled areas, especially with few samples, is a fundamental issue of SDMs. In order to explore this issue, we used the best available presence records for the Hooded Crane (Grus monacha, n = 33, White-naped Crane (Grus vipio, n = 40, and Black-necked Crane (Grus nigricollis, n = 75 in China as three case studies, employing four powerful and commonly used machine learning algorithms to map the breeding distributions of the three species: TreeNet (Stochastic Gradient Boosting, Boosted Regression Tree Model, Random Forest, CART (Classification and Regression Tree and Maxent (Maximum Entropy Models. In addition, we developed an ensemble forecast by averaging predicted probability of the above four models results. Commonly used model performance metrics (Area under ROC (AUC and true skill statistic (TSS were employed to evaluate model accuracy. The latest satellite tracking data and compiled literature data were used as two independent testing datasets to confront model predictions. We found Random Forest demonstrated the best performance for the most assessment method, provided a better model fit to the testing data, and achieved better species range maps for each crane species in undersampled areas. Random Forest has been generally available for more than 20 years and has been known to perform extremely well in ecological predictions. However, while increasingly on the rise, its potential is still widely underused in conservation, (spatial ecological applications and for inference. Our results show that it informs ecological and biogeographical theories as well as being suitable for conservation applications, specifically when the study area is undersampled. This method helps to save model-selection time and effort, and allows robust and rapid

  20. Direct Visualization of RNA-DNA Primer Removal from Okazaki Fragments Provides Support for Flap Cleavage and Exonucleolytic Pathways in Eukaryotic Cells.

    Science.gov (United States)

    Liu, Bochao; Hu, Jiazhi; Wang, Jingna; Kong, Daochun

    2017-03-24

    During DNA replication in eukaryotic cells, short single-stranded DNA segments known as Okazaki fragments are first synthesized on the lagging strand. The Okazaki fragments originate from ∼35-nucleotide-long RNA-DNA primers. After Okazaki fragment synthesis, these primers must be removed to allow fragment joining into a continuous lagging strand. To date, the models of enzymatic machinery that removes the RNA-DNA primers have come almost exclusively from biochemical reconstitution studies and some genetic interaction assays, and there is little direct evidence to confirm these models. One obstacle to elucidating Okazaki fragment processing has been the lack of methods that can directly examine primer removal in vivo In this study, we developed an electron microscopy assay that can visu