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Sample records for proving peripartum care

  1. Experiences of health care in women with Peripartum Cardiomyopathy in Sweden: a qualitative interview study.

    Science.gov (United States)

    Patel, Harshida; Schaufelberger, Maria; Begley, Cecily; Berg, Marie

    2016-12-08

    Peripartum cardiomyopathy is often associated with severe heart failure occurring towards the end of pregnancy or in the months following birth with debilitating, exhausting and frightening symptoms requiring person-centered care. The aim of this study was to explore women's experiences of health care while being diagnosed with peripartum cardiomyopathy. Qualitative interviews were conducted with 19 women with peripartum cardiomyopathy in Sweden, following consent. Data were analysed using qualitative content analysis. Confirmability was ensured by peer-debriefing, and an audit trail was kept to establish the credibility of the study. The main theme in the experience of health care was, 'Exacerbated Suffering', expressed in three subthemes; 'not being cared about', 'not being cared for' and 'not feeling secure.' The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. Women felt they were on an assembly line in midwives' routine work where knowledge about peripartum cardiomyopathy was lacking and they showed distrust and dissatisfaction with care related to negligence and indifference experienced from healthcare professionals. Feelings of being alone and lost were prominent and related to a sense of insecurity, distress and uneasiness. This study shows a knowledge gap of peripartum cardiomyopathy in maternity care personnel. This is alarming as the deprecation of symptoms and missed diagnosis of peripartum cardiomyopathy can lead to life-threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women's narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms.

  2. [Consultation liaison during the peripartum: Network care between liaison and mobile unit].

    Science.gov (United States)

    Garez, V; Devouche, E; Bobin-Bègue, A; Alecian, M; Minjollet, P; Vallerent, A; Poget, M; Oguibenine, H; Héroux, C; Medjkane, F; Apter, G

    2017-04-26

    The pregnancy periods of peripartum and immediate postpartum represent moments of opportunity to access care. Both prevention and therapeutic management can be offered with a better chance of success during these periods. Our specific Consultation Liaison (CL) team PPUMMA was created in order to respond to the need for early detection of psychopathology and rapid implementation of therapeutic management and preventive measure for mother and child. The importance of urgently intervening "on site" seemed a necessity since duration of hospitalization in maternity wards is very short. Women might not know or understand their symptoms or be ready to ask for a referral for themselves but could be ready to respond positively to a team approach where the psychiatrist is part of the Ob-Gyn department. Working with an interdisciplinary approach tends to lower stress linked to the psychiatric side of the consultation and stigma related to psychological or psychiatric issues; therefore, PPUMMA intervenes within 48 to 72hours of birth. It deals with assessment and diagnosis during the peripartum period and orientation and referral for both mother and infant when necessary after birth. The Perinatal Psychiatry emergency mobile unit PPUMMA was created in order to address these issues. From 2008 to 2015, 1907 patients were assessed but data were missing for 90 patients. We therefore analyzed 1817 patient files looking at age, diagnosis origin of referral, time of referral (pre or postpartum) and delay from referral to assessment. Most patients were between 20 and 40 (81.5 %). One hundred and eighteen patients were under 20 years of age, of whom 64 were minors (3.5 %), and 218 were 40 or more (12 %). These two groups were over-represented close to threefold when comparing with national birth data records. A psychologist had first seen three out of four women. Midwives and Ob-Gyn referred 9 % and 8 % of patients while Social workers sent in 4 %. Two thirds of the

  3. Peripartum Cardiomyopathy

    Science.gov (United States)

    ... short- ness of breath, and palpitations. •  Electrocardiogram (heart tracing) to assess heart rate and rhythm, to look ... Accessed January 22, 2013. The Peripartum Cardiomyopathy Network Web site. http: / / www. peripartumcmnetwork. pitt. edu. Accessed January ...

  4. Peripartum cardiomyopathy

    International Nuclear Information System (INIS)

    Velasquez V, Jorge E; Duque R, Mauricio

    2008-01-01

    Peripartum cardiomyopathy is a clinical entity with a variable frequency according to the zone of the study. It is characterized by a systolic dysfunction of the left ventricle and posterior appearance of heart failure symptoms that occur during the last month of pregnancy and the first post-partum months. Its etiology isn't still clear, but different theories are proposed based on inflammatory, infectious and autoimmune processes. Alterations related to oxidative stress that could largely explain this pathology were recently described. Its clinical presentation has a big similitude with all other causes of heart failure although atypical presentations have been described. Its diagnosis requires a high suspicion level and must be considered in any woman with symptoms of heart failure during the peripartum. The conventional treatment of chronic heart failure that includes beta-blockers, angiotensin converting enzyme inhibitors and diuretics, in addition to the advances in diagnosis and management of acute heart failure, allowed changing the history of the disease by lowering mortality and recovering systolic function of the left ventricle. Gestations posterior to the development of this entity will depend on the complete recovery of heart function without lowering the risk of recurrence. There still remain many questions to answer in areas like etiology, risk factors, treatment and prognosis markers that may allow to prevent and to manage in an appropriate and safe way both the mother and her son.

  5. Emergency peripartum hysterectomy: an experience at a tertiary care hospital of mardan, pakistan

    International Nuclear Information System (INIS)

    Qadir, M.

    2017-01-01

    To study the incidence, demographic characteristics, indications, complications, associated maternal and perinatal outcome in patients with emergency peripartum hysterectomy (EPH). Methodology: This prospective cross sectional study was performed at Department of Gynecology and Obstetrics, Mardan Medical Complex, Mardan from February 2017 to July 2017. All women of any age, parity and booking status, who underwent emergency peripartum hysterectomy within 24 hours of delivery through any mode were included in the study. Results: Incidence of EPH was 0.1%. Most common age group was more than 35 years where 12(57%) women, majority (76%) were multiparous, 17(81%) were non booked and 15(71.4%) were delivered through cesarean section. Indication for EPH was uterine rupture in 10(47.6%), followed by uterine atony and abruption placentae in 4(19%) each and placenta previa in 2(9.5%) cases. Main intraoperative complications were hemorrhage in 13(62%) and shock in 9(42.8%) patients. Postoperative complications were anemia in 15(71.4%), wound sepsis in 8(38%) and paralytic ileus in 7(33%) cases. Maternal mortality was 3(14.3%) and perinatal mortality rate was 52%, including 9(43%) stillbirths and 2(9.5%) early neonatal deaths. Subtotal hysterectomy was performed in 16(76%) and total hysterectomy in 5(24%) cases. Conclusion: The incidence of EPH and associated rates of maternal and perinatal morbidity and mortality were high in our hospital, with most common indication being uterine rupture followed by atonic uterus. Important risk factors were multiparity, age >35 years, non booked status, rural residence and delivery by cesarean section. (author)

  6. Peripartum Cardiomyopathy Presenting as Bradycardia

    OpenAIRE

    Codsi, Elisabeth; Rose, Carl H.; Tweet, Marysia S.; Hayes, Sharonne N.; Best, Patricia J. M.; Blauwet, Lori A.

    2017-01-01

    Peripartum cardiomyopathy (PPCM) is a disease that typically affects young otherwise healthy women. As PPCM is associated with significant mortality, timely diagnosis is necessary to ensure appropriate care. To our knowledge, this represents the first reported case of PPCM presenting as symptomatic bradycardia. We describe the patient’s clinical presentation and relevant findings and review the potential etiology and ramifications of bradycardia in patients with PPCM.

  7. [Neuroradiological pattern of peripartum cerebro vascular disease medicating transfer to determine care unit].

    Science.gov (United States)

    Lakhdar, Rim; Baffoun, Nader; Hammami, Nadia; Nagi, Sonia; Baccar, Kamel; Drissi, Syrine; Kaddour, Chokri

    2012-03-01

    Pregnancy and puerperium are considered a period of a high risk of stroke responsible in a part of the morbidity and mortality in women. Imaging is the pivotal tool to diagnostics and care. To investigate the clinical and imaging features cerebrovascular complications during pregnancy and in post partum period. We report a retrospective analysis of forty four patients (November 2002 - October 2010) admitted in the intensive car department of the national institute of neurology for cerebro-vascular complications during pregnancy and in post partum period. Cerebro-vascular imaging modalities included cerebral computed tomography (CCT) with and without contrast in 94% of cases, magnetic resonance imaging (MRI) in 30.6% of cases completed by venous angiography MRI in 27.2% of cases and angiography MRI of Willis polygon in 11.3% of cases and by cerebral angiography in 13.6% of cases. Posterior reversible encephalopathy syndrome (PRES) is diagnosed in 61.4 % of cases followed by meningo-cerebral haemorrhage (MCH) in 29.5% and finally cerebral venous thrombosis (CVT) and arterial ischemia in 4.5% of cases each one. The cerebro-vascular complications are revelled in 86.3 % of the cases during the postpartum and were associated with the eclampsia or preeclampsia in 90.9 % of the cases (n=40). CCT showed typical lesions of PRES in 23 patients. It confirms the presence of hematoma in the 13 patients with MCH and find hypodense lesion in one case with ischemic stroke. CCT show direct (delta sign) and indirect signs of CVT. MRI confirms the diagnostic of PRES, when done (11 of 12 cases) and show cortical sub cortical hyper signal on T2 and FLAIR and hypo signal on T1 sequences. MRI was normal in one case. It shows hemorrhagic lesion in the 2 cases of MCH, thrombosis in the cases of CVT and ischemic lesion in the cases of ischemic stroke. CCT and MRI done within 48 hours from admission were decisive for early diagnostic and for fast and adequate care. Early recognition of stroke

  8. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

    Jakobsson, Maija; Tapper, Anna Maija; Colmorn, Lotte Berdiin

    2015-01-01

    peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10 000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n = 91, 43.1%), atonic bleeding (n = 69, 32.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  9. Sepsis: Primary indication for peripartum hysterectomies in a South ...

    African Journals Online (AJOL)

    limit the definition to a hysterectomy performed for uncontrolled haemorrhage only[4 ... and peripartum care due to limited resources, a high burden of HIV infection and a ... countries the aetiology is variable, with studies from Turkey, India and. Thailand ..... Improving access to ART is important as all the women who were.

  10. Psychological adaptation after peripartum cardiomyopathy

    DEFF Research Database (Denmark)

    de Wolff, Mie; Ersbøll, Anne Schjødt; Hegaard, Hanne

    2018-01-01

    of regaining psychological balance and wellbeing (i.e. psychological adaptation) after having experienced severe peripartum morbidity. DESIGN: A qualitative exploratory research design was applied to guide the study. Data was collected through in-depth, semi-structured, face-toface telephone and e...

  11. TREATMENT OF PERIPARTUM CARDIOMYOPATHY (REVIEW

    Directory of Open Access Journals (Sweden)

    N. T. Vatutin

    2017-01-01

    Full Text Available The presented review concerns discussion about current insights into treatment of peripartum cardiomyopathy. The definition of peripartum cardiomyopathy and general issues about diagnosis and pathogenesis of the disorder are provided at the head of the review. Particularly, the role of the system «prolactin — cathepsin D — prolactin 16 kDa» in cardiomyopathy development is disclosed. The general approaches to management of the patients are highlighted. The review provides detailed data about indications, adverse effects and derived clinical experience concerning the main pharmacological drugs which had been used in peripartum cardiomyopathy treatment given their possible unfavorable influence on fetus maturation and maternal lactation. The detailed description is provided on diuretics including loop, thiazide and potassium-sparing drugs. It was noted relative safety and efficiency of nitrates and hydralazine in conditions of limited choice from vasodilator group and, particularly, angiotensinconverting-enzyme inhibitors and angiotensin-II receptor blockers which are contraindicated in pregnancy. A special attention is paid to the group of inotropic drugs: levosimendan, milrinone, and cardiac glycosides. The role of β-blockers and ivabradine is disclosed in heart failure treatment of peripartum cardiomyopathy. Anticoagulants were presented in details given that these drugs are justified in severe cardiac chambers dilation, decrease in ejection fraction, and in presence of intracardiac thrombosis. The place of antiarrhythmic drugs administrating in various cardiac rhythm disorders is discussed in the review. The data is given with account of potential influence on fetus in antenatal peripartum cardiomyopathy in which lidocaine and sotalol are the most preferable drugs; adenosine, quinidine, and flecainide are useful with caution, but amiodarone and dronedarone are absolutely contraindicated. Taking into account proposed pathogenic

  12. Peripartum hysterectomy: an evolving picture.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.

  13. A serotonin transporter gene polymorphism predicts peripartum depressive symptoms in an at-risk psychiatric cohort.

    Science.gov (United States)

    Binder, Elisabeth B; Newport, D Jeffrey; Zach, Elizabeth B; Smith, Alicia K; Deveau, Todd C; Altshuler, Lori L; Cohen, Lee S; Stowe, Zachary N; Cubells, Joseph F

    2010-07-01

    Peripartum major depressive disorder (MDD) is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Two hundred and seventy four women with a prior history of MDD were genotyped for 5-HTTLPR and serially evaluated in late pregnancy (gestational weeks 31-40), early post-partum (week 1-8) and late post-partum (week 9-24) for diagnosis of a current major depressive episode (MDE) and depressive symptom severity. 5-HTTLPR S-allele carrier status predicted the occurrence of a MDE in the early post-partum period only (OR=5.13, p=0.017). This association persisted despite continued antidepressant treatment. The 5-HTTLPR genotype may be a clinically relevant predictor of early post-partum depression in an at-risk population. Peripartum major depressive disorder is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Copyright 2009 Elsevier Ltd. All rights reserved.

  14. Rate-difference method proved satisfactory in estimating the influenza burden in primary care visits

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Sanders, Elisabeth A M; Wallinga, Jacco; Groen, Eelke J; van Loon, Anton M; Hoes, Arno W; Hak, Eelko

    OBJECTIVE: To compare different methods to estimate the disease burden of influenza, using influenza and respiratory syncytial virus-(RSV) associated primary care data as an example. STUDY DESIGN AND SETTING: In a retrospective study in the Netherlands over 1997-2003, primary care attended

  15. Anaesthetic challenges in emergency peripartum hysterectomy in ...

    African Journals Online (AJOL)

    ... with 16 emergency peripartum hysterectomies. The incidence of emergency peripartum hysterectomy was 0.23% of all deliveries (2.3/1 000 deliveries). The causes of emergency hysterectomies were ruptured uterus (11 patients or 69%), placenta accreta/morbidly adherent placenta (4 patients or 25%) and uncontrollable ...

  16. Peripartum cardiomyopathy: Euro Observational Research Program

    NARCIS (Netherlands)

    Hoes, M. F.; van Hagen, I.; Russo, F.; van Veldhuisen, D. J.; van den Berg, M. P.; Roos-Hesselink, J.; van Spaendonck-Zwarts, K. Y.; van der Meer, P.

    2014-01-01

    Peripartum cardiomyopathy is a rare but potentially life-threatening form of heart failure affecting women late in pregnancy or in the first months after delivery. Peripartum cardiomyopathy is difficult to diagnose and its onset and progression are variable between individuals. The pathophysiology

  17. Peripartum cardiomyopathy : Euro Observational Research Program

    NARCIS (Netherlands)

    Hoes, M. F.; van Hagen, I.; Russo, F.; Van Veldhuisen, D. J.; Van den Berg, M. P.; Roos-Hesselink, J.; van Spaendonck-Zwarts, K. Y.; van der Meer, P.

    Peripartum cardiomyopathy is a rare but potentially life-threatening form of heart failure affecting women late in pregnancy or in the first months after delivery. Peripartum cardiomyopathy is difficult to diagnose and its onset and progression are variable between individuals. The pathophysiology

  18. Peripartum Cardiomyopathy: Euro Observational Research Program

    NARCIS (Netherlands)

    M.F. Hoes; I.M. van Hagen (Iris); F. Russo; D.J. van Veldhuisen (Dirk); M.P. van den Berg (Maarten); J.W. Roos-Hesselink (Jolien); K.Y. van Spaendonck-Zwarts (Karin); P. van der Meer (Peter)

    2014-01-01

    textabstractPeripartum cardiomyopathy is a rare but potentially life-threatening form of heart failure affecting women late in pregnancy or in the first months after delivery. Peripartum cardiomyopathy is difficult to diagnose and its onset and progression are variable between individuals. The

  19. Peripartum cardiomyopathy: A contemporary review

    Directory of Open Access Journals (Sweden)

    Akshai Bhandary

    2018-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is a rare, potentially life-threatening disorder affecting women in late pregnancy and the postpartum period. Historically, PPCM was not recognized as a separate disease entity until the 1930s. Further research has since led to the identification of at-risk demographics, theories on etiology, and new targets of therapy. Management to date has largely been focused on guideline-based treatment for heart failure with reduced ejection fraction. However, newer studies have shown the efficacy of novel therapies. In this article, we will review the pathogenesis and diagnosis of PPCM and conclude with some of the newest therapies being offered.

  20. Peripartum Cardiomyopathy: A Current Review

    Directory of Open Access Journals (Sweden)

    Katie M. Twomley

    2010-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is a rare but potentially lethal complication of pregnancy occurring in approximately 1 : 3,000 live births in the United States although some series report a much higher incidence. African-American women are particularly at risk. Diagnosis requires symptoms of heart failure in the last month of pregnancy or within five months of delivery in the absence of recognized cardiac disease prior to pregnancy as well as objective evidence of left ventricular systolic dysfunction. This paper provides an updated, comprehensive review of PPCM, including emerging insights into the etiology of this disorder as well as current treatment options.

  1. Potentially avoidable peripartum hysterectomies in Denmark

    DEFF Research Database (Denmark)

    Colmorn, Lotte Berdiin; Krebs, Lone; Langhoff-Roos, Jens

    2016-01-01

    to minimize the number of unnecessary peripartum hysterectomies, obstetricians and anesthesiologists should investigate individual cases by structured clinical audit, and disseminate and discuss the results for educational purposes. An international collaboration is warranted to strengthen our recommendations...

  2. Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year ...

    African Journals Online (AJOL)

    Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year review. ... Nigerian Journal of Clinical Practice ... were 6,137 deliveries and 38 cases of emergency peripartum hysterectomies, giving an incidence of 6.2 per 1000 deliveries.

  3. Sepsis: Primary indication for peripartum hysterectomies in a South ...

    African Journals Online (AJOL)

    Background. Peripartum hysterectomies are lifesaving procedures but definitions vary. Indications are variable and dependant on resources and geographical factors. Objectives. To evaluate the incidence, aetiology and complications associated with peripartum hysterectomies in a tertiary hospital in South Africa. Methods.

  4. Mental Illness in the Peripartum Period

    Science.gov (United States)

    Ostler, Teresa

    2009-01-01

    Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…

  5. Peripartum hysterectomy: two years experience at Nelson Mandela Academic hospital, Mthatha, Eastern Cape South Africa.

    Science.gov (United States)

    Wandabwa, J N; Businge, C; Longo-Mbenza, B; Mdaka, M L; Kiondo, P

    2013-06-01

    Obstetric haemorrhage is the leading direct cause of maternal mortality in South Africa. To determine the incidence, indications, associations and maternal outcomes of emergency peripartum hysterectomies. A descriptive and retrospective analysis of patients who had peripartum hysterectomy between 1(st) February 2007 and 31(st) January 2009 in Nelson Mandela Academic Hospital at Mthatha city. The incidence of 0.95% of peripartum hysterectomies (n=63 or 9.5/1000 births) increased with the increasing maternal age from 0.121% at age of less than 20 years to 0.5% at age more or equal to 30 years. Similarly the incidence increased with parity from 0.332% for Primiparity to 0.468% at parity of four or more. The indications for the operation were uterine atony 19/63 (30.2%), secondary haemorrhage/puerperal sepsis 17/63 (27%) and ruptured uterus 16/63 (23.4%). The main intra operative complication was haemorrhage 13/63 (20.6%). Repeat laparotomy was done in 10/63 (15%) of patients due to haemorrhage. Admission to intensive care unit was 25/63 (39.7%). The case specific mortality rate was of 19 % (n=12). The main causes of death were hypovolaemic shock and septicemia. The incidence of peripartum hysterectomies was high and was associated with ruptured uterus and puerperal sepsis which are preventable.

  6. [Assessment, delivery and peripartum care in the case of a uterine rupture during labor of a woman with a previous C-section].

    Science.gov (United States)

    Parrilla-Fernández, Alberto; Manrique-Tejedor, Javier; Figuerol-Calderó, M Inmaculada; García-Romero, Verónica

    Uterine rupture is a rare but severe complication in obstetrics. A previous C-section is the most important risk factor. Its incidence during labor in women with a previous C-section is of approximately 0.3-0.47%, being potentially severe. We present the case of a pregnant women with a previous C-section who suffered uterine rupture during labor. The rapid assessment and action of the midwife and obstetric team was essential to obtain a successful obstetric outcome, avoiding maternal and fetal mortality; and nursing care given to the mother and the newborn after birth contributed to achieving a normal postpartum. It is necessary to have specific knowledge about this condition that, despite rare, can present insidiously with a potential risk for the mother and the fetus. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. A case of peripartum heart failure

    Directory of Open Access Journals (Sweden)

    Annalisa Vinci

    2008-03-01

    Full Text Available A 32-year-old woman was admitted in congestive heart failure (CHF 3 days after delivery. She had no history of cardiovascular disease and impaired left ventricular Ejection Fraction (EF 35%. She underwent complete heart catheterisation, selective coronary angiography and right ventricular endomyocardial biopsy (EMB.Coronary arteries were normal and EMB revealed active virus negative myocarditis. Serum was positive for anti-heart autoantibodies (AHA. Thus myocarditis was classified as autoimmune and the patient was treated with immunosuppressive therapy, with clinical and hemodynamic improvement. At 27 months follow-up EMB showed healed myocarditis. Peripartum cardiomyopathy (PPCM is a rare disorder in which left ventricular dysfunction and heart failure occur in the peripartum period in previously healthy women. The etiology is still unknown but a sizable proportion of patients may have an underlying organ-specific autoimmune myocarditis.

  8. Peripartum hysterectomy: an economic analysis of direct healthcare costs using routinely collected data.

    Science.gov (United States)

    Achana, F A; Fleming, K M; Tata, L J; Sultan, A A; Petrou, S

    2017-10-03

    To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators. Primary care, hospital outpatient and inpatient attendances and costs (UK 2015 prices). The study sample included 1362 women (192 cases and 1170 controls) who gave birth between 1997 and 2013; 1088 (153 cases and 935 controls) of these were deliveries between 2003 and 2013 when all categories of hospital resource use were available. Based on the 2003-2013 delivery cohort, peripartum hysterectomy was associated with a mean adjusted additional total cost of £5380 (95% CI £4436-6687) and a cost ratio of 1.76 (95% CI 1.61-1.98) over 5 years of follow up compared with controls. Inpatient costs, mostly incurred during the first year following surgery, accounted for 78% excluding or 92% including delivery-related costs. Peripartum hysterectomy is associated with increased healthcare costs driven largely by increased post-surgery hospitalisation rates. To reduce healthcare costs and improve outcomes for women who undergo hysterectomy, interventions that reduce avoidable repeat hospitalisations following surgery such as providing active follow up, treatment and support in the community should be considered. A large amount of NHS data on peripartum hysterectomy suggests active community follow up could reduce costs, #HealthEconomics. © 2017 Royal College of Obstetricians and Gynaecologists.

  9. Peripartum cardiomeyopathy in a pakistani cohort

    International Nuclear Information System (INIS)

    Munir, R.; Hussain, S.; Kayani, A.M.

    2016-01-01

    Objective: To describe the demographics, risk factors, and clinical presentation in Pakistani patients with peripartum cardiomyopathy. Study Design: A descriptive observational study. Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi, from June 2014 to June 2015. Methodology: Seventy patients meeting criteria of peripartum cardiomyopathy were included in the study. Adetailed history, physical examination and investigations were done. Epidemiologic data, risk factors, New York Heart Association (NYHA) class and echocardiographic findings were recorded. Statistical analyses were done using SPSS version 19. Result: The mean age was 28.66 ±4.57 years. Mean parity and weight was 3.04 ±1.7 and 60.97 ±12.40 Kg, respectively. Fifty-five (78.6 percent) cases were diagnosed in the postpartum period. Thirty-three (50.8 percent) and 31 patients (44.7 percent) presented in NYHA- III and IV classes, respectively. Pregnancy-induced hypertension was seen in 16 (22.9 percent) cases, diabetes in 6 (8.6 percent), and twin pregnancy in 2 (2.9 percent) cases. The mean hemoglobin and brain natriuretic peptide (BNP) was 11.26 ±1.61 gm/dl and 1583.70 ±1237.65 pg/ml, respectively. Echocardiography showed mean ejection fraction of 21.74 ±7.45 percent. Left ventricle systolic and diastolic diameters were 53.71 ±9.74 mm and 63.37 ±8.48 mm, respectively. Conclusion: Peripartum cardiomyopathy was seen in younger women with higher parity and pregnancy induced hypertension, often manifesting in the postpartum period with NHYAclass III and IV status. (author)

  10. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy.

    Science.gov (United States)

    Patten, Ian S; Rana, Sarosh; Shahul, Sajid; Rowe, Glenn C; Jang, Cholsoon; Liu, Laura; Hacker, Michele R; Rhee, Julie S; Mitchell, John; Mahmood, Feroze; Hess, Philip; Farrell, Caitlin; Koulisis, Nicole; Khankin, Eliyahu V; Burke, Suzanne D; Tudorache, Igor; Bauersachs, Johann; del Monte, Federica; Hilfiker-Kleiner, Denise; Karumanchi, S Ananth; Arany, Zoltan

    2012-05-09

    Peripartum cardiomyopathy (PPCM) is an often fatal disease that affects pregnant women who are near delivery, and it occurs more frequently in women with pre-eclampsia and/or multiple gestation. The aetiology of PPCM, and why it is associated with pre-eclampsia, remain unknown. Here we show that PPCM is associated with a systemic angiogenic imbalance, accentuated by pre-eclampsia. Mice that lack cardiac PGC-1α, a powerful regulator of angiogenesis, develop profound PPCM. Importantly, the PPCM is entirely rescued by pro-angiogenic therapies. In humans, the placenta in late gestation secretes VEGF inhibitors like soluble FLT1 (sFLT1), and this is accentuated by multiple gestation and pre-eclampsia. This anti-angiogenic environment is accompanied by subclinical cardiac dysfunction, the extent of which correlates with circulating levels of sFLT1. Exogenous sFLT1 alone caused diastolic dysfunction in wild-type mice, and profound systolic dysfunction in mice lacking cardiac PGC-1α. Finally, plasma samples from women with PPCM contained abnormally high levels of sFLT1. These data indicate that PPCM is mainly a vascular disease, caused by excess anti-angiogenic signalling in the peripartum period. The data also explain how late pregnancy poses a threat to cardiac homeostasis, and why pre-eclampsia and multiple gestation are important risk factors for the development of PPCM.

  11. Peripartum Depression, Traditional Culture, and Israeli Society.

    Science.gov (United States)

    Dekel, Sharon; Stanger, Varda; Georgakopoulos, Emily R; Stuebe, Caren M; Dishy, Gabriella A

    2016-08-01

    Although it is known that culture affects psychopathology, the nature of the relationship between culture and peripartum depression (PPD) is not fully understood. Here we report on 2 cases of Israeli women who are affiliated with traditional cultural groups that emphasize reproduction but developed PPD after childbirth. The first woman is an ultra-Orthodox Israeli Jew and the second is an Israeli Arab. The 2 cases illustrate the effect of cultural beliefs and rituals on the conceptualization, treatment, and trajectory of PPD. The cases suggest a complex relationship between traditional cultures and PPD, including the possibility that cultural factors may have both adaptive and maladaptive consequences. Future qualitative and quantitative studies are needed to further clarify this relationship. © 2016 Wiley Periodicals, Inc.

  12. Superior vena thrombosis with peripartum dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Munir, R.; Hussain, S.; Kayani, A.M.

    2014-01-01

    A 30 years multiparous female with history of emergency caesarean section 10 days back was referred to us with cough, severe breathlessness at rest, orthopnea with pain in neck and arms. Clinical examination revealed signs of heart failure. Echocardiography showed ejection fraction of 15%, with no right ventricular strain. A diagnosis of peripartum cardiomyopathy was made. Doppler ultrasound of neck veins showed bilateral internal jugular vein thrombosis. Subsequent multislice CT examination showed thrombosis of superior vena cava and both internal jugular veins (with collateral formation) and pulmonary embolism. There were no mediastinal abnormalities on the CT scan. Her thrombophilia screen and CT scan brain was normal. She was managed in collaboration with cardiologist. Following treatment with subcutaneous enoxaparin therapy and warfarin her symptoms of upper limb pain improved. She responded very well to medical therapy for heart failure with marked improvement of NYHA functional class. (author)

  13. [Plasma selenium and peripartum cardiomyopathy in Bamako, Mali].

    Science.gov (United States)

    Cénac, A; Touré, K; Diarra, M B; Sergeant, C; Jobic, Y; Sanogo, K; Dembele, M; Fayol, V; Simonoff, M

    2004-01-01

    Peripartum heart failure due to unexplained dilated cardiomyopathy is a common disorder as Savannak-Sahelian Africa. One of the many suspected risk factors identified is selenium deficiency. The purpose of this study was to measure plasma selenium levels in patients with peripartum heart failure due to cardiomyopathy in Bamako, Republic of Mali and compare data with healthy Sahalian women with the same obstetrical status. Plasma selenium was measured in a patient group consisting of 28 Malian women presenting peripartum heart failure and in a control group of 28 healthy breast-feeding Nigerien women of comparable age. The criteria for matching the two groups was parity (similar number of deliveries) since multiparity is a risk factor for peripartum cardiomyopathy. The Wilcoxon test (nonparametric) was used to compare the 2 groups considering up value < 0.05 as significant. Plasma selenium was significantly lower in patients from Mali than in controls from Niger (65 +/- 17 ng/ml vs. 78 +/- 17 ng/ml, p = 0.01). The results of this study showing lower plasma selenium in Bamako patients with peripartum cardiomyopathy than in a matching healthy control population confirms the previous data from the Niamey study.

  14. WA42 Proving its worth - changing public policy for palliative care, end of life care and bereavement through advocacy and communications.

    Science.gov (United States)

    Edghill, Angela; Donohoe, Miriam

    2015-04-01

    The 2015 palliative care budget is €72 million (Euros) but up to €1.3 billion spent on end of life care annually - much of this larger figure unplanned and uncoordinated. Geographic and other inequities evident in palliative care provision. Build support for the development and implementation of a National Strategy on Palliative Care, End of Life and Bereavement. Multi-layered approach to raising awareness and building consensus: Targeting the correct audience who can make change happen Presenting robust evidence including costs justifying reform and investment Demonstrating that issues affect a significant number of people Sharing experience and knowledge Knowing their policy priorities Staying resilient - advancing and introducing new angles to argument Engaging directly as advocates within the political system at all political levels - developing relationships with politicians Identifying advocates in the public service to promote policy change Using a variety of new and existing projects and programmes Encouraging patients and families to be self-advocates - using a novel project for discussing and recording future care preferences Supporting healthcare professionals to become effective advocates for patients Creating alliances to lobby for policy development Using media opportunities to sell the message The recognition of the importance of a strategic approach to palliative and end of life care acknowledged in Parliamentary Committee Report affords an opportunity to develop further policy and practice. This a long - term exercise, dependent on supporting the implementation plan, building momentum and promoting a public dialogue on sensitive issues around dying, death and bereavement. © 2015, 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.

  15. Cardiomiopatía periparto Peripartum cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Jorge E Velásquez V

    2008-02-01

    Full Text Available La cardiomiopatía periparto es una entidad clínica con una frecuencia variable de acuerdo con la zona en estudio. Se caracteriza por disfunción sistólica del ventrículo izquierdo y posterior aparición de síntomas de falla cardiaca, los cuales ocurren durante el último mes de gestación y los primeros meses post- parto. Su etiología aún no es clara, pero se plantean diferentes teorías, las cuales se basan en fenómenos inflamatorios, infecciosos y auto-inmunes. Recientemente, se describieron alteraciones relacionadas con el estrés oxidativo, que podrían explicar en gran medida esta patología. Su presentación clínica guarda gran similitud con las demás causas de falla cardíaca, aunque se han descrito presentaciones atípicas. Su diagnóstico requiere alto nivel de sospecha y debe considerarse en toda mujer con síntomas de falla cardíaca durante el periparto. El tratamiento convencional de la falla cardiaca crónica que incluye beta-bloqueadores, inhibidores de la enzima convertidora de angiotensina y diuréticos, además de los adelantos en el diagnóstico y manejo de la falla cardiaca aguda, permitió cambiar la historia de la enfermedad al disminuir la mortalidad y recuperar la función sistólica del ventrículo izquierdo. Las gestaciones posteriores al desarrollo de esta entidad, dependerán de la recuperación completa de la función cardíaca, sin disminuir el riesgo de recurrencia. Todavía existen múltiples preguntas por responder en áreas como etiología, factores de riesgo, tratamiento y marcadores pronósticos que permitan prevenir y manejar en forma oportuna y segura tanto a la madre como a su hijo.Peripartum cardiomyopathy is a clinical entity with a variable frequency according to the zone of the study. It is characterized by a systolic dysfunction of the left ventricle and posterior appearance of heart failure symptoms that occur during the last month of pregnancy and the first post-partum months. Its etiology

  16. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  17. Peripartum cardiomyopathy as a part of familial dilated cardiomyopathy

    NARCIS (Netherlands)

    K.Y. van Spaendonck-Zwarts (Karin); J.P. van Tintelen (Peter); D.J. van Veldhuisen (Dirk); R. van der Werf (Rik); J.D.H. Jongbloed (Jan); W.J. Paulus (Walter); D. Dooijes (Dennis); M.P. van den Berg (Maarten)

    2010-01-01

    textabstractBACKGROUND-: Anecdotal cases of familial clustering of peripartum cardiomyopathy (PPCM) and familial occurrences of PPCM and idiopathic dilated cardiomyopathy (DCM) together have been observed, suggesting that genetic factors play a role in the pathogenesis of PPCM. We hypothesized that

  18. Increased risk of peripartum perinatal mortality in unplanned births outside an institution: a retrospective population-based study.

    Science.gov (United States)

    Engjom, Hilde M; Morken, Nils-Halvdan; Høydahl, Even; Norheim, Ole F; Klungsøyr, Kari

    2017-08-01

    Births in midwife-led institutions may reduce the frequency of medical interventions and provide cost-effective care, while larger institutions offer medically and technically advanced obstetric care. Unplanned births outside an institution and intrapartum stillbirths have frequently been excluded in previous studies on adverse outcomes by place of birth. The objective of the study was to assess peripartum mortality by place of birth and travel time to obstetric institutions, with the hypothesis that centralization reduces institution availability but improves mortality. This was a national population-based retrospective cohort study of all births in Norway from 1999 to 2009 (n = 648,555) using data from the Medical Birth Registry of Norway and Statistics Norway and including births from 22 gestational weeks or birthweight ≥500 g. Main exposures were travel time to the nearest obstetric institution and place of birth. The main clinical outcome was peripartum mortality, defined as death during birth or within 24 hours. Intrauterine fetal deaths prior to start of labor were excluded from the primary outcome. A total of 1586 peripartum deaths were identified (2.5 per 1000 births). Unplanned birth outside an institution had a 3 times higher mortality (8.4 per 1000) than institutional births (2.4 per 1000), relative risk, 3.5 (95% confidence interval, 2.5-4.9) and contributed 2% (95% confidence interval, 1.2-3.0%) of the peripartum mortality at the population level. The risk of unplanned birth outside an institution increased from 0.5% to 3.3% and 4.5% with travel time 2 hours, respectively. In obstetric institutions the mortality rate at term ranged from 0.7 per 1000 to 0.9 per 1000. Comparable mortality rates in different obstetric institutions indicated well-functioning routines for referral. Unplanned birth outside an institution was associated with increased peripartum mortality and with long travel time to obstetric institutions. Structural determinants have

  19. Peripartum cardiomyopathy in the Hospital Albert Schweitzer District of Haiti.

    Science.gov (United States)

    Fett, James D; Carraway, Robert D; Dowell, Duane L; King, Mary Etta; Pierre, Ronald

    2002-05-01

    This report details current epidemiologic information on peripartum cardiomyopathy in 1 district of Haiti and represents the initial report of an ongoing investigation that addresses potential etiologic and prognostic factors. Another goal is to alert the medical community of what appears to be a high-incidence area. A detailed peripartum cardiomyopathy registry has been implemented to include a review of case records from 1994 to 2000 and subsequently to identify new cases from February 1, 2000, to July 1, 2001. The Hospital Albert Schweitzer District of Haiti is a 600-square mile area with approximately 258,000 population served by a hospital, an associated clinic, and outlying health centers. There are approximately 7740 live births annually. This report details epidemiologic information on the HAS District peripartum cardiomyopathy patients including incidence, mortality rate, complications, and prognostic factors. There were 47 confirmed patients (retrospective cohort, 20 patients; prospective cohort, 27 patients), which was approximately 1 case per 400 live births (compared with an incidence of 1 case per 3000 to 4000 live births in the United States). There were 4 deaths (14% of 29 patients with follow-up), and 7 complications (pulmonary embolism, 1 case; hemiplegia, 1 case; subsequent deterioration of heart function, 5 cases). The prognosis for subsequent pregnancy was 4 of 5 cases (80%) of recurrent congestive heart failure. Peripartum cardiomyopathy appears to be relatively common in the Hospital Albert Schweitzer District of Haiti. A core group of patients is identified for ongoing epidemiologic and immunohematologic investigation of risk factors and potential etiologic factors.

  20. A 35-year-old pregnant woman presenting with sudden cardiac arrest secondary to peripartum cardiomyopathy.

    Science.gov (United States)

    Nelson, Matthew; Moorhead, Amy; Yost, Dana; Whorton, Adrian

    2012-01-01

    We present a case of successful resuscitation from cardiac arrest after 25 minutes of ventricular fibrillation (VF) secondary to peripartum cardiomyopathy. This case highlights a rare disease, but also, more importantly, the successful use of the five links of survival: early access to 9-1-1, early cardiopulmonary resuscitation (CPR), early defibrillation, early advanced life support, and postresuscitative care. We also demonstrate the importance of high-quality resuscitation practices in order to achieve a successful outcome. Manual compressions can be performed at a guidelines-compliant rate. With training, users are able to achieve high compression fractions. Pre/post shock delays can be minimized to further increase compression fraction. Nationally, CPR interruptions are often long. We recommend closer attention to uninterrupted 2-minute cycles of CPR, minimizing delays in CPR through training, and a focus on a closely choreographed approach. User review of transthoracic impedance feedback data should play a vital role in a cardiac arrest quality-improvement program.

  1. A cross-sectional study of peripartum blood transfusion in the ...

    African Journals Online (AJOL)

    A cross-sectional study of peripartum blood transfusion in the Eastern Cape, South Africa. ... To assess the incidence of peripartum transfusion in a sample of Eastern Cape, SA hospitals to evaluate generalisability of preceding study findings. Methods. Hospital chart reviews were conducted of all deliveries at three large ...

  2. Emergency Peripartum Hysterectomy as Postpartum Hemorrhage Treatment: Incidence, Risk factors, and Complications

    Directory of Open Access Journals (Sweden)

    Meena Pradhan

    2014-03-01

    Full Text Available Introduction: The aim of the research was to investigate incidence, risk factors, and complications associated with emergency peripartum hysterectomy, the ultimate treatment method for intractable postpartum hemorrhage. Methods: This is a single center case-control study conducted in Chongqing city in central China from 1st January 2007 to 31st December 2012 for emergency peripartum hysterectomy performed as a treatment of postpartum hemorrhage both in caesarean and vaginal delivery cases. While the study group included emergency peripartum hysterectomy (n=61 due to intractable postpartum hemorrhage, the control group included no hysterectomy (n=333 during the same study period. Results: We found 61 cases recorded for emergency peripartum hysterectomy for intractable postpartum hemorrhage. Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries. Emergency peripartum hysterectomy as treatment of intractable postpartum hemorrhage include the followings: (i blood loss 1000-2000 ml, crude odd ratio (OR =18.48 (95% CI 5.1-65.7, adjusted odd ratio (AOR = 9.1 (95% CI 2.2-37.7; (ii blood loss >2000 ml, OR = 152 (95% CI 43.7-528.4, AOR = 45.3 (95% CI 11.6-176.9; (iii previous caesarean section, OR = 5.5 (95% CI 2.9-9.7, AOR = 3.7(95% CI 1.4-9.9; (iv uterine atony, OR = 11.9 (95% CI 5.8-24.6, AOR = 7.5 (95% CI 1.8-30.2; (v placenta previa, OR = 2.04 (95% CI 1.1-3.5, AOR = none. Conclusions: Emergency peripartum hysterectomy is the last resort as treatment of intractable severe postpartum hemorrhage. Our study depicts that severe post partum hemorrhage, further dreaded complex events for emergency peripartum hysterectomy, has significant association with placental factors, previous caesarean section, and uterine atony. Pathologically, placenta accreta remained the most leading cause of hysterectomy. Keywords: caesarean section; hemorrhage; peripartum hysterectomy; placenta previa.

  3. Peripartum Cardiomyopathy: Moving Towards a More Central Role of Genetics#

    Science.gov (United States)

    Cemin, Roberto; Janardhanan, Rajesh; Donazzan, Luca; Daves, Massimo

    2013-01-01

    Peripartum cardiomyopathy (PCM) is a relatively rare disease with potentially devasting consequences requiring prompt identification and correct treatment. Overall prognosis is good in majority of the cases, although some patients may progress to irreversible heart failure. Early diagnosis is important and effective treatment reduces mortality rates and increases the chance of complete recovery of ventricular systolic function. The aetiology and pathogenesis seems to be multifactorial and poorly understood, with the available literature rather conflicting. In recent years, there has been increased interest in the role played by genetic predisposition in the development of PCM. It probably develops as a result of a complex interaction of pregnancy-associated factors and genetic factors and recently there have been many observations pointing out the central role played by a genetic predisposition. The direct and indirect observations on genetic susceptibility may offer new insights into the pathogenesis of PCM. However, larger studies are needed before advising routine genetic testing in these patients. PMID:23909634

  4. Quality of Life in Survivors of Peripartum Cardiomyopathy.

    Science.gov (United States)

    Koutrolou-Sotiropoulou, Paraskevi; Lima, Fabio Vasconcelos; Stergiopoulos, Kathleen

    2016-07-15

    Little data exist with regard to the effect of peripartum cardiomyopathy (PPCM) on quality of life. The aim of this study was to determine the impact of PPCM on quality of life and emotional well-being. We sought to determine the feasibility of using social media to perform quality of life research. We conducted a study using a survey distributed to established members of "Peripartum Cardiomyopathy Survivors" support group on the social networking site Facebook. A total of 116 women completed the survey (age 36 ± 6.4 years; 91% white, 75% married, 46% college educated), with 4.9 ± 0.5 years (range 0.02 to 24 years) since the initial diagnosis. Most women (41%) never returned to their baseline level of activity, and 28% discontinued their job because of the diagnosis. Most respondents (56%) were not limited or only slightly limited by heart failure symptoms over the past 2 months. Most respondents (56%) never returned to their baseline emotionally after the diagnosis of PPCM, and most patients (73%) were dissatisfied with their current level of heart failure symptoms. Most patients (67%) felt discouraged frequently (more than several times per month) because of heart failure. Only 26% of women were satisfied with the counseling they received from their providers. The emotional and physical burden of PPCM on young mothers with PPCM years after the diagnosis is striking. Identifying strategies that promote better emotional health and potential treatment strategies may be required. Copyright © 2016. Published by Elsevier Inc.

  5. EMERGENCY PERIPARTUM HYSTERECTOMY IN THE LAKES REGION OF TURKEY: INCIDENCE AND MATERNAL MORBIDITY

    Directory of Open Access Journals (Sweden)

    Mehmet Güney

    2006-06-01

    Full Text Available OBJECTIVE: To estimate the incidence, indications, risk factors, and complications of peripartum hysterectomy in a university clinic and a state hospital in the Lakes region of Anatolia.\tDesign: Retrospective clinical study.\tSetting: This retrospective study was conducted between December 1996 and December 2005 at the Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women’s and Children’s Hospital.\tPatients: Twenty-eight patients who underwent emergency peripartum hysterectomy.\tMain Outcome Measures: Twenty-eight patients with emergency peripartum hysterectomy were evaluated with respect to the demographic characteristics, clinical manifestation, state of parity and type of hysterectomy.\tRESULTS: In the study period, the incidence of emergency peripartum hysterectomy was 0.8 per 1000 deliveries. The main indications for emergency hysterectomy were uterine atony in 18 cases (64 %, rupture of uterus in 6 cases (21 % and placenta accreta in 4 cases (14 %. There were 20 (71 % multiparaous and 8 (28 % primiparaous women. There were 4 total abdominal hysterectomies and 24 subtotal hysterectomies.The rate of maternal mortality was 4% (1 cases.\tCONCLUSION: Our incidence of emergent peripartum hysterectomy was low when compared with most of the studies and uterine atony was the most common indication for emergent peripartum hysterectomy.

  6. Emergency peripartum hysterectomy in the Dubai health system: A fifteen year experience.

    Science.gov (United States)

    Tahlak, Muna Abdulrazzaq; Abdulrahman, Mahera; Hubaishi, Nawal Mahmood; Omar, Mushtaq; Cherifi, Fatima; Magray, Shazia; Carrick, Frederick Robert

    2018-03-01

    To determine the incidence, demographic data, risk factors, indications, outcome and complications of emergency peripartum hysterectomy (EPH) performed in two major tertiary care hospitals in Dubai, and to compare the results with the literature. The records of all women who underwent EPH from January 2000 to December 2015 in two major tertiary care hospitals in Dubai were accessed and reviewed. Maternal characteristics, hysterectomy indications, outcomes, and postoperative complications were recorded using descriptive statistics to describe the cohort. There were 79 EPH out of 168.293 deliveries, a rate of 0.47/1000 deliveries. The most common indications for hysterectomy were abnormal placentation (previa and/or accreta) and uterine atony. The majority of hysterectomies were subtotal (70%). The complications were dominated by massive transfusion, urinary tract injuries, one case of maternal death, and one case of neonatal death. The main indication for EPH was abnormal placentation in scarred uterus and uterine atony. The major method of prevention of EPH is to assess women's risks and to reduce the number of cesarean section deliveries, by limiting the rate of primary cesareans. This is challenging in the United Arab Emirates (UAE) where the culture is for high gravidity and high parity. Recommendations to act to reduce primary and repeated cesareans should be included on the national agenda in UAE.

  7. Changing trends in peripartum hysterectomy over the last 4 decades.

    LENUS (Irish Health Repository)

    Flood, Karen M

    2012-02-01

    OBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4\\/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.

  8. Fetal placental prostaglandin metabolism in the peripartum cow

    International Nuclear Information System (INIS)

    Gross, T.S.; Williams, W.F.; Lewis, G.S.

    1986-01-01

    Previous results demonstrate that fetal placental tissue synthesizes prostaglandin E (PGE) prior to parturition. When placental membranes do not separate postpartum, PGE synthesis is maintained, while prostaglandin F (PGF) synthesis predominates when the membranes separate. Concurrent with separation is a decline in fetal placental binucleate cell (BNC) numbers. These data suggest a fetal placental conversion of PGE to PGF. For this experiment, placentomes were collected at ten days prepartum (PRE, n=12) and within 1 hr postpartum. Nine of the postpartum animals had fetal membrane separation within 12 hr postpartum (S) and eight did not exhibit membrane separation (NS). For each placentome, fetal (villi) components were manually isolated and examined for the ability to interconvert 3 H labeled PGE 2 and PGF 2 . All villi were unable to convert PGE 2 to PGF 2 (P > .05). The PRE and NS villi were able to convert PGF 2 to PGE 2 (P 2 to PGE 2 (P 2 to PGE 2 also declines (P < .05). These data suggest that peripartum fetal placental tissue might synthesize PGF which is then converted to PGE. It is possible that the BNC are directly converting PGF to PGE or that they are modulating this conversion. Therefore, with a decline in BNC numbers, PGF synthesis would predominate

  9. A Change of Heart: Case Series of Peripartum Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Sean Martin

    2013-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.

  10. Analysis of 127 peripartum hypoxic brain injuries from closed claims registered by the Danish Patient Insurance Association

    DEFF Research Database (Denmark)

    Bock, J.; Christoffersen, J.K.; Hedegaard, M.

    2008-01-01

    : The authors retrospectively investigated peripartum hypoxic brain injuries registered by the Danish Patient Insurance Association. RESULTS: From 1992 to 2004, 127 approved claims concerning peripartum hypoxic brain injuries were registered and subsequently analysed. Thirty-eight newborns died, and a majority...

  11. Elliptic curves and primality proving

    Science.gov (United States)

    Atkin, A. O. L.; Morain, F.

    1993-07-01

    The aim of this paper is to describe the theory and implementation of the Elliptic Curve Primality Proving algorithm. Problema, numeros primos a compositis dignoscendi, hosque in factores suos primos resolvendi, ad gravissima ac utilissima totius arithmeticae pertinere, et geometrarum tum veterum tum recentiorum industriam ac sagacitatem occupavisse, tam notum est, ut de hac re copiose loqui superfluum foret.

  12. Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures.

    Science.gov (United States)

    Babb, Jessica A; Deligiannidis, Kristina M; Murgatroyd, Christopher A; Nephew, Benjamin C

    2015-01-01

    Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Geometric inequalities methods of proving

    CERN Document Server

    Sedrakyan, Hayk

    2017-01-01

    This unique collection of new and classical problems provides full coverage of geometric inequalities. Many of the 1,000 exercises are presented with detailed author-prepared-solutions, developing creativity and an arsenal of new approaches for solving mathematical problems. This book can serve teachers, high-school students, and mathematical competitors. It may also be used as supplemental reading, providing readers with new and classical methods for proving geometric inequalities. .

  14. The significance of peripartum fever in women undergoing vaginal deliveries.

    Science.gov (United States)

    Bensal, Adi; Weintraub, Adi Y; Levy, Amalia; Holcberg, Gershon; Sheiner, Eyal

    2008-10-01

    We investigated whether patients undergoing vaginal delivery who developed peripartum fever (PPF) had increased rates of other gestational complications. A retrospective study was undertaken comparing pregnancy complications of patients who developed PPF with those who did not. A multivariable logistic regression model was constructed to control for confounders. To avoid ascertainment bias, the year of birth was included in the model. Women who underwent cesarean delivery and those with multiple pregnancies were excluded from the study. During the study period, there were 169,738 singleton vaginal deliveries, and 0.4% of the women suffered from PPF. Hypertensive disorders, induction of labor, dystocia of labor in the second stage, suspected fetal distress, meconium-stained amniotic fluid, postpartum hemorrhage, manual lysis of a retained placenta, and revision of the uterine cavity and cervix were found to be independently associated with PPF by multivariable analysis. Year of birth was found to be a risk factor for fever. Apgar scores lower than 7 at 1 but not 5 minutes were significantly higher in the PPF group. Perinatal mortality rates were significantly higher among women with PPF (6.7% versus 1.3%, odds ratio [OR] = 5.4; 95% confidence interval [CI] 3.9 to 7.3; P < 0.001). Using another multivariable analysis, with perinatal mortality as the outcome variable, PPF was found as an independent risk factor for perinatal mortality (OR = 2.9; 95% CI 1.9 to 4.6; P < 0.001). PPF in women undergoing vaginal deliveries is associated with adverse perinatal outcomes and specifically is an independent risk factor for perinatal mortality.

  15. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    LENUS (Irish Health Repository)

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  16. Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports

    Directory of Open Access Journals (Sweden)

    Drexler Helmut

    2010-03-01

    Full Text Available Abstract Introduction Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality. Case presentation We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics. During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage. Conclusion The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.

  17. Peripartum Cardiomyopathy Treatment with Dopamine Agonist and Subsequent Pregnancy with a Satisfactory Outcome.

    Science.gov (United States)

    Melo, Maria Adélia Medeiros E; Carvalho, Jordão Sousa; Feitosa, Francisco Edson de Lucena; Araujo Júnior, Edward; Peixoto, Alberto Borges; Costa Carvalho, Francisco Herlânio; Carvalho, Regina Coeli Marques

    2016-06-01

    Pathophysiological mechanisms of peripartum cardiomyopathy are not yet completely defined, although there is a strong association with various factors that are already known, including pre-eclampsia. Peripartum cardiomyopathy treatment follows the same recommendations as heart failure with systolic dysfunction. Clinical and experimental studies suggest that products of prolactin degradation can induce this cardiomyopathy. The pharmacological suppression of prolactin production by D2 dopamine receptor agonists bromocriptine and cabergoline has demonstrated satisfactory results in the therapeutic response to the treatment. Here we present a case of an adolescent patient in her first gestation with peripartum cardiomyopathy that evolved to the normalized left ventricular function after cabergoline administration, which was used as an adjuvant in cardiac dysfunction treatment. Subsequently, despite a short interval between pregnancies, the patient exhibited satisfactory progress throughout the entire gestation or puerperium in a new pregnancy without any cardiac alterations. Dopamine agonists that are orally used and are affordable in most tertiary centers, particularly in developing countries, should be considered when treating peripartum cardiomyopathy cases. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  18. High-fat diet prevents adaptive peripartum-associated adrenal gland plasticity and anxiolysis.

    Science.gov (United States)

    Perani, Clara V; Neumann, Inga D; Reber, Stefan O; Slattery, David A

    2015-10-07

    Maternal obesity is associated with lower basal plasma cortisol levels and increased risk of postpartum psychiatric disorders. Given that both obesity and the peripartum period are characterized by an imbalance between adrenocorticotropic hormone (ACTH) and cortisol, we hypothesized that the adrenal glands undergo peripartum-associated plasticity and that such changes would be prevented by a high-fat diet (HFD). Here, we demonstrate substantial peripartum adrenal gland plasticity in the pathways involved in cholesterol supply for steroidogenesis in female rats. In detail, the receptors involved in plasma lipid uptake, low density lipoprotein (LDL) receptor (LDLR) and scavenger receptor class B type 1 (SRB1), are elevated, intra-adrenal cholesterol stores are depleted, and a key enzyme in de novo cholesterol synthesis, hydroxymethylglutaryl coenzyme A reductase (HMGCR), is downregulated; particularly at mid-lactation. HFD prevented the lactation-associated anxiolysis, basal hypercorticism, and exaggerated the corticosterone response to ACTH. Moreover, we show that HFD prevented the downregulation of adrenal cholesterol stores and HMGCR expression, and LDLR upregulation at mid-lactation. These findings show that the adrenal gland is an important regulator of peripartum-associated HPA axis plasticity and that HFD has maladaptive consequences for the mother, partly by preventing these neuroendocrine and also behavioural changes.

  19. Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM)

    NARCIS (Netherlands)

    Sliwa, Karen; Mebazaa, Alexandre; Hilfiker-Kleiner, Denise; Petrie, Mark C.; Maggioni, Aldo P.; Laroche, Cecile; Regitz-Zagrosek, Vera; Schaufelberger, Maria; Tavazzi, Luigi; van der Meer, Peter; Roos-Hesselink, JolienW.; Seferovic, Petar; van Spandonck-Zwarts, Karin; Mbakwem, Amam; Boehm, Michael; Mouquet, Frederic; Pieske, Burkert; Hall, Roger; Ponikowski, Piotre; Bauersachs, Johann

    Aims: The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries. Methods and results:

  20. Titin gene mutations are common in families with both peripartum cardiomyopathy and dilated cardiomyopathy

    NARCIS (Netherlands)

    van Spaendonck-Zwarts, Karin Y.; Posafalvi, Anna; van den Berg, Maarten P.; Hilfiker-Kleiner, Denise; Bollen, Ilse A. E.; Sliwa, Karen; Alders, Marielle; AlMomani, Rowida; van Langen, Irene M.; van der Meer, Peter; Sinke, Richard J.; van der Velden, Jolanda; Van Veldhuisen, Dirk J.; van Tintelen, J. Peter; Jongbloed, Jan D. H.

    2014-01-01

    Aim Peripartum cardiomyopathy (PPCM) can be an initial manifestation of familial dilated cardiomyopathy (DCM). We aimed to identify mutations in families that could underlie their PPCM and DCM. Methods and results We collected 18 families with PPCM and DCM cases from various countries. We studied

  1. Titin gene mutations are common in families with both peripartum cardiomyopathy and dilated cardiomyopathy

    NARCIS (Netherlands)

    van Spaendonck-Zwarts, Karin Y.; Posafalvi, Anna; van den Berg, Maarten P.; Hilfiker-Kleiner, Denise; Bollen, Ilse A. E.; Sliwa, Karen; Alders, Mariëlle; Almomani, Rowida; van Langen, Irene M.; van der Meer, Peter; Sinke, Richard J.; van der Velden, Jolanda; van Veldhuisen, Dirk J.; van Tintelen, J. Peter; Jongbloed, Jan D. H.

    2014-01-01

    Peripartum cardiomyopathy (PPCM) can be an initial manifestation of familial dilated cardiomyopathy (DCM). We aimed to identify mutations in families that could underlie their PPCM and DCM. We collected 18 families with PPCM and DCM cases from various countries. We studied the clinical

  2. Peripartum back fat thickness of multiparous Holstein-Friesian cows with displacement of the abomasum or ketosis.

    Science.gov (United States)

    Yamakawa, Kazuhiro; Aoki, Takahiro; Matsui, Motozumi; Yamada, Kazutaka; Ishii, Mitsuo

    2012-05-01

    To establish a method to predict postpartum diseases using prepartum back fat thickness (BFT), the peripartum BFTs of 54 healthy multiparous cows before calving, which were diagnosed with postpartum displacement of the abomasum (DA), clinical ketosis or subclinical ketosis were compared with those of healthy cows from 8 weeks before the expected calving date to 8 weeks after calving. The peripartum BFTs of the cows with DA or clinical ketosis were significantly higher than those of healthy cows. The peripartum BFTs of the cows with subclinical ketosis were not significantly higher than those of the healthy cows.

  3. Clinical Risk Factors Associated With Peripartum Maternal Bacteremia.

    Science.gov (United States)

    Easter, Sarah Rae; Molina, Rose L; Venkatesh, Kartik K; Kaimal, Anjali; Tuomala, Ruth; Riley, Laura E

    2017-10-01

    To evaluate risk factors associated with maternal bacteremia in febrile peripartum women. We performed a case-control study of women with fevers occurring between 7 days before and up to 42 days after delivery of viable neonates at two academic hospitals. Women with positive blood cultures were matched with the next two febrile women meeting inclusion criteria with negative blood cultures in the microbiology data without other matching parameters. We compared maternal and neonatal characteristics and outcomes between women in the case group and those in the control group with univariate analysis. We then used logistic regression to examine the association between clinical characteristics and maternal bacteremia. After excluding blood cultures positive only for contaminants, we compared 115 women in the case group with 285 in the control group. Bacteremic women were more likely to experience their initial fever during labor (40.9% compared with 22.8%, P<.01) and more likely to have fever at or above 102°F (62.6% compared with 31.6%, P<.01). These associations persisted in the adjusted analysis: multiparity (adjusted odds ratio [OR] 1.75, 95% CI 1.07-2.87), initial fever during labor (adjusted OR 2.82, 95% CI 1.70-4.70), and fever at or above 102°F (adjusted OR 3.83, 95% CI 2.37-6.19). In an analysis restricted to neonates whose mothers had initial fevers before or in the immediate 24 hours after delivery, neonates born to women in the case group had higher rates of bacteremia compared with those born to women in the control group (9.0% compared with 1.3%, P<.01). Eight of the nine bacteremic neonates born to bacteremic mothers (89%) grew the same organism as his or her mother in blood culture. Maternal bacteremia is associated with multiparity, initial fever during labor, and fever at or above 102°F; however, 37.5% of cases of bacteremia occurred in women with maximum fevers below this threshold. Obstetricians should maintain a heightened suspicion for an

  4. Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS).

    Science.gov (United States)

    Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin; Lindqvist, Pelle G; Klungsøyr, Kari; Krebs, Lone; Børdahl, Per E; Gottvall, Karin; Källén, Karin; Bjarnadóttir, Ragnheiður I; Langhoff-Roos, Jens; Gissler, Mika

    2015-07-01

    To assess the prevalence and risk factors of emergency peripartum hysterectomy. Nordic collaborative study. 605 362 deliveries across the five Nordic countries. We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7 days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. Emergency peripartum hysterectomy rate. The total number of emergency peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10 000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n = 91, 43.1%), atonic bleeding (n = 69, 32.7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum hysterectomy. The number of stillbirths was substantially high (70/1000), but the case fatality rate stood at 0.47% (one death, maternal mortality rate 0.17/100 000 deliveries). A combination of prospective data collected from clinicians and information gathered from register-based databases can yield valuable data, improving the registration accuracy for rare, near-miss cases. However, proper and uniform clinical guidelines for the use of well-defined international diagnostic codes are still needed. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Peripartum events and molar-incisor hypomineralisation (MIH) amongst young patients in southwest France.

    Science.gov (United States)

    Garot, E; Manton, D; Rouas, P

    2016-08-01

    This was to investigate the association of peripartum events with the occurrence of MIH. This study, carried out between 2010 and 2011, was based on objective information noted in child health booklets on putative risk factors for MIH during the Peripartum period, aged between 6 to 28 years. The target population consisted of patients with MIH and a control group. Among the 849 patients examined by two calibrated paediatric dentists, 75 patients with MIH were recorded. These patients attended for consultation either at the teaching dental hospital of Bordeaux (France) or at a private dental practice (Bordeaux, France). Pearson's Chi-squared test was used and Odds ratios (OR) with 95 % test-based confidence intervals (CI) were calculated. Correlations were observed between hypoxia during delivery and occurrence of MIH (OR = 6.1; CI = 1.7-21.85), and also between birth by caesarean section and MIH (OR = 2.9; CI = 1.2-6.9). There was no association between prematurity and MIH. Peripartum events such as hypoxia during birth or delivery by caesarean section are suggested to be risk factors for the occurrence of MIH in this population.

  6. The Effect of Race on Provider Decisions to Test for Illicit Drug Use in the Peripartum Setting

    Science.gov (United States)

    KUNINS, HILLARY VEDA; BELLIN, ERAN; CHAZOTTE, CYNTHIA; DU, EVELYN; ARNSTEN, JULIA HOPE

    2010-01-01

    Background Testing for illicit drugs may expose women who test positive to severe legal and social consequences. It is unknown whether racial disparities in drug testing practices underlie observed disparities in legal and social consequences of positive tests. Methods Using administrative hospital and birth certificate data, we analyzed factors associated with both receipt and results of illicit drug testing among women with live births during 2002–2003. We assessed the independent association of race and other sociodemographic factors with both receipt of a drug test by the mother or her newborn infant and positive maternal or neonatal toxicology results, after controlling for obstetrical conditions and birth outcomes associated with maternal substance abuse. Results Of the 8487 women with live births, 244 mother-newborn pairs (3%) were tested for illicit drug use. Black women and their newborns were 1.5 times more likely to be tested for illicit drugs as nonblack women in multivariable analysis. However, race was not independently associated with a positive result. Conclusions We identified racial differences in rates of testing for illicit drug use between black and nonblack women. We found equivalent positivity rates among tested black and nonblack women. The prevalence of drug use among untested women is unknown, however, so although tested women had equivalent rates of substance use detected, whether black and nonblack substance users are equally likely to be identified in the course of peripartum care remains uncertain. PMID:17388741

  7. Recruiting and consenting into a peripartum trial in an emergency setting: a qualitative study of the experiences and views of women and healthcare professionals.

    Science.gov (United States)

    Lawton, Julia; Snowdon, Claire; Morrow, Susan; Norman, Jane E; Denison, Fiona C; Hallowell, Nina

    2016-04-11

    Recruiting and consenting women to peripartum trials can be challenging as the women concerned may be anxious, in pain, and exhausted; there may also be limited time for discussion and decision-making to occur. To address these potential difficulties, we undertook a qualitative evaluation of the internal pilot of a trial (Got-it) involving women who had a retained placenta (RP). We explored the experiences and views of women and staff about the information and consent pathway used within the pilot, in order to provide recommendations for use in future peripartum trials involving recruitment in emergency situations. In-depth interviews were undertaken with staff (n = 27) and participating women (n = 22). Interviews were analysed thematically. The accounts of women and staff were compared to identify differences and similarities in their views about recruitment and consent procedures. Women and staff regarded recruitment as having been straightforward and facilitated by the use of simplified (verbal and written) summaries of trial information. Both parties, however, conveyed discordant views about whether fully informed consent had been obtained. These differences in perspectives appeared to arise from the different factors and considerations impinging on women and staff at the time of recruitment. While staff placed emphasis on promoting understanding in the emergency situation of RP by imparting information in clear and succinct ways, women highlighted the experiential realities of their pre- and post-birthing situations, and how these had led to quick decisions being made without full engagement with the potential risks of trial participation. To facilitate informed consent, women suggested that trial information should be given during the antenatal period, and, in doing so, articulated a rights-based discourse. Staff, however, voiced opposition to this approach by emphasising a duty of care to all pregnant women, and raising concerns about causing undue

  8. Symbolic logic and mechanical theorem proving

    CERN Document Server

    Chang, Chin-Liang

    1969-01-01

    This book contains an introduction to symbolic logic and a thorough discussion of mechanical theorem proving and its applications. The book consists of three major parts. Chapters 2 and 3 constitute an introduction to symbolic logic. Chapters 4-9 introduce several techniques in mechanical theorem proving, and Chapters 10 an 11 show how theorem proving can be applied to various areas such as question answering, problem solving, program analysis, and program synthesis.

  9. Valutazione economica dello studio PROVE-IT

    Directory of Open Access Journals (Sweden)

    Lorenzo G. Mantovani

    2007-10-01

    Full Text Available Introduction: the PROVE-IT (“Intensive versus moderate lipid lowering with statins after acute coronary syndromes” was a comparison of pravastatin 40 mg/die versus atorvastatin 80 mg/die in patients with an acute coronary syndrome (ACS. Aim: our aim was to investigate the economic consequence of high dose of atorvastatin vs usual-dose of pravastatin in Italian patients with a history of acute coronary syndrome. Methods: the analysis is conducted on the basis of clinical outcomes of the PROVE-IT study. We conducted a cost-effectiveness analysis, comparing high dose of atorvastatin (80 mg/die versus usual-dose of pravastatin (40 mg/die in the perspective of the Italian National Health Service. We identified and quantified medical costs: drug costs according to the Italian National Therapeutic Formulary and hospitalizations were quantified based on the Italian National Health Service tariffs (2006. Effects were measured in terms of mortality and morbidity reduction (number of deaths, life years gained and frequency of hospitalizations. We considered an observation period of 24 months. The costs borne after the first 12 months were discounted using an annual rate of 3%. We conducted one and multi-way sensitivity analyses on unit cost and effectiveness. We also conducted a threshold analysis. Results: the cost of pravastatin or atorvastatin therapy over the 2 years period amounted to approximately 1.3 millions euro and 870,000 euro per 1,000 patients respectively. Atorvastatin was more efficacious compared to pravastatin and the overall cost of care per 1,000 patients over 24 months of follow-up was estimated at 3.2 millions euro in the pravastatin and 2.5 millions euro in the atorvastatin group, resulting into a cost saving of about 700,000 euro that is 27% of total costs occurred in the pravastatin group. Discussion: this study demonstrates that high does atorvastatin treatment leads to a reduction of direct costs for the National Health System

  10. Challenges in managing a mother with a dual diagnosis of peripartum cardiomyopathy and paranoid schizophrenia - a case report.

    Science.gov (United States)

    Weerasundera, Rajiv; Yogaratnam, Jegan

    2013-01-01

    Psychotic illness has a low incidence in the puerperal period. Peripartum cardiomyopathy as a complication of pregnancy is also rare. We report a case where the above two conditions occurred simultaneously in a patient and posed significant difficulties in the clinical management. She was diagnosed as having paranoid schizophrenia and peripartum cardiomyopathy. Many of the antipsychotics were contraindicated, and electroconvulsive therapy could not be administered due to the added risks involved with regard to anesthesia. She was therefore managed with clonazepam and olanzapine. This case highlights the challenges in a patient with a psychiatric illness presenting with comorbid physical illness. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Proving productivity in infinite data structures

    NARCIS (Netherlands)

    Zantema, H.; Raffelsieper, M.; Lynch, C.

    2010-01-01

    For a general class of infinite data structures including streams, binary trees, and the combination of finite and infinite lists, we investigate the notion of productivity. This generalizes stream productivity. We develop a general technique to prove productivity based on proving context-sensitive

  12. Proving relations between modular graph functions

    International Nuclear Information System (INIS)

    Basu, Anirban

    2016-01-01

    We consider modular graph functions that arise in the low energy expansion of the four graviton amplitude in type II string theory. The vertices of these graphs are the positions of insertions of vertex operators on the toroidal worldsheet, while the links are the scalar Green functions connecting the vertices. Graphs with four and five links satisfy several non-trivial relations, which have been proved recently. We prove these relations by using elementary properties of Green functions and the details of the graphs. We also prove a relation between modular graph functions with six links. (paper)

  13. Peripartum cardiomyopathy is associated with increased uric acid concentrations: A population based study.

    Science.gov (United States)

    Sagy, Iftach; Salman, Amjad Abu; Kezerle, Louise; Erez, Offer; Yoel, Idan; Barski, Leonid

    Peri-partum cardiomyopathy (PPCM) is a clinical heart failure that usually develops during the final stage of pregnancy or the first months following delivery. High maternal serum uric acid concentrations have been previous associated with heart failure and preeclampsia. 1) To explored the clinical characteristics of PPCM patients; and 2) to determine the association between maternal serum uric acid concentrations and PPCM. This is a retrospective population based case control study. Cases and controls were matched 1:4 (for gestational age, medical history of cardiac conditions and creatinine); conditional logistic regression was used to identify clinical parameters that were associated with PPCM. The prevalence of peripartum cardiomyopathy at our institution was 1-3832 deliveries (42/160,964). In a matched multivariate analysis high maternal serum uric acid concentrations were associated with PPCM (O.R 1.336, 95% C.I 1.003-1.778). Uric acid concentrations were higher within the Non-Jewish patients and mothers of male infant with PPCM in compare to those without PPCM (p value 0.003 and 0.01 respectively). PPCM patients had increased maternal serum uric acid concentrations. This observation aligns with previous report regarding the increased uric acid concentration in women with preeclampsia and congestive heart failure, suggestive of a common underlying mechanism that mediates the myocardial damage. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Metabolic profile of santa inês ewes whith low body condition score during peripartum

    Directory of Open Access Journals (Sweden)

    Nayara Resende Nasciutti

    2012-02-01

    Full Text Available The objective of this study was to analyse the variations in the metabolic profile of protein, energy enzyme and mineral of Santa Inês ewes with low body condition score (BCS during peripartum. Blood samples were collected from 12 animals by jugular venipuncture to determine the serum biochemical profiles of protein, energy, mineral and enzyme metabolisms. Samples were collected on the following days: days 28, 21, 14, and 7 before lambing, at birth and, at days 2, 4, 7, 14, 21, and 28 postpartum (dpp. The samples were centrifuged and the serum analysed by Automated-Analyser. There was no alteration of the BCS during the 28 dpp, between 0.6 and 2.1 ± 2.4 ± 0.5, and was considered, as lean. The values of the total serum protein, globulin, albumin, and albumin/globulin ratio were reduced effective from the period before birth until 28dpp. The values of beta-hydroxybutyrate, calcium, phosphorus and magnesium remained below those of reference values. The concentrations of alanin aminotransferase (ALT were decreased particularly during the weeks before delivery. It was concluded that Santa Inês sheep with low body condition score demonstrated a reduction in the metabolism of proteins, energy, mineral and enzyme during peripartum.

  15. Prolactin fragmentation by trophoblastic matrix metalloproteinases as a possible contributor to peripartum cardiomyopathy and pre-eclampsia

    NARCIS (Netherlands)

    Reuwer, Anne Q.; Reuwer, Paul J. H. M.; van der Post, Joris A.; Cramer, Maarten J.; Kastelein, John J. P.; Twickler, Marcel Th B.

    2010-01-01

    Although peripartum cardiomyopathy (PPCM) is a rare disease, it has very serious consequences for both mother and child. No single cause has been held responsible for the pathogenesis. Recent studies have indicated that increased proteolytic cathepsin D activity in cardiomyocytes results in 16 kDa

  16. Generic Example Proving Criteria for All

    Science.gov (United States)

    Yopp, David; Ely, Rob; Johnson­-Leung, Jennifer

    2015-01-01

    We review literature that discusses generic example proving and highlight ambiguities that pervade our research community's discourse about generic example arguments. We distinguish between pedagogical advice for choosing good examples that can serve as generic examples when teaching and advice for developing generic example arguments. We provide…

  17. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...

  18. SARS – Koch´Postulates proved.

    Indian Academy of Sciences (India)

    SARS – Koch´Postulates proved. Novel coronavirus identified from fluids of patients. Virus cultured in Vero cell line. Sera of patients have antibodies to virus. Cultured virus produces disease in Macaque monkeys. -produces specific immune response; -isolated virus is SARS CoV; -pathology similar to human.

  19. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review

    OpenAIRE

    Olieman, Renske M; Siemonsma, Femke; Bartens, Margaux A; Niegel, Susan; Scheele, Fedde; Honig, Adriaan

    2017-01-01

    Background Obstetricians are often reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear. To date, it is unknown if an ECS on request improves mental well-being in the mother in the peripartum period and if possible beneficial effects on anxiety and depression could outweigh the increased risk of complications associated with a surgical delivery. A systematic review was conducted to explore the effect of ECS on request on peripartum anxiety and depression. ...

  20. Association of a patent foramen ovale with myocardial infarction and pulmonary emboli in a peripartum woman.

    Science.gov (United States)

    Ramineni, Rajesh; Daniel, George K

    2010-10-01

    Peripartum myocardial infarction is uncommon but devastating in young women. Although it is generally associated with arterial dissection, pregnancy-induced hypercoagulable state can also be a major contributor. Association of patent foramen ovale (PFO) adds to this potential risk. A 29-year-old postpartum female presented with worsening chest pressure, shortness of breath and syncope. She was hypotensive and tachycardic. A ventilation perfusion imaging displayed high probability for pulmonary emboli. With elevated cardiac enzymes and echocardiogram showing wall motion abnormalities, patient underwent percutaneous coronary angioplasty for a midvessel thrombus in the left anterior descending artery. Further workup showed a thrombus straddling into the left atrium via a PFO and a deep venous thrombus in the right iliac vein. Hormonal changes in pregnancy are noted to place young women in a hypercoagulable state. Screening for PFO in this group of patients with timely intervention might prevent a major systemic event caused by paradoxical embolus.

  1. Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms

    Science.gov (United States)

    Iliadis, Stavros I.; Comasco, Erika; Sylvén, Sara; Hellgren, Charlotte; Sundström Poromaa, Inger; Skalkidou, Alkistis

    2015-01-01

    Background The biology of peripartum depression remains unclear, with altered stress and the Hypothalamus-Pituitary-Adrenal axis response having been implicated in its pathophysiology. Methods The current study was undertaken as a part of the BASIC project (Biology, Affect, Stress, Imaging, Cognition), a population-based longitudinal study of psychological wellbeing during pregnancy and the postpartum period in Uppsala County, Sweden, in order to assess the association between evening salivary cortisol levels and depressive symptoms in the peripartum period. Three hundred and sixty-five pregnant women from the BASIC cohort were recruited at pregnancy week 18 and instructed to complete a Swedish validated version of the Edinburgh Postnatal Depression Scale at the 36th week of pregnancy as well as the sixth week after delivery. At both times, they were also asked to provide evening salivary samples for cortisol analysis. A comprehensive review of the relevant literature is also provided. Results Women with postpartum EPDS score ≥ 10 had higher salivary evening cortisol at six weeks postpartum compared to healthy controls (median cortisol 1.19 vs 0.89 nmol/L). A logistic regression model showed a positive association between cortisol levels and depressive symptoms postpartum (OR = 4.1; 95% CI 1.7–9.7). This association remained significant even after controlling for history of depression, use of tobacco, partner support, breastfeeding, stressful life events, and sleep problems, as possible confounders (aOR = 4.5; 95% CI 1.5–14.1). Additionally, women with postpartum depressive symptoms had higher postpartum cortisol levels compared to both women with depressive symptoms antenatally and controls (p = 0.019 and p = 0.004, respectively). Conclusions Women with depressive symptoms postpartum had higher postpartum cortisol levels, indicating an altered response of the HPA-axis in postpartum depression. PMID:26322643

  2. Metabolic predictors of peri-partum diseases and their association with parity in dairy cows.

    Science.gov (United States)

    Ruprechter, Gretel; Adrien, Maria de Lourdes; Larriestra, Alejandro; Meotti, Otavio; Batista, Chester; Meikle, Ana; Noro, Mirela

    2018-02-19

    The predictive values of plasma non-esterified fatty acid (NEFA), beta-hydroxybutyrate (BHB), cholesterol, albumin and calcium to predict risk of peripartum diseases in primiparous (PP) and multiparous (MP) Holstein cows was investigated. Besides it was assessed if the health status interacted with parity on body condition score and metabolic profiles during the transition period. Dairy cows (126 PP and 182 MP) from a commercial dairy free stall herd (loose-housing system) were weekly body condition scored and tail bled for metabolites determination from -3 to +4 weeks relative to calving. Peripartum diseases were diagnosed by a single trained veterinarian, while subclinical diseases (ketosis and hypocalcemia) were diagnosed at the laboratory. Cows were classified as healthy cows, cows with one event, or cows with two clinical events following a prospective observational cohort study, with only healthy cows enrolled at the beginning of the study. The largest incidence was for metritis (26.6%) followed by retained placenta (17.2%) and mastitis (15.2%) with no effect of parity, while subclinical hypocalcemia incidence was greater in MP than PP cows (43% vs 9.5%) respectively. In MP cows albumin concentrations were predictive for metritis at week -2 and for retained placenta at weeks -2 and -1, while cholesterol was predictive for mastitis at week -2, -1 and at calving. The interaction between health status and parity affected all metabolites during the transition period. This study showed a different evolution of metabolic profiles in healthy and sick cows during the transition according to parity, pointing out albumin and cholesterol as diseases predictors before calving. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Peripartum cardiomyopathy: risk factors, hospital course and prognosis; experiences at lady reading hospital Peshawar

    International Nuclear Information System (INIS)

    Shah, I.; Shahzeb, A.; Shah, S.T.; Faheem, M.; Rafiullah, A.; Hafizullah, M.

    2012-01-01

    Objective: To study the so-called risk factors associated with peripartum cardiomyopathy (PPCM), its hospital course, short and long term mortality and outcome of subsequent pregnancies. Methodology: A total of 61 patients diagnosed with PPCM were enrolled in the study. Data regarding risk factors, presenting complaints, complications, pregnancy outcomes, therapeutics used and outcome at 3, 6 and 12 months were recorded. Results: The incidence was estimated to be 1 per 933 deliveries. Mean age +- SD was 30.94+-6.63 years. Majority of patients 33(54.1%) were obese. The mean parity was 3.66 +- 1.41. Other risk factors were chronic hypertension 19 (31.1%), pre-eclampsia 12 (19.7%) and multiple pregnancies 5(8.2%). Forty-three patients 43(70.5%) presented in post partum period while 18 (29.5%) in antepartum period. All patients presented with dyspnea. Main ECG findings were sinus tachycardia 39 (63.9%), LV hypertrophy 42 (68.9%) and T wave inversion 28(45.9%). Ejection fraction was universally reduced on echocardiography. There were 50(82%) live births and 11(18%) perinatal deaths. Main complications were pulmonary edema 7(11.5%), cardiogenic shock 8(13.1%) and thromboembolism 13(21.3%). At hospital discharge, 9 (14.8%) patients were dead and 52(85.2%) were discharged with stable heart failure. At 12 month follow up, a total of 20(32.8%) were dead while 32(52.5%) had recovered fully and 9(14.75%) were still suffering from heart failure. During follow up, only 8(19.5%) pregnancies were detected. Five (62.5%) patients had uneventful course while 3(37.5%) developed heart failure again. Conclusion: Peripartum cardiomyopathy is associated with multiple risk factors and carries high morbidity and mortality. (author)

  4. Peripartum Cardiomyopathy

    African Journals Online (AJOL)

    disease has multifactorial origin.[6] In acute ... devices, and extracorporeal membrane oxygenation. In severe ... In this article, we reviewed the current status of PPCM. Materials .... concentration of plasma inflammatory cytokines such as tumor.

  5. Peripartum cardiomyopathy

    Science.gov (United States)

    ... sounds. The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when standing up. Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement ...

  6. Peripartum cardiomyopathy

    DEFF Research Database (Denmark)

    Ersboll, Anne S.; Damm, Peter; Gustafsson, Finn

    2016-01-01

    . The prevalence of concomitant preeclampsia is high (often 30-45%) and symptoms can be similar, posing diagnostic difficulties. Most women (71-98%) present postpartum. Echocardiography is essential for diagnosis, and cardiac magnetic resonance imaging may provide new insights to pathophysiology and prognosis....... Management is multidisciplinary and involves advanced heart failure therapy. Treatment, timing and mode of delivery in pregnant women depend on disease severity. The risk of relapse in subsequent pregnancies is >20%, and women are often advised against a new pregnancy. CONCLUSIONS: PPCM has a huge impact...... of pathophysiology, diagnostics and clinical management. MATERIAL AND METHODS: Systematic literature searches were performed in PubMed and Embase up to June 2016. Cohorts of more than 20 women with PPCM conducted after 2000 were selected to report contemporary outcomes and prognostic data. Guidelines and reviews...

  7. Proving Non-Deterministic Computations in Agda

    Directory of Open Access Journals (Sweden)

    Sergio Antoy

    2017-01-01

    Full Text Available We investigate proving properties of Curry programs using Agda. First, we address the functional correctness of Curry functions that, apart from some syntactic and semantic differences, are in the intersection of the two languages. Second, we use Agda to model non-deterministic functions with two distinct and competitive approaches incorporating the non-determinism. The first approach eliminates non-determinism by considering the set of all non-deterministic values produced by an application. The second approach encodes every non-deterministic choice that the application could perform. We consider our initial experiment a success. Although proving properties of programs is a notoriously difficult task, the functional logic paradigm does not seem to add any significant layer of difficulty or complexity to the task.

  8. The role of therapeutic optimism in recruitment to a clinical trial in a peripartum setting: balancing hope and uncertainty.

    Science.gov (United States)

    Hallowell, Nina; Snowdon, Claire; Morrow, Susan; Norman, Jane E; Denison, Fiona C; Lawton, Julia

    2016-06-01

    Hope has therapeutic value because it enables people to cope with uncertainty about their future health. Indeed, hope, or therapeutic optimism (TO), is seen as an essential aspect of the provision and experience of medical care. The role of TO in clinical research has been briefly discussed, but the concept, and whether it can be transferred from care to research and from patients to clinicians, has not been fully investigated. The role played by TO in research emerged during interviews with staff involved in a peripartum trial. This paper unpacks the concept of TO in this setting and considers the role it may play in the wider delivery of clinical trials. The Got-it trial is a UK-based, randomised placebo-controlled trial that investigates the use of sublingual glyceryl trinitrate (GTN) spray to treat retained placenta. Qualitative data were collected in open-ended interviews with obstetricians, research and clinical midwives (n =27) involved in trial recruitment. Data were analysed using the method of constant comparison. TO influenced staff engagement with Got-it at different points in the trial and in different ways. Prior knowledge of, and familiarity with, GTN meant that from the outset staff perceived the trial as low risk. TO facilitated staff involvement in the trial; staff who already understood GTN's effects were optimistic that it would work, and staff collaborated because they hoped that the trial would address what they identified as an important clinical need. TO could fluctuate over the course of the trial, and was sustained or undermined by unofficial observation of clinical outcomes and speculations about treatment allocation. Thus, TO appeared to be influenced by key situational factors: prior knowledge and experience, clinical need and observed participant outcomes. Situational TO plays a role in facilitating staff engagement with clinical research. TO may affect trial recruitment by enabling staff to sustain the levels of uncertainty, or

  9. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...... of parameters of continuations in its output. To this end, we specify the one-pass CPS transformation relationally and we use the proof technique of logical relations....

  10. Theorem Proving In Higher Order Logics

    Science.gov (United States)

    Carreno, Victor A. (Editor); Munoz, Cesar A.; Tahar, Sofiene

    2002-01-01

    The TPHOLs International Conference serves as a venue for the presentation of work in theorem proving in higher-order logics and related areas in deduction, formal specification, software and hardware verification, and other applications. Fourteen papers were submitted to Track B (Work in Progress), which are included in this volume. Authors of Track B papers gave short introductory talks that were followed by an open poster session. The FCM 2002 Workshop aimed to bring together researchers working on the formalisation of continuous mathematics in theorem proving systems with those needing such libraries for their applications. Many of the major higher order theorem proving systems now have a formalisation of the real numbers and various levels of real analysis support. This work is of interest in a number of application areas, such as formal methods development for hardware and software application and computer supported mathematics. The FCM 2002 consisted of three papers, presented by their authors at the workshop venue, and one invited talk.

  11. Automated theorem proving theory and practice

    CERN Document Server

    Newborn, Monty

    2001-01-01

    As the 21st century begins, the power of our magical new tool and partner, the computer, is increasing at an astonishing rate. Computers that perform billions of operations per second are now commonplace. Multiprocessors with thousands of little computers - relatively little! -can now carry out parallel computations and solve problems in seconds that only a few years ago took days or months. Chess-playing programs are on an even footing with the world's best players. IBM's Deep Blue defeated world champion Garry Kasparov in a match several years ago. Increasingly computers are expected to be more intelligent, to reason, to be able to draw conclusions from given facts, or abstractly, to prove theorems-the subject of this book. Specifically, this book is about two theorem-proving programs, THEO and HERBY. The first four chapters contain introductory material about automated theorem proving and the two programs. This includes material on the language used to express theorems, predicate calculus, and the rules of...

  12. Theorem Proving in Intel Hardware Design

    Science.gov (United States)

    O'Leary, John

    2009-01-01

    For the past decade, a framework combining model checking (symbolic trajectory evaluation) and higher-order logic theorem proving has been in production use at Intel. Our tools and methodology have been used to formally verify execution cluster functionality (including floating-point operations) for a number of Intel products, including the Pentium(Registered TradeMark)4 and Core(TradeMark)i7 processors. Hardware verification in 2009 is much more challenging than it was in 1999 - today s CPU chip designs contain many processor cores and significant firmware content. This talk will attempt to distill the lessons learned over the past ten years, discuss how they apply to today s problems, outline some future directions.

  13. a Test to Prove Cloud Whitening THEORY!

    Science.gov (United States)

    Buttram, J. W.

    2011-12-01

    Climate science researchers believe our planet can possibly tolerate twice the present carbon dioxide levels with no upwards temperature change, IF we could increase the amount of energy reflected back out into space by about 2.0%. (c)Cloudtec basically alters a blend of seawater and applies heat derived from magma to it at a temperature exceeding 2,000 degrees F. The interaction of seawater and magma displaces the oxygen, causing the volume of water to vaporize and expand over 4,000 times - transforming billions of tons of seawater into thousands of cubic miles of white, maritime, stratocumulus clouds to reflect the incident Sun's rays back out into space. A 6 month test to prove Cloud Whitening Theory will cost 6 million dollars. (No profit added.) This study will enable everyone on the planet with a computer the transparency to use satellite imagery and check out for themselves - if and when Cloud Whitening is occurring. If Cloud Whitening Theory is validated, (c)Cloudtec's innovation can strategically create the clouds we need to reflect the Sun's rays back out into space and help neutralize the projected 3.6 degrees F rise in temperature. Based on reasonable calculations of anthropogenic global warming: this one move alone would be comparable to slashing global carbon dioxide emissions by over 60% over the next 40 years.

  14. Usefulness of vessel-sealing devices for peripartum hysterectomy: a retrospective cohort study.

    Science.gov (United States)

    Rossetti, Diego; Vitale, Salvatore Giovanni; Bogani, Giorgio; Rapisarda, Agnese Maria Chiara; Gulino, Ferdinando Antonio; Frigerio, Luigi

    2015-09-01

    To evaluate the feasibility to perform peripartum hysterectomy (PH) with the introduction of LigaSure™ vessels-sealing device (LVSD) and how it influenced the surgical outcomes. We retrospectively evaluated procedures and outcome of women undergoing PH during the period between January 2001 and October 2013. Perioperative surgical results of patients undergoing PH using LVSD were compared to patients undergoing PH without LVSD. Forty-nine subjects had PH during the study period. Twenty (41%) hysterectomies were performed for placenta accreta, 8 (16%) for placenta previa, 21 (43%) for atony. Twenty-three subjects had PH using LVSD and 26 subjects had hysterectomy without the use of this device. We observe significant differences in estimated blood loss (p = 0.001), massive blood transfusions (>10 units RBC) (p = 0.025), operative time (p = 0.06). No difference in term of hospital stay and complications were observed (p = 0.78 and p = 0.35). One patient for each group had intraoperative complication (p = 0.9). The use of LVSD during PH does not increase operative complications, blood loss, and operative time in comparison to standard procedure.

  15. Transient peripartum osteoporosis of the femoral head in first and third pregnancy.

    Science.gov (United States)

    Truszczyńska, Aleksandra; Walczak, Piotr; Rapała, Kazimierz

    2012-01-01

    The aim of this article was to present transient peripartum femoral head osteoporosis. This very rare condition occurred twice in our patient-a woman in her 30s. The cases described in the literature were mostly unilateral, with bilateral hip involvement noted much less frequently. In our patient, transient osteoporosis occurred in the third trimester of her first pregnancy in the right hip, her second pregnancy was uncomplicated, and in the third trimester of the patient's third pregnancy, osteoporotic changes were noted in the left hip joint. The patient breastfed her first and third babies only 3 wk each. She breastfed her second baby for 4 mo. The diagnostic workup was based on the clinical examination and radiographic/magnetic resonance imaging, which revealed bone marrow edema, and the dual-energy X-ray absorptiometry scans. The treatment consisted in core decompression of the femoral head (foragé), unloading of the hip using crutches as well as administration of calcitonin and calcium supplements. Complete recovery of the femoral heads was achieved. The follow-up time was 7 yr. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  16. The Medical Treatment of New-Onset Peripartum Cardiomyopathy: A Systematic Review of Prospective Studies.

    Science.gov (United States)

    Desplantie, Olivier; Tremblay-Gravel, Maxime; Avram, Robert; Marquis-Gravel, Guillaume; Ducharme, Anique; Jolicoeur, E Marc

    2015-12-01

    Peripartum cardiomyopathy (PPCM) is a rare disorder with potentially fatal consequences, which occurs mainly in previously healthy women. The aetiology of PPCM remains unknown and various pathologic mechanisms have been proposed, including immune-mediated injuries and impaired response to oxidative stress and inflammatory cytokines. Several therapies have been studied, but few have been validated in a well-designed randomized controlled trial. In the present study we sought to review the medical treatment intended for acute PPCM. To this end, we performed a systematic review of the literature of randomized and nonrandomized prospective clinical studies. We identified 2 randomized controlled trials that evaluated the dopamine agonist bromocriptine and the inotrope levosimendan, respectively, and 1 nonrandomized study that evaluated the nonselective phosphodiesterase inhibitor pentoxifylline. We reviewed the pathophysiological, pharmacological, and clinical properties for each treatment option identified. Bromocriptine and pentoxifylline both improved left ventricular systolic function and patient-oriented clinical end points and levosimendan did not improve mortality or echocardiographic findings of PPCM. In this review we identified bromocriptine and pentoxifylline, but not levosimendan, as potentially useful agents to improve left ventricle function and outcomes in PPCM. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  17. Peripartum hysterectomy in the first decade of the 21st century.

    LENUS (Irish Health Repository)

    Tadesse, W

    2012-02-01

    We reviewed the role of peripartum hysterectomy (PH) in the first decade of the 21st century. The study was confined to women who delivered a baby weighing 500 g or more between 2000 and 2009, and who required a hysterectomy within 72 h of delivery for obstetric reasons. Individual case records were reviewed. There were 19 cases of PH in 78,961 deliveries giving an incidence of 1 in 4,156 (0.02%). Of the 19 cases, 95% were delivered by caesarean section and 89% had one or more prior sections. The indications were placental bed pathology (79%), uterine atony (16%) and uterine trauma (5%). Of the 19 hysterectomies, 16 (84%) were total and a gynaecological oncologist was involved in nine (56%) of these cases. There were no maternal or fetal deaths, but a mother required an average blood transfusion of 10 units. The overall rate of PH was remarkably low compared with other studies but it is likely to increase in the future because of the strong association between increasing caesarean section rates and placental bed pathology. The potential involvement of the cervix and other pelvic structures by placental pathology means that PH in the future will be more challenging, and the hysterectomy will need to be total rather than subtotal.

  18. L’Inquisizione, gli indizi, le prove

    Directory of Open Access Journals (Sweden)

    Guido Dall’Olio

    2012-11-01

    Full Text Available This essay focuses on some characteristics of the inquisitorial trial, comparing it with the accusatory procedure. The inquisitorial trial, which resulted in almost inevitable torture of the accused, is certainly in our eyes an injustice and a violation of the legal rights that are essential for us in a proper procedure. However, the care with which the evidence was produced and examined by the institutions that adopted the inquisitorial procedure deserves to be emphasized, especially for the consequences it had in certain types of imaginary crime such as witchcraft.

  19. Rationale and Design for the Peripartum Cardiomyopathy in Nigeria (PEACE Registry

    Directory of Open Access Journals (Sweden)

    Kamilu M Karaye

    2017-01-01

    Full Text Available Background Nigeria probably has the highest burden of Peripartum Cardiomyopathy (PPCM in the world. The primary objective of this study is to describe the burden, ventricular remodelling and survival of PPCM in Nigeria. In the sub-studies, we aim to describe the relationship between selenium deficiency, oxidative stress and PPCM, the impact of sodium selenite supplementation on left ventricular reverse remodelling, change in New York Heart Association functional class and survival in PPCM, and the prevalence of selenium deficiency and its relationship with cardiac function in apparently healthy pregnant women. Methods The main registry and the first sub-study are prospective longitudinal studies, while the second sub-study is an open-label randomised trial. 36 study centres across Nigeria have been registered and 14 of them are already recruiting subjects. Patients will be recruited from June to December 2017 and followed up till December 2018. Serum selenium and glutathione peroxidase will be assayed at recruitment for consecutive PPCM patients with LV ejection fraction (LVEF <45% at 6 months postpartum. 200 subjects with selenium deficiency will be randomised into treatment (Selenium Selenite 200μg tablets daily for 3 months and no-treatment arms. In the second sub-study, 120 apparently healthy pregnant women (Controls will be recruited at 28-38 weeks of gestation and reviewed at 6-8 weeks postpartum, and their serum selenium and GPO levels will be measured at recruitment. Conclusions This will be the largest systematic evaluation of PPCM in Nigeria, and it is hoped that the information will assist in understanding the disease better and developing locally applicable interventions for the disease. ClinicalTrials.gov Identifier: NCT03081949

  20. Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study

    Directory of Open Access Journals (Sweden)

    Denisa-Oana Bălălău

    2016-04-01

    Full Text Available Emergency peripartum hysterectomy (EPH is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 cases occurred one or more of the risk factors that lead to EPH, divided equally across the two groups above. The main two types of surgery are a more frequent subtotal hysterectomy, which is the preferred type of EPH as it takes less time and is associated with fewer complications, and a total hysterectomy. The majority of procedures were performed at patients over 35 years old (9 of 12, with a median age of 31,16 (ranging from 21 to 44 years old. The most important risk factor present across the lot was multiparity (11 from 12, with cicatricial uterus being the second one (4 of 12. ICU median time was 4,5 days (ranging from 3 to 15 days, with a median blood transfusion necessity of around 2,4 I.U per patient. There were no mother or newborn reported deaths, neither PTSD following EPH.EPH is a procedure performed as last-resort, life-saving surgery, leaving no time for mental preparation of the patients. This may predispose to negative psychological outcomes, especially because they are not part of decision-making process due to the emergency character of hysterectomy.

  1. Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More?

    Directory of Open Access Journals (Sweden)

    Hironori Takahashi

    2016-01-01

    Full Text Available Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy. Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919. Of the 18, 14 (78% had a prior cesarean section (CS history and the other 4 (22% were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%, with the remaining 6 (33% undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67% patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%. Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon (4,448±1,948 versus 8,861±3,988 mL, planned hysterectomy (5,003±2,057 versus 9,957±4,485 mL, and prior CS (5,706±2,727 versus 9,975±5,532 mL. Patients with prior CS (− bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation. Conclusion. Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS.

  2. Impact of Preeclampsia on Clinical and Functional Outcomes in Women With Peripartum Cardiomyopathy.

    Science.gov (United States)

    Lindley, Kathryn J; Conner, Shayna N; Cahill, Alison G; Novak, Eric; Mann, Douglas L

    2017-06-01

    Preeclampsia is a risk factor for the development of peripartum cardiomyopathy (PPCM), but it is unknown whether preeclampsia impacts clinical or left ventricular (LV) functional outcomes. This study sought to assess clinical and functional outcomes in women with PPCM complicated by preeclampsia. This retrospective cohort study included women diagnosed with PPCM delivering at Barnes-Jewish Hospital between 2004 to 2014. The primary outcome was one-year event-free survival rate for the combined end point of death and hospital readmission. The secondary outcome was recovery of LV ejection fraction. Seventeen of 39 women (44%) with PPCM had preeclampsia. The groups had similar mean LV ejection fraction at diagnosis (29.6 with versus 27.3 without preeclampsia; P =0.5). Women with preeclampsia had smaller mean LV end-diastolic diameters (5.2 versus 6.0 cm; P =0.001), greater relative wall thickness (0.41 versus 0.35 mm Hg; P =0.009), and lower incidence of eccentric remodeling (12% versus 48%; P =0.03). Clinical follow-up was available for 32 women; 5 died of cardiovascular complications within 1 year of diagnosis (4/15 with versus 1/17 without preeclampsia; P =0.16). In time to event analysis, patients with preeclampsia had worse event-free survival during 1-year follow-up ( P =0.047). Echocardiographic follow-up was available in 10 survivors with and 16 without preeclampsia. LV ejection fraction recovered in 80% of survivors with versus 25% without preeclampsia ( P =0.014). PPCM with concomitant preeclampsia is associated with increased morbidity and mortality and different patterns of LV remodeling and recovery of LV function when compared with patients with PPCM that is not complicated by preeclampsia. © 2017 American Heart Association, Inc.

  3. Defining the Adipose Tissue Proteome of Dairy Cows to Reveal Biomarkers Related to Peripartum Insulin Resistance and Metabolic Status.

    Science.gov (United States)

    Zachut, Maya

    2015-07-02

    Adipose tissue is a central regulator of metabolism in dairy cows; however, little is known about the association between various proteins in adipose tissue and the metabolic status of peripartum cows. Therefore, the objectives were to (1) examine total protein expression in adipose tissue of dairy cows and (2) identify biomarkers in adipose that are linked to insulin resistance and to cows' metabolic status. Adipose tissue biopsies were obtained from eight multiparous cows at -17 and +4 days relative to parturition. Proteins were analyzed by intensity-based, label-free, quantitative shotgun proteomics (nanoLC-MS/MS). Cows were divided into groups with insulin-resistant (IR) and insulin-sensitive (IS) adipose according to protein kinase B phosphorylation following insulin stimulation. Cows with IR adipose lost more body weight postpartum compared with IS cows. Differential expression of 143 out of 586 proteins was detected in prepartum versus postpartum adipose. Comparing IR to IS adipose revealed differential expression of 18.9% of the proteins; those related to lipolysis (hormone-sensitive lipase, perilipin, monoglycerol lipase) were increased in IR adipose. In conclusion, we found novel biomarkers related to IR in adipose and to metabolic status that could be used to characterize high-yielding dairy cows that are better adapted to peripartum metabolic stress.

  4. Peripartum Antibiotics Promote Gut Dysbiosis, Loss of Immune Tolerance, and Inflammatory Bowel Disease in Genetically Prone Offspring.

    Science.gov (United States)

    Miyoshi, Jun; Bobe, Alexandria M; Miyoshi, Sawako; Huang, Yong; Hubert, Nathaniel; Delmont, Tom O; Eren, A Murat; Leone, Vanessa; Chang, Eugene B

    2017-07-11

    Factors affecting the developing neonatal gut microbiome and immune networks may increase the risk of developing complex immune disorders such as inflammatory bowel diseases (IBD). In particular, peripartum antibiotics have been suggested as risk factors for human IBD, although direct evidence is lacking. Therefore, we examined the temporal impact of the commonly used antibiotic cefoperazone on both maternal and offspring microbiota when administered to dams during the peripartum period in the IL-10-deficient murine colitis model. By rigorously controlling for cage, gender, generational, and murine pathobiont confounders, we observed that offspring from cefoperazone-exposed dams develop a persistent gut dysbiosis into adulthood associated with skewing of the host immune system and increased susceptibility to spontaneous and chemically dextran sodium sulfate (DSS)-induced colitis. Thus, early life exposure to antibiotic-induced maternal dysbiosis during a critical developmental window for gut microbial assemblage and immune programming elicits a lasting impact of increased IBD risk on genetically susceptible offspring. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  5. Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy.

    Science.gov (United States)

    Haghikia, A; Podewski, E; Libhaber, E; Labidi, S; Fischer, D; Roentgen, P; Tsikas, D; Jordan, J; Lichtinghagen, R; von Kaisenberg, C S; Struman, I; Bovy, N; Sliwa, K; Bauersachs, J; Hilfiker-Kleiner, Denise

    2013-07-01

    Peripartum cardiomyopathy (PPCM) is a life-threatening heart disease developing towards the end of pregnancy or in the months following delivery in previously healthy women in terms of cardiac disease. Enhanced oxidative stress and the subsequent cleavage of the nursing hormone Prolactin into an anti-angiogenic 16 kDa subfragment emerged as a potential causal factor of the disease. We established a prospective registry with confirmed PPCM present in 115 patients (mean baseline left ventricular ejection fraction, LVEF: 27 ± 9 %). Follow-up data (6 ± 3 months) showed LVEF improvement in 85 % and full recovery in 47 % while 15 % failed to recover with death in 2 % of patients. A positive family history of cardiomyopathy was present in 16.5 %. Pregnancy-associated hypertension was associated with a better outcome while a baseline LVEF ≤ 25 % was associated with a worse outcome. A high recovery rate (96 %) was observed in patients obtaining combination therapy with beta-blocker, angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor-blockers (ARBs) and bromocriptine. Increased serum levels of Cathepsin D, the enzyme that generates 16 kDa Prolactin, miR-146a, a direct target of 16 kDa Prolactin, N-terminal-pro-brain-natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) emerged as biomarkers for PPCM. In conclusion, low baseline LVEF is a predictor for poor outcome while pregnancy-induced hypertensive disorders are associated with a better outcome in this European PPCM cohort. The high recovery rate in this collective is associated with a treatment concept using beta-blockers, ACE inhibitors/ARBs and bromocriptine. Increased levels of Cathepsin D activity, miR-146a and ADMA in serum of PPCM patients support the pathophysiological role of 16 kDa Prolactin for PPCM and may be used as a specific diagnostic marker profile.

  6. Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using item response theory (IRT).

    Science.gov (United States)

    Hoertel, Nicolas; López, Saioa; Peyre, Hugo; Wall, Melanie M; González-Pinto, Ana; Limosin, Frédéric; Blanco, Carlos

    2015-02-01

    Whether there are systematic differences in depression symptom expression during pregnancy, the postpartum period and outside these periods (i.e., outside the peripartum period) remains debated. The aim of this study was to use methods based on item response theory (IRT) to examine, after equating for depression severity, differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) in women of childbearing age (i.e., aged 18-50) during pregnancy, the postpartum period and outside the peripartum period. We conducted these analyses using a large, nationally representative sample of women of childbearing age from the United States (n = 11,256) who participated in the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The overall 12-month prevalence of all depressive criteria (except for worthlessness/guilt) was significantly lower in pregnant women than in women of childbearing age outside the peripartum period, whereas the prevalence of all symptoms (except for "psychomotor symptoms") was not significantly different between the postpartum and the nonperipartum group. There were no clinically significant differences in the endorsement rates of symptoms of MDE by pregnancy status when equating for levels of depression severity. This study suggests that the clinical presentation of depressive symptoms in women of childbearing age does not differ during pregnancy, the postpartum period and outside the peripartum period. These findings do not provide psychometric support for the inclusion of the peripartum onset specifier for major depressive disorder in the DSM-5. © 2014 Wiley Periodicals, Inc.

  7. Perturbation of neonatal microbial gut community by peripartum antibiotics in wistar rats lead to decreased weight gain

    DEFF Research Database (Denmark)

    Tulstrup, Monica Vera-Lise; Bahl, Martin Iain; Roager, Henrik Munch

    2016-01-01

    orally to either mothers or young children to treat or prevent bacterial infections not necessarily related to the gastrointestinal system. This has adverse effects on the commensal gut microbial community, as it disrupts the intricate balance between specific bacterial groups within this ecosystem......, potentially leading to dysbiosis. We hypothesized that modulation of community composition and function induced by peripartum antibiotics affects intestinal microbial composition and general health of the offspring. To address this, 33 pregnant Wistar rats were dosed by oral gavage with either amoxicillin......H as well as spleen size than control animals. Offspring were dissected at different time points and significant changes in liver, spleen and epididymal fat were measured between groups. Composition of the gut microbiota, alpha diversity, caecum short chain fatty acid levels, caloric contents of faeces...

  8. Characterization of peripartum rumination and activity of cows diagnosed with metabolic and uterine diseases.

    Science.gov (United States)

    Liboreiro, Daniela N; Machado, Karine S; Silva, Paula R B; Maturana, Milton M; Nishimura, Thiago K; Brandão, Alice P; Endres, Márcia I; Chebel, Ricardo C

    2015-10-01

    The objectives of the current experiment were to characterize the correlation among total serum Ca, nonesterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), and haptoglobin concentrations and daily rumination time (DRT) and activity of periparturient cows and to determine the association between periparturient events and peripartum DRT and activity. Holstein animals (nulliparous = 77, parous = 219) were enrolled in the experiment approximately 21 d before expected calving date. Cows were fitted with individual Heat Rumination Long Distance collars (HRLD, SCR Engineers Ltd., Netanya, Israel) from enrollment until approximately 21 ± 3 d postpartum. Blood samples collected weekly from enrollment to 21 d postpartum were used to determine concentrations of NEFA, BHBA, and haptoglobin. Blood samples collected within 72 h after calving were used to determine total serum Ca concentration. Subclinical ketosis was characterized by BHBA > 1,000 µmol/L in any sample, and subclinical hypocalcemia was characterized by Ca Cows were examined 1, 7 ± 3, and 14 ± 3 d postpartum for diagnosis of retained fetal membrane and metritis. Total Ca (r = 0.15), NEFA (r = -0.27), and haptoglobin (r = -0.18) concentrations were weakly correlated with DRT. Concentration of BHBA (r = -0.14) was weakly correlated with activity. Postpartum DRT was reduced among cows that delivered twins compared with cows that delivered singletons (437.9 ± 4.8 vs. 385.9 ± 17.1 min/d). Prepartum (465.8 ± 4.1 vs 430.8 ± 14.9 arbitrary units) and postpartum (536.5 ± 5.5 vs. 480.3 ± 19.4 arbitrary units) activity were reduced among cows that delivered twins compared with cows that delivered singletons. Delivery of stillborn calves was associated with reduced DRT prepartum (478.0 ± 5.9 vs. 417.0 ± 23.4 min/d) and postpartum (437.2 ± 4.8 vs. 386.5 ± 19.3 min/d). On the other hand, cows delivering stillborn calves had increased activity prepartum compared with cows delivering live calves (499.3 ± 16

  9. Preservice Mathematics Teachers' Metaphorical Perceptions towards Proof and Proving

    Science.gov (United States)

    Ersen, Zeynep Bahar

    2016-01-01

    Since mathematical proof and proving are in the center of mathematics; preservice mathematics teachers' perceptions against these concepts have a great importance. Therefore, the study aimed to determine preservice mathematics teachers' perceptions towards proof and proving through metaphors. The participants consisted of 192 preservice…

  10. Proving termination of logic programs with delay declarations

    NARCIS (Netherlands)

    E. Marchiori; F. Teusink (Frank)

    1996-01-01

    textabstractIn this paper we propose a method for proving termination of logic programs with delay declarations. The method is based on the notion of recurrent logic program, which is used to prove programs terminating wrt an arbitrary selection rule. Most importantly, we use the notion of bound

  11. 20 CFR 219.23 - Evidence to prove death.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evidence to prove death. 219.23 Section 219... EVIDENCE REQUIRED FOR PAYMENT Evidence of Age and Death § 219.23 Evidence to prove death. (a) Preferred evidence of death. The best evidence of a person's death is— (1) A certified copy of or extract from the...

  12. A New Approach for Proving or Generating Combinatorial Identities

    Science.gov (United States)

    Gonzalez, Luis

    2010-01-01

    A new method for proving, in an immediate way, many combinatorial identities is presented. The method is based on a simple recursive combinatorial formula involving n + 1 arbitrary real parameters. Moreover, this formula enables one not only to prove, but also generate many different combinatorial identities (not being required to know them "a…

  13. Reasoning and Proving Opportunities in Textbooks: A Comparative Analysis

    Science.gov (United States)

    Hong, Dae S.; Choi, Kyong Mi

    2018-01-01

    In this study, we analyzed and compared reasoning and proving opportunities in geometry lessons from American standard-based textbooks and Korean textbooks to understand how these textbooks provide student opportunities to engage in reasoning and proving activities. Overall, around 40% of exercise problems in Core Plus Mathematics Project (CPMP)…

  14. The Earth is Flat, and I Can Prove It!

    Science.gov (United States)

    Klinger, Art

    1998-01-01

    Describes an educational program that asks students to attempt to prove that the earth is spherical and that it rotates. Presents tips to pique student interest and charts related to sensing the spin, nonrotation notions, flat earth fallacies, evidence that the earth is spherical and rotates, and the role of watersheds in proving that the earth…

  15. Effects of dietary energy levels using calcium salts of fatty acids on nutritive value of diets and milk quality in peripartum dairy goats

    Directory of Open Access Journals (Sweden)

    Rodrigo de Souza

    2014-06-01

    Full Text Available Peripartum is a critical period for dairy goats, as dry matter intake (DMI is not enough to supply the energy requirement for foetal growth and subsequent lactation. The objective of this study was to evaluate the use of calcium salts of fatty acids (CSFA to increase dietary energy level of peripartum dairy goats and its effects on nutritive value of diets and milk quality. Twenty multiparous Saanen goats (body weight 63.5±10.3 kg were distributed in a completely randomised design in four treatments at the following dietary energy levels: 2.6 Mcal of metabolisable energy per kg of dry matter (Mcal ME/kg DM - control diet; and 2.7, 2.8, and 2.9 Mcal/kg DM - with added CSFA. Goats were housed in individual stalls and evaluated in the peripartum period, by measuring body weight (BW, DMI, dry matter and nutrient digestibility of diets, blood composition, and milk quality and yield. Increasing dietary energy level to 2.9 Mcal ME/kg DM had no effect on BW and did not limit DMI. CSFA supplementation increased intake of total digestible nutrients and did not affect fibre digestion. Blood triglycerides and cholesterol concentration increased with CSFA addition. The treatments had no effect on milk yield and composition; however, CSFA supplementation changed the fatty acid concentration of milk fat, increasing levels of polyunsaturated and essential fatty acids. In conclusion, peripartum dairy goats supplemented with CSFA to increase dietary energy level up to 2.9 Mcal ME/kg DM had a greater supply of total digestible nutrients and showed altered fatty acid concentration of milk fat.

  16. Written versus verbal consent: a qualitative study of stakeholder views of consent procedures used at the time of recruitment into a peripartum trial conducted in an emergency setting.

    Science.gov (United States)

    Lawton, J; Hallowell, N; Snowdon, C; Norman, J E; Carruthers, K; Denison, F C

    2017-05-24

    Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women's and staff views about the consent procedures used during the internal pilot of a trial (GOT-IT), where the protocol permitted staff to gain verbal consent at recruitment. Interviews with staff (n = 27) and participating women (n = 22). Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants' views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for

  17. On the problem of proving the existence of ''charmed'' particles

    International Nuclear Information System (INIS)

    Tyapkin, A.A.

    1975-01-01

    In order to search for ''charmed'' particles a possibility of performing an experiment is discussed in which one could observe a new particle and prove a necessity of introducting for this particle a new quantum number conserved in strong interactions

  18. Models and Techniques for Proving Data Structure Lower Bounds

    DEFF Research Database (Denmark)

    Larsen, Kasper Green

    In this dissertation, we present a number of new techniques and tools for proving lower bounds on the operational time of data structures. These techniques provide new lines of attack for proving lower bounds in both the cell probe model, the group model, the pointer machine model and the I...... bound of tutq = (lgd􀀀1 n). For ball range searching, we get a lower bound of tutq = (n1􀀀1=d). The highest previous lower bound proved in the group model does not exceed ((lg n= lg lg n)2) on the maximum of tu and tq. Finally, we present a new technique for proving lower bounds....../O-model. In all cases, we push the frontiers further by proving lower bounds higher than what could possibly be proved using previously known techniques. For the cell probe model, our results have the following consequences: The rst (lg n) query time lower bound for linear space static data structures...

  19. Effect of Moxidectin Treatment at Peripartum on Gastrointestinal Parasite Infections in Ewes Raised under Tropical Andes High Altitude Conditions

    Science.gov (United States)

    Vargas-Duarte, J. J.; Lozano-Márquez, H.; Grajales-Lombana, H. A.; Manrique-Perdomo, C.; Martínez-Bello, D. A.; Saegerman, C.; Raes, M.; Kirschvink, N.

    2015-01-01

    This study tested the impact of moxidectin at peripartum on nematode fecal egg count (FEC) and clinical parameters on ewes in the high altitude tropical Andes of Colombia. FEC and clinical evaluations were performed on 9 occasions in 43 naturally infected ewes before and during gestation and after lambing. Moxidectin (Mox, 200 µg kg−1) was applied at late pregnancy (T 1, n = 15) or 48 hours after parturition (T 2, n = 14). 14 untreated ewes served as controls (C). Suckling lambs (n = 58) remained untreated and underwent four clinical and parasitological evaluations until 8 weeks after birth. Mox efficacy equaled 99.3% (T 1) and 96.9% (T 2). Highest mean FEC value reflecting periparturient nematode egg rise (PPER) was recorded in C ewes at 4–6 weeks after lambing. Significant FEC reductions were found in T 1 (94.8%) and T 2 (96.7%) ewes (p ewes-group independent increase in FEC before weaning (p < 0.05). Clinical parameters (anemia and diarrhea) showed time- and treatment-related differences (p < 0.05). Monitoring of FEC and clinical parameters linked to gastrointestinal parasite infections allowed demonstrating that postpartum or preweaning are two critical periods to nematode infection for sheep raised under tropical Andes high altitude conditions. Use of Mox as anthelmintic treatment prevented PPER. PMID:26078913

  20. Inhibition of Progenitor Dendritic Cell Maturation by Plasma from Patients with Peripartum Cardiomyopathy: Role in Pregnancy-associated Heart Disease

    Directory of Open Access Journals (Sweden)

    Jane E. Ellis

    2005-01-01

    Full Text Available Dendritic cells (DCs play dual roles in innate and adaptive immunity based on their functional maturity, and both innate and adaptive immune responses have been implicated in myocardial tissue remodeling associated with cardiomyopathies. Peripartum cardiomyopathy (PPCM is a rare disorder which affects women within one month antepartum to five months postpartum. A high occurrence of PPCM in central Haiti (1 in 300 live births provided the unique opportunity to study the relationship of immune activation and DC maturation to the etiology of this disorder. Plasma samples from two groups (n = 12 of age- and parity-matched Haitian women with or without evidence of PPCM were tested for levels of biomarkers of cardiac tissue remodeling and immune activation. Significantly elevated levels of GM-CSF, endothelin-1, proBNP and CRP and decreased levels of TGF- were measured in PPCM subjects relative to controls. Yet despite these findings, in vitro maturation of normal human cord blood derived progenitor dendritic cells (CBDCs was significantly reduced (p < 0.001 in the presence of plasma from PPCM patients relative to plasma from post-partum control subjects as determined by expression of CD80, CD86, CD83, CCR7, MHC class II and the ability of these matured CBDCs to induce allo-responses in PBMCs. These results represent the first findings linking inhibition of DC maturation to the dysregulation of normal physiologic cardiac tissue remodeling during pregnancy and the pathogenesis of PPCM.

  1. Myofilament Remodeling and Function Is More Impaired in Peripartum Cardiomyopathy Compared with Dilated Cardiomyopathy and Ischemic Heart Disease.

    Science.gov (United States)

    Bollen, Ilse A E; Ehler, Elisabeth; Fleischanderl, Karin; Bouwman, Floor; Kempers, Lanette; Ricke-Hoch, Melanie; Hilfiker-Kleiner, Denise; Dos Remedios, Cristobal G; Krüger, Martina; Vink, Aryan; Asselbergs, Folkert W; van Spaendonck-Zwarts, Karin Y; Pinto, Yigal M; Kuster, Diederik W D; van der Velden, Jolanda

    2017-12-01

    Peripartum cardiomyopathy (PPCM) and dilated cardiomyopathy (DCM) show similarities in clinical presentation. However, although DCM patients do not recover and slowly deteriorate further, PPCM patients show either a fast cardiac deterioration or complete recovery. The aim of this study was to assess if underlying cellular changes can explain the clinical similarities and differences in the two diseases. We, therefore, assessed sarcomeric protein expression, modification, titin isoform shift, and contractile behavior of cardiomyocytes in heart tissue of PPCM and DCM patients and compared these with nonfailing controls. Heart samples from ischemic heart disease (ISHD) patients served as heart failure control samples. Passive force was only increased in PPCM samples compared with controls, whereas PPCM, DCM, and ISHD samples all showed increased myofilament Ca 2+ sensitivity. Length-dependent activation was significantly impaired in PPCM compared with controls, no impairment was observed in ISHD samples, and DCM samples showed an intermediate response. Contractile impairments were caused by impaired protein kinase A (PKA)-mediated phosphorylation because exogenous PKA restored all parameters to control levels. Although DCM samples showed reexpression of EH-myomesin, an isoform usually only expressed in the heart before birth, PPCM and ISHD did not. The lack of EH-myomesin, combined with low PKA-mediated phosphorylation of myofilament proteins and increased compliant titin isoform, may explain the increase in passive force and blunted length-dependent activation of myofilaments in PPCM samples. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  2. Seismic proving test of PWR reactor containment vessel

    International Nuclear Information System (INIS)

    Akiyama, H.; Yoshikawa, T.; Tokumaru, Y.

    1987-01-01

    The seismic reliability proving tests of nuclear power plant facilities are carried out by Nuclear Power Engineering Test Center (NUPEC), using the large-scale, high-performance vibration of Tadotsu Engineering Laboratory, and sponsored by the Ministry of International Trade and Industry (MITI). In 1982, the seismic reliability proving test of PWR containment vessel started using the test component of reduced scale 1/3.7 and the test component proved to have structural soundness against earthquakes. Subsequently, the detailed analysis and evaluation of these test results were carried out, and the analysis methods for evaluating strength against earthquakes were established. Whereupon, the seismic analysis and evaluation on the actual containment vessel were performed by these analysis methods, and the safety and reliability of the PWR reactor containment vessel were confirmed

  3. Proving test on the reliability for nuclear valves

    International Nuclear Information System (INIS)

    Kajiyama, Yasuo; Tashiro, Hisao; Uga, Takeo; Maeda, Shunichi.

    1986-01-01

    Since valves are the most common components, they could be the most frequent causes of troubles in nuclear power plants. This proving test, therefore, has an important meaning to examine and verify the reliability of various valves under simulating conditions of abnormal and transient operations of the nuclear power plant. The test was performed mainly for the various types and pressure ratings of valves which were used in the primary and secondary systems in BWR and PWR nuclear power plants and which had major operating or safety related functions in those nuclear power plants. The results of the proving test, confirmed for more than four years, showed relatively favourable performance of the tested valves. It is concluded that performances of valves including operability, seat sealing and structural integrity were proved under the thermal cycling, vibration and pipe reaction load conditions. Operating functions during and after accident such as loss of coolant accident were satisfactory. From these results, it was considered that the purpose of this proving test was satisfactorily fulfilled. Several data accumulated by the test would be useful to get better reliability if it was evaluated with the actually experienced data of valves in the nuclear power plants. (Nogami, K.)

  4. Responsibility for proving and defining in abstract algebra class

    Science.gov (United States)

    Fukawa-Connelly, Timothy

    2016-07-01

    There is considerable variety in inquiry-oriented instruction, but what is common is that students assume roles in mathematical activity that in a traditional, lecture-based class are either assumed by the teacher (or text) or are not visible at all in traditional math classrooms. This paper is a case study of the teaching of an inquiry-based undergraduate abstract algebra course. In particular, gives a theoretical account of the defining and proving processes. The study examines the intellectual responsibility for the processes of defining and proving that the professor devolved to the students. While the professor wanted the students to engage in all aspects of defining and proving, he was only successful at devolving responsibility for certain aspects and much more successful at devolving responsibility for proving than conjecturing or defining. This study suggests that even a well-intentioned instructor may not be able to devolve responsibility to students for some aspects of mathematical practice without using a research-based curriculum or further professional development.

  5. Overcoming the Obstacle of Poor Knowledge in Proving Geometry Tasks

    Directory of Open Access Journals (Sweden)

    Zlatan Magajna

    2013-12-01

    Full Text Available Proving in school geometry is not just about validating the truth of a claim. In the school setting, the main function of the proof is to convince someone that a claim is true by providing an explanation. Students consider proving to be difficult; in fact, they find the very concept of proof demanding. Proving a claim in planar geometry involves several processes, the most salient being visual observation and deductive argumentation. These two processes are interwoven, but often poor observation hinders deductive argumentation. In the present article, we consider the possibility of overcoming the obstacle of a student’s poor observation by making use of computer-aided observation with appropriate software. We present the results of two small-scale research projects, both of which indicate that students are able to work out considerably more deductions if computer-aided observation is used. Not all students use computer-aided observation effectively in proving tasks: some find an exhaustive computer-provided list of properties confusing and are not able to choose the properties that are relevant to the task.

  6. Pengembangan Perangkat Pembelajaran Geometri Ruang dengan Model Proving Theorem

    Directory of Open Access Journals (Sweden)

    Bambang Eko Susilo

    2016-03-01

    Full Text Available Kemampuan berpikir kritis dan kreatif mahasiswa masih lemah. Hal ini ditemukan pada mahasiswa yang mengambil mata kuliah Geometri Ruang yaitu dalam membuktikan soal-soal pembuktian (problem to proof. Mahasiswa masih menyelesaikan secara algoritmik atau prosedural sehingga diperlukan pengembangan perangkat pembelajaran Geometri Ruang berbasis kompetensi dan konservasi dengan model Proving Theorem. Dalam penelitian ini perangkat perkuliahan yang dikembangkan yaitu Silabus, Satuan Acara Perkuliahan (SAP, Kontrak Perkuliahan, Media Pembelajaran, Bahan Ajar, Tes UTS dan UAS serta Angket Karakter Konservasi telah dilaksanakan dengan baik dengan kriteria (1 validasi perangkat pembelajaran mata kuliah Geometri ruang berbasis kompetensi dan konservasi dengan model proving theorem berkategori baik dan layak digunakan dan (2 keterlaksanaan RPP pada pembelajaran yang dikembangkan secara keseluruhan berkategori baik.Critical and creative thinking abilities of students still weak. It is found in students who take Space Geometry subjects that is in solving problems to to prove. Students still finish in algorithmic or procedural so that the required the development of Space Geometry learning tools based on competency and conservation with Proving Theorem models. This is a research development which refers to the 4-D models that have been modified for the Space Geometry learning tools, second semester academic year 2014/2015. Instruments used include validation sheet, learning tools and character assessment questionnaire. In this research, the learning tools are developed, namely Syllabus, Lesson Plan, Lecture Contract, Learning Media, Teaching Material, Tests, and Character Conservation Questionnaire had been properly implemented with the criteria (1 validation of Space Geometry learning tools based on competency and conservation with Proving Theorem models categorized good and feasible to use, and (2 the implementation of Lesson Plan on learning categorized

  7. Unexploded ordnance issues at Aberdeen Proving Ground: Background information

    Energy Technology Data Exchange (ETDEWEB)

    Rosenblatt, D.H.

    1996-11-01

    This document summarizes currently available information about the presence and significance of unexploded ordnance (UXO) in the two main areas of Aberdeen Proving Ground: Aberdeen Area and Edgewood Area. Known UXO in the land ranges of the Aberdeen Area consists entirely of conventional munitions. The Edgewood Area contains, in addition to conventional munitions, a significant quantity of chemical-munition UXO, which is reflected in the presence of chemical agent decomposition products in Edgewood Area ground-water samples. It may be concluded from current information that the UXO at Aberdeen Proving Ground has not adversely affected the environment through release of toxic substances to the public domain, especially not by water pathways, and is not likely to do so in the near future. Nevertheless, modest but periodic monitoring of groundwater and nearby surface waters would be a prudent policy.

  8. Unicorns do exist: a tutorial on "proving" the null hypothesis.

    Science.gov (United States)

    Streiner, David L

    2003-12-01

    Introductory statistics classes teach us that we can never prove the null hypothesis; all we can do is reject or fail to reject it. However, there are times when it is necessary to try to prove the nonexistence of a difference between groups. This most often happens within the context of comparing a new treatment against an established one and showing that the new intervention is not inferior to the standard. This article first outlines the logic of "noninferiority" testing by differentiating between the null hypothesis (that which we are trying to nullify) and the "nill" hypothesis (there is no difference), reversing the role of the null and alternate hypotheses, and defining an interval within which groups are said to be equivalent. We then work through an example and show how to calculate sample sizes for noninferiority studies.

  9. Logic for computer science foundations of automatic theorem proving

    CERN Document Server

    Gallier, Jean H

    2015-01-01

    This advanced text for undergraduate and graduate students introduces mathematical logic with an emphasis on proof theory and procedures for algorithmic construction of formal proofs. The self-contained treatment is also useful for computer scientists and mathematically inclined readers interested in the formalization of proofs and basics of automatic theorem proving. Topics include propositional logic and its resolution, first-order logic, Gentzen's cut elimination theorem and applications, and Gentzen's sharpened Hauptsatz and Herbrand's theorem. Additional subjects include resolution in fir

  10. IHSI [Induction Heating Stress Improvement] proves its worth

    International Nuclear Information System (INIS)

    Froehlich, C.H.; Cofie, N.G.; Sheffield, J.R.

    1988-01-01

    Based upon the wealth of experimental test data, extensive and successful in-plant application, and the decreasing cost of applying the process, IHSI is proving itself an important part of overall IGSCC mitigation programmes. Work is ongoing on the development of new temperature sensing systems, more efficient equipment immobilization/demobilization hardware configurations, and craft support management practices to further enhance the cost-effectiveness of IHSI. (author)

  11. Renewable Energy Opportunties at Dugway Proving Ground, Utah

    Energy Technology Data Exchange (ETDEWEB)

    Orrell, Alice C.; Kora, Angela R.; Russo, Bryan J.; Horner, Jacob A.; Williamson, Jennifer L.; Weimar, Mark R.; Gorrissen, Willy J.; Nesse, Ronald J.; Dixon, Douglas R.

    2010-05-31

    This document provides an overview of renewable resource potential at Dugway Proving Ground, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and ground source heat pumps (GSHPs). The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment.

  12. Seismic proving test of BWR primary loop recirculation system

    International Nuclear Information System (INIS)

    Sato, H.; Shigeta, M.; Karasawa, Y.

    1987-01-01

    The seismic proving test of BWR Primary Loop Recirculation system is the second test to use the large-scale, high-performance vibration table of Tadotsu Engineering Laboratory. The purpose of this test is to prove the seismic reliability of the primary loop recirculation system (PLR), one of the most important safety components in the BWR nuclear plants, and also to confirm the adequacy of seismic analysis method used in the current seismic design. To achieve the purpose, the test was conducted under conditions and scale as near as possible to actual systems. The strength proving test was carried out with the test model mounted on the vibration table in consideration of basic design earthquake ground motions and other conditions to confirm the soundness of structure and the strength against earthquakes. Detailed analysis and analytic evaluation of the data obtained from the test was conducted to confirm the adequacy of the seismic analysis method and earthquake response analysis method used in the current seismic design. Then, on the basis of the results obtained, the seismic safety and reliability of BWR primary loop recirculation of the actual plants was fully evaluated

  13. Insertion/deletion polymorphism of ACE gene in females with peripartum cardiomyopathy: A case-control study.

    Science.gov (United States)

    Yaqoob, Irfan; Tramboo, Nisar A; Bhat, Irfan A; Pandith, Arshad; Beig, Jahangir R; Hafeez, Imran; Lone, Aijaz A; Shah, Tariq R; Samreen, Sumera

    The role of polymorphism of Angiotensin converting enzyme (ACE) gene and ACE activity in etiopathogenesis, prognosis, and many other clinical parameters in the various form of the cardiovascular disease has been established to some degree of certainty. The pathophysiology of Peripartum cardiomyopathy (PPCM) remains an area of active research. The main aim of our study was to see pattern of ACE- Insertion/Deletion (I/D) allele in PPCM and its implications on left ventricular performance indices. This single-center case-control study included 45 cases and 70 controls. The diagnosis of PPCM was established clinically and echocardiographically. ACE genotyping was done by polymerase chain reaction (PCR) method in all subjects. The II, ID, and DD genotype was present in 16, 18 and 11 of subjects with PPCM and 48, 19 and 3 of controls respectively. The odds ratio for ACE-II genotype in cases vs. controls was 0.253 (95% CI=0.114-0.558; p=0.007), for that of II genotype was 1.93 (95% CI=0.86-4.3; p=0.107) and for DD genotype was 7.225 (95% CI; 1.88-27.6; p=0.0039). Overall frequency of D allele in cases was significantly higher than controls (odds=4.25; 95% CI=2.01-6.7; p=0.0001). Moreover, ejection fraction, left ventricular volume and linear dimensions were worse in patients with DD genotype. ACE DD genotype and overall frequency of D allele is significantly higher in patients with PPCM. Also, the presence of DD genotype is associated with worse systolic performance indices measured echocardiographically. Copyright © 2017. Published by Elsevier B.V.

  14. Preparing for Mars: The Evolvable Mars Campaign 'Proving Ground' Approach

    Science.gov (United States)

    Bobskill, Marianne R.; Lupisella, Mark L.; Mueller, Rob P.; Sibille, Laurent; Vangen, Scott; Williams-Byrd, Julie

    2015-01-01

    As the National Aeronautics and Space Administration (NASA) prepares to extend human presence beyond Low Earth Orbit, we are in the early stages of planning missions within the framework of an Evolvable Mars Campaign. Initial missions would be conducted in near-Earth cis-lunar space and would eventually culminate in extended duration crewed missions on the surface of Mars. To enable such exploration missions, critical technologies and capabilities must be identified, developed, and tested. NASA has followed a principled approach to identify critical capabilities and a "Proving Ground" approach is emerging to address testing needs. The Proving Ground is a period subsequent to current International Space Station activities wherein exploration-enabling capabilities and technologies are developed and the foundation is laid for sustained human presence in space. The Proving Ground domain essentially includes missions beyond Low Earth Orbit that will provide increasing mission capability while reducing technical risks. Proving Ground missions also provide valuable experience with deep space operations and support the transition from "Earth-dependence" to "Earth-independence" required for sustainable space exploration. A Technology Development Assessment Team identified a suite of critical technologies needed to support the cadence of exploration missions. Discussions among mission planners, vehicle developers, subject-matter-experts, and technologists were used to identify a minimum but sufficient set of required technologies and capabilities. Within System Maturation Teams, known challenges were identified and expressed as specific performance gaps in critical capabilities, which were then refined and activities required to close these critical gaps were identified. Analysis was performed to identify test and demonstration opportunities for critical technical capabilities across the Proving Ground spectrum of missions. This suite of critical capabilities is expected to

  15. On proving confluence modulo equivalence for Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne

    2017-01-01

    -logical built-in predicates such as var/1 and incomplete ones such as is/2, that are ignored in previous work on confluence. To this end, a new operational semantics for CHR is developed which includes such predicates. In addition, this semantics differs from earlier approaches by its simplicity without loss......Previous results on proving confluence for Constraint Handling Rules are extended in two ways in order to allow a larger and more realistic class of CHR programs to be considered confluent. Firstly, we introduce the relaxed notion of confluence modulo equivalence into the context of CHR: while...

  16. Proving Test on the Reliability for Reactor Containment Vessel

    International Nuclear Information System (INIS)

    Takumi, K.; Nonaka, A.

    1988-01-01

    NUPEC (Nuclear Power Engineering Test Center) has started an eight-year project of Proving Test on the Reliability for Reactor Containment Vessel since June 1987. The objective of this project is to confirm the integrity of containment vessels under severe accident conditions. This paper shows the outline of this project. The test Items are (1) Hydrogen mixing and distribution test, (2) Hydrogen burning test, (3) Iodine trapping characteristics test, and (4) Structural behavior test. Based on the test results, computer codes are verified and as the results of analysis and evaluation by the computer codes, containment integrity is to be confirmed

  17. Reasoning by analogy as an aid to heuristic theorem proving.

    Science.gov (United States)

    Kling, R. E.

    1972-01-01

    When heuristic problem-solving programs are faced with large data bases that contain numbers of facts far in excess of those needed to solve any particular problem, their performance rapidly deteriorates. In this paper, the correspondence between a new unsolved problem and a previously solved analogous problem is computed and invoked to tailor large data bases to manageable sizes. This paper outlines the design of an algorithm for generating and exploiting analogies between theorems posed to a resolution-logic system. These algorithms are believed to be the first computationally feasible development of reasoning by analogy to be applied to heuristic theorem proving.

  18. Case report 486: Spondyloepiphyseal dysplasia tarda (SDT) (presumptively proved)

    International Nuclear Information System (INIS)

    Brown, D.D.; Childress, M.H.

    1988-01-01

    A 51 year old man with severe degenerative joint disease, short stature, barrel chest deformity, platyspondyly, a narrow pelvis, small iliac bones, dysplastic femoral heads and necks, notching of the patellae and flattening of the femoral intercondylar notches has been described as an example of Spondyloepiphyseal dysplasia tarda SDT. The entity was discussed in detail. The notching of the patellae has not been reported in association with SDT to the authors' knowledge. Characteristic features of SDT allow it to be differentiated from other arthropathies and dysplasias and these distinctions have been emphasized in the discussion. The diagnosis in this case can only be considered presumptively proved. (orig./MG)

  19. A Hybrid Approach to Proving Memory Reference Monotonicity

    KAUST Repository

    Oancea, Cosmin E.

    2013-01-01

    Array references indexed by non-linear expressions or subscript arrays represent a major obstacle to compiler analysis and to automatic parallelization. Most previous proposed solutions either enhance the static analysis repertoire to recognize more patterns, to infer array-value properties, and to refine the mathematical support, or apply expensive run time analysis of memory reference traces to disambiguate these accesses. This paper presents an automated solution based on static construction of access summaries, in which the reference non-linearity problem can be solved for a large number of reference patterns by extracting arbitrarily-shaped predicates that can (in)validate the reference monotonicity property and thus (dis)prove loop independence. Experiments on six benchmarks show that our general technique for dynamic validation of the monotonicity property can cover a large class of codes, incurs minimal run-time overhead and obtains good speedups. © 2013 Springer-Verlag.

  20. Formal Analysis of Soft Errors using Theorem Proving

    Directory of Open Access Journals (Sweden)

    Sofiène Tahar

    2013-07-01

    Full Text Available Modeling and analysis of soft errors in electronic circuits has traditionally been done using computer simulations. Computer simulations cannot guarantee correctness of analysis because they utilize approximate real number representations and pseudo random numbers in the analysis and thus are not well suited for analyzing safety-critical applications. In this paper, we present a higher-order logic theorem proving based method for modeling and analysis of soft errors in electronic circuits. Our developed infrastructure includes formalized continuous random variable pairs, their Cumulative Distribution Function (CDF properties and independent standard uniform and Gaussian random variables. We illustrate the usefulness of our approach by modeling and analyzing soft errors in commonly used dynamic random access memory sense amplifier circuits.

  1. Peripartum dynamics of Coxiella burnetii infections in intensively managed dairy goats associated with a Q fever outbreak in Australia.

    Science.gov (United States)

    Muleme, Michael; Stenos, John; Vincent, Gemma; Wilks, Colin R; Devlin, Joanne M; Campbell, Angus; Cameron, Alexander; Stevenson, Mark A; Graves, Stephen; Firestone, Simon M

    2017-04-01

    Coxiella burnetii may cause reproduction disorders in pregnant animals but subclinical infection in other animals. Unrecognised disease may delay implementation of control interventions, resulting in transmission of infection to other livestock and to humans. Seroreactivity to C. burnetii phase-specific antigens, is routinely used to interpret the course of human Q fever. This approach could be similarly useful in identifying new and existing infections in livestock herds to help describe risk factors or production losses associated with the infections and the implementation of disease-control interventions. This study aimed to elucidate the dynamics of C. burnetii infections using seroreactivity to phase-specific antigens and to examine the impact of infection on milk yield in goats in an endemically-infected farm that was associated with a Q fever outbreak in Australia. Seroreactivity pre- and post-partum and milk yield were studied in 164 goats (86 nulliparous and 78 parous). Post-partum, the seroprevalence of antibodies to C. burnetti increased from 4.7% to 31.4% throughout goats' first kiddings and from 47.4% to 55.1% in goats kidding for the second or greater time. Of 123 goats that were seronegative pre-partum, 26.8% seroconverted over the three-month peri-partum period, highlighting the importance of controlling infection throughout this time. The risk of seroconversion was comparable in first or later kidders, suggesting constant risk irrespective of parity. No loss in milk production associated with seroconversion to phase 2 was observed within the first nine weeks of lactation. However, seroconversion to only phase 1 was associated with extra 0.276L of milk per day (95% Confidence Interval: 0.010, 0.543; P=0.042), which warrants further investigation to ascertain whether or not the association is causal. Further studies on seroreactivity and milk production over longer periods are required, as milk production loss caused by C. burnetti may be an

  2. Evaluation of depleted uranium in the environment at Aberdeen Proving Grounds, Maryland and Yuma Proving Grounds, Arizona. Final report

    International Nuclear Information System (INIS)

    Kennedy, P.L.; Clements, W.H.; Myers, O.B.; Bestgen, H.T.; Jenkins, D.G.

    1995-01-01

    This report represents an evaluation of depleted uranium (DU) introduced into the environment at the Aberdeen Proving Grounds (APG), Maryland and Yuma Proving Grounds (YPG) Arizona. This was a cooperative project between the Environmental Sciences and Statistical Analyses Groups at LANL and with the Department of Fishery and Wildlife Biology at Colorado State University. The project represents a unique approach to assessing the environmental impact of DU in two dissimilar ecosystems. Ecological exposure models were created for each ecosystem and sensitivity/uncertainty analyses were conducted to identify exposure pathways which were most influential in the fate and transport of DU in the environment. Research included field sampling, field exposure experiment, and laboratory experiments. The first section addresses DU at the APG site. Chapter topics include bioenergetics-based food web model; field exposure experiments; bioconcentration by phytoplankton and the toxicity of U to zooplankton; physical processes governing the desorption of uranium from sediment to water; transfer of uranium from sediment to benthic invertebrates; spead of adsorpion by benthic invertebrates; uptake of uranium by fish. The final section of the report addresses DU at the YPG site. Chapters include the following information: Du transport processes and pathway model; field studies of performance of exposure model; uptake and elimination rates for kangaroo rates; chemical toxicity in kangaroo rat kidneys

  3. Evaluation of depleted uranium in the environment at Aberdeen Proving Grounds, Maryland and Yuma Proving Grounds, Arizona. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, P.L.; Clements, W.H.; Myers, O.B.; Bestgen, H.T.; Jenkins, D.G. [Colorado State Univ., Fort Collins, CO (United States). Dept. of Fishery and Wildlife Biology

    1995-01-01

    This report represents an evaluation of depleted uranium (DU) introduced into the environment at the Aberdeen Proving Grounds (APG), Maryland and Yuma Proving Grounds (YPG) Arizona. This was a cooperative project between the Environmental Sciences and Statistical Analyses Groups at LANL and with the Department of Fishery and Wildlife Biology at Colorado State University. The project represents a unique approach to assessing the environmental impact of DU in two dissimilar ecosystems. Ecological exposure models were created for each ecosystem and sensitivity/uncertainty analyses were conducted to identify exposure pathways which were most influential in the fate and transport of DU in the environment. Research included field sampling, field exposure experiment, and laboratory experiments. The first section addresses DU at the APG site. Chapter topics include bioenergetics-based food web model; field exposure experiments; bioconcentration by phytoplankton and the toxicity of U to zooplankton; physical processes governing the desorption of uranium from sediment to water; transfer of uranium from sediment to benthic invertebrates; spead of adsorpion by benthic invertebrates; uptake of uranium by fish. The final section of the report addresses DU at the YPG site. Chapters include the following information: Du transport processes and pathway model; field studies of performance of exposure model; uptake and elimination rates for kangaroo rates; chemical toxicity in kangaroo rat kidneys.

  4. Proving the Efficiency of Placental Transfer of Maternal Measles

    African Journals Online (AJOL)

    are immunoglobulins, which makeup about 20% of plasma proteins.[1] The antibody ... Annals of Medical and Health Sciences Research | Sep-Oct 2014 | Vol 4 | Special Issue 3 |. 299. UMTH is a ... bio-data, pregnancy history and antenatal care history. The .... [12] this could have been responsible for the negative effect of.

  5. Bronco Junction Proves Asthmatic Kids Can Live Active Lives.

    Science.gov (United States)

    Foster, Scarlett Lee

    1980-01-01

    Camp Bronco Junction combines physical development, medical self-care knowledge, and fun in its eight-week program for asthmatic youngsters. In this environment, children are able to undertake activities that were formerly thought beyond their physical or emotional capabilities. (CJ)

  6. The GOES-R Proving Ground: 2012 Update

    Science.gov (United States)

    Gurka, J.; Goodman, S. J.; Schmit, T.; Demaria, M.; Mostek, A.; Siewert, C.; Reed, B.

    2011-12-01

    The Geostationary Operational Environmental Satellite (GOES)-R will provide a great leap forward in observing capabilities, but will also offer a significant challenge to ensure that users are ready to exploit the vast improvements in spatial, spectral, and temporal resolutions. To ensure user readiness, forecasters and other users must have access to prototype advanced products well before launch, and have the opportunity to provide feedback to product developers and computing and communications managers. The operational assessment is critical to ensure that the end products and NOAA's computing and communications systems truly meet their needs in a rapidly evolving environment. The GOES-R Proving Ground (PG) engages the National Weather Service (NWS) forecast, watch and warning community and other agency users in pre-operational demonstrations of select products with GOES-R attributes (enhanced spectral, spatial, and temporal resolution). In the PG, developers and forecasters test and apply algorithms for new GOES-R satellite data and products using proxy and simulated data sets, including observations from current and future satellite instruments (MODIS, AIRS, IASI, SEVIRI, NAST-I, NPP/VIIRS/CrIS, LIS), lightning networks, and computer simulated products. The complete list of products to be evaluated in 2012 will be determined after evaluating results from experiments in 2011 at the NWS' Storm Prediction Center, National Hurricane Center, Aviation Weather Center, Ocean Prediction Center, Hydrometeorological Prediction Center, and from the six NWS regions. In 2012 and beyond, the PG will test and validate data processing and distribution systems and the applications of these products in operational settings. Additionally developers and forecasters will test and apply display techniques and decision aid tools in operational environments. The PG is both a recipient and a source of training. Training materials are developed using various distance training tools in

  7. NASA SPoRT GOES-R Proving Ground Activities

    Science.gov (United States)

    Stano, Geoffrey T.; Fuell, Kevin K.; Jedloec, Gary J.

    2010-01-01

    The NASA Short-term Prediction Research and Transition (SPoRT) program is a partner with the GOES-R Proving Ground (PG) helping prepare forecasters understand the unique products to come from the GOES-R instrument suite. SPoRT is working collaboratively with other members of the GOES-R PG team and Algorithm Working Group (AWG) scientists to develop and disseminate a suite of proxy products that address specific forecast problems for the WFOs, Regional and National Support Centers, and other NOAA users. These products draw on SPoRT s expertise with the transition and evaluation of products into operations from the MODIS instrument and the North Alabama Lightning Mapping Array (NALMA). The MODIS instrument serves as an excellent proxy for the Advanced Baseline Imager (ABI) that will be aboard GOES-R. SPoRT has transitioned and evaluated several multi-channel MODIS products. The true and false color products are being used in natural hazard detection by several SPoRT partners to provide better observation of land features, such as fires, smoke plumes, and snow cover. Additionally, many of SPoRT s partners are coastal offices and already benefit from the MODIS sea surface temperature composite. This, along with other surface feature observations will be developed into ABI proxy products for diagnostic use in the forecast process as well as assimilation into forecast models. In addition to the MODIS instrument, the NALMA has proven very valuable to WFOs with access to these total lightning data. These data provide situational awareness and enhanced warning decision making to improve lead times for severe thunderstorm and tornado warnings. One effort by SPoRT scientists includes a lightning threat product to create short-term model forecasts of lightning activity. Additionally, SPoRT is working with the AWG to create GLM proxy data from several of the ground based total lightning networks, such as the NALMA. The evaluation will focus on the vastly improved spatial

  8. Geophysics: Building E5481 decommissioning, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Thompson, M.D.; McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.

    1992-11-01

    Building E5481 is one of ten potentially contaminated sites in the Canal Creek and Westwood areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. The building is located on the northern margin of a landfill that was sited in a wetland. The large number of magnetic sources surrounding the building are believed to be contained in construction fill that had been used to raise the grade. The smaller anomalies, for the most part, are not imaged with ground radar or by electrical profiling. A conductive zone trending northwest to southeast across the site is spatially related to an old roadbed. Higher resistivity areas in the northeast and east are probably representive of background values. Three high-amplitude, positive, rectangular magnetic anomalies have unknown sources. The features do not have equivalent electrical signatures, nor are they seen with radar imaging

  9. Geophysics: Building E5476 decommissiong, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Miller, S.F.; Thompson, M.D.; McGinnis, M.G.; McGinnis, L.D.

    1992-11-01

    Building E5476 was one of ten potentially contaminated sites in the Canal Creek and Westwood areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. The large number of magnetic sources surrounding the building are believed to be contained in construction fill. The smaller anomalies, for the most part, were not imaged with ground radar or by electrical profiling. Large magnetic anomalies near the southwest comer of the building are due to aboveground standpipes and steel-reinforced concrete. Two high-resistivity areas, one projecting northeast from the building and another south of the original structure, may indicate the presence of organic pore fluids in the subsurface. A conductive lineament protruding from the south wall that is enclosed by the southem, high-resistivity feature is not associated with an equivalent magnetic anomaly. Magnetic and electrical anomalies south of the old landfill boundary are probably not associated with the building. The boundary is marked by a band of magnetic anomalies and a conductive zone trending northwest to southeast. The cause of high resistivities in a semicircular area in the southwest comer, within the landfill area, is unexplained

  10. Geophysics: Building E5375 decommissioning, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1992-08-01

    Building E5375 was one of ten potentially contaminated sites in the Canal Creek area of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May 1992. Noninvasive geophysical surveys, including magnetics, electrical resistivity, and ground-penetrating radar (GPR), were conducted around the perimeter of the building to guide a sampling program prior to decommissioning and dismantling. Several anomalies wear, noted: (1) An underground storage tank located 25 ft east of Building E5375 was identified with magnetic, resistivity, and GPR profiling. (2) A three-point resistivity anomaly, 12 ft east of the northeast comer of Building E5374 (which borders Building E5375) and 5 ft south of the area surveyed with the magnetometer, may be caused by another underground storage tank. (3) A 2,500-gamma magnetic anomaly near the northeast corner of the site has no equivalent resistivity anomaly, although disruption in GPR reflectors was observed. (4) A one-point magnetic anomaly was located at the northeast comer, but its source cannot be resolved. A chaotic reflective zone to the east represents the radar signature of Building E5375 construction fill

  11. Safety objectives for next generation reactors: proving their achievement

    International Nuclear Information System (INIS)

    Tanguy, P.Y.

    1996-01-01

    Assuming that there is a consensus between regulatory bodies and nuclear operating organizations on safety objectives for future plants, how are we going to demonstrate that they have been achieved, with a reasonable certainty? Right from the beginning, I would like to underline the importance of convincing the public that high level safety objectives will be effectively achieved in future nuclear power plants. The mere fulfillment of administrative requirements might not be sufficient to obtain public acceptance. One has to take into account the changes that have occurred in the public preception of nuclear risks in the wake of the Chernobyl accident. Today public opinion rules out the possibility not only that such a catastrophic accident could recur, but also that any accident with detrimental health consequences off-site could occur. The nuclear industry has to reflect this concern in its safety demonstration, independently of proving the achievement of technical safety goals. The public opinion issue will be readdressed at the end of this paper. (orig.)

  12. Potential Cislunar and Interplanetary Proving Ground Excursion Trajectory Concepts

    Science.gov (United States)

    McGuire, Melissa L.; Strange, Nathan J.; Burke, Laura M.; MacDonald, Mark A.; McElrath, Timothy P.; Landau, Damon F.; Lantoine, Gregory; Hack, Kurt J.; Lopez, Pedro

    2016-01-01

    NASA has been investigating potential translunar excursion concepts to take place in the 2020s that would be used to test and demonstrate long duration life support and other systems needed for eventual Mars missions in the 2030s. These potential trajectory concepts could be conducted in the proving ground, a region of cislunar and near-Earth interplanetary space where international space agencies could cooperate to develop the technologies needed for interplanetary spaceflight. Enabled by high power Solar Electric Propulsion (SEP) technologies, the excursion trajectory concepts studied are grouped into three classes of increasing distance from the Earth and increasing technical difficulty: the first class of excursion trajectory concepts would represent a 90-120 day round trip trajectory with abort to Earth options throughout the entire length, the second class would be a 180-210 day round trip trajectory with periods in which aborts would not be available, and the third would be a 300-400 day round trip trajectory without aborts for most of the length of the trip. This paper provides a top-level summary of the trajectory and mission design of representative example missions of these three classes of excursion trajectory concepts.

  13. Why prove it again? alternative proofs in mathematical practice

    CERN Document Server

    Dawson, Jr , John W

    2015-01-01

    This monograph considers several well-known mathematical theorems and asks the question, “Why prove it again?” while examining alternative proofs.   It  explores the different rationales mathematicians may have for pursuing and presenting new proofs of previously established results, as well as how they judge whether two proofs of a given result are different.  While a number of books have examined alternative proofs of individual theorems, this is the first that presents comparative case studies of other methods for a variety of different theorems. The author begins by laying out the criteria for distinguishing among proofs and enumerates reasons why new proofs have, for so long, played a prominent role in mathematical practice.  He then outlines various purposes that alternative proofs may serve.  Each chapter that follows provides a detailed case study of alternative proofs for particular theorems, including the Pythagorean Theorem, the Fundamental Theorem of Arithmetic, Desargues’ Theorem, the...

  14. Depleted uranium risk assessment at Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Myers, O.B.; Kennedy, P.L.; Clements, W.H.

    1993-01-01

    The Environmental Science Group at Los Alamos and the Test and Evaluation Command (TECOM) are assessing the risk of depleted uranium (DU) testing at Aberdeen Proving Ground (APG). Conceptual and mathematical models of DU transfer through the APG ecosystem have been developed in order to show the mechanisms by which DU migrates or remains unavailable to different flora and fauna and to humans. The models incorporate actual rates of DU transfer between different ecosystem components as much as possible. Availability of data on DU transport through different pathways is scarce and constrains some of the transfer rates that can be used. Estimates of transfer rates were derived from literature sources and used in the mass-transfer models when actual transfer rates were unavailable. Objectives for this risk assessment are (1) to assess if DU transports away from impact areas; (2) to estimate how much, if any, DU migrates into Chesapeake Bay; (3) to determine if there are appreciable risks to the ecosystems due to DU testing; (4) to estimate the risk to human health as a result of DU testing

  15. Environmental geophysics at J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Daudt, C.R.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1994-11-01

    Geophysical data collected at J-Field, Aberdeen Proving Ground, Maryland, were used in the characterization of the natural hydrogeologic framework of the J-Field area and in the identification of buried disturbances (trenches and other evidences of contamination). Seismic refraction and reflection data and electrical resistivity data have aided in the characterization of the leaky confining unit at the base of the surficial aquifer (designated Unit B of the Tertiary Talbot Formation). Excellent reflectors have been observed for both upper and lower surfaces of Unit B that correspond to stratigraphic units observed in boreholes and on gamma logs. Elevation maps of both surfaces and an isopach map of Unit B, created from reflection data at the toxic burning pits site, show a thickening of Unit B to the east. Abnormally low seismic compressional-wave velocities suggest that Unit B consists of gassy sediments whose gases are not being flushed by upward or downward moving groundwater. The presence of gases suggests that Unit B serves as an efficient aquitard that should not be penetrated by drilling or other activities. Electromagnetic, total-intensity magnetic, and ground-penetrating radar surveys have aided in delineating the limits of two buried trenches, the VX burning pit and the liquid smoke disposal pit, both located at the toxic burning pits site. The techniques have also aided in determining the extent of several other disturbed areas where soils and materials were pushed out of disposal pits during trenching activities. Surveys conducted from the Prototype Building west to the Gunpowder River did not reveal any buried trenches.

  16. Automated Theorem Proving in High-Quality Software Design

    Science.gov (United States)

    Schumann, Johann; Swanson, Keith (Technical Monitor)

    2001-01-01

    The amount and complexity of software developed during the last few years has increased tremendously. In particular, programs are being used more and more in embedded systems (from car-brakes to plant-control). Many of these applications are safety-relevant, i.e. a malfunction of hardware or software can cause severe damage or loss. Tremendous risks are typically present in the area of aviation, (nuclear) power plants or (chemical) plant control. Here, even small problems can lead to thousands of casualties and huge financial losses. Large financial risks also exist when computer systems are used in the area of telecommunication (telephone, electronic commerce) or space exploration. Computer applications in this area are not only subject to safety considerations, but also security issues are important. All these systems must be designed and developed to guarantee high quality with respect to safety and security. Even in an industrial setting which is (or at least should be) aware of the high requirements in Software Engineering, many incidents occur. For example, the Warshaw Airbus crash, was caused by an incomplete requirements specification. Uncontrolled reuse of an Ariane 4 software module was the reason for the Ariane 5 disaster. Some recent incidents in the telecommunication area, like illegal "cloning" of smart-cards of D2GSM handies, or the extraction of (secret) passwords from German T-online users show that also in this area serious flaws can happen. Due to the inherent complexity of computer systems, most authors claim that only a rigorous application of formal methods in all stages of the software life cycle can ensure high quality of the software and lead to real safe and secure systems. In this paper, we will have a look, in how far automated theorem proving can contribute to a more widespread application of formal methods and their tools, and what automated theorem provers (ATPs) must provide in order to be useful.

  17. Depleted uranium human health risk assessment, Jefferson Proving Ground, Indiana

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1994-01-01

    The risk to human health from fragments of depleted uranium (DU) at Jefferson Proving Ground (JPG) was estimated using two types of ecosystem pathway models. A steady-state, model of the JPG area was developed to examine the effects of DU in soils, water, and vegetation on deer that were hunted and consumed by humans. The RESRAD code was also used to estimate the effects of farming the impact area and consuming the products derived from the farm. The steady-state model showed that minimal doses to humans are expected from consumption of deer that inhabit the impact area. Median values for doses to humans range from about 1 mrem (±2.4) to 0.04 mrem (±0.13) and translate to less than 1 x 10 -6 detriments (excess cancers) in the population. Monte Carlo simulation of the steady-state model was used to derive the probability distributions from which the median values were drawn. Sensitivity analyses of the steady-state model showed that the amount of DU in airborne dust and, therefore, the amount of DU on the vegetation surface, controlled the amount of DU ingested by deer and by humans. Human doses from the RESRAD estimates ranged from less than 1 mrem/y to about 6.5 mrem/y in a hunting scenario and subsistence fanning scenario, respectively. The human doses exceeded the 100 mrem/y dose limit when drinking water for the farming scenario was obtained from the on-site aquifer that was presumably contaminated with DU. The two farming scenarios were unrealistic land uses because the additional risk to humans due to unexploded ordnance in the impact area was not figured into the risk estimate. The doses estimated with RESRAD translated to less than 1 x 10 -6 detriments to about 1 x 10 -3 detriments. The higher risks were associated only with the farming scenario in which drinking water was obtained on-site

  18. Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

    Directory of Open Access Journals (Sweden)

    Abdullah Şimşek

    Full Text Available ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both. Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%. Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%. Smear microscopy of BAL fluid (BALF was performed in 16 patients and was positive for AFB in 10 (62.5%. Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%. Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%; bronchial brushing, in 7 (38.8%; fine-needle aspiration biopsy, in 2 (11.1%; and BAL, in 2 (11.1%. Bronchial anthracofibrosis was observed in 5 (27.7% of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

  19. Supplemental fish oil does not alter immune competence or the pathophysiological response to an intramammary infusion of endotoxin in peri-partum multiparous Holstein cows.

    Science.gov (United States)

    Ballou, Michael A; Gomes, Rodrigo C; DePeters, Edward J

    2009-05-01

    The objective was to determine the effects of supplementing the diet with fish oil during the peri-partum period on the immune competence and the pathophysiological response to a lipopolysaccharide-induced mastitis challenge. Multiparous Holstein cows (n=30) were completely randomized to one of two treatments at 3 weeks pre-partum. Treatments differed only in the source of supplemental lipid and included either Energy Booster or fish oil. Treatment diets were fed from -21 d relative to expected date of parturition until 10 d post partum. Treatments were fed as a bolus prior to the a.m. feeding. The dose of lipid during the pre-partum period was 250 g/d, whereas the amount of lipid supplemented post partum was adjusted to the level of intake, approximately 0.92% of the previous day's dry matter intake. Ex-vivo analyses of immune competence were measured including the antimicrobial activity of whole blood against Escherichia coli, Salmonella typhimurium and Candida albicans as well as the production of interferon-gamma by peripheral blood mononuclear cultures. At 7 days in milk cows were infused with 100 microg of Esch. coli lipopolysaccharide into one rear quarter. Supplementing fish oil increased plasma concentrations of eicosapentaenoic and docosahexaenoic acids, but had no affect on the proportions of arachidonic acid at calving. Fish oil did not influence the production of interferon-gamma or the antimicrobial activity of whole blood against any of the microorganisms. Furthermore, fish oil had no ameliorative effect on either the local or the systemic acute phase response following an intramammary lipopolysaccharide challenge in early lactating Holstein cows. Supplementing fish oil in the diet of peri-partum cows will not protect them from deleterious effects of an excessive acute phase response.

  20. The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery.

    Science.gov (United States)

    Colmorn, Lotte B; Petersen, Kathrine B; Jakobsson, Maija; Lindqvist, Pelle G; Klungsoyr, Kari; Källen, Karin; Bjarnadottir, Ragnheidur I; Tapper, Anna-Maija; Børdahl, Per E; Gottvall, Karin; Thurn, Lars; Gissler, Mika; Krebs, Lone; Langhoff-Roos, Jens

    2015-07-01

    To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. Prospective, Nordic collaboration. The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. Rates of the studied complications and possible risk factors among parturients in the Nordic countries. The studied complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review.

    Science.gov (United States)

    Olieman, Renske M; Siemonsma, Femke; Bartens, Margaux A; Garthus-Niegel, Susan; Scheele, Fedde; Honig, Adriaan

    2017-06-19

    Obstetricians are often reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear. To date, it is unknown if an ECS on request improves mental well-being in the mother in the peripartum period and if possible beneficial effects on anxiety and depression could outweigh the increased risk of complications associated with a surgical delivery. A systematic review was conducted to explore the effect of ECS on request on peripartum anxiety and depression. We searched on PubMed, PsychoInfo and Embase. Studies were included with primary data on anxiety and/or depression postpartum in women with childbirth fear who had requested an ECS. After full-text evaluation of 65 papers and quality analysis of four papers, three papers were included. Of one paper additional and yet unpublished data were provided. Studies varied in outcome measures, hence no meta-analysis was performed. Women who requested an ECS had higher antepartum depression and anxiety levels but no different postpartum depression levels than women who delivered vaginally. One study of good quality examined the effect of vaginal delivery in women preferring ECS: These women had significantly higher symptom levels of post-traumatic stress disorder (PTSD) and depression than women with normal vaginal delivery. The prospect of an ECS does not lower antepartum anxiety and/or depression levels in women requesting an ECS. If women resolutely persist in wishing an ECS despite adequate counselling and/or psychiatric treatment, the risk of developing depressive and PTSD symptoms in case of vaginal delivery should be taken into account, and an ECS may be considered as a valid alternative.

  2. Comparison of peripartum metabolic status and postpartum health of Holstein and Montbéliarde-sired crossbred dairy cows.

    Science.gov (United States)

    Mendonça, L G D; Abade, C C; da Silva, E M; Litherland, N B; Hansen, L B; Hansen, W P; Chebel, R C

    2014-02-01

    Objectives of the current experiment were to evaluate plasma concentrations of metabolites and haptoglobin peripartum, uterine health and involution, and follicle growth and resumption of cyclicity of Holstein (HO) and Montbéliarde-sired crossbred cows. Cows (52 HO and 52 crossbred) were enrolled in the study 45 d before expected calving date. Cows had body weight and body condition score recorded on d -45, -14, 0, 1, 28, and 56 relative to calving. Dry matter intake was calculated for a subgroup of cows (25 HO and 38 crossbred) from 6 wk before to 6 wk after calving. Blood was sampled weekly from d -14 to 56 relative to calving for determination of glucose, nonesterified fatty acid, and β-hydroxybutyrate concentrations; from d -7 to 21 relative to calving for determination of haptoglobin concentration; and from d 14 to 56 postpartum for determination of progesterone concentration. Cows were examined at calving and on d 4, 7, 10, and 14 postpartum for diagnosis of postparturient diseases, on d 24 postpartum for diagnosis of purulent vaginal discharge, and on d 42 postpartum for diagnosis of subclinical endometritis. Uteri and ovaries were examined by ultrasonography every 3 d from d 14 to 41 postpartum. Milk yield and composition were measured monthly and yield of milk, fat, protein, and energy-corrected milk were recorded for the first 90 d postpartum. Body weight was not different between Holstein and crossbred cows, but HO cows had reduced body condition score compared with crossbred cows. Even though DMI from 6 wk before to 6 wk after calving tended to be greater for HO cows (16.8 ± 0.7 vs. 15.3 ± 0.5 kg/d), HO cows tended to have more pronounced decline in dry matter intake, expressed in percentage of body weight from d -15 to 0 relative to calving. Energy-corrected milk and nonesterified fatty acid and β-hydroxybutyrate concentrations were not different between breeds. No differences were observed in incidence of retained fetal membranes, metritis, and

  3. Peripartum cardiomyopathy in Denmark

    DEFF Research Database (Denmark)

    Ersbøll, Anne S; Johansen, Marianne; Damm, Peter

    2017-01-01

    equalling 1 in 10 149 deliveries. The majority recovered left ventricular systolic function within one year, but 14.8% suffered a major adverse event with 3.3% mortality, 8.2% mechanical circulatory support requirement and/or heart transplantation and 4.9% persistent severe heart failure. Half of the women...

  4. Three Smoking Guns Prove Falsity of Green house Warming

    Science.gov (United States)

    Fong, P.

    2001-12-01

    Three observed facts: 1, the cloud coverage increased 4.1% in 50 years; 2. the precipitation increased 7.8% in 100 years; 3. the two rates are the same. {Interpretation}. 1, By the increased albedo of the clouds heat dissipation is increased 3.98 W/m2 by 2XCO2 time, canceling out greenhouse warming of 4 W/m{2}. Thus no global warming. 2, The precipitation increase show the increased release of latent heat of vaporization, which turns out to be equal to that absorbed by ocean due to increased evaporation by the greenhouse forcing. This all greenhouse heat is used up in evaporation and the warming of the earth is zero. 3, The identity of the two rates double-checked the two independent proofs. Therefore experimentally no greenhouse warming is triply proved. A new branch of science Pleistocene Climatology is developed to study the theoretical origin of no greenhouse warming. Climatology, like mechanics of a large number of particles, is of course complex and unwieldy. If totally order-less then there is no hope. However, if some regularity appears, then a systematic treatment can be done to simplify the complexity. The rigid bodies are subjected to a special simplifying condition (the distances between all particles are constant) and only 6 degrees of freedom are significant, all others are sidetracked. To study the spinning top there is no need to study the dynamics of every particle of the top by Newton's laws through super-computer. It only needs to solve the Euler equations without computer. In climate study the use of super-computer to study all degrees of freedom of the climate is as untenable as the study of the spinning top by super-computer. Yet in spite of the complexity there is strict regularity as seen in the ice ages, which works as the simplifying conditions to establish a new science Pleistocene climatology. See my book Greenhouse Warming and Nuclear Hazards just published (www.PeterFongBook.com). This time the special condition is the presence of a

  5. Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis.

    Science.gov (United States)

    Şimşek, Abdullah; Yapıcı, İlhami; Babalık, Mesiha; Şimşek, Zekiye; Kolsuz, Mustafa

    2016-01-01

    To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB. Determinar a distribuição proporcional dos subtipos de tuberculose endobrônquica (TBEB) e avaliar os tipos de procedimentos diagnósticos broncoscópicos que podem revelar inflamação granulomatosa. Este foi um estudo retrospectivo com 18 pacientes HIV negativos com TBEB comprovada

  6. Emotional changes occurring in women in pregnancy, parturition and lying-in period according to factors exerting an effect on a woman during the peripartum period

    Directory of Open Access Journals (Sweden)

    Beata Pięta

    2014-09-01

    Full Text Available [b]Introduction[/b]. Pregnancy, parturition and childcare, which are important moments in a woman’s life, are connected with many emotional states of a future mother, a pregnant woman and a lying-in woman. The perinatal period is the time when the risk of psychological disorders in a pregnant woman may increase by even several times. [b]Objective.[/b] The objective of the study was recognition of the main emotional and psychological changes in pregnant women, those in labour and lying-in, according to the factors occurring during the peripartum period. [b]Material and method[/b]. The study was conducted in the form of a survey and covered a group of 108 mothers who were hospitalized in gynaecological-obstetric and obstetric wards in the Karol Marcinkowski Gynaecological-Obstetric University Hospital in Poznań. [b]Results[/b]. There are a number of factors which may exert a negative effect on the emotions of women in pregnancy, parturition, and during lying-in. The study showed that there is a close relationship between the occurrence of these factors and emotional states of the mothers after giving birth. [b]Conclusion[/b]. Special attention should be given to women in whom already during pregnancy factors arise which may have a negative impact on their mental state. Emotions during pregnancy, parturition and lying-in are often quite extreme, and achieve a high intensity, as well being very variable within a short period of time.

  7. Emotional changes occurring in women in pregnancy, parturition and lying-in period according to factors exerting an effect on a woman during the peripartum period.

    Science.gov (United States)

    Pięta, Beata; Jurczyk, Mieczysława Urszula; Wszołek, Katarzyna; Opala, Tomasz

    2014-01-01

    Pregnancy, parturition and childcare, which are important moments in a woman's life, are connected with many emotional states of a future mother, a pregnant woman and a lying-in woman. The perinatal period is the time when the risk of psychological disorders in a pregnant woman may increase by even several times. Objective. The objective of the study was recognition of the main emotional and psychological changes in pregnant women, those in labour and lying-in, according to the factors occurring during the peripartum period. The study was conducted in the form of a survey and covered a group of 108 mothers who were hospitalized in gynaecological-obstetric and obstetric wards in the Karol Marcinkowski Gynaecological-Obstetric University Hospital in Poznań. There are a number of factors which may exert a negative effect on the emotions of women in pregnancy, parturition, and during lying-in. The study showed that there is a close relationship between the occurrence of these factors and emotional states of the mothers after giving birth. Special attention should be given to women in whom already during pregnancy factors arise which may have a negative impact on their mental state. Emotions during pregnancy, parturition and lying-in are often quite extreme, and achieve a high intensity, as well being very variable within a short period of time.

  8. Changes in the expression of α-tocopherol-related genes in liver and mammary gland biopsy specimens of peripartum dairy cows.

    Science.gov (United States)

    Haga, S; Miyaji, M; Nakano, M; Ishizaki, H; Matsuyama, H; Katoh, K; Roh, S G

    2018-03-28

    Blood α-tocopherol (α-Toc) concentrations decline gradually throughout the prepartum period, reaching the nadir after calving in dairy cows. The 6 α-Toc-related molecules [α-Toc transfer protein (TTPA); afamin; scavenger receptor class B, Type I; ATP-binding cassette transporter A1; tocopherol-associated protein (SEC14L2); and cytochrome P450 family 4, subfamily F, polypeptide 2 (CYP4F2)] are expressed in liver and other peripheral tissues. These molecules could regulate α-Toc transport, blood concentrations, and metabolism of α-Toc. Therefore, the aim of this study was to evaluate the changes in the expression of α-Toc-related genes in liver and mammary gland tissues of dairy cows around calving, which have remained elusive until now. In experiment (Exp.) 1, 28 multiparous Holstein cows were used (from -5 to 6 wk relative to parturition) to monitor the changes in dietary α-Toc intake, blood concentrations of α-Toc, and lipoproteins; in Exp. 2, 7 peripartum Holstein cows were used (from -4 to 4 wk relative to parturition) for liver tissue biopsy; and in Exp. 3, 10 peripartum Holstein cows were used (from -8 to 6 wk relative to parturition) to carry out the mammary gland tissue biopsy and milk sampling. In Exp. 1, the serum α-Toc concentrations declined gradually with decreasing amount of α-Toc intake and plasma high-density lipoprotein concentrations toward calving time. However, in the early lactation period after calving, serum α-Toc concentrations remained at a lower concentration despite the recovery of α-Toc intake and plasma high-density lipoprotein concentrations. In Exp. 2, just after calving, the TTPA, SEC14L2, afamin, and albumin mRNA expression levels in the liver were temporarily downregulated, and the hepatic mRNA levels of endoplasmic reticulum stress-induced unfolded protein response markers and acute-phase response marker increased at calving. In Exp. 3, the concentrations of α-Toc in colostrum were greater than those in precolostrum

  9. Collaborative networks in the internet of services: 13th IFIP WG 5.5 working conference on virtual enterprises, PRO-VE 2012, Bournemouth, UK, October 2012: proceedings

    NARCIS (Netherlands)

    Camarinha-Matos, L.M.; Xu, L.; Afsarmanesh, H.

    2012-01-01

    This book constitutes the refereed proceedings of the 13th IFIP WG 5.5 Working Conference on Virtual Enterprises, PRO-VE 2012, held in Bournemouth, UK, in October 2012. The 61 revised papers presented were carefully selected from numerous submissions. They provide a comprehensive overview of

  10. Peripartum Morbidity after Cesarean Delivery for Arrest of Dilation at 4 to 5 cm Compared with 6 to 10 cm.

    Science.gov (United States)

    Dahlke, Joshua D; Sperling, Jeffrey D; Has, Phinnara; Lovgren, Todd R; Connealy, Brendan D; Rouse, Dwight J

    2018-04-24

     Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm.  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation. We compared those who reached a maximum cervical dilation of 4 to 5 cm with those of ≥6 cm. Our primary outcome was composite maternal morbidity that included chorioamnionitis, endometritis, transfusion, wound complication, operative injury, intensive care unit admission, or death.  Of the 73,257 women in the dataset, 5,681 met the inclusion criteria. After adjusting for confounders, there was no difference in composite maternal (adjusted odds ratio [aOR]: 1.19; 95% confidence interval [CI]: 0.94-1.52) or neonatal morbidity (aOR: 0.94; 95% CI: 0.79-1.10) between the groups.  In this historical cohort, maternal and neonatal outcomes after CD for arrest of dilation ≥ 6 cm were comparable to those performed at 4 to 5 cm and support recent labor management guidelines. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Research gaps in neonatal HIV-related care

    Directory of Open Access Journals (Sweden)

    Mary-Ann Davies

    2015-05-01

    Full Text Available The South African prevention of mother to child transmission programme has made excellentprogress in reducing vertical HIV transmission, and paediatric antiretroviral therapyprogrammes have demonstrated good outcomes with increasing treatment initiation inyounger children and infants. However, both in South Africa and across sub-Saharan African,lack of boosted peri-partum prophylaxis for high-risk vertical transmission, loss to followup,and failure to initiate HIV-infected infants on antiretroviral therapy (ART before diseaseprogression are key remaining gaps in neonatal HIV-related care. In this issue of the Southern African Journal of HIV Medicine, experts provide valuable recommendations for addressingthese gaps. The present article highlights a number of areas where evidence is lacking toinform guidelines and programme development for optimal neonatal HIV-related care.

  12. Effect of peripartum dietary energy supplementation on thyroid hormones, insulin-like growth factor-i and its binding proteins in early lactation dairy cows

    Directory of Open Access Journals (Sweden)

    Kirovski Danijela

    2012-01-01

    three examined postpartum periods, but the difference was significant only on day 60 after parturition (p<0.01, respectively. Concentrations of total protein and albumin were significantly higher in GLY compared to the control group in all three examined periods after parturition. Based on these results it can be concluded that peripartum dietary energy supplementation prevent cows' exposure to severe negative energy balance, preserves synthetic activity of hepatocytes and consequently has a positive impact on milk production and reproductive performances in dairy cows.

  13. Events occurring during the previous lactation, the dry period, and peripartum as risk factors for early lactation mastitis in cows receiving 2 different intramammary dry cow therapies.

    Science.gov (United States)

    Pinedo, P J; Fleming, C; Risco, C A

    2012-12-01

    The objective of this study was to investigate the association between mastitis events occurring during the previous lactation, the dry period, and the peripartum period on the incidence of early lactation mastitis in cows receiving ceftiofur hydrochloride or penicillin dihydrostreptomycin as intramammary dry cow antibiotic therapy. Cows (n=402) from 2 large dairy farms in Central Florida were enrolled in the study at the time of dry-off processing and were randomly assigned to 1 of 2 dry cow therapies: ceftiofur hydrochloride or penicillin dihydrostreptomycin. Composite milk samples were collected at dry-off and after calving for bacteriological examination and somatic cell count. Peripartal health disorders were monitored during the first 30 d of lactation and included calving difficulty, metritis, ketosis, and left displaced abomasum. Milk production and individual somatic cell scores (SCS) were recorded monthly by the Dairy Herd Improvement Association. The main outcome variables were the risk of clinical mastitis during the first 30 and 60 d of lactation, and the risk of subclinical mastitis at the first 2 monthly Dairy Herd Improvement Association tests after calving (up to 70 d in milk). Additionally, the SCS and the presence of mastitis pathogens in milk at dry-off and at calving were analyzed. Explanatory variables consisted of events occurring during the previous lactation, at dry-off and during the dry period, at calving, and within the first 30 d after calving. Multiple events occurring during the previous lactation had a significant effect on the incidence of mastitis in the subsequent lactation. These events included low milk yield, intermediate lactation length, clinical mastitis, and lactation SCS average. Similarly, intramammary infections with environmental bacteria at dry-off increased the chances of clinical mastitis the first month after calving. Dry-off therapy had a significant effect on mastitis incidence; cows treated with ceftiofur

  14. Risk factors relating to helminth infections in cows during the peripartum Fatores de risco relacionados à infecção por helmintos em vacas durante o periparto

    Directory of Open Access Journals (Sweden)

    Jenevaldo Barbosa da Silva

    2012-06-01

    Full Text Available The aim of this study was to investigate whether season, lactation number, breed standard and milk production were risk factors relating to occurrences of gastrointestinal nematodes in dairy cows during the peripartum period. Eighty-four cows were randomly selected through proportional stratified sampling. In order to analyze the fecal egg per gram (EPG count, the data were subjected to the Spearman test, Kruskal-Wallis test at 5% significance and linear regression. At the time of calving, the cows showed high EPG counts in relation to all variables analyzed. Among the animals studied, we observed that purebred Holstein cows at their first lactation and with high milk production showed high EPG counts (600 and comprised the group most at risk within the herd studied. In this group, the animals showed moderate EPG during the prepartum period (300 and a significant increase (p O objetivo foi investigar a estação do ano, número de lactações, padrão racial e produção de leite como fatores de risco relacionados à ocorrência de helmintos gastrintestinais em vacas durante o periparto. Foram selecionadas randomicamente 84 vacas através de amostragem estratificada proporcional. Para análise dos resultados da contagem de ovos por grama de fezes (OPG, foram utilizados os testes de Spearman , Kruskal-Wallis a 5% de significância e regressão linear. Entre os fatores de risco avaliados, o parto esteve associado à elevada contagem de OPG em todos os grupos estudados. Por ocasião do parto, as vacas apresentaram alta contagem de OPG em relação a todas as variáveis analisadas. Dentre os animais estudados, observou-se que vacas holandesas puras de primeira lactação e de alta produção leiteira apresentaram elevada contagem de OPG (600, constituindo o grupo de maior risco dentro do rebanho estudado. Nesse grupo, observou-se que os animais apresentaram contagem de OPG moderada no pré-parto (300, com aumento significativo (p < 0.01 na contagem

  15. Proving the AGT relation for N f = 0, 1, 2 antifundamentals

    Science.gov (United States)

    Hadasz, Leszek; Jaskólski, Zbigniew; Suchanek, Paulina

    2010-06-01

    Using recursive relations satisfied by Nekrasov partition functions and by irregular conformal blocks we prove the AGT correspondence in the case of mathcal{N} = 2 superconformal SU(2) quiver gauge theories with N f = 0, 1, 2 antifundamental hypermultiplets.

  16. Classificació de proves no paramètriques. Com aplicar-les en SPSS

    Directory of Open Access Journals (Sweden)

    Vanesa Berlanga-Silvente

    2012-07-01

    Full Text Available Les proves no paramètriques engloben una sèrie de proves estadístiques, que tenen com a denominador comú l'absència de assumpcions sobre la llei de probabilitat que segueix la població de la qual ha estat extreta la mostra. Per aquesta raó és comú referir-s'hi com a proves de distribució lliure. A l'article es descriuen i treballen les proves no paramètriques ressaltant el seu fonament i les indicacions per al seu ús quan es tracta d'una sola mostra (Chi-quadrat, de dues mostres amb dades independents (U de Mann-Whitney, de dues mostres amb dades relacionades (T de Wilcoxon, de diverses mostres amb dades independents (H de Kruskal-Wallis i de diverses mostres amb dades relacionades (Friedman.

  17. “Deliberate distortion of facts” and the problem of proving bias:

    African Journals Online (AJOL)

    user

    informed observer would reasonably perceive bias on the part of the officer .... represent an excellent illustration of what an Australian Chief Justice once .... the appellants prove that the Justice of Appeal who had no financial or other.

  18. PROVE Land Cover and Leaf Area of Jornada Experimental Range, New Mexico, 1997

    Data.gov (United States)

    National Aeronautics and Space Administration — Field measurement of shrubland ecological properties is important for both site monitoring and validation of remote-sensing information. During the PROVE exercise on...

  19. PROVE Land Cover and Leaf Area of Jornada Experimental Range, New Mexico, 1997

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: Field measurement of shrubland ecological properties is important for both site monitoring and validation of remote-sensing information. During the PROVE...

  20. Technical report on the Piping Reliability Proving Tests at the Japan Atomic Energy Research Institute

    International Nuclear Information System (INIS)

    1993-05-01

    Japan Atomic Energy Research Institute (JAERI) conducts Piping Reliability Proving Tests from 1975 to 1992 based upon the contracts between JAERI and Science and Technology Agency of Japan (STA) under the auspices of the special account law for electric power development promotion. The purpose of these tests are to prove the structural reliability of the primary cooling piping constituting a part of the pressure boundary in the light water reactor power plants. The tests with large experimental facilities had ended already in 1990. Presently piping reliability analysis by the probabilistic fracture mechanics method is being done. Until now annual reports concerning the proving tests were produced and submitted to STA, whereas this report summarizes the test results done during these 16 years. Objectives of the piping reliability proving tests are to prove that the primary piping of the light water reactor (1) be reliable throughout the service period, (2) have no possibility of rupture, (3) bring no detrimental influence on the surrounding instrumentations or equipments near the break location even if it ruptured suddenly. To attain these objectives (i) pipe fatigue tests, (ii) unstable pipe fracture tests, (iii) pipe rupture tests and also the analyses by computer codes were done. After carrying out these tests, it is verified that the piping is reliable throughout the service period. The authors of this report are T. Isozaki, K. Shibata, S. Ueda, R. Kurihara, K. Onizawa and A. Kohsaka. The parts they wrote are shown in contents. (author)

  1. Proving the correctness of unfold/fold program transformations using bisimulation

    DEFF Research Database (Denmark)

    Hamilton, Geoff W.; Jones, Neil

    2011-01-01

    by a labelled transition system whose bisimilarity relation is a congruence that coincides with contextual equivalence. Labelled transition systems are well-suited to represent global program behaviour. On the other hand, unfold/fold program transformations use generalization and folding, and neither is easy......This paper shows that a bisimulation approach can be used to prove the correctness of unfold/fold program transformation algorithms. As an illustration, we show how our approach can be use to prove the correctness of positive supercompilation (due to Sørensen et al). Traditional program equivalence...... to describe contextually, due to use of non-local information. We show that weak bisimulation on labelled transition systems gives an elegant framework to prove contextual equivalence of original and transformed programs. One reason is that folds can be seen in the context of corresponding unfolds....

  2. Formalizing and proving a typing result for security protocols in Isabelle/HOL

    DEFF Research Database (Denmark)

    Hess, Andreas Viktor; Modersheim, Sebastian

    2017-01-01

    or the positive output of a verification tool. However several of these works have used a typed model, where the intruder is restricted to "well-typed" attacks. There also have been several works that show that this is actually not a restriction for a large class of protocols, but all these results so far...... are again pen-and-paper proofs. In this work we present a formalization of such a typing result in Isabelle/HOL. We formalize a constraint-based approach that is used in the proof argument of such typing results, and prove its soundness, completeness and termination. We then formalize and prove the typing...... result itself in Isabelle. Finally, to illustrate the real-world feasibility, we prove that the standard Transport Layer Security (TLS) handshake satisfies the main condition of the typing result....

  3. The in-pile proving test for fuel assembly of Qinshan nuclear power plant

    International Nuclear Information System (INIS)

    Chen Dianshan; Zhang Shucheng; Kang Rixin; Wang Huarong; Chen Guanghan

    1989-10-01

    The in-pile proving test for fuel assembly of Qinshan nuclear power plant had been conducted in the experimental loop of HWRR at IAE (Institute of Atomic Energy) in Beijing, China, from January 1985 to December 1986. Average burnup of 27000 MWd/tU and peak burnup of 34000 MWd/tU of fuel rod had already been reached. The basic status of the experiment are described, emphasis is placed on the discussion of proving test parameters and analysis of experiment results

  4. Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM.

    Science.gov (United States)

    Sliwa, Karen; Mebazaa, Alexandre; Hilfiker-Kleiner, Denise; Petrie, Mark C; Maggioni, Aldo P; Laroche, Cecile; Regitz-Zagrosek, Vera; Schaufelberger, Maria; Tavazzi, Luigi; van der Meer, Peter; Roos-Hesselink, Jolien W; Seferovic, Petar; van Spandonck-Zwarts, Karin; Mbakwem, Amam; Böhm, Michael; Mouquet, Frederic; Pieske, Burkert; Hall, Roger; Ponikowski, Piotre; Bauersachs, Johann

    2017-09-01

    The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries. Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry. There were marked differences in socio-demographic parameters such as Human Development Index, GINI index on inequality, and Health Expenditure in PPCM patients from ESC vs. non-ESC countries (P heart failure after 1 month (92.3% vs. 81.3%, P heart failure were common within 1 month post-diagnosis and required intensive, multidisciplinary management. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  5. Origin of choriocarcinoma in previous molar pregnancy proved by DNA analysis

    International Nuclear Information System (INIS)

    Vojtassak, J.; Repiska, V.; Konecna, B.; Zajac, V.; Korbel, M.; Danihel, L.

    1996-01-01

    A 17-year old woman had in a short time period (seven months) a very exciting reproduction history. Molar pregnancy in December 1993, choriocarcinoma in January 1994 and induced abortion in June 1994. DNA analysis proved the origin of the choriocarcinoma in the previous molar pregnancy. (author)

  6. Automatically Proving Termination and Memory Safety for Programs with Pointer Arithmetic

    DEFF Research Database (Denmark)

    Ströder, Thomas; Giesl, Jürgen; Brockschmidt, Marc

    2017-01-01

    While automated verification of imperative programs has been studied intensively, proving termination of programs with explicit pointer arithmetic fully automatically was still an open problem. To close this gap, we introduce a novel abstract domain that can track allocated memory in detail. We use...

  7. Wind tunnel experiments to prove a hydraulic passive torque control concept for variable speed wind turbines

    NARCIS (Netherlands)

    Diepeveen, N.F.B.; Jarquin-Laguna, A.

    2014-01-01

    In this paper the results are presented of experiments to prove an innovative concept for passive torque control of variable speed wind turbines using fluid power technology. It is demonstrated that by correctly configuring the hydraulic drive train, the wind turbine rotor operates at or near

  8. 20 CFR 416.1603 - How to prove you are a resident of the United States.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How to prove you are a resident of the United States. 416.1603 Section 416.1603 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... as— (1) Property, income, or other tax forms or receipts; (2) Utility bills, leases or rent payment...

  9. Using eternity variables to specify and prove a serializable database interface

    NARCIS (Netherlands)

    Hesselink, Wim H.

    Eternity variables are introduced to specify and verify serializability of transactions of a distributed database. Eternity variables are a new kind of auxiliary variables. They do not occur in the implementation but are used in specification and verification. Elsewhere it has been proved that

  10. Proving termination of graph transformation systems using weighted type graphs over semirings

    NARCIS (Netherlands)

    Bruggink, H.J.S.; König, B.; Nolte, D.; Zantema, H.; Parisi-Presicce, F.; Westfechtel, B.

    2015-01-01

    We introduce techniques for proving uniform termination of graph transformation systems, based on matrix interpretations for string rewriting. We generalize this technique by adapting it to graph rewriting instead of string rewriting and by generalizing to ordered semirings. In this way we obtain a

  11. Proof and Proving: Logic, Impasses, and the Relationship to Problem Solving

    Science.gov (United States)

    Savic, Milos

    2012-01-01

    Becoming a skillful prover is critical for success in advanced undergraduate and graduate mathematics courses. In this dissertation, I report my investigations of proof and the proving process in three separate studies. In the first study, I examined the amount of logic used in student-constructed proofs to help in the design of…

  12. The Secret Prover : Proving Possession of Arbitrary Files While not Giving Them Away

    NARCIS (Netherlands)

    Teepe, Wouter

    2005-01-01

    The Secret Prover is a Java application which allows a user (A) to prove to another user (B), that A possesses a file. If B also possesses this file B will get convinced, and if B does not possess this file B will gain no information on (the contents of) this file. This is the first implementation

  13. Searching for fixed point combinators by using automated theorem proving: A preliminary report

    International Nuclear Information System (INIS)

    Wos, L.; McCune, W.

    1988-09-01

    In this report, we establish that the use of an automated theorem- proving program to study deep questions from mathematics and logic is indeed an excellent move. Among such problems, we focus mainly on that concerning the construction of fixed point combinators---a problem considered by logicians to be significant and difficult to solve, and often computationally intensive and arduous. To be a fixed point combinator, Θ must satisfy the equation Θx = x(Θx) for all combinators x. The specific questions on which we focus most heavily ask, for each chosen set of combinators, whether a fixed point combinator can be constructed from the members of that set. For answering questions of this type, we present a new, sound, and efficient method, called the kernel method, which can be applied quite easily by hand and very easily by an automated theorem-proving program. For the application of the kernel method by a theorem-proving program, we illustrate the vital role that is played by both paramodulation and demodulation---two of the powerful features frequently offered by an automated theorem-proving program for treating equality as if it is ''understood.'' We also state a conjecture that, if proved, establishes the completeness of the kernel method. From what we can ascertain, this method---which relies on the introduced concepts of kernel and superkernel---offers the first systematic approach for searching for fixed point combinators. We successfully apply the new kernel method to various sets of combinators and, for the set consisting of the combinators B and W, construct an infinite set of fixed point combinators such that no two of the combinators are equal even in the presence of extensionality---a law that asserts that two combinators are equal if they behave the same. 18 refs

  14. Searching for fixed point combinators by using automated theorem proving: A preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Wos, L.; McCune, W.

    1988-09-01

    In this report, we establish that the use of an automated theorem- proving program to study deep questions from mathematics and logic is indeed an excellent move. Among such problems, we focus mainly on that concerning the construction of fixed point combinators---a problem considered by logicians to be significant and difficult to solve, and often computationally intensive and arduous. To be a fixed point combinator, THETA must satisfy the equation THETAx = x(THETAx) for all combinators x. The specific questions on which we focus most heavily ask, for each chosen set of combinators, whether a fixed point combinator can be constructed from the members of that set. For answering questions of this type, we present a new, sound, and efficient method, called the kernel method, which can be applied quite easily by hand and very easily by an automated theorem-proving program. For the application of the kernel method by a theorem-proving program, we illustrate the vital role that is played by both paramodulation and demodulation---two of the powerful features frequently offered by an automated theorem-proving program for treating equality as if it is ''understood.'' We also state a conjecture that, if proved, establishes the completeness of the kernel method. From what we can ascertain, this method---which relies on the introduced concepts of kernel and superkernel---offers the first systematic approach for searching for fixed point combinators. We successfully apply the new kernel method to various sets of combinators and, for the set consisting of the combinators B and W, construct an infinite set of fixed point combinators such that no two of the combinators are equal even in the presence of extensionality---a law that asserts that two combinators are equal if they behave the same. 18 refs.

  15. Mathematical Understanding and Proving Abilities: Experiment With Undergraduate Student By Using Modified Moore Learning Approach

    Directory of Open Access Journals (Sweden)

    Rippi Maya

    2011-07-01

    Full Text Available This paper reports findings of  a  post test experimental control group design conducted to investigate the role of modified Moore learning approach  on improving students’ mathematical understanding and proving abilities. Subject of study were 56 undergradute students of one state university in Bandung, who took advanced abstract algebra course. Instrument of study were a set test of mathematical understanding ability, a set test of mathematical proving ability, and a set of students’ opinion scale on modified Moore learning approach. Data were analyzed by using two path ANOVA. The study found that proof construction process was more difficult than mathematical understanding  task  for all students, and students still posed some difficulties on constructing mathematical proof task.  The study also found there were not differences  between students’  abilities on mathematical understanding and on proving abilities of  the both classes, and both abilities were classified as mediocre. However, in modified Moore learning approach class there were more students who got above average grades on mathematical understanding than those of conventional class. Moreover, students performed positive  opinion toward  modified Moore learning approach. They  were  active in questioning and solving problems, and in explaining their works in front of class as well, while students of conventional teaching prefered to listen to lecturer’s explanation. The study also found that there was no interaction between learning approach and students’ prior mathematics ability on mathematical understanding and proving abilities,  but  there were  quite strong  association between students’ mathematical understanding and proving abilities.Keywords:  modified Moore learning approach, mathematical understanding ability, mathematical proving ability. DOI: http://dx.doi.org/10.22342/jme.2.2.751.231-250

  16. Impact of cooking, proving, and baking on the (poly)phenol content of wild blueberry.

    Science.gov (United States)

    Rodriguez-Mateos, Ana; Cifuentes-Gomez, Tania; George, Trevor W; Spencer, Jeremy P E

    2014-05-07

    Accumulating evidence suggests that diets rich in (poly)phenols may have positive effects on human health. Currently there is limited information regarding the effects of processing on the (poly)phenolic content of berries, in particular in processes related to the baking industry. This study investigated the impact of cooking, proving, and baking on the anthocyanin, procyanidin, flavonol, and phenolic acid contents of wild blueberry using HPLC with UV and fluorescence detection. Anthocyanin levels decreased during cooking, proving, and baking, whereas no significant changes were observed for total procyanidins. However, lower molecular weight procyanidins increased and high molecular weight oligomers decreased during the process. Quercetin and ferulic and caffeic acid levels remained constant, whereas increases were found for chlorogenic acid. Due to their possible health benefits, a better understanding of the impact of processing is important to maximize the retention of these phytochemicals in berry-containing products.

  17. Research in advanced formal theorem-proving techniques. [design and implementation of computer languages

    Science.gov (United States)

    Raphael, B.; Fikes, R.; Waldinger, R.

    1973-01-01

    The results are summarised of a project aimed at the design and implementation of computer languages to aid in expressing problem solving procedures in several areas of artificial intelligence including automatic programming, theorem proving, and robot planning. The principal results of the project were the design and implementation of two complete systems, QA4 and QLISP, and their preliminary experimental use. The various applications of both QA4 and QLISP are given.

  18. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 3: Ecological risk assessment

    International Nuclear Information System (INIS)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R.; Van Lonkhuyzen, R.

    2000-01-01

    The Environmental Management Division of the U.S. Army Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation (RI) and feasibility study (FS) of the J-Field area at APG, pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. As part of that activity, Argonne National Laboratory (ANL) conducted an ecological risk assessment (ERA) of the J-Field site. This report presents the results of that assessment

  19. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 3: Ecological risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R.; Van Lonkhuyzen, R.

    2000-02-25

    The Environmental Management Division of the U.S. Army Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation (RI) and feasibility study (FS) of the J-Field area at APG, pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. As part of that activity, Argonne National Laboratory (ANL) conducted an ecological risk assessment (ERA) of the J-Field site. This report presents the results of that assessment.

  20. An Archeological Overview and Management Plan for the Dugway Proving Ground.

    Science.gov (United States)

    1984-03-29

    niches, particulary the lacustrine environment of the Great Basin (Baumhoff and Heizer 1965, Butler 1978, Heizer and Krieger 1956, Heizer and Harper...power that would capture the animals souls, rendering them docile and stupid (Steward 1970:34). Other large game was present, but were not numerous...uni versity. Baum, Bernard. 1947. Dugway Proving Ground. Aberdeen: U.S. Army Chemical Corps.* Bailmhoff, W.A. and R.F. Heizer . 1965. Postglacial

  1. JPSS Preparations at the Satellite Proving Ground for Marine, Precipitation, and Satellite Analysis

    Science.gov (United States)

    Folmer, Michael J.; Berndt, E.; Clark, J.; Orrison, A.; Kibler, J.; Sienkiewicz, J.; Nelson, J.; Goldberg, M.; Sjoberg, W.

    2016-01-01

    The ocean prediction center at the national hurricane center's tropical analysis and forecast Branch, the Weather Prediction center and the Satellite analysis branch of NESDIS make up the Satellite Proving Ground for Marine, Precipitation and Satellite Analysis. These centers had early exposure to JPSS products using the S-NPP Satellite that was launched in 2011. Forecasters continue to evaluate new products in anticipation for the launch of JPSS-1 sometime in 2017.

  2. Conceptualizing reasoning-and-proving opportunities in textbook expositions : Cases from secondary calculus

    OpenAIRE

    Bergwall, Andreas

    2017-01-01

    Several recent textbook studies focus on opportunities to learn reasoning-and-proving. They typically investigate the extent to which justifications are general proofs and what opportunities exist for learning important elements of mathematical reasoning. In this paper, I discuss how a particular analytical framework for this might be refined. Based on an in-depth analysis of certain textbook passages in upper secondary calculus textbooks, I make an account for analytical issues encountered d...

  3. SPoRT's Participation in the GOES-R Proving Ground Activity

    Science.gov (United States)

    Jedlovec, Gary; Fuell, Kevin; Smith, Matthew; Stano, Geoffrey; Molthan, Andrew

    2011-01-01

    The next generation geostationary satellite, GOES-R, will carry two new instruments with unique atmospheric and surface observing capabilities, the Advanced Baseline Imager (ABI) and the Geostationary Lightning Mapper (GLM), to study short-term weather processes. The ABI will bring enhanced multispectral observing capabilities with frequent refresh rates for regional and full disk coverage to geostationary orbit to address many existing and new forecast challenges. The GLM will, for the first time, provide the continuous monitoring of total lightning flashes over a hemispherical region from space. NOAA established the GOES-R Proving Ground activity several years ago to demonstrate the new capabilities of these instruments and to prepare forecasters for their day one use. Proving Ground partners work closely with algorithm developers and the end user community to develop and transition proxy data sets representing GOES-R observing capabilities. This close collaboration helps to maximize refine algorithms leading to the delivery of a product that effectively address a forecast challenge. The NASA Short-term Prediction Research and Transition (SPoRT) program has been a participant in the NOAA GOES-R Proving Ground activity by developing and disseminating selected GOES-R proxy products to collaborating WFOs and National Centers. Established in 2002 to demonstrate the weather and forecasting application of real-time EOS measurements, the SPoRT program has grown to be an end-to-end research to operations activity focused on the use of advanced NASA modeling and data assimilation approaches, nowcasting techniques, and unique high-resolution multispectral data from EOS satellites to improve short-term weather forecasts on a regional and local scale. Participation in the Proving Ground activities extends SPoRT s activities and taps its experience and expertise in diagnostic weather analysis, short-term weather forecasting, and the transition of research and experimental

  4. 76 FR 50771 - Submission for Review: RI 25-37, Evidence To Prove Dependency of a Child, 3206-0206

    Science.gov (United States)

    2011-08-16

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: RI 25-37, Evidence To Prove Dependency of a...) 3206-0206, Evidence to Prove Dependency of a Child. As required by the Paperwork Reduction Act of 1995... or faxed to (202) 395-6974. SUPPLEMENTARY INFORMATION: Evidence to Prove Dependency of a Child is...

  5. Research Objectives for Human Missions in the Proving Ground of Cis-Lunar Space

    Science.gov (United States)

    Spann, James; Niles, Paul; Eppler, Dean; Kennedy, Kriss; Lewis, Ruthan; Sullivan, Thomas

    2016-07-01

    Introduction: This talk will introduce the preliminary findings in support of NASA's Future Capabilities Team. In support of the ongoing studies conducted by NASA's Future Capabilities Team, we are tasked with collecting re-search objectives for the Proving Ground activities. The objectives could include but are certainly not limited to: demonstrating crew well being and performance over long duration missions, characterizing lunar volatiles, Earth monitoring, near Earth object search and identification, support of a far-side radio telescope, and measuring impact of deep space environment on biological systems. Beginning in as early as 2023, crewed missions beyond low Earth orbit will be enabled by the new capabilities of the SLS and Orion vehicles. This will initiate the "Proving Ground" phase of human exploration with Mars as an ultimate destination. The primary goal of the Proving Ground is to demonstrate the capability of suitably long dura-tion spaceflight without need of continuous support from Earth, i.e. become Earth Independent. A major component of the Proving Ground phase is to conduct research activities aimed at accomplishing major objectives selected from a wide variety of disciplines including but not limited to: Astronomy, Heliophysics, Fun-damental Physics, Planetary Science, Earth Science, Human Systems, Fundamental Space Biology, Microgravity, and In Situ Resource Utilization. Mapping and prioritizing the most important objectives from these disciplines will provide a strong foundation for establishing the architecture to be utilized in the Proving Ground. Possible Architectures: Activities and objectives will be accomplished during the Proving Ground phase using a deep space habitat. This habitat will potentially be accompanied by a power/propulsion bus capable of moving the habitat to accomplish different objectives within cis-lunar space. This architecture can also potentially support stag-ing of robotic and tele-robotic assets as well as

  6. How cytogenetical methods help victims prove radiation exposure and claim right for social support: NCERM experience

    International Nuclear Information System (INIS)

    Aleksanin, S.; Slozina, N.; Neronova, E.; Smoliakov, E.

    2011-01-01

    Russian citizens who were irradiated because of radiation disasters, nuclear weapons testing and some other sources have a right to some social support and financial compensation. In order to get this compensation people have to prove that they were irradiated. As it is, not all victims for a variety of reasons have formal documents. Thus they apply for cytogenetic investigation to prove irradiation months, years and even decades after irradiation. Since 1992 the cytogenetic investigations related to radiation exposure were performed in NRCERM for more than 700 people. At the beginning of this investigation FISH method was not certified as a biodosimenty test in Russia. Only dicentric analysis was approved as a proof of irradiation. It is known that the rate of dicentrics decrease in time, but the residual level of cytogenetical markers could be revealed a long time after a radiation accident. Thus the dicentric analysis was performed for the people who applied for biological indication of radiation exposure at that time. Rates of dicentrics exceeding control levels were revealed in half the people who applied for radiation conformation. Now FISH method is certified in Russia and both cytogenetic tests of biodosimetry (dicentrics and FISH) are available for all comers. Increased levels of translocations were found in 8 cases (the dose rate from 0.16 to 0.64 Gy). On the basis of the results of cytogenetic tests official documents were supplied to these people and they were entitled to apply for radiation exposure compensation. Thus cytogenetic tests are very effective and in some cases the only possible way for the victims to prove irradiation exposure and to apply for radiation exposure compensation a long time after an accident.

  7. How cytogenetical methods help victims prove radiation exposure and claim right for social support: NCERM experience

    Energy Technology Data Exchange (ETDEWEB)

    Aleksanin, S., E-mail: Aleksanin@arcerm.spb.ru [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation); Slozina, N., E-mail: NataliaSlozina@peterlink.ru [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation); Neronova, E.; Smoliakov, E. [Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia, (NRCERM) ul. Akademika Lebedeva 4/2, 194044 St. Petersburg (Russian Federation)

    2011-09-15

    Russian citizens who were irradiated because of radiation disasters, nuclear weapons testing and some other sources have a right to some social support and financial compensation. In order to get this compensation people have to prove that they were irradiated. As it is, not all victims for a variety of reasons have formal documents. Thus they apply for cytogenetic investigation to prove irradiation months, years and even decades after irradiation. Since 1992 the cytogenetic investigations related to radiation exposure were performed in NRCERM for more than 700 people. At the beginning of this investigation FISH method was not certified as a biodosimenty test in Russia. Only dicentric analysis was approved as a proof of irradiation. It is known that the rate of dicentrics decrease in time, but the residual level of cytogenetical markers could be revealed a long time after a radiation accident. Thus the dicentric analysis was performed for the people who applied for biological indication of radiation exposure at that time. Rates of dicentrics exceeding control levels were revealed in half the people who applied for radiation conformation. Now FISH method is certified in Russia and both cytogenetic tests of biodosimetry (dicentrics and FISH) are available for all comers. Increased levels of translocations were found in 8 cases (the dose rate from 0.16 to 0.64 Gy). On the basis of the results of cytogenetic tests official documents were supplied to these people and they were entitled to apply for radiation exposure compensation. Thus cytogenetic tests are very effective and in some cases the only possible way for the victims to prove irradiation exposure and to apply for radiation exposure compensation a long time after an accident.

  8. Initial building investigations at Aberdeen Proving Ground, Maryland: Objectives and methodology

    Energy Technology Data Exchange (ETDEWEB)

    Brubaker, K.L.; Dougherty, J.M.; McGinnis, L.D.

    1994-12-01

    As part of an environmental-contamination source-definition program at Aberdeen Proving Ground, detailed internal and external inspections of 23 potentially contaminated buildings are being conducted to describe and characterize the state of each building as it currently exists and to identify areas potentially contaminated with toxic or other hazardous substances. In addition, a detailed geophysical investigation is being conducted in the vicinity of each target building to locate and identify subsurface structures, associated with former building operations, that are potential sources of contamination. This report describes the objectives of the initial building inspections, including the geophysical investigations, and discusses the methodology that has been developed to achieve these objectives.

  9. Using aetnanova to formally prove that the Davis-Putnam satisfiability test is correct

    Directory of Open Access Journals (Sweden)

    Eugenio G. Omodeo

    2008-05-01

    Full Text Available This paper reports on using the ÆtnaNova/Referee proof-verification system to formalize issues regarding the satisfiability of CNF-formulae of propositional logic. We specify an “archetype” version of the Davis-Putnam-Logemann-Loveland algorithm through the THEORY of recursive functions based on a well-founded relation, and prove it to be correct.Within the same framework, and by resorting to the Zorn lemma, we develop a straightforward proof of the compactness theorem.

  10. Divide and conquer method for proving gaps of frustration free Hamiltonians

    DEFF Research Database (Denmark)

    Kastoryano, Michael J.; Lucia, Angelo

    2018-01-01

    Providing system-size independent lower bounds on the spectral gap of local Hamiltonian is in general a hard problem. For the case of finite-range, frustration free Hamiltonians on a spin lattice of arbitrary dimension, we show that a property of the ground state space is sufficient to obtain...... such a bound. We furthermore show that such a condition is necessary and equivalent to a constant spectral gap. Thanks to this equivalence, we can prove that for gapless models in any dimension, the spectral gap on regions of diameter $n$ is at most $o\\left(\\frac{\\log(n)^{2+\\epsilon}}{n}\\right)$ for any...... positive $\\epsilon$....

  11. Application of proving-ring technology to measure thermally induced displacements in large boreholes in rock

    International Nuclear Information System (INIS)

    Patrick, W.C.; Reactor, N.L.; Butkovich, T.R.

    1984-03-01

    A strain-gauged proving-ring transducer was designed and deployed to measure small diametral displacements in 0.61-m diameter boreholes in rock. The rock surrounding the boreholes was previously heated by storage of spent nuclear fuel assemblies and measurements during post-retrieval cooling of the rock were made. To accomplish this, a transducer was designed to measure displacements in the range of 10 to 100 μm, to function in a time-varying temperature regime of 30 0 to 60 0 C at a relative humidity of 100%, to be of low stiffness, and to be easily and quickly installed. 7 references, 6 figures, 1 table

  12. Seismic proving test of ultimate piping strength (current status of preliminary tests)

    International Nuclear Information System (INIS)

    Suzuki, K.; Namita, Y.; Abe, H.; Ichihashi, I.; Suzuki, K.; Ishiwata, M.; Fujiwaka, T.; Yokota, H.

    2001-01-01

    In 1998 Fiscal Year, the 6 year program of piping tests was initiated with the following objectives: i) to clarify the elasto-plastic response and ultimate strength of nuclear piping, ii) to ascertain the seismic safety margin of the current seismic design code for piping, and iii) to assess new allowable stress rules. In order to resolve extensive technical issues before proceeding on to the seismic proving test of a large-scale piping system, a series of preliminary tests of materials, piping components and simplified piping systems is intended. In this paper, the current status of the material tests and the piping component tests is reported. (author)

  13. Ecological survey of M-Field, Edgewood Area Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Downs, J.L.; Eberhardt, L.E.; Fitzner, R.E.; Rogers, L.E.

    1991-12-01

    An ecological survey was conducted on M-Field, at the Edgewood Area, Aberdeen Proving Ground, Maryland. M-Field is used routinely to test army smokes and obscurants, including brass flakes, carbon fibers, and fog oils. The field has been used for testing purposes for the past 40 years, but little documented history is available. Under current environmental regulations, the test field must be assessed periodically to document the presence or potential use of the area by threatened and endangered species. The M-Field area is approximately 370 acres and is part of the US Army's Edgewood Area at Aberdeen Proving Ground in Harford County, Maryland. The grass-covered field is primarily lowlands with elevations from about 1.0 to 8 m above sea level, and several buildings and structures are present on the field. The ecological assessment of M-Field was conducted in three stages, beginning with a preliminary site visit in May to assess sampling requirements. Two field site visits were made June 3--7, and August 12--15, 1991, to identify the biota existing on the site. Data were gathered on vegetation, small mammals, invertebrates, birds, large mammals, amphibians, and reptiles.

  14. Ecological survey of M-Field, Edgewood Area Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Downs, J.L.; Eberhardt, L.E.; Fitzner, R.E.; Rogers, L.E.

    1991-12-01

    An ecological survey was conducted on M-Field, at the Edgewood Area, Aberdeen Proving Ground, Maryland. M-Field is used routinely to test army smokes and obscurants, including brass flakes, carbon fibers, and fog oils. The field has been used for testing purposes for the past 40 years, but little documented history is available. Under current environmental regulations, the test field must be assessed periodically to document the presence or potential use of the area by threatened and endangered species. The M-Field area is approximately 370 acres and is part of the US Army`s Edgewood Area at Aberdeen Proving Ground in Harford County, Maryland. The grass-covered field is primarily lowlands with elevations from about 1.0 to 8 m above sea level, and several buildings and structures are present on the field. The ecological assessment of M-Field was conducted in three stages, beginning with a preliminary site visit in May to assess sampling requirements. Two field site visits were made June 3--7, and August 12--15, 1991, to identify the biota existing on the site. Data were gathered on vegetation, small mammals, invertebrates, birds, large mammals, amphibians, and reptiles.

  15. Proving test on the performance of a Multiple-Excitation Simulator

    International Nuclear Information System (INIS)

    Fujita, Katsuhisa; Ito, Tomohiro; Kojima, Nobuyuki; Sasaki, Yoichi; Abe, Hiroshi; Kuroda, Katsuhiko

    1995-01-01

    Seismic excitation test on large scale piping systems is scheduled to be carried out by the Nuclear power Engineering Corporation (NUPEC) using the large-scale, high-performance vibration table at the Tadotsu Engineering Laboratory, under the sponsorship of the Ministry of International Trade and Industry (MITI). In the test, the piping systems simulate the main steam piping system and the main feed water piping system in the nuclear power plants. In this study, a fundamental test was carried out to prove the performance of the Multiple Excitation Simulator which consists of the hydraulic actuator and the control system. An L-shaped piping system and a hydraulic actuator were installed on the shaking table. Acceleration and displacement generated by the actuator were measured. The performance of the actuator and the control system was discussed comparing the measured values and the target values on the time histories and the response spectrum of the acceleration. As a result, it was proved that the actuator and the control system have good performance and will be applicable to the verification test

  16. Seismic proving tests on the reliability for large components and equipment of nuclear power plants

    International Nuclear Information System (INIS)

    Ohno, Tokue; Tanaka, Nagatoshi

    1988-01-01

    Since Japan has destructive earthquakes frequently, the structural reliability for large components and equipment of nuclear power plants are rigorously required. They are designed using sophisticated seismic analyses and have not yet encountered a destructive earthquake. When nuclear power plants are planned, it is very important that the general public understand the structural reliability during and after an earthquake. Seismic Proving Tests have been planned by Ministry of International Trade and Industry (Miti) to comply with public requirement in Japan. A large-scale high-performance vibration table was constructed at Tasted Engineering Laboratory of Nuclear Power Engineering Test Center (NU PEC), in order to prove the structural reliability by vibrating the test model (of full scale or close to the actual size) in the condition of a destructive earthquake. As for the test models, the following four items were selected out of large components and equipment important to the safety: Reactor Containment Vessel; Primary Coolant Loop or Primary Loop Recirculation System; Reactor Pressure Vessel; and Reactor Core Internals. Here is described a brief of the vibration table, the test method and the results of the tests on PWR Reactor Containment Vessel and BWR Primary Loop Recirculation System (author)

  17. Seismic proving test of process computer systems with a seismic floor isolation system

    International Nuclear Information System (INIS)

    Fujimoto, S.; Niwa, H.; Kondo, H.

    1995-01-01

    The authors have carried out seismic proving tests for process computer systems as a Nuclear Power Engineering Corporation (NUPEC) project sponsored by the Ministry of International Trade and Industry (MITI). This paper presents the seismic test results for evaluating functional capabilities of process computer systems with a seismic floor isolation system. The seismic floor isolation system to isolate the horizontal motion was composed of a floor frame (13 m x 13 m), ball bearing units, and spring-damper units. A series of seismic excitation tests was carried out using a large-scale shaking table of NUPEC. From the test results, the functional capabilities during large earthquakes of computer systems with a seismic floor isolation system were verified

  18. Remediation application strategies for depleted uranium contaminated soils at the US Army Yuma Proving Ground

    International Nuclear Information System (INIS)

    Vandel, D.S.; Medina, S.M.; Weidner, J.R.

    1994-03-01

    The US Army Yuma Proving Ground (YPG), located in the southwest portion of Arizona conducts firing of projectiles into the Gunpoint (GP-20) firing range. The penetrators are composed of titanium and DU. The purpose of this project was to determine feasible cleanup technologies and disposal alternatives for the cleanup of the depleted uranium (DU) contaminated soils at YPG. The project was split up into several tasks that include (a) collecting and analyzing samples representative of the GP-20 soils, (b) evaluating the data results, (c) conducting a literature search of existing proven technologies for soil remediation, and (0) making final recommendations for implementation of this technology to the site. As a result of this study, several alternatives for the separation, treatment, and disposal procedures are identified that would result in meeting the cleanup levels defined by the Nuclear Regulatory Commission for unrestricted use of soils and would result in a significant cost savings over the life of the firing range

  19. Proving Continuity of Coinductive Global Bisimulation Distances: A Never Ending Story

    Directory of Open Access Journals (Sweden)

    David Romero-Hernández

    2015-12-01

    Full Text Available We have developed a notion of global bisimulation distance between processes which goes somehow beyond the notions of bisimulation distance already existing in the literature, mainly based on bisimulation games. Our proposal is based on the cost of transformations: how much we need to modify one of the compared processes to obtain the other. Our original definition only covered finite processes, but a coinductive approach allows us to extend it to cover infinite but finitary trees. After having shown many interesting properties of our distance, it was our intention to prove continuity with respect to projections, but unfortunately the issue remains open. Nonetheless, we have obtained several partial results that are presented in this paper.

  20. Fractal geometry as a new approach for proving nanosimilarity: a reflection note.

    Science.gov (United States)

    Demetzos, Costas; Pippa, Natassa

    2015-04-10

    Nanosimilars are considered as new medicinal outcomes combining the generic drugs and the nanocarrier as an innovative excipient, in order to evaluate them as final products. They belong to the grey area - concerning the evaluation process - between generic drugs and biosimilar medicinal products. Generic drugs are well documented and a huge number of them are in market, replacing effectively the off-patent drugs. The scientific approach for releasing them to the market is based on bioequivalence studies, which are well documented and accepted by the regulatory agencies. On the other hand, the structural complexity of biological/biotechnology-derived products demands a new approach for the approval process taking into consideration that bioequivalence studies are not considered as sufficient as in generic drugs, and new clinical trials are needed to support their approval process of the product to the market. In proportion, due to technological complexity of nanomedicines, the approaches for proving the statistical identity or the similarity for generic and biosimilar products, respectively, with those of prototypes, are not considered as effective for nanosimilar products. The aim of this note is to propose a complementary approach which can provide realistic evidences concerning the nanosimilarity, based on fractal analysis. This approach is well fit with the structural complexity of nanomedicines and smooths the difficulties for proving the similarity between off-patent and nanosimilar products. Fractal analysis could be considered as the approach that completely characterizes the physicochemical/morphological characteristics of nanosimilar products and could be proposed as a start point for a deep discussion on nanosimilarity. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Fake News: A Technological Approach to Proving the Origins of Content, Using Blockchains.

    Science.gov (United States)

    Huckle, Steve; White, Martin

    2017-12-01

    In this article, we introduce a prototype of an innovative technology for proving the origins of captured digital media. In an era of fake news, when someone shows us a video or picture of some event, how can we trust its authenticity? It seems that the public no longer believe that traditional media is a reliable reference of fact, perhaps due, in part, to the onset of many diverse sources of conflicting information, via social media. Indeed, the issue of "fake" reached a crescendo during the 2016 U.S. Presidential Election, when the winner, Donald Trump, claimed that The New York Times was trying to discredit him by pushing disinformation. Current research into overcoming the problem of fake news does not focus on establishing the ownership of media resources used in such stories-the blockchain-based application introduced in this article is technology that is capable of indicating the authenticity of digital media. Put simply, using the trust mechanisms of blockchain technology, the tool can show, beyond doubt, the provenance of any source of digital media, including images used out of context in attempts to mislead. Although the application is an early prototype and its capability to find fake resources is somewhat limited, we outline future improvements that would overcome such limitations. Furthermore, we believe that our application (and its use of blockchain technology and standardized metadata) introduces a novel approach to overcoming falsities in news reporting and the provenance of media resources used therein. However, while our application has the potential to be able to verify the originality of media resources, we believe that technology is only capable of providing a partial solution to fake news. That is because it is incapable of proving the authenticity of a news story as a whole. We believe that takes human skills.

  2. 76 FR 22938 - Submission for Review: RI 25-37, Evidence To Prove Dependency of a Child

    Science.gov (United States)

    2011-04-25

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: RI 25-37, Evidence To Prove Dependency of a..., Evidence to Prove Dependency of a Child. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13... Dependency of a Child, is designed to collect sufficient information for the Office of Personnel Management...

  3. Contamination source review for Building E2370, Edgewood Area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    O`Reilly, D.P.; Glennon, M.A.; Draugelis, A.K.; Rueda, J.; Zimmerman, R.E.

    1995-09-01

    The US Army Aberdeen Proving Ground (APG) commissioned Argonne National Laboratory (ANL) to conduct a contamination source review to identify and define areas of toxic or hazardous contaminants and to assess the physical condition and accessibility of APG buildings. The information obtained from this review may be used to assist the US Army in planning for the future use or disposition of the buildings. The contamination source review consisted of the following tasks: historical records search, physical inspection, photographic documentation, and geophysical investigation. This report provides the results of the contamination source review for Building E2370. Many of the APG facilities constructed between 1917 and the 1960s are no longer used because of obsolescence and their poor state of repair. Because many of these buildings were used for research, development, testing, and/or pilot-scale production of chemical warfare agents and other military substances, the potential exists for portions of the buildings to be contaminated with these substances, their degradation products, and other laboratory or industrial chemicals. These buildings and associated structures or appurtenances may contribute to environmental concerns at APG.

  4. Environmental geophysics at the Southern Bush River Peninsula, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Davies, B.E.; Miller, S.F.; McGinnis, L.D. [and others

    1995-05-01

    Geophysical studies have been conducted at five sites in the southern Bush River Peninsula in the Edgewood Area of Aberdeen Proving Ground, Maryland. The goals of the studies were to identify areas containing buried metallic objects and to provide diagnostic signatures of the hydrogeologic framework of the site. These studies indicate that, during the Pleistocene Epoch, alternating stands of high and low sea level resulted in a complex pattern of channel-fill deposits. Paleochannels of various sizes and orientations have been mapped throughout the study area by means of ground-penetrating radar and EM-31 techniques. The EM-31 paleochannel signatures are represented onshore either by conductivity highs or lows, depending on the depths and facies of the fill sequences. A companion study shows the features as conductivity highs where they extend offshore. This erosional and depositional system is environmentally significant because of the role it plays in the shallow groundwater flow regime beneath the site. Magnetic and electromagnetic anomalies outline surficial and buried debris throughout the areas surveyed. On the basis of geophysical measurements, large-scale (i.e., tens of feet) landfilling has not been found in the southern Bush River Peninsula, though smaller-scale dumping of metallic debris and/or munitions cannot be ruled out.

  5. Interim progress report -- geophysics: Decommissioning of Buildings E5974 and E5978, Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    McGinnis, M.G.; McGinnis, L.D.; Miller, S.F.; Thompson, M.D.

    1992-11-01

    Buildings E5974 and E5978, located near the mouth of Canal Creek, were among 10 potentially contaminated sites in the Westwood and Canal Creek areas of the Edgewood section of Aberdeen Proving Ground examined by a geophysical team from Argonne National Laboratory in April and May of 1992. Noninvasive geophysical surveys, including the complementary technologies of magnetics, electrical resistivity, and ground-penetrating radar, were conducted around the perimeters of the buildings to guide a sampling program prior to decommissioning and dismantling. The magnetic anomalies and the electrically conductive areas around these buildings have a spatial relationship similar to that observed in low-lying sites in the Canal Creek area; they are probably associated with construction fill. Electrically conductive terrain is dominant on the eastern side of the site, and resistive terrain predominates on the west. The smaller magnetic anomalies are not imaged with ground radar or by electrical profiling. The high resistivities in the northwest quadrant are believed to be caused by a natural sand lens. The causes of three magnetic anomalies in the high-resistivity area are unidentified, but they are probably anthropogenic

  6. A Mechanically Proved and an Incremental Development of the Session Initiation Protocol INVITE Transaction

    Directory of Open Access Journals (Sweden)

    Rajaa Filali

    2014-01-01

    Full Text Available The Session Initiation Protocol (SIP is an application layer signaling protocol used to create, manage, and terminate sessions in an IP based network. SIP is considered as a transactional protocol. There are two main SIP transactions, the INVITE transaction and the non-INVITE transaction. The SIP INVITE transaction specification is described in an informal way in Request for Comments (RFC 3261 and modified in RFC 6026. In this paper we focus on the INVITE transaction of SIP, over reliable and unreliable transport mediums, which is used to initiate a session. In order to ensure the correctness of SIP, the INVITE transaction is modeled and verified using event-B method and its Rodin platform. The Event-B refinement concept allows an incremental development by defining the studied system at different levels of abstraction, and Rodin discharges almost all proof obligations at each level. This interaction between modeling and proving reduces the complexity and helps in assuring that the INVITE transaction SIP specification is correct, unambiguous, and easy to understand.

  7. The written mathematical communication profile of prospective math teacher in mathematical proving

    Science.gov (United States)

    Pantaleon, K. V.; Juniati, D.; Lukito, A.; Mandur, K.

    2018-01-01

    Written mathematical communication is the process of expressing mathematical ideas and understanding in writing. It is one of the important aspects that must be mastered by the prospective math teacher as tool of knowledge transfer. This research was a qualitative research that aimed to describe the mathematical communication profile of the prospective mathematics teacher in mathematical proving. This research involved 48 students of Mathematics Education Study Program; one of them with moderate math skills was chosen as the main subject. Data were collected through tests, assignments, and task-based interviews. The results of this study point out that in the proof of geometry, the subject explains what is understood, presents the idea in the form of drawing and symbols, and explains the content/meaning of a representation accurately and clearly, but the subject can not convey the argument systematically and logically. Whereas in the proof of algebra, the subject describes what is understood, explains the method used, and describes the content/meaning of a symbolic representation accurately, systematically, logically, but the argument presented is not clear because it is insufficient detailed and complete.

  8. Hydrogeologic and chemical data for the O-Field area, Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    Nemoff, P.R.; Vroblesky, D.A.

    1989-01-01

    O-Field, located at the Edgewood area of Aberdeen Proving Ground, Maryland, was periodically used for disposal of munitions, waste chemicals, and chemical-warfare agents from World War II through the 1950's. This report includes various physical, geologic, chemical, and hydrologic data obtained from well-core, groundwater, surface water, and bottom-sediment sampling sites at and near the O-Field disposal area. The data are presented in tables and hydrographs. Three site-location maps are also included. Well-core data include lithologic logs for 11 well-cluster sites, grain-size distributions, various chemical characteristics, and confining unit characteristics. Groundwater data include groundwater chemistry, method blanks for volatile organic carbon, available data on volatile and base/neutral organics, and compilation of corresponding method blanks, chemical-warfare agents, explosive-related products, radionuclides, herbicides, and groundwater levels. Surface-water data include field-measured characteristics; concentrations of various inorganic constituents including arsenic; selected organic constituents with method blanks; detection limits of organics; and a compilation of information on corresponding acids, volatiles, and semivolatiles; and method blanks corresponding to acids, volatiles, and semivolatiles. A set of 15 water-level hydrographs for the period March 1986 through September 1987 also is included in the report. 3 refs., 18 figs., 24 tabs

  9. Modeling exposure to depleted uranium in support of decommissioning at Jefferson Proving Ground, Indiana

    Energy Technology Data Exchange (ETDEWEB)

    Ebinger, M.H. [Los Alamos National Lab., NM (United States); Oxenburg, T.P. [Army Test and Evaluation Command, Aberdeen Proving Ground, MD (United States)

    1997-02-01

    Jefferson Proving Ground was used by the US Army Test and Evaluation Command for testing of depleted uranium munitions and closed in 1995 under the Base Realignment and Closure Act. As part of the closure of JPG, assessments of potential adverse health effects to humans and the ecosystem were conducted. This paper integrates recent information obtained from site characterization surveys at JPG with environmental monitoring data collected from 1983 through 1994 during DU testing. Three exposure scenarios were evaluated for potential adverse effects to human health: an occasional use scenario and two farming scenarios. Human exposure was minimal from occasional use, but significant risk were predicted from the farming scenarios when contaminated groundwater was used by site occupants. The human health risk assessments do not consider the significant risk posed by accidents with unexploded ordnance. Exposures of white-tailed deer to DU were also estimated in this study, and exposure rates result in no significant increase in either toxicological or radiological risks. The results of this study indicate that remediation of the DU impact area would not substantially reduce already low risks to humans and the ecosystem, and that managed access to JPG is a reasonable model for future land use options.

  10. Contamination source review for Building E3236, Edgewood Area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S.D.; Smits, M.P.; Draugelis, A.K.; Glennon, M.A.; Rueda, J.; Zimmerman, R.E.

    1995-09-01

    The US Army Aberdeen Proving Ground (APG) commissioned Argonne National Laboratory (ANL) to conduct a contamination source review to identify and define areas of toxic or hazardous contaminants and to assess the physical condition and accessibility of APG buildings. The information obtained from the review may be used to assist the US Army in planning for the future use or disposition of the buildings. The contamination source review consisted of the following tasks: historical records search, physical inspection, photographic documentation, geophysical investigation, and review of available records regarding underground storage tanks associated with each building. This report provides the results of the contamination source review for Building E3236. Many of the APG facilities constructed between 1917 and the 1960s are no longer used because of obsolescence and their poor state of repair. Because many of these buildings were used for research, development, testing, and/or pilot- scale production of chemical warfare agents and other military substances, the potential exists for portions of the buildings to be contaminated with these substances, their degradation products, and other laboratory or industrial chemicals. These buildings and associated structures or appurtenances may contribute to environmental concerns at APG.

  11. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 1: Remedial investigation results

    International Nuclear Information System (INIS)

    Yuen, C. R.; Martino, L. E.; Biang, R. P.; Chang, Y. S.; Dolak, D.; Van Lonkhuyzen, R. A.; Patton, T. L.; Prasad, S.; Quinn, J.; Rosenblatt, D. H.; Vercellone, J.; Wang, Y. Y.

    2000-01-01

    This report presents the results of the remedial investigation (RI) conducted at J-Field in the Edgewood Area of Aberdeen Proving Ground (APG), a U.S. Army installation located in Harford County, Maryland. Since 1917, activities in the Edgewood Area have included the development, manufacture, and testing of chemical agents and munitions and the subsequent destruction of these materials at J-Field by open burning and open detonation. These activities have raised concerns about environmental contamination at J-Field. This RI was conducted by the Environmental Conservation and Restoration Division, Directorate of Safety, Health and Environmental Division of APG, pursuant to requirements outlined under the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). The RI was accomplished according to the procedures developed by the U.S. Environmental Protection Agency (EPA 1988). The RI provides a comprehensive evaluation of the site conditions, nature of contaminants present, extent of contamination, potential release mechanisms and migration pathways, affected populations, and risks to human health and the environment. This information will be used as the basis for the design and implementation of remedial actions to be performed during the remedial action phase, which will follow the feasibility study (FS) for J-Field

  12. How to prove the Earth's daily and annual direction of its spinning

    Directory of Open Access Journals (Sweden)

    Drago Špoljarić

    2014-12-01

    Full Text Available Every day, we can observe the Sun's apparent motion around the sky. It rises in the east, gets to its highest point above the horizon at noon, and sets in the west. The stars appear to be fixed on the sky and move around apparently together with the Sun. We have daytime1 and night. The apparent annual motion of the Sun results in seasons when we can see different stars. These directly visible daily and annual changes result from real Earth’s motions – the Earth’s daily and annual spinning (rotation and revolution and they are not easily explainable without understanding the Earth’s motions. In order to understand the apparent daily and annual motions and motion direction of the Sun and stars (night sky, it is very important to know where we are on the Earth, what is our geographic position, i.e. to know the cardinal points. At the same time, one should take into consideration also the direction of the Earth’s rotation and revolution. What is the Earth’s daily or annual direction of spinning as related to the direction of clock hands, and how do we prove it?

  13. Remedial investigation report for J-Field, Aberdeen Proving Ground, Maryland. Volume 1: Remedial investigation results

    Energy Technology Data Exchange (ETDEWEB)

    Yuen, C. R.; Martino, L. E.; Biang, R. P.; Chang, Y. S.; Dolak, D.; Van Lonkhuyzen, R. A.; Patton, T. L.; Prasad, S.; Quinn, J.; Rosenblatt, D. H.; Vercellone, J.; Wang, Y. Y.

    2000-03-14

    This report presents the results of the remedial investigation (RI) conducted at J-Field in the Edgewood Area of Aberdeen Proving Ground (APG), a U.S. Army installation located in Harford County, Maryland. Since 1917, activities in the Edgewood Area have included the development, manufacture, and testing of chemical agents and munitions and the subsequent destruction of these materials at J-Field by open burning and open detonation. These activities have raised concerns about environmental contamination at J-Field. This RI was conducted by the Environmental Conservation and Restoration Division, Directorate of Safety, Health and Environmental Division of APG, pursuant to requirements outlined under the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). The RI was accomplished according to the procedures developed by the U.S. Environmental Protection Agency (EPA 1988). The RI provides a comprehensive evaluation of the site conditions, nature of contaminants present, extent of contamination, potential release mechanisms and migration pathways, affected populations, and risks to human health and the environment. This information will be used as the basis for the design and implementation of remedial actions to be performed during the remedial action phase, which will follow the feasibility study (FS) for J-Field.

  14. The existence of propagated sensation along the meridian proved by neuroelectrophysiology

    Science.gov (United States)

    Xu, Jinsen; Zheng, Shuxia; Pan, Xiaohua; Zhu, Xiaoxiang; Hu, Xianglong

    2013-01-01

    Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the dian were given electro-acupuncture at the Jianyu (LI15) acupoint of the large intestine meridian. When participants stated that the sensation reached the back of their hand, regular nervous system action discharge was examined using a physiological recording electrode placed on the superficial branch of the radial nerve. The topographical maps of brain-evoked potential in the primary cortical somatosensory area were also detected. When Guangming (GB37) acupoint in the lower limb and Hegu (LI4) acupoint in the upper limb were stimulated, subjects without propagated sensation along the meridian exhibited a high potential reaction in the corresponding area of the brain cortical so-matosensory area. For subjects with a notable propagated sensation along the meridian, the tion area was larger and extended into the face representative area. These electrophysiological measures directly prove the existence of propagated sensation along the meridian, and the pheral stimulated site is consistent with the corresponding primary cortical somatosensory area, which presents a high potential reaction. PMID:25206574

  15. Transgenic Drosophila simulans strains prove the identity of the speciation gene Lethal hybrid rescue.

    Science.gov (United States)

    Prigent, Stéphane R; Matsubayashi, Hiroshi; Yamamoto, Masa-Toshi

    2009-10-01

    Speciation genes are responsible for genetic incompatibilities in hybrids of incipient species and therefore participate in reproductive isolation leading to complete speciation. Hybrid males between Drosophila melanogaster females and D. simulans males die at late larval or prepupal stages due to a failure in chromosome condensation during mitosis. However a mutant male of D. simulans, named Lethal hybrid rescue (Lhr), produces viable hybrid males when crossed to females of D. melanogaster. Recently the Lhr gene has been proposed as corresponding to the CG18468 gene in D. melanogaster. However this identification relied on sequence characteristics more than on a precise mapping and the use of the GAL4/UAS system to drive the transgene in D. melanogaster might have increased the complexity of interaction. Thus here we propose an independent identification of the Lhr gene based on a more precise mapping and transgenic experiments in D. simulans. We have mapped the Lhr gene by using Single Nucleotide Polymorphisms (SNPs) and identified within the candidate region the gene homologous to CG18468 as the Lhr gene as it was previously reported. Transgenic experiments in D. simulans with the native promoter of CG18468 prove that it is the Lhr gene of D. simulans by inducing the lethality of the hybrid males.

  16. Review of analytical results from the proposed agent disposal facility site, Aberdeen Proving Ground

    Energy Technology Data Exchange (ETDEWEB)

    Brubaker, K.L.; Reed, L.L.; Myers, S.W.; Shepard, L.T.; Sydelko, T.G.

    1997-09-01

    Argonne National Laboratory reviewed the analytical results from 57 composite soil samples collected in the Bush River area of Aberdeen Proving Ground, Maryland. A suite of 16 analytical tests involving 11 different SW-846 methods was used to detect a wide range of organic and inorganic contaminants. One method (BTEX) was considered redundant, and two {open_quotes}single-number{close_quotes} methods (TPH and TOX) were found to lack the required specificity to yield unambiguous results, especially in a preliminary investigation. Volatile analytes detected at the site include 1, 1,2,2-tetrachloroethane, trichloroethylene, and tetrachloroethylene, all of which probably represent residual site contamination from past activities. Other volatile analytes detected include toluene, tridecane, methylene chloride, and trichlorofluoromethane. These compounds are probably not associated with site contamination but likely represent cross-contamination or, in the case of tridecane, a naturally occurring material. Semivolatile analytes detected include three different phthalates and low part-per-billion amounts of the pesticide DDT and its degradation product DDE. The pesticide could represent residual site contamination from past activities, and the phthalates are likely due, in part, to cross-contamination during sample handling. A number of high-molecular-weight hydrocarbons and hydrocarbon derivatives were detected and were probably naturally occurring compounds. 4 refs., 1 fig., 8 tabs.

  17. Ecological risk assessment of depleted uranium in the environment at Aberdeen Proving Ground

    International Nuclear Information System (INIS)

    Clements, W.H.; Kennedy, P.L.; Myers, O.B.

    1993-01-01

    A preliminary ecological risk assessment was conducted to evaluate the effects of depleted uranium (DU) in the Aberdeen Proving Ground (APG) ecosystem and its potential for human health effects. An ecological risk assessment of DU should include the processes of hazard identification, dose-response assessment, exposure assessment, and risk characterization. Ecological risk assessments also should explicitly examine risks incurred by nonhuman as well as human populations, because risk assessments based only on human health do not always protect other species. To begin to assess the potential ecological risk of DU release to the environment we modeled DU transport through the principal components of the aquatic ecosystem at APG. We focused on the APG aquatic system because of the close proximity of the Chesapeake Bay and concerns about potential impacts on this ecosystem. Our objective in using a model to estimate environmental fate of DU is to ultimately reduce the uncertainty about predicted ecological risks due to DU from APG. The model functions to summarize information on the structure and functional properties of the APG aquatic system, to provide an exposure assessment by estimating the fate of DU in the environment, and to evaluate the sources of uncertainty about DU transport

  18. Physiotherapy Rehabilitation for Osteoporotic Vertebral Fracture (PROVE): study protocol for a randomised controlled trial

    Science.gov (United States)

    2014-01-01

    Background Osteoporosis and vertebral fracture can have a considerable impact on an individual’s quality of life. There is increasing evidence that physiotherapy including manual techniques and exercise interventions may have an important treatment role. This pragmatic randomised controlled trial will investigate the clinical and cost-effectiveness of two different physiotherapy approaches for people with osteoporosis and vertebral fracture, in comparison to usual care. Methods/Design Six hundred people with osteoporosis and a clinically diagnosed vertebral fracture will be recruited and randomly allocated to one of three management strategies, usual care (control - A), an exercise-based physiotherapy intervention (B) or a manual therapy-based physiotherapy intervention (C). Those in the usual care arm will receive a single session of education and advice, those in the active treatment arms (B + C) will be offered seven individual physiotherapy sessions over 12 weeks. The trial is designed as a prospective, adaptive single-blinded randomised controlled trial. An interim analysis will be completed and if one intervention is clearly superior the trial will be adapted at this point to continue with just one intervention and the control. The primary outcomes are quality of life measured by the disease specific QUALLEFO 41 and the Timed Loaded Standing test measured at 1 year. Discussion There are a variety of different physiotherapy packages used to treat patients with osteoporotic vertebral fracture. At present, the indication for each different therapy is not well defined, and the effectiveness of different modalities is unknown. Trial registration Reference number ISRCTN49117867. PMID:24422876

  19. Improving immunization delivery using an electronic health record: the ImmProve project.

    Science.gov (United States)

    Bundy, David G; Persing, Nichole M; Solomon, Barry S; King, Tracy M; Murakami, Peter N; Thompson, Richard E; Engineer, Lilly D; Lehmann, Christoph U; Miller, Marlene R

    2013-01-01

    Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care, and provider-specific bulletins listing children overdue for immunizations. Overall, the proportion of children up to date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their second birthday was significantly improved during the intervention period. Human papillomavirus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio 1.32; 95% confidence interval 1.12-1.56); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower baseline uptake. Copyright © 2013 Academic

  20. Experimental study of soil-structure interaction for proving the three dimensional thin layered element method

    International Nuclear Information System (INIS)

    Kuwabara, Y.; Ogiwara, Y.; Suzuki, T.; Tsuchiya, H.; Nakayama, M.

    1981-01-01

    It is generally recognized that the earthquake response of a structure can be significantly affected by the dynamic interaction between the structure and the surrounding soil. Dynamic soil-structure interaction effects are usually analyzed by using a lumped mass model or a finite element model. In the lumped mass model, the soil is represented by springs and dashpots based on the half-space elastic theory. Each model has its advantages and limitations. The Three Dimensional Thin Layered Element Theory has been developed by Dr. Hiroshi Tajimi based on the combined results of the abovementioned lumped mass model and finite element model. The main characteristic of this theory is that, in consideration and can be applied in the analysis of many problems in soil-structure interaction, such as those involving radiation damping, embedded structures, and multi-layered soil deposits. This paper describes test results on a small scale model used to prove the validity of the computer program based on the Thin Layered Element Theory. As a numerical example, the response analysis of a PWR nuclear power plant is carried out using this program. The vibration test model is simplified and the scale is 1/750 for line. The soil layer of the model is made of congealed gelatine. The test soil layer is 80 cm long, 35 cm wide and 10 cm thick. The super structure is a one mass model made of metal sheet spring and solid mass metal. As fixed inputs, sinusoidal waves (10, 20 gal level) are used. The displacements of the top and base of the super structure, and the accelerations and the displacements of the shaking table are measured. The main parameter of the test is the shear wave velocity of the soil layer. (orig./RW)

  1. Potential health impacts from range fires at Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    Willians, G.P.; Hermes, A.M.; Policastro, A.J.; Hartmann, H.M.; Tomasko, D.

    1998-03-01

    This study uses atmospheric dispersion computer models to evaluate the potential for human health impacts from exposure to contaminants that could be dispersed by fires on the testing ranges at Aberdeen Proving Ground, Maryland. It was designed as a screening study and does not estimate actual human health risks. Considered are five contaminants possibly present in the soil and vegetation from past human activities at APG--lead, arsenic, trichloroethylene (TCE), depleted uranium (DU), and dichlorodiphenyltrichloroethane (DDT); and two chemical warfare agents that could be released from unexploded ordnance rounds heated in a range fire--mustard and phosgene. For comparison, dispersion of two naturally occurring compounds that could be released by burning of uncontaminated vegetation--vinyl acetate and 2-furaldehyde--is also examined. Data from previous studies on soil contamination at APG are used in conjunction with conservative estimates about plant uptake of contaminants, atmospheric conditions, and size and frequency of range fires at APG to estimate dispersion and possible human exposure. The results are compared with US Environmental Protection Agency action levels. The comparisons indicate that for all of the anthropogenic contaminants except arsenic and mustard, exposure levels would be at least an order of magnitude lower than the corresponding action levels. Because of the compoundingly conservative nature of the assumptions made, they conclude that the potential for significant human health risks from range fires is low. The authors recommend that future efforts be directed at fire management and control, rather than at conducting additional studies to more accurately estimate actual human health risk from range fires

  2. JPSS Preparations at the Satellite Proving Ground for Marine, Precipitation, and Satellite Analysis

    Science.gov (United States)

    Folmer, M. J.; Berndt, E.; Clark, J.; Orrison, A.; Kibler, J.; Sienkiewicz, J. M.; Nelson, J. A., Jr.; Goldberg, M.

    2016-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Satellite Proving Ground (PG) for Marine, Precipitation, and Satellite Analysis (MPS) has been demonstrating and evaluating Suomi National Polar-orbiting Partnership (S-NPP) products along with other polar-orbiting satellite platforms in preparation for the Joint Polar Satellite System - 1 (JPSS-1) launch in March 2017. The first S-NPP imagery was made available to the MPS PG during the evolution of Hurricane Sandy in October 2012 and has since been popular in operations. Since this event the MPS PG Satellite Liaison has been working with forecasters on ways to integrate single-channel and multispectral imagery from the Visible Infrared Imaging Radiometer Suite (VIIRS), the Moderate Resolution Imaging Spectroradiometer (MODIS), and the Advanced Very High Resolution Radiometer (AVHRR)into operations to complement numerical weather prediction and geostationary satellite savvy National Weather Service (NWS) National Centers. Additional unique products have been introduced to operations to address specific forecast challenges, including the Cooperative Institute for Research in the Atmosphere (CIRA) Layered Precipitable Water, the National Environmental Satellite, Data, and Information Service (NESDIS) Snowfall Rate product, NOAA Unique Combined Atmospheric Processing System (NUCAPS) Soundings, ozone products from the Atmospheric Infrared Sounder (AIRS), Cross-track Infrared Sounder/Advanced Technology Microwave Sounder (CrIS/ATMS), and Infrared Atmospheric Sounding Interferometer (IASI). In addition, new satellite domains have been created to provide forecasters at the NWS Ocean Prediction Center and Weather Prediction Center with better quality imagery at high latitudes. This has led to research projects that are addressing forecast challenges such as tropical to extratropical transition and explosive cyclogenesis. This presentation will provide examples of how the MPS PG has been introducing and integrating

  3. Environmental radiation monitoring plan for depleted uranium and beryllium areas, Yuma Proving Ground

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1994-01-01

    This Environmental Radiation Monitoring Plan (ERM) discusses sampling soils, vegetation, and biota for depleted uranium (DU) and beryllium (Be) at Yuma Proving Ground (YPG). The existing ERM plan was used and modified to more adequately assess the potential of DU and Be migration through the YPG ecosystem. The potential pathways for DU and Be migration are discussed and include soil to vegetation, soil to animals, vegetation to animals, animals to animals, and animals to man. Sample collection will show DU deposition and will be used to estimate DU migration. The number of samples from each area varies and depends on if the firing range of interest is currently used for DU testing (GP 17A) or if the range is not used currently for DU testing (GP 20). Twenty to thirty-five individual mammals or lizards will be sampled from each transect. Air samples and samples of dust in the air fall will be collected in three locations in the active ranges. Thirty to forty-five sediment samples will be collected from different locations in the arroys near the impact areas. DU and Be sampling in the Hard Impact and Soft Impact areas changed only slightly from the existing ERM. The modifications are changes in sample locations, addition of two sediment transport locations, addition of vegetation samples, mammal samples, and air sampling from three to five positions on the impact areas. Analysis of samples for DU or total U by inductively-coupled mass spectroscopy (ICP/MS), cc spectroscopy, neutron activation analysis (NAA), and kinetic phosphorimetric analysis (KPA) are discussed, and analysis for Be by ICP/MS are recommended. Acquiring total U (no isotope data) from a large number of samples and analysis of those samples with relatively high total U concentrations results in fewer isotopic identifications but more information on U distribution. From previous studies, total U concentrations greater than about 3 times natural background are usually DU by isotopic confirmation

  4. Work plan for conducting an ecological risk assessment at J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Hlohowskyj, I.; Hayse, J.; Kuperman, R. [Argonne National Lab., IL (United States). Environmental Assessment Div.] [and others

    1995-03-01

    The Environmental Management Division of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study (RI/FS) of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. J-Field is within the Edgewood Area of APG in Harford County, Maryland, and activities at the Edgewood Area since World War II have included the development, manufacture, testing, and destruction of chemical agents and munitions. The J-Field site was used to destroy chemical agents and munitions by open burning and open detonation. This work plan presents the approach proposed to conduct an ecological risk assessment (ERA) as part of the RI/FS program at J-Field. This work plan identifies the locations and types of field studies proposed for each area of concern (AOC), the laboratory studies proposed to evaluate toxicity of media, and the methodology to be used in estimating doses to ecological receptors and discusses the approach that will be used to estimate and evaluate ecological risks at J-Field. Eight AOCs have been identified at J-Field, and the proposed ERA is designed to evaluate the potential for adverse impacts to ecological receptors from contaminated media at each AOC, as well as over the entire J-Field site. The proposed ERA approach consists of three major phases, incorporating field and laboratory studies as well as modeling. Phase 1 includes biotic surveys of the aquatic and terrestrial habitats, biological tissue sampling and analysis, and media toxicity testing at each AOC and appropriate reference locations. Phase 2 includes definitive toxicity testing of media from areas of known or suspected contamination or of media for which the Phase 1 results indicate toxicity or adverse ecological effects. In Phase 3, the uptake models initially developed in Phase 2 will be finalized, and contaminant dose to each receptor from all complete pathways will be estimated.

  5. Potential health impacts from range fires at Aberdeen Proving Ground, Maryland.

    Energy Technology Data Exchange (ETDEWEB)

    Willians, G.P.; Hermes, A.M.; Policastro, A.J.; Hartmann, H.M.; Tomasko, D.

    1998-03-01

    This study uses atmospheric dispersion computer models to evaluate the potential for human health impacts from exposure to contaminants that could be dispersed by fires on the testing ranges at Aberdeen Proving Ground, Maryland. It was designed as a screening study and does not estimate actual human health risks. Considered are five contaminants possibly present in the soil and vegetation from past human activities at APG--lead, arsenic, trichloroethylene (TCE), depleted uranium (DU), and dichlorodiphenyltrichloroethane (DDT); and two chemical warfare agents that could be released from unexploded ordnance rounds heated in a range fire--mustard and phosgene. For comparison, dispersion of two naturally occurring compounds that could be released by burning of uncontaminated vegetation--vinyl acetate and 2-furaldehyde--is also examined. Data from previous studies on soil contamination at APG are used in conjunction with conservative estimates about plant uptake of contaminants, atmospheric conditions, and size and frequency of range fires at APG to estimate dispersion and possible human exposure. The results are compared with US Environmental Protection Agency action levels. The comparisons indicate that for all of the anthropogenic contaminants except arsenic and mustard, exposure levels would be at least an order of magnitude lower than the corresponding action levels. Because of the compoundingly conservative nature of the assumptions made, they conclude that the potential for significant human health risks from range fires is low. The authors recommend that future efforts be directed at fire management and control, rather than at conducting additional studies to more accurately estimate actual human health risk from range fires.

  6. Generator, mechanical, smoke: For dual-purpose unit, XM56, Yuma Proving Ground, Yuma, Arizona

    Energy Technology Data Exchange (ETDEWEB)

    Driver, C.J.; Ligotke, M.W.; Moore, E.B. Jr. (Pacific Northwest Lab., Richland, WA (United States)); Bowers, J.F. (Dugway Proving Ground, UT (United States))

    1991-10-01

    The US Army Chemical Research, Development and Engineering Center (CRDEC) is planning to perform a field test of the XM56 smoke generator at the US Army Yuma Proving Ground (YPG), Arizona. The XM56, enabling the use of fog oil in combination with other materials, such as graphite flakes, is part of an effort to improve the efficiency of smoke generation and to extend the effectiveness of the resulting obscurant cloud to include the infrared spectrum. The plan field operation includes a road test and concurrent smoke- generation trials. Three M1037 vehicles with operation XM56 generators will be road-tested for 100 h. Smoke will be generated for 30 min from a single stationary XM56 four times during the road test, resulting in a total of 120 min of smoke generation. The total aerial release of obscurant materials during this test is expected to be 556 kg (1,220 lb) of fog oil and 547 kg (1,200 lb) of graphite flakes. This environmental assessment has evaluated the consequences of the proposed action. Air concentrations and surface deposition levels were estimated using an atmospheric dispersion model. Degradation of fog oil and incorporation of graphite in the soil column will limit the residual impacts of the planned action. No significant impacts to air, water, and soil quality are anticipated. risks to the environment posed by the proposed action were determined to be minimal or below levels previously found to pose measurable impacts. Cultural resources are present on YPG and have been identified in adjacent areas; therefore, off-road activities should be preceded by a cultural resource survey. A Finding of No Significant Impact is recommended. 61 refs., 1 fig.

  7. Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study: findings at 3 months

    Directory of Open Access Journals (Sweden)

    Reddy RK

    2013-09-01

    Full Text Available Rahul K Reddy,1 Maziar Lalezary,1 Stephen J Kim,1 Jeffrey A Kammer,1 Rachel W Kuchtey,1 Edward F Cherney,1 Franco M Recchia,2 Karen M Joos,1 Anita Agarwal,1 Janice C Law11Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, TN, USA; 2Tennessee Retina, PC, Nashville, TN, USABackground: The purpose of this paper is to report the 3-month findings of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study.Methods: Eighty eyes of 40 participants undergoing vitrectomy were enrolled. Participants underwent baseline evaluation of the study (surgical and fellow (control eye that included: intraocular pressure, central corneal thickness, gonioscopy, cup-to-disc ratio measurement, color fundus and optic disc photography, automated perimetry, and optical coherence tomography of the macula and optic nerve. Evaluation was repeated at 3 months. Main outcome measures were changes in macula and retinal nerve fiber layer (RNFL thickness and intraocular pressure.Results: All participants completed follow-up. Mean cup-to-disc ratio of study and fellow eyes at baseline was 0.43 ± 0.2 and 0.46 ± 0.2, respectively, and 13% of participants had undiagnosed narrow angles. There was no significant change in intraocular pressure, cup-to-disc ratio, or pattern standard deviation in study eyes compared with baseline or fellow eyes at 3 months. Vision improved in all study eyes at 3 months compared with baseline (P = 0.013, but remained significantly worse than fellow eyes (P < 0.001. Central subfield and temporal peripapillary RNFL thickness were significantly greater in eyes with epiretinal membrane (P < 0.05, and resolution after surgery correlated with visual improvement (P < 0.05.Conclusion: The 3-month results do not indicate any increased risk for open-angle glaucoma but suggest that a relatively high percentage of eyes may be at risk of angle closure glaucoma. Temporal RNFL thickness and central subfield were increased

  8. A practical approach to proving waste metals suitable for consignment as radiologically exempt materials - 59266

    International Nuclear Information System (INIS)

    Carvel, Iain; Gunn, Richard D.; Orr, Christopher H.; Strange, Robin

    2012-01-01

    Building 220 at Harwell was built by the Ministry of Works as a Radiochemical Research and Development facility in the latter part of the 1940's. The facility has been operational since 1949 and has been extended several times, most notably the Plutonium Glove Box Wing in the 1950's and the Remote Handling Wing in the 1980's. Only the Remote Handling wing remains operational, processing Historic Waste which is being recovered from storage holes elsewhere on site. The remainder of the facility is undergoing progressive strip out and decommissioning. In the Plutonium Wing and associated areas the waste 'fingerprint' (nuclide vector) consists predominately of alpha emitting radionuclides. Decommissioning and Decontamination (D and D) operations often result in the production of large volumes of scrap metal waste with little or no radioactive contamination. Proving that the waste is clean can be costly and time consuming, as the shape and size of the metallic waste items often means that it is difficult or impossible to monitor all surfaces using conventional hand-held survey meters. This is a particular problem for alpha contamination measurement. Traditional radiological surveying techniques are very labour intensive and involve surveyors checking every surface using hand held instruments and smear sampling the hard to access areas. Even then 100% monitoring cannot be guaranteed. An alternative to traditional methods is the Long Range Alpha Detection (LRAD) technique which remotely detects and measures secondary ionization created in air by alpha particle interactions, allowing extremely low levels of alpha contamination to be measured. A survey system, IonSens R , using the LRAD technique, was developed by BNFL Instruments Ltd (now Babcock Nuclear) which allows rapid surveying of scrap metal for alpha contamination at very low levels. Two versions of this system exist but both essentially comprise a measurement chamber into which scrap metal is placed and sealed

  9. GOES-R Proving Ground Activities at the NASA Short-Term Prediction Research and Transition (SPoRT) Center

    Science.gov (United States)

    Molthan, Andrew

    2011-01-01

    SPoRT is actively involved in GOES-R Proving Ground activities in a number of ways: (1) Applying the paradigm of product development, user training, and interaction to foster interaction with end users at NOAA forecast offices national centers. (2) Providing unique capabilities in collaboration with other GOES-R Proving Ground partners (a) Hybrid GOES-MODIS imagery (b) Pseudo-GLM via regional lightning mapping arrays (c) Developing new RGB imagery from EUMETSAT guidelines

  10. What does an experimental test of quantum contextuality prove or disprove?

    International Nuclear Information System (INIS)

    Winter, Andreas

    2014-01-01

    The possibility of experimentally testing the Bell–Kochen–Specker theorem is investigated critically, following the demonstrations by Meyer, Kent, and Clifton–Kent that the predictions of quantum mechanics are indistinguishable (up to arbitrary precision) from those of a non-contextual model, and the subsequent debate about the extent to which these models are actually classical or non-contextual. The present analysis starts from a careful consideration of these ‘finite-precision’ approximations. A stronger condition for non-contextual models, dubbed ontological faithfulness, is exhibited. It is shown that this allows us to approximately formulate the constraints in Bell–Kochen–Specker theorems, such as to render the usual proofs robust. Consequently, one can experimentally test to finite precision ontologically faithful non-contextuality, and thus experimentally refute explanations from this smaller class. We include a discussion of the relation of ontological faithfulness to other proposals to overcome the finite precision objection. This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘50 years of Bell’s theorem’. (paper)

  11. Users manual on database of the Piping Reliability Proving Tests at the Japan Atomic Energy Research Institute

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    Japan Atomic Energy Research Institute(JAERI) conducted Piping Reliability Proving Tests from 1975 to 1992 based upon the contracts between JAERI and Science and Technology Agency of Japan under the auspices of the special account law for electric power development promotion. The purposes of those tests are to prove the structural reliability of the primary cooling piping constituting a part of the pressure boundary in the water reactor power plants. The tests with large experimental facilities had ended already in 1990. After that piping reliability analysis by the probabilistic method followed until 1992. This report describes the users manual on databases about the test results using the large experimental facilities. Objectives of the piping reliability proving tests are to prove that the primary piping of the water reactor (1) be reliable throughout the service period, (2) have no possibility of rupture, (3) bring no detrimental influence on the surrounding instrumentations or equipments near the break location. The research activities using large scale piping test facilities are described. The present report does the database about the test results pairing the former report. With these two reports, all the feature of Piping Reliability Proving Tests is made clear. Briefings of the tests are described also written in Japanese or English. (author)

  12. E-squared nine do-it-yourself energy experiments that prove your thoughts create your reality

    CERN Document Server

    Grout, Pam

    2013-01-01

    E-Squared is a lab manual with simple experiments to prove once and for all that there really is a good, loving, totally hip force in the universe. Rather than take it on faith, you are invited to conduct ten 48-hour experiments to prove each of the principles in this book. Yes, you read that right. It says prove. The experiments, each of which can be conducted with absolutely no money and very little time expenditure, demonstrate that spiritual principles are as dependable as gravity, as consistent as Newton's 2nd law of motion. For years, you've been hoping and praying that spiritual principles are true. Now, you can know.

  13. The effects of GeoGebra software on pre-service mathematics teachers' attitudes and views toward proof and proving

    Science.gov (United States)

    Zengin, Yılmaz

    2017-11-01

    The purpose of this study is to determine the effect of GeoGebra software on pre-service mathematics teachers' attitudes towards proof and proving and to determine pre-service teachers' pre- and post-views regarding proof. The study lasted nine weeks and the participants of the study consisted of 24 pre-service mathematics teachers. The study used the 'Attitude Scale Towards Proof and Proving' and an open-ended questionnaire that were administered before and after the intervention as data collection tools. Paired samples t-test analysis was used for the analysis of quantitative data and content and descriptive analyses were utilized for the analysis of qualitative data. As a result of the data analysis, it was determined that GeoGebra software was an effective tool in increasing pre-service teachers' attitudes towards proof and proving.

  14. Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ubong Bassey Akpan

    2018-05-01

    CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.

  15. Meeting on Solute/Solvent Interactions Held in Aberdeen Proving Ground, Maryland on May 29-30, 1991

    Science.gov (United States)

    1992-01-01

    the magnitudes of the nuclear charges and therefore cannot be assumed to indicate relative reactivities toward nucleophiles. There is accordingly no...APPENDIX 3 ORGANIZATIONS OF AUTHORS IN THESE PROCEEDINGS Central Michigan University 49 Instituto de Quimica Fisica 33 La Sierra University, Riverside 71...Aberdeen Proving Gd, MD Joxe-Luis Abbud Christopher Cramer Instituto de Quimica Fisica SMCCR-RSP-C "Rocasolano" U.S. Army Chemical RD&E Center Conajo

  16. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    Science.gov (United States)

    de Paor, A. M.

    Hide (Nonlinear Processes in Geophysics, 1998) has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ɛ has the value 1 is proved via the Popov theorem from feedback system stability theory.

  17. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    OpenAIRE

    A. M. de Paor

    1998-01-01

    International audience; Hide (Nonlinear Processes in Geophysics, 1998) has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ? has the value 1 is proved via ...

  18. Seismic test facilities at the ENEA Casaccia Research Center; Prove sismiche con le tavole vibranti al centro ricerche Enea Casaccia

    Energy Technology Data Exchange (ETDEWEB)

    De Canio, G. [ENEA, Divisione Servizi Tecnologici, Centro Ricerche Casaccia, Rome (Italy)

    2000-07-01

    The main experimental facilities for seismic tests at the ENEA C.R. Casaccia laboratories consist of two high performance shake table for three axial seismic tests of structures up to 10 ton mass and 3g acceleration applied at the Center of Gravity at 1m from the base table. The activities are principally devoted to the dynamic characterization and vibration tests for mechanical and aero spatial structures, and the experimental analysis of innovative systems for the seismic isolation and retrofitting of civil, industrial, and historical buildings; together with the seismic tests of sub-structures and scaled mock-ups, in order to evaluate the isolation/dissipation performance of the anti-seismic devices, and the failure modes of the structural parts of the building. [Italian] Le principali attrezzature per le prove sismiche presso i laboratori del C.R. Casaccia consistono di due tavole vibranti triassali per prove su strutture fino a 10t di peso con una accelerazione di 3g applicata al centro di gravita' posto ad 1 m di altezza dal piano della tavola. Le principali attivita' riguardano: (a) test di caratterizzazione dinamica e prove di vibrazioni per strutture meccaniche ed aerospaziali; (b) l'analisi sperimentale di sistemi innovativi per l'isolamento sismico ed il consolidamento di strutture civili, industriali e storico monumentali, e le prove sismiche di elementi strutturali e di modelli in scala per la valutazione della capacita' di dissipazione dei dispositivi antisismici e le modalita' di formazione delle fratture.

  19. Preconception Care and Prenatal Care

    Science.gov (United States)

    ... Twitter Pinterest Email Print About Preconception Care and Prenatal Care What is preconception care? Preconception care is the ... improve the health of your child. What is prenatal care? Prenatal care is the health care a woman ...

  20. Depleted uranium risk assessment for Jefferson Proving Ground using data from environmental monitoring and site characterization. Final report

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Hansen, W.R.

    1996-10-01

    This report documents the third risk assessment completed for the depleted uranium (DU) munitions testing range at Jefferson Proving Ground (JPG), Indiana, for the U.S. Army Test and Evaluation command. Jefferson Proving Ground was closed in 1995 under the Base Realignment and Closure Act and the testing mission was moved to Yuma Proving Ground. As part of the closure of JPG, assessments of potential adverse health effects to humans and the ecosystem were conducted. This report integrates recent information obtained from site characterization surveys at JPG with environmental monitoring data collected from 1983 through 1994 during DU testing. Three exposure scenarios were evaluated for potential adverse effects to human health: an occasional use scenario and two farming scenarios. Human exposure was minimal from occasional use, but significant risk were predicted from the farming scenarios when contaminated groundwater was used by site occupants. The human health risk assessments do not consider the significant risk posed by accidents with unexploded ordnance. Exposures of white-tailed deer to DU were also estimated in this study, and exposure rates result in no significant increase in either toxicological or radiological risks. The results of this study indicate that remediation of the DU impact area would not substantially reduce already low risks to humans and the ecosystem, and that managed access to JPG is a reasonable model for future land use options

  1. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

    Science.gov (United States)

    Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

    2015-08-01

    Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

  2. Taking care of Care

    NARCIS (Netherlands)

    Evelien Eggink; Debbie Oudijk; Isolde Woittiez

    2010-01-01

    Original title: Zorgen voor Zorg. The Dutch population will become increasingly older over the coming decades. This will have consequences for the use of care and consequently the demand for staff, especially in the nursing and care sectors (home care, nursing homes and residential care

  3. The effect of herbal formula PROVE 1 and Stevia levels in diets on diet utilization of growing pigs

    Directory of Open Access Journals (Sweden)

    Kooprasert, S.

    2007-05-01

    Full Text Available The objective of this experiment was to study the effect of 0.2% antibiotic (ascomix-s®, one kilogram of which contains lincomycin hydrochloride 44 g and sulfamethazine 110 g or 0.25% herbal formulaPROVE 1, combined with five levels of Stevia supplementation in the diets on digestibility of pigs. Two factors; 1 type of drug (0.2% antibiotic and 0.25% herbal formula PROVE 1 and 2 five Stevia levels (0,0.2, 0.4, 0.6 and 0.8% were investigated and 10 dietary treatments were used in this study. Ten related growing crossbred (Large White x Landrace barrow pigs (30±1.5 kg body weight were raised in individualmetabolism cages for three collecting periods (30, 40 and 50 kg body weight, each pig was fed one experimental diet throughout the collecting period.The results showed that pigs fed diet with either 0.2% antibiotic or 0.25% herbal formula PROVE 1 had similar digestibility of diet, crude protein (CP, fiber, ash and nitrogen free extract (NFE (89.01 vs 87.83,94.96 vs 94.23, 60.73 vs 59.03, 61.22 vs 60.44 and 93.28 vs 92.03%, respectively. Negligible differences were observed between 0 and 0.4% Stevia supplementation in diet, but levels showed better digestibility than the other levels of Stevia supplementation, and the diet with 0.4% Stevia supplementation had the highestdigestibility of diet, CP, fiber, ash and NFE (91.04, 96.43, 69.48, 70.47 and 94.07%, respectively. The diet with antibiotic combined with 0.4% Stevia had digestibility of diet, CP, fat and fiber better than the otherlevels of Stevia supplementation, especially digestibility of ash, which was significantly higher than that of diet with 0.2% Stevia, but not significantly different from the other levels of Stevia supplementation. A partof herbal formula PROVE1 combined with 0% Stevia had the highest digestibility of ash (72.90%, significantly higher than the other levels of Stevia supplementation, except the diet with herbal formula PROVE 1combined with 0.4% Stevia supplementation

  4. Retention in Care among HIV-Infected Pregnant Women in Haiti with PMTCT Option B

    Directory of Open Access Journals (Sweden)

    Jodie Dionne-Odom

    2016-01-01

    Full Text Available Background. Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding. Methods. Retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing. Results. Women in the cohort had 463 pregnancies between 2009 and 2012 with retention rates of 80% at delivery, 67% at one year, and 59% at 2 years. Among those who were LFU, the highest risk period was during pregnancy (60% or shortly afterwards (24.4% by 12 months. Never starting on antiretroviral therapy (aRR 2.29, 95% CI 1.4–3.8 was associated with loss to follow-up. Conclusions. Loss to follow-up during and after pregnancy was common in HIV-infected women in Haiti under PMTCT Option B. Since sociodemographic factors and distance from home to facility did not predict LFU, future work should elicit and address barriers to retention at the initial prenatal care visit in all women. Better tracking systems to capture engagement in care in the wider network are needed.

  5. Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

    Directory of Open Access Journals (Sweden)

    A. M. de Paor

    1998-01-01

    Full Text Available Hide (Nonlinear Processes in Geophysics, 1998 has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ε has the value 1 is proved via the Popov theorem from feedback system stability theory.

  6. Correlation of Fault Size, Moment Magnitude, and Tsunami Height to Proved Paleo-tsunami Data in Sulawesi Indonesia

    Science.gov (United States)

    Julius, A. M.; Pribadi, S.

    2016-02-01

    Sulawesi (Indonesia) island is located in the meeting of three large plates i.e. Indo-Australia, Pacific, and Eurasia. This configuration surely make high risk on tsunami by earthquake and by sea floor landslide. NOAA and Russia Tsunami Laboratory show more than 20 tsunami data recorded in Sulawesi since 1820. Based on this data, determine of correlation between all tsunami parameter need to be done to proved all event in the past. Complete data of magnitudes, fault sizes and tsunami heights in this study sourced from NOAA and Russia Tsunami database and completed with Pacific Tsunami Warning Center (PTWC) catalog. This study aims to find correlation between fault area, moment magnitude, and tsunami height by simple regression in Sulawesi. The step of this research are data collect, processing, and regression analysis. Result shows very good correlation, each moment magnitude, tsunami heights, and fault parameter i.e. long, wide, and slip are correlate linier. In increasing of fault area, the tsunami height and moment magnitude value also increase. In increasing of moment magnitude, tsunami height also increase. This analysis is enough to proved all Sulawesi tsunami parameter catalog in NOAA, Russia Tsunami Laboratory and PTWC are correct. Keyword: tsunami, magnitude, height, fault

  7. Filtered air plastic chamber as an experimental facility to prove visible damage of crops due to air pollution

    Energy Technology Data Exchange (ETDEWEB)

    Matsuoka, Y; Yoda, H; Omichi, S; Shiratori, K

    1975-01-01

    An experimental filtered air chamber was constructed to prove the visible damage of crops due to air pollution. The chamber was provided with another room into which non-filtered ambient air was introduced. The purified air was prepared by filtering ambient air with activated carbon. The average content of air pollutants in the purified air chamber was less than 10 to 20% of the ozone and 20% of the sulfur oxides in the ambient air. However, cultivated vegetables such as tobacco and spinach, which are susceptible to oxidant, showed no visible damage in the filtered air chamber, and showed the same damage in the nonfiltered air chamber as was seen in fields at the same time.

  8. Historical wildlife dynamics on Dugway Proving Ground: population and disease trends in jack rabbits over two decades. [Lepus californicus

    Energy Technology Data Exchange (ETDEWEB)

    Eberhardt, L.E.; Van Voris, P.

    1986-08-01

    In an effort to determine whether US Army activities on the Dugway Proving Ground (DPG) have had an impact on resident wildlife, intensive studies have been conducted on the biology and ecology of the black-tailed jack rabbit (Lepus californicus) since 1965. in addition, the incidence of endemic diseases in several species of resident wildlife on the DPG have been studied from the late 1950s through the mid-1970s. The objectives of this report are to: (1) compile and summarize the jack rabbit data and some of the disease information that is presently contained only in annual reports; (2) compare the DPG jack rabbit data to data available on other jack rabbit populations; and (3) analyze the data for unusual or unexplained fluctuations in population densities or in incidence of disease.

  9. Methodology of proving long-term safety of a salt dome repository with existing insecurities forming the background

    International Nuclear Information System (INIS)

    Storck, R.

    1992-01-01

    Existing methods to prove safety can consider the insecurities of input data within the framework of probabilistic analyses. The results of application calculations show that inspite of considerable band widths of input data the scattering widths of radiation exposures are comparably limited, and calculated radiation exposures are clearly below acceptable limits. Moreover it can be demonstrated that in the event of an assumed brine influx into the repository radionuclides are released only if parameter combinations are unfavourable. Therefore such incident in general does not have any radiological consequences. Insecurities in model approaches can be taken into consideration only partly so far by using alternative models, or indirectly through data insecurities. (orig./DG) [de

  10. Long-term fate of depleted uranium at Aberdeen and Yuma Proving Grounds: Human health and ecological risk assessments

    International Nuclear Information System (INIS)

    Ebinger, M.H.; Beckman, R.J.; Myers, O.B.; Kennedy, P.L.; Clements, W.; Bestgen, H.T.

    1996-09-01

    The purpose of this study was to evaluate the immediate and long-term consequences of depleted uranium (DU) in the environment at Aberdeen Proving Ground (APG) and Yuma Proving Ground (YPG) for the Test and Evaluation Command (TECOM) of the US Army. Specifically, we examined the potential for adverse radiological and toxicological effects to humans and ecosystems caused by exposure to DU at both installations. We developed contaminant transport models of aquatic and terrestrial ecosystems at APG and terrestrial ecosystems at YPG to assess potential adverse effects from DU exposure. Sensitivity and uncertainty analyses of the initial models showed the portions of the models that most influenced predicted DU concentrations, and the results of the sensitivity analyses were fundamental tools in designing field sampling campaigns at both installations. Results of uranium (U) isotope analyses of field samples provided data to evaluate the source of U in the environment and the toxicological and radiological doses to different ecosystem components and to humans. Probabilistic doses were estimated from the field data, and DU was identified in several components of the food chain at APG and YPG. Dose estimates from APG data indicated that U or DU uptake was insufficient to cause adverse toxicological or radiological effects. Dose estimates from YPG data indicated that U or DU uptake is insufficient to cause radiological effects in ecosystem components or in humans, but toxicological effects in small mammals (e.g., kangaroo rats and pocket mice) may occur from U or DU ingestion. The results of this study were used to modify environmental radiation monitoring plans at APG and YPG to ensure collection of adequate data for ongoing ecological and human health risk assessments

  11. Demonstration of the Military Ecological Risk Assessment Framework (MERAF): Apache Longbow - Hell Missile Test at Yuma Proving Ground

    Energy Technology Data Exchange (ETDEWEB)

    Efroymson, R.A.

    2002-05-09

    This ecological risk assessment for a testing program at Yuma Proving Ground, Arizona, is a demonstration of the Military Ecological Risk Assessment Framework (MERAF; Suter et al. 2001). The demonstration is intended to illustrate how risk assessment guidance concerning-generic military training and testing activities and guidance concerning a specific type of activity (e.g., low-altitude aircraft overflights) may be implemented at a military installation. MERAF was developed with funding from the Strategic Research and Development Program (SERDP) of the Department of Defense. Novel aspects of MERAF include: (1) the assessment of risks from physical stressors using an ecological risk assessment framework, (2) the consideration of contingent or indirect effects of stressors (e.g., population-level effects that are derived from habitat or hydrological changes), (3) the integration of risks associated with different component activities or stressors, (4) the emphasis on quantitative risk estimates and estimates of uncertainty, and (5) the modularity of design, permitting components of the framework to be used in various military risk assessments that include similar activities. The particular subject of this report is the assessment of ecological risks associated with a testing program at Cibola Range of Yuma Proving Ground, Arizona. The program involves an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. Thus, the three component activities of the Apache-Hellfire test were: (1) helicopter overflight, (2) missile firing, and (3) tracked vehicle movement. The demonstration was limited, to two ecological endpoint entities (i.e., potentially susceptible and valued populations or communities): woody desert wash communities and mule deer populations. The core assessment area is composed of about 126 km{sup 2} between the Chocolate and Middle Mountains. The core time of the program is a three-week period, including fourteen days of

  12. JPSS Proving Ground Activities with NASA's Short-term Prediction Research and Transition (SPoRT) Center

    Science.gov (United States)

    Schultz, L. A.; Smith, M. R.; Fuell, K.; Stano, G. T.; LeRoy, A.; Berndt, E.

    2015-12-01

    Instruments aboard the Joint Polar Satellite System (JPSS) series of satellites will provide imagery and other data sets relevant to operational weather forecasts. To prepare current and future weather forecasters in application of these data sets, Proving Ground activities have been established that demonstrate future JPSS capabilities through use of similar sensors aboard NASA's Terra and Aqua satellites, and the S-NPP mission. As part of these efforts, NASA's Short-term Prediction Research and Transition (SPoRT) Center in Huntsville, Alabama partners with near real-time providers of S-NPP products (e.g., NASA, UW/CIMSS, UAF/GINA, etc.) to demonstrate future capabilities of JPSS. This includes training materials and product distribution of multi-spectral false color composites of the visible, near-infrared, and infrared bands of MODIS and VIIRS. These are designed to highlight phenomena of interest to help forecasters digest the multispectral data provided by the VIIRS sensor. In addition, forecasters have been trained on the use of the VIIRS day-night band, which provides imagery of moonlit clouds, surface, and lights emitted by human activities. Hyperspectral information from the S-NPP/CrIS instrument provides thermodynamic profiles that aid in the detection of extremely cold air aloft, helping to map specific aviation hazards at high latitudes. Hyperspectral data also support the estimation of ozone concentration, which can highlight the presence of much drier stratospheric air, and map its interaction with mid-latitude or tropical cyclones to improve predictions of their strengthening or decay. Proving Ground activities are reviewed, including training materials and methods that have been provided to forecasters, and forecaster feedback on these products that has been acquired through formal, detailed assessment of their applicability to a given forecast threat or task. Future opportunities for collaborations around the delivery of training are proposed

  13. Long-term fate of depleted uranium at Aberdeen and Yuma Proving Grounds: Human health and ecological risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    Ebinger, M.H.; Beckman, R.J.; Myers, O.B. [Los Alamos National Lab., NM (United States); Kennedy, P.L.; Clements, W.; Bestgen, H.T. [Colorado State Univ., Ft. Collins, CO (United States). Dept. of Fishery and Wildlife Biology

    1996-09-01

    The purpose of this study was to evaluate the immediate and long-term consequences of depleted uranium (DU) in the environment at Aberdeen Proving Ground (APG) and Yuma Proving Ground (YPG) for the Test and Evaluation Command (TECOM) of the US Army. Specifically, we examined the potential for adverse radiological and toxicological effects to humans and ecosystems caused by exposure to DU at both installations. We developed contaminant transport models of aquatic and terrestrial ecosystems at APG and terrestrial ecosystems at YPG to assess potential adverse effects from DU exposure. Sensitivity and uncertainty analyses of the initial models showed the portions of the models that most influenced predicted DU concentrations, and the results of the sensitivity analyses were fundamental tools in designing field sampling campaigns at both installations. Results of uranium (U) isotope analyses of field samples provided data to evaluate the source of U in the environment and the toxicological and radiological doses to different ecosystem components and to humans. Probabilistic doses were estimated from the field data, and DU was identified in several components of the food chain at APG and YPG. Dose estimates from APG data indicated that U or DU uptake was insufficient to cause adverse toxicological or radiological effects. Dose estimates from YPG data indicated that U or DU uptake is insufficient to cause radiological effects in ecosystem components or in humans, but toxicological effects in small mammals (e.g., kangaroo rats and pocket mice) may occur from U or DU ingestion. The results of this study were used to modify environmental radiation monitoring plans at APG and YPG to ensure collection of adequate data for ongoing ecological and human health risk assessments.

  14. Demonstration of the Military Ecological Risk Assessment Framework (MERAF): Apache Longbow - Hell Missile Test at Yuma Proving Ground

    International Nuclear Information System (INIS)

    Efroymson, R.A.

    2002-01-01

    This ecological risk assessment for a testing program at Yuma Proving Ground, Arizona, is a demonstration of the Military Ecological Risk Assessment Framework (MERAF; Suter et al. 2001). The demonstration is intended to illustrate how risk assessment guidance concerning-generic military training and testing activities and guidance concerning a specific type of activity (e.g., low-altitude aircraft overflights) may be implemented at a military installation. MERAF was developed with funding from the Strategic Research and Development Program (SERDP) of the Department of Defense. Novel aspects of MERAF include: (1) the assessment of risks from physical stressors using an ecological risk assessment framework, (2) the consideration of contingent or indirect effects of stressors (e.g., population-level effects that are derived from habitat or hydrological changes), (3) the integration of risks associated with different component activities or stressors, (4) the emphasis on quantitative risk estimates and estimates of uncertainty, and (5) the modularity of design, permitting components of the framework to be used in various military risk assessments that include similar activities. The particular subject of this report is the assessment of ecological risks associated with a testing program at Cibola Range of Yuma Proving Ground, Arizona. The program involves an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. Thus, the three component activities of the Apache-Hellfire test were: (1) helicopter overflight, (2) missile firing, and (3) tracked vehicle movement. The demonstration was limited, to two ecological endpoint entities (i.e., potentially susceptible and valued populations or communities): woody desert wash communities and mule deer populations. The core assessment area is composed of about 126 km 2 between the Chocolate and Middle Mountains. The core time of the program is a three-week period, including fourteen days of

  15. Durability and service life design of concrete structures. Experiences and the way to prove in The Netherlands

    NARCIS (Netherlands)

    Siemes, A.J.M.; Vrouwenvelder, A.C.W.M.

    2002-01-01

    After the introduction of reinforced concrete it was believed that the material was extremely durable. Soon it was found however, that reinforced concrete could have serious durability problems and that special care should be taken to avoid them. Durability became an issue.

  16. Communication-related allegations against physicians caring for premature infants.

    Science.gov (United States)

    Nguyen, J; Muniraman, H; Cascione, M; Ramanathan, R

    2017-10-01

    Maternal-fetal medicine physicians (MFMp) and neonatal-perinatal medicine physicians (NPMp) caring for premature infants and their families are exposed to significant risk for malpractice actions. Effective communication practices have been implicated to decrease litigious intentions but the extent of miscommunication as a cause of legal action is essentially unknown in this population. Analysis of communication-related allegations (CRAs) may help toward improving patient care and physician-patient relationships as well as decrease litigation risks. We retrospectively reviewed the Westlaw database, a primary online legal research resource used by United States lawyers and legal professionals, for malpractice cases against physicians involving premature infants. Inclusion criteria were: 22 to 36 weeks gestational age, cases related to peripartum events through infant discharge and follow-up, and legal records with detailed factual narratives. The search yielded 736 legal records, of which 167 met full inclusion criteria. A CRA was identified in 29% (49/167) of included cases. MFMp and/or NPMp were named in 104 and 54 cases, respectively. CRAs were identified in 26% (27/104) and 35% (19/54) of MFMp- and NPMp-named cases, respectively, with a majority involving physician-family for both specialties (81% and 74%, respectively). Physician-family CRAs for MFMp and NPMp most often regarded lack of informed consent (50% and 57%, respectively), lack of full disclosure (41% and 29%, respectively) and lack of anticipatory guidance (36% and 21%, respectively). This study of a major legal database identifies CRAs as significant causes of legal action against MFMp and NPMp involved in the care of high-risk women and infants delivered preterm. Physicians should be especially vigilant with obtaining genuine informed consent and maintaining open communication with families.

  17. Seeing a Colleague Encourage a Student to Make an Assumption while Proving: What Teachers Put in Play when Casting an Episode of Instruction

    Science.gov (United States)

    Nachlieli, Talli; Herbst, Patricio

    2009-01-01

    This article reports on an investigation of how teachers of geometry perceived an episode of instruction presented to them as a case of engaging students in proving. Confirming what was hypothesized, participants found it remarkable that a teacher would allow a student to make an assumption while proving. But they perceived this episode in various…

  18. 20 CFR 1002.33 - Does the employee have to prove that the employer discriminated against him or her in order to be...

    Science.gov (United States)

    2010-04-01

    ... employer discriminated against him or her in order to be eligible for reemployment? 1002.33 Section 1002.33... have to prove that the employer discriminated against him or her in order to be eligible for reemployment? No. The employee is not required to prove that the employer discriminated against him or her...

  19. An optimized groundwater extraction system for the toxic burning pits area of J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, J.J.; Johnson, R.L.; Patton, T.L.; Martino, L.E.

    1996-06-01

    Testing and disposal of chemical warfare agents, munitions, and industrial chemicals at the J-Field area of the Aberdeen Proving Ground (APG) have resulted in contamination of soil and groundwater. The discharge of contaminated groundwater to on-site marshes and adjacent estuaries poses a potential risk to ecological receptors. The Toxic Burning Pits (TBP) area is of special concern because of its disposal history. This report describes a groundwater modeling study conducted at J-Field that focused on the TBP area. The goal of this modeling effort was optimization of the groundwater extraction system at the TBP area by applying linear programming techniques. Initially, the flow field in the J-Field vicinity was characterized with a three-dimensional model that uses existing data and several numerical techniques. A user-specified border was set near the marsh and used as a constraint boundary in two modeled remediation scenarios: containment of the groundwater and containment of groundwater with an impermeable cap installed over the TBP area. In both cases, the objective was to extract the minimum amount of water necessary while satisfying the constraints. The smallest number of wells necessary was then determined for each case. This optimization approach provided two benefits: cost savings, in that the water to be treated and the well installation costs were minimized, and minimization of remediation impacts on the ecology of the marsh.

  20. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    International Nuclear Information System (INIS)

    Gallucci, Raymond H.V.

    2016-01-01

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  1. The Apache Longbow-Hellfire Missile Test at Yuma Proving Ground: Ecological Risk Assessment for Missile Firing

    International Nuclear Information System (INIS)

    Jones, Daniel Steven; Efroymson, Rebecca Ann; Hargrove, William Walter; Suter, Glenn; Pater, Larry

    2008-01-01

    A multiple stressor risk assessment was conducted at Yuma Proving Ground, Arizona, as a demonstration of the Military Ecological Risk Assessment Framework. The focus was a testing program at Cibola Range, which involved an Apache Longbow helicopter firing Hellfire missiles at moving targets, M60-A1 tanks. This paper describes the ecological risk assessment for the missile launch and detonation. The primary stressor associated with this activity was sound. Other minor stressors included the detonation impact, shrapnel, and fire. Exposure to desert mule deer (Odocoileus hemionus crooki) was quantified using the Army sound contour program BNOISE2, as well as distances from the explosion to deer. Few effects data were available from related studies. Exposure-response models for the characterization of effects consisted of human 'disturbance' and hearing damage thresholds in units of C-weighted decibels (sound exposure level) and a distance-based No Observed Adverse Effects Level for moose and cannonfire. The risk characterization used a weight-of-evidence approach and concluded that risk to mule deer behavior from the missile firing was likely for a negligible number of deer, but that no risk to mule deer abundance and reproduction is expected

  2. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Raymond H.V., E-mail: Ray.Gallucci@nrc.gov

    2016-11-15

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  3. Tracheostomy care

    Science.gov (United States)

    Respiratory failure - tracheostomy care; Ventilator - tracheostomy care; Respiratory insufficiency - tracheostomy care ... Before you leave the hospital, health care providers will teach you how ... and suction the tube Keep the air you breathe moist Clean ...

  4. Ex Vivo and In Vivo Mice Models to Study Blastocystis spp. Adhesion, Colonization and Pathology: Closer to Proving Koch's Postulates.

    Directory of Open Access Journals (Sweden)

    Sitara S R Ajjampur

    Full Text Available Blastocystis spp. are widely prevalent extra cellular, non-motile anerobic protists that inhabit the gastrointestinal tract. Although Blastocystis spp. have been associated with gastrointestinal symptoms, irritable bowel syndrome and urticaria, their clinical significance has remained controversial. We established an ex vivo mouse explant model to characterize adhesion in the context of tissue architecture and presence of the mucin layer. Using confocal microscopy with tissue whole mounts and two axenic isolates of Blastocystis spp., subtype 7 with notable differences in adhesion to intestinal epithelial cells (IEC, isolate B (ST7-B and isolate H (more adhesive, ST7-H, we showed that adhesion is both isolate dependent and tissue trophic. The more adhesive isolate, ST7-H was found to bind preferentially to the colon tissue than caecum and terminal ileum. Both isolates were also found to have mucinolytic effects. We then adapted a DSS colitis mouse model as a susceptible model to study colonization and acute infection by intra-caecal inoculation of trophic Blastocystis spp.cells. We found that the more adhesive isolate ST7-H was also a better colonizer with more mice shedding parasites and for a longer duration than ST7-B. Adhesion and colonization was also associated with increased virulence as ST7-H infected mice showed greater tissue damage than ST7-B. Both the ex vivo and in vivo models used in this study showed that Blastocystis spp. remain luminal and predominantly associated with mucin. This was further confirmed using colonic loop experiments. We were also successfully able to re-infect a second batch of mice with ST7-H isolates obtained from fecal cultures and demonstrated similar histopathological findings and tissue damage thereby coming closer to proving Koch's postulates for this parasite.

  5. Remedial investigation sampling and analysis plan for J-Field, Aberdeen Proving Ground, Maryland. Volume 1: Field Sampling Plan

    Energy Technology Data Exchange (ETDEWEB)

    Benioff, P.; Biang, R.; Dolak, D.; Dunn, C.; Martino, L.; Patton, T.; Wang, Y.; Yuen, C.

    1995-03-01

    The Environmental Management Division (EMD) of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study (RI/FS) of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. J-Field is within the Edgewood Area of APG in Harford County, Maryland (Figure 1. 1). Since World War II activities in the Edgewood Area have included the development, manufacture, testing, and destruction of chemical agents and munitions. These materials were destroyed at J-Field by open burning and open detonation (OB/OD). Considerable archival information about J-Field exists as a result of efforts by APG staff to characterize the hazards associated with the site. Contamination of J-Field was first detected during an environmental survey of the Edgewood Area conducted in 1977 and 1978 by the US Army Toxic and Hazardous Materials Agency (USATHAMA) (predecessor to the US Army Environmental Center [AEC]). As part of a subsequent USATHAMA -environmental survey, 11 wells were installed and sampled at J-Field. Contamination at J-Field was also detected during a munitions disposal survey conducted by Princeton Aqua Science in 1983. The Princeton Aqua Science investigation involved the installation and sampling of nine wells and the collection and analysis of surficial and deep composite soil samples. In 1986, a Resource Conservation and Recovery Act (RCRA) permit (MD3-21-002-1355) requiring a basewide RCRA Facility Assessment (RFA) and a hydrogeologic assessment of J-Field was issued by the US Environmental Protection Agency (EPA). In 1987, the US Geological Survey (USGS) began a two-phased hydrogeologic assessment in data were collected to model, groundwater flow at J-Field. Soil gas investigations were conducted, several well clusters were installed, a groundwater flow model was developed, and groundwater and surface water monitoring programs were established that continue today.

  6. Work plan for focused feasibility study of the toxic burning pits area at J-Field, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Biang, C.; Benioff, P.; Martino, L.; Patton, T.

    1995-03-01

    The Environmental Management Division (EMD) of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study (RI/FS) of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCIA). J-Field is within the Edgewood Area of APG in Harford County, Maryland. Since World War II, activities in the Edgewood Area have included the development, manufacture, testing, and destruction of chemical agents and munitions. These materials were destroyed at J-Field by open burning and open detonation (OB/OD). Considerable archival information about J-Field exists as a result of efforts by APG staff to characterize the hazards associated with the site. Contamination of J-Field was first detected during an environmental survey of the Edgewood Area conducted in 1977 and 1978 by the US Army Toxic and Hazardous Materials Agency (USATHAMA)(predecessor to the US Army Environmental Center). As part of a subsequent USATHAMA environmental survey, 11 wells were installed and sampled at J-Field. Contamination at J-Field was also detected during a munitions disposal survey conducted by Princeton Aqua Science in 1983. The Princeton Aqua Science investigation involved the installation and sampling of nine wells and the collection and analysis of surficial and deep composite soil samples. In 1986, a Resource Conservation and Recovery Act (RCRA) permit (MD3-21-0021355) requiring a basewide RCRA Facility Assessment (RFA) and a hydrogeologic assessment of J-Field was issued by the US Environmental Protection Agency (EPA). In 1987, the US Geological Survey (USGS) began a two-phased hydrogeologic assessment in which data were collected to model groundwater flow at J-Field. Soil gas investigations were conducted, several well clusters were installed, a groundwater flow model was developed, and groundwater and surface water monitoring programs were established that continue today-

  7. Nuclear Bombs and Coral: Guam Coral Core Reveals Operation-Specific Radiocarbon Signals from the Pacific Proving Grounds

    Science.gov (United States)

    Andrews, A. H.

    2016-12-01

    Radiocarbon (14C) analyses on a coral core extracted from the western Central Pacific (Guam) has revealed a series of early peaks in the marine bomb 14C record. The typical marine bomb 14C signal, one that is phase lagged and attenuated relative to atmospheric bomb 14C, is present in the coral core and is consistent with other North Pacific records. However, 14C levels that are well above what can be explained by air-sea diffusion alone punctuate this pattern. This anomaly has been demonstrated to a limited extent in other coral cores of the Indo-Pacific region, but is unmatched relative to the magnitude and temporal resolution recorded in the Guam coral core. Other records have shown an early Δ14C rise on the order of 40-50‰ above pre-bomb levels, with a subsequent decline before continuing the gradual Δ14C rise that is indicative of air-sea diffusion of 14CO2. The Guam coral Δ14C record provided three strong pulses in 1954-55, 1956-57, and 1958-59 that are superimposed on the pre-bomb to initial Δ14C rise from atmospheric bomb 14C. Each of these peaks can be directly linked to testing of thermonuclear devices in the Pacific Proving Grounds at Eniwetok and Bikini Atoll of the Marshall Islands. The measurable lag in reaching Guam can be tied to ocean surface currents and can be traced to other regional Δ14C records from corals, providing a transport timeline to places as distant as the Indonesian throughflow, Okinawa and Palmyra.

  8. Caratterizzazione microstrutturale e prove di resilienza su giunti Friction Stir Welding e Linear Friction Welding di compositi a matrice metallica

    Directory of Open Access Journals (Sweden)

    M. Merlin

    2010-04-01

    Full Text Available In questo studio sono stati caratterizzati giunti Friction Stir Welding e Linear Friction Welding su compositi a matrice in lega di alluminio e rinforzo particellare ceramico. Il processo FSW è stato applicato a due compositi ottenuti con processo fusorio, quindi estrusi e trattati termicamente T6: AA6061/20%vol.Al2O3p e AA7005/10%vol.Al2O3p. I giunti LFW sono stati invece realizzati su un composito con matrice in lega di alluminio e rinforzo particellare in carburo di silicio, ottenuto mediante metallurgia delle polveri, quindi forgiato e trattato termicamente T4: AA2124/25%vol.SiCp. Sono stati esaminati gli effetti della saldatura sullecaratteristiche microstrutturali dei giunti, avvalendosi di tecniche di microscopia ottica con analisi di immagine e di microscopia elettronica in scansione (SEM con microsonda a dispersione di energia (EDS. Sono state quindi condotte prove di resilienza con pendolo strumentato Charpy. Lo studio dei meccanismi di danneggiamento è stato effettuato mediante analisi al SEM delle superfici di frattura. Entrambi i processi di saldatura hanno portato a giunti sostanzialmente esenti da difetti. La microstruttura dei cordoni è risultata dipendente sia dalle caratteristiche microstrutturali iniziali dei compositi considerati, sia dalla tipologia di processo di saldatura. Nel caso dei compositi AA6061/20%Al2O3p e AA7005/10%Al2O3p saldati FSW si è osservato un sostanziale incremento di resilienza, rispetto al materiale base, in conseguenza dell’affinamento dei grani della matrice, della riduzione della dimensione media delle particelle di rinforzo e della loro spigolosità, indotte dal processo di saldatura. Il composito AA2124/25%SiCp saldato LFW ha presentato valori di resilienza confrontabili con quelli del materiale base, in conseguenza, soprattutto, dei limitati effetti della saldatura su dimensione e distribuzione delle particelle di rinforzo.

  9. The Public Stigma of Mental Illness: What Do We Think; What Do We Know; What Can We Prove?

    Science.gov (United States)

    Pescosolido, Bernice

    2015-01-01

    By the 1990s, sociology faced a frustrating paradox. Classic work on mental illness stigma and labeling theory reinforced that the “mark” of mental illness created prejudice and discrimination for individuals and family members. Yet that foundation, coupled with deinstitutionalization of mental health care, produced contradictory responses. Claims that stigma was dissipating were made, while others argued that intervention efforts were needed to reduce stigma. While signaling the critical role of theory-based research in establishing the pervasive effects of stigma, both claims directed resources away from social science research. Yet the contemporary scientific foundation underlying both claims was weak. A reply came in a resurgence of research directed toward mental illness stigma nationally and internationally, bringing together researchers from different disciplines for the first time. The author reports on the general population’s attitudes, beliefs, and behavioral dispositions that targeted public stigma and implications for the next decade of research and intervention efforts. PMID:23325423

  10. Simultaneous perineal ultrasound and vaginal pressure measurement prove the action of electrical pudendal nerve stimulation in treating female stress incontinence.

    Science.gov (United States)

    Wang, Siyou; Zhang, Shujing

    2012-11-01

    Study Type - Diagnostic (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Pelvic floor muscle training (PFMT) and transvaginal electrical stimulation (TES) are two commonly used forms of conservative treatment for stress urinary incontinence (SUI). PFMT may build up the structural support of the pelvis, but many SUI patients are unable to perform PFMT effectively and its primary disadvantage is lack of long-term patient compliance. TES is a passive treatment that produces PFM contraction and patient compliance with it is good; however, its effect is not as good as that of PFMT when performed correctly. Electrical pudendal nerve stimulation (EPNS) combines the advantages of PFMT and TES and incorporates the technique of deep insertion of long needles. In this study, simultaneous perineal ultrasound and vaginal pressure measurement prove that EPNS can contract the PFM and simulate PFMT. It is shown that EPNS is an alternative therapy for female SUI patients who fail PFMT and TES and the therapy can also be used for severe SUI. • To prove that electrical pudendal nerve stimulation (EPNS) can contract the pelvic floor muscles (PFM) and simulate pelvic floor muscle training (PFMT). • To show that EPNS is an alternative therapy for female stress urinary incontinence (SUI) that does not respond effectively to PFMT and transvaginal electrical stimulation (TES). • Thirty-five female patients with SUI who did not respond effectively to PFMT and TES (group I) were enrolled and 60 other female patients with SUI were allocated to group II (30 patients) and group III (30 patients). • Long needles were deeply inserted into four sacral points and electrified to stimulate the pudendal nerves. Group I and group II were treated by a doctor skilled in performing EPNS and group III, by a doctor unskilled in performing EPNS. • When EPNS was performed in group I, perineal ultrasonographic PFM movements, vaginal pressure (VP) and PFM

  11. The U.S. Army Occupational and Environmental Medicine Residency at Aberdeen Proving Ground, Maryland: 1960-1996.

    Science.gov (United States)

    Gaydos, Joel C; Mallon, Timothy M; Rice, William A

    2016-11-01

    Reorganization of the Army and critical assessment of Army Graduate Medical Education programs prompted the Occupational and Environmental Medicine (OEM) Consultant to the Army Surgeon General to initiate a review of current Army OEM residency training. Available information indicated the Army OEM residency at Aberdeen Proving Ground, MD, was the first and longest operating Army OEM residency. Describing this residency was identified as the first step in the review, with the objectives of determining why the residency was started and sustained and its relevance to the needs of the Army. Records possibly related to the residency were reviewed, starting with 1954 since certification of physicians as Occupation Medicine specialists began in 1955. Interviews were conducted with selected physicians who had strong affiliations with the Army residency and the practice of Army OEM. The Army OEM residency began in 1960 and closed in 1996 with the transfer of Army OEM residency training to the Uniformed Services University of the Health Sciences, Bethesda, MD. Over 36 years, 47 uniformed residency graduates were identified; 44 were from the Army. Forty graduated between 1982 and 1996. The OEM residency was part of a dynamic cycle. Uniformed OEM leaders identified the knowledge and skills required of military OEM physicians and where these people should be stationed in the global Army. Rotations at military sites to acquire the needed knowledge and skills were integrated into the residency. Residency graduates were assigned to positions where they were needed. Having uniformed residents and preceptors facilitated the development of trust with military leaders and access to areas where OEM physician skills and knowledge could have a positive impact. Early reports indicated the residency was important in recruiting and retaining OEM physicians, with emphasis placed on supporting the Army industrial base. The late 1970s into the 1990s was a more dynamic period. There was

  12. Residential Care

    Science.gov (United States)

    ... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... longer an option Costs Choosing a care setting Types of residential care A good long-term care ...

  13. Palliative Care

    Science.gov (United States)

    Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

  14. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

  15. Comprehensive Care

    Science.gov (United States)

    ... Comprehensive Care Share this page Facebook Twitter Email Comprehensive Care Understand the importance of comprehensive MS care ... In this article A complex disease requires a comprehensive approach Today multiple sclerosis (MS) is not a ...

  16. Com aplicar les proves paramètriques bivariades t de Student i ANOVA en SPSS. Cas pràctic

    Directory of Open Access Journals (Sweden)

    María-José Rubio-Hurtado

    2012-07-01

    Full Text Available Les proves paramètriques són un tipus de proves de significació estadística que quantifiquen l'associació o independència entre una variable quantitativa i una categòrica. Les proves paramètriques són exigents amb certs requisits previs per a la seva aplicació: la distribució Normal de la variable quantitativa en els grups que es comparen, l'homogeneïtat de variàncies en les poblacions de les quals procedeixen els grups i una n mostral no inferior a 30. El seu no compliment comporta la necessitat de recórrer a proves estadístiques no paramètriques. Les proves paramètriques es classifiquen en dos: prova t (per a una mostra o per a dues mostres relacionades o independents i prova ANOVA (per a més de dues mostres independents.

  17. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care.

    Science.gov (United States)

    Goodwin, N

    2001-01-01

    This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital) services and also, potentially, social care. This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  18. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2001-03-01

    Full Text Available Purpose: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Theory: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital services and also, potentially, social care. Method: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Results: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. Conclusions: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  19. Palliative Care

    Science.gov (United States)

    ... for Patients and Families What Is Palliative Care? Definition Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to ...

  20. Palliative Care.

    Science.gov (United States)

    Swetz, Keith M; Kamal, Arif H

    2018-03-06

    Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, symptom management, and end-of-life care is crucial. This article reviews these essentials and provides an overview of current evidence to support patient-centered palliative care.

  1. The Effects of GeoGebra Software on Pre-Service Mathematics Teachers' Attitudes and Views toward Proof and Proving

    Science.gov (United States)

    Zengin, Yilmaz

    2017-01-01

    The purpose of this study is to determine the effect of GeoGebra software on pre-service mathematics teachers' attitudes towards proof and proving and to determine pre-service teachers' pre- and post-views regarding proof. The study lasted nine weeks and the participants of the study consisted of 24 pre-service mathematics teachers. The study used…

  2. NIDCAP and developmental care

    Directory of Open Access Journals (Sweden)

    Dominique Haumont

    2014-06-01

    Full Text Available Perinatal mortality in very low birth weight infants has dramatically decreased during the last decades. However, 15-25% of these infants will show neurodevelopmental impairment later on. The aim of implementing early developmental care (EDC, emerged as a new field in neonatology, is to create an intervention program designed to provide support for optimal neurobehavioral development during this highly vulnerable period of brain growth. The theoretical framework, which underlies the approach, is supported by research in different scientific fields, including neuroscience, psychology, medicine and nursing. EDC utilizes a range of medical and nursing interventions that aim to decrease the stress of preterm neonates in neonatal intensive care units (NICUs. The Neonatal Individualized Developmental Care Assessment Program (NIDCAP is an integrated and holistic form of family-centered developmental care. Changing the traditional NICU towards an EDC-NICU includes training nursing and medical staff, investing in their quality and most importantly keeping parents in proximity to the infants. The new challenge of modern neonatology is to restore the mother-infant dyad applying “couplet care” starting at birth until discharge. Most of the European NICUs apply some elements of EDC, but it is more consistent in northern Europe. The development of NIDCAP training centers in Europe demonstrates the evolution of care. It is likely that future research and intervention programs will optimize our practices. Developmental care could prove to be an important recent step in improving outcome in extremely preterm neonates. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  3. Performance and burnout in intensive care units

    NARCIS (Netherlands)

    Keijsers, GJ; Schaufeli, WB; LeBlanc, P; Zwerts, C; Miranda, DR

    1995-01-01

    The relationship between three different performance measures and burnout was explored in 20 Dutch Intensive Care Units (ICUs). Burnout (i.e. emotional exhaustion and depersonalization) proved to be significantly related to nurses' perceptions of performance as well as to objectively assessed unit

  4. Virtual care

    DEFF Research Database (Denmark)

    Kamp, Annette; Aaløkke Ballegaard, Stinne

    of retrenchment, promising better quality, empowerment of citizens and work that is smarter and more qualified. Through ethnographic field studies we study the introduction of virtual home care in Danish elderly care, focusing on the implications for relational work and care relations. Virtual home care entails...... the performance of specific home care services by means of video conversations rather than physical visits in the citizens’ homes. As scholars within the STS tradition maintain, technologies do not simply replace a human function; they rather transform care work, redistributing tasks between citizens, technology...... point out how issues of trust and surveillance, which are always negotiated in care relations, are in fact accentuated in this kind of virtual care work. Moreover, we stress that the contemporary institutional context, organization and time schedules have a vast impact on the practices developed....

  5. Interactive Theorem Proving and Verification

    Indian Academy of Sciences (India)

    human beings and computers. ... proofs themselves come from humans, the formalisations are meant to be ... real feel for the formalization process, it also addresses some of the central questions ... outside mathematics and computer science.

  6. Combining norms to prove termination

    DEFF Research Database (Denmark)

    Genaim, S.; Codish, M.; Gallagher, John Patrick

    2002-01-01

    Automatic termination analysers typically measure the size of terms applying norms which are mappings from terms to the natural numbers. This paper illustrates howt o enable the use of size functions defined as tuples of these simpler norm functions. This approach enables us to simplify the probl...... of the recursive data-types in the program, is often a suitable choice. We first demonstrate the power of combining norm functions and then the adequacy of combining norms based on regular types....

  7. Test to prove the resistance to incidents of components of electric and control systems in the safety containment of nuclear power plants

    International Nuclear Information System (INIS)

    1982-01-01

    The marginal program for proving the suitability of safety-relevant components of electric and control systems in the safety containment during a loss-of-coolant incident is described. Variant test conditions are established in the component-specific test program. Special attention has been paid to the representation of the course of pressure and temperature for the performance test of the valve room of the Nuclear Power Plant Philippsburg 2. (DG) [de

  8. Managing care.

    Science.gov (United States)

    Sandifer, Q D

    1997-09-01

    The terms 'managed care' and 'disease management' are gaining common usage in the health service but their meaning is not widely understood. Managed care is a generic term describing any health care system that integrates the financing and delivery of medical care. Its growth in the United States has been driven by pressure to control costs, and there is circumstantial evidence that costs are slowing as a result of better management of resources. However, it is not clear how much of this is due to managed care, the selection of more favourable enrollees to health plans or other factors. Research evidence is limited, and that available is constrained by the rapidly changing nature of managed care. In the United States a bewildering variety of managed care arrangements have emerged, although several common characteristics can be identified: limited choice of physician providers; controlled access to secondary care; selective contracting; financial incentives; quality management; and utilization management. All are present in the National Health Service (NHS), which exemplifies a nationalized managed care system. Disease management is an extension of managed care that takes a global approach to patient care by attempting to co-ordinate resources across the entire health care delivery system throughout the life cycle of the disease. This is poorly developed in the NHS, so that the attention of commercial organizations has been attracted. However, concern has been expressed about the implications of commercial involvement: the fragmentation of general medical services; effect of for-profit status; and use of patient-based data. Recent policy developments could allow disease management to develop within the NHS.

  9. Employee Care

    OpenAIRE

    Zavadilová, Eva

    2014-01-01

    The theme of the bachelor's thesis is the issue of employee care and related provision of employee benefits. The main objective is to analyze the effective legislation and characterize the basic areas of employee care. First of all, the thesis focuses on the matter of employee care and related legislation analyzing the working conditions, professional growth of the employees, catering of employees and special conditions for some employees. Furthermore, the special attention is paid to the vol...

  10. In situ analysis of soil at an open burning/open detonation disposal facility: J-Field, Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    Martino, L.; Cho, E.; Wrobel, J.

    1994-01-01

    Investigators have used a field-portable X-Ray Fluorescence (XRF) Analyzer to screen soils for a suite of metals indicative of the open burning and open detonation (OB/OD) activities that occurred at the J-Field site at Aberdeen Proving Ground, Maryland. The field XRF results were incorporated into a multiphase investigation of contaminants at the Toxic Burning Pits Area of Concern at J-Field. The authors determined that the field-portable XRF unit used for the study and the general concept of field XRF screening are invaluable tools for investigating an OB/OD site where intrusive sampling techniques could present unacceptable hazards to site workers

  11. Proceedings of the Scientific Conference on Obscuration and Aerosol Research Held in Aberdeen Proving Ground, Maryland on 17-21 June 1985.

    Science.gov (United States)

    1986-07-01

    Chem. Engrs., 32, 35 (1954). 9. Littman, H., Vukovic , D.V., Zdansk, F.K., and Grabavtit, Z.B., Can. J . Chem. Eng., 54, 33 (1976). 10. Morgan, M.H...COMMAND Aberdeen Proving Ground, Maryland 21010-5423 DISTRIBUTIONSTATEMENW A, Approvod iapublic releaB6~ s11 "’ftbui U o ited’ ^ J .. Di scl aimer The...PARTICLE COMPOSITION R. G. Keesee and A. W. Castleman, Jr ........ ........................ .13 NUCLEATION AND PARTICLE GROWTH " S. G. Kim and J . R

  12. Pin care

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Pin care URL of this page: //medlineplus.gov/ency/patientinstructions/000481.htm Pin care To use the sharing features on this page, please enable JavaScript. Broken bones can be fixed in surgery with metal ...

  13. Il Servizio Nazionale di Valutazione e le prove Invalsi. Stato dell’arte e proposte per una valutazione come agente di cambiamento

    Directory of Open Access Journals (Sweden)

    Roberto Trinchero

    2014-12-01

    Full Text Available Qual è la funzione del Servizio Nazionale di Valutazione formativa degli istituti scolastici? A cosa servono davvero le prove Invalsi? Le critiche che spesso vengono mosse a queste prove sono veramente fondate? Come può la valutazione dell’offerta formativa scolastica costituire davvero un agente di miglioramento? Il presente articolo intende fornire alcune risposte a queste domande, partendo dalle istanze che hanno ispirato l’autonomia scolastica e offrendo spunti per un utilizzo non fazioso della valutazione. La valutazione può essere davvero agente di cambiamento a patto che: i sia attribuito ai dati il corretto significato; ii la scuola sia in grado di comprendere i potenziali suggerimenti che la valutazione può dare e si apra al cambiamento positivo. La valutazione applicata ad una “scuola che si difende” non può che provocare inutili esiti di facciata. La valutazione applicata ad una “scuola che apprende” può davvero aiutarla ad esplicare appieno tutte le proprie potenzialità.

  14. Volume measurement system for plutonium nitrate solution and its uncertainty to be used for nuclear materials accountancy proved by demonstration over fifteen years

    International Nuclear Information System (INIS)

    Hosoma, Takashi

    2010-10-01

    An accurate volume measurement system for plutonium nitrate solution stored in an accountability tank with dip-tubes has been developed and demonstrated over fifteen years at the Plutonium Conversion Development Facility of the Japan Atomic Energy Agency. As a result of calibrations during the demonstration, it was proved that measurement uncertainty practically achieved and maintained was less than 0.1% (systematic character) and 0.15% (random) as one sigma which was half of the current target uncertainty admitted internationally. It was also proved that discrepancy between measured density and analytically determined density was less than 0.002 g·cm -3 as one sigma. These uncertainties include effects by long term use of the accountability tank where cumulative plutonium throughput is six tons. The system consists of high precision differential pressure transducers and a dead-weight tester, sequentially controlled valves for periodical zero adjustment, dampers to reduce pressure oscillation and a procedure to correct measurement biases. The sequence was also useful to carry out maintenances safely without contamination. Longevity of the transducer was longer than 15 years. Principles and essentials to determine solution volume and weight of plutonium, measurement biases and corrections, accurate pressure measurement system, maintenances and diagnostics, operational experiences, evaluation of measurement uncertainty are described. (author)

  15. Developing a decision support system for tobacco use counselling using primary care physicians

    Directory of Open Access Journals (Sweden)

    Theodore Marcy

    2008-07-01

    Conclusions A multi-method evaluation process utilising primary care physicians proved useful for developing a CDSS that was acceptable to physicians and patients, and feasible to use in their clinical environment.

  16. [Internal audit--the foundation of healthcare quality management in health care].

    Science.gov (United States)

    Smiianov, V A

    2014-01-01

    The paper proved the need for internal audit as the basis for quality control of medical care in a health facility, developed the project milestones and explains what needs to be taken into account at every stage during its implementation.

  17. Modern community care program

    International Nuclear Information System (INIS)

    Nordin, Staffan

    2000-01-01

    Going into the next millennium do we see nuclear energy? Yes we will see an expanding nuclear sector in the modem community. he modem community that cares for people, health and environment needs nuclear. Energy saves lives. Electricity is efficient use of energy. Energy will be the key to a sustainable society, energy is life. Nuclear energy protects the environment. Nuclear is an integral part of the modern community caring for people, health and environment. The dynamics of the public opinion-forming process and its effects on the nuclear industry are a challenge of the global nuclear industry. Current communications strategy and its consequences are on of the key issues. The nuclear industry must be perceived in certain ways in order to move towards achieving the vision and avoiding the harassment scenario. Each perception goal does not bear the same function within the communications process. As the nuclear industry is oe of the keys to a sustainable society, it must achieve legitimacy in its capacity as an interesting agenda-setter for tackling problems and as an expert. We have to build our communication activities on an open and honest attitude and we have to establish trust and confidence. The nuclear industry must also prove its ability and performance. If this could be achieved there will be an option for the future

  18. The use of peracetic acid in drinking water systems: flow tests; L'acido peracetico in potabilizzazione: prove in flusso

    Energy Technology Data Exchange (ETDEWEB)

    Ragazzo, P. [Consorzio per l' Acquedotto del Basso Piave, San Dona' di Piave, VE (Italy); Navazio, G. [Padua Univ., Padua (Italy). Dipt. dei Processi Chimici dell' Ingegneria; Cavadone, A. [Solvay Chimica Italia S.p.A., Milan (Italy)

    2000-09-01

    In a previous research, a preliminary study was carried out on the disinfection efficiency of peracetic acid (PAA), comparing it to that of other disinfectants that are typically used, in batch tests with dosage values ranging from 0.5 to 5 ppm. The study was carried out on samples of water collected from several significant points of the treatment process at the main water treatment plant in Jesolo (Venice, Italy). On the basis of results (basically positive at that time) obtained from these tests, a 400 litre/hour pilot plant was built, as a lower scale reproduction of the drink water treatment system mentioned earlier, in order to study the characteristics of PAA even in tests that could more realistically simulate the flow of water along the process. These tests essentially confirmed the kinetics of the spontaneous hydrolysis to CH{sub 3} COOH+H{sub 2}O{sub 2} and those of dismutation to CH{sub 3}COOH+O{sub 2}, with half-life time values ranging from 3 to 12 hours, depending on the characteristics of the water (especially the pH factor) and the PAA concentration values. [Italian] In un precedente lavoro e' stato effettuato un preventivo studio sull'efficienza disinfettiva dell'acido peracetico, anche in confronto con gli altri piu' usuali disinfettanti, in prove condotte in batch, con dosaggi compresi tra 0.5 e 5 ppm, su campioni di acqua prelevati dai diversi punti significativi della linea di trattamento della centrale di Jesolo (Torre Caligo), gestita dal Consorzio Acquedottistico del Basso Piave di S. Dona' di Piave (Venezia). Sulla base dei risultati, sostanzialmente positivi, e' stato costruito un impianto pilota da 400l/h, riproducente, in scala, la linea di potabilizzazione su ricordata, per studiare le caratteristiche del PAA anche in prove piu' probanti condotte in flusso. In tali prove sono state sostanzialmente riconfermate le cinetiche delle reazioni spontanee di dirolisi a CH{sub 3}COOH+H{sub 2}O{sub 2} e di

  19. NOAA's Joint Polar Satellite System's (JPSS) Proving Ground and Risk Reduction (PGRR) Program - Bringing JPSS Science into Support of Key NOAA Missions!

    Science.gov (United States)

    Sjoberg, W.; McWilliams, G.

    2017-12-01

    This presentation will focus on the continuity of the NOAA Joint Polar Satellite System (JPSS) Program's Proving Ground and Risk Reduction (PGRR) and key activities of the PGRR Initiatives. The PGRR Program was established in 2012, following the launch of the Suomi National Polar Partnership (SNPP) satellite. The JPSS Program Office has used two PGRR Project Proposals to establish an effective approach to managing its science and algorithm teams in order to focus on key NOAA missions. The presenter will provide details of the Initiatives and the processes used by the initiatives that have proven so successful. Details of the new 2017 PGRR Call-for-Proposals and the status of project selections will be discussed.

  20. Focused feasibility study for surface soil at the main pits and pushout area, J-field toxic burning pits area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Patton, T.; Benioff, P.; Biang, C.; Butler, J. [and others

    1996-06-01

    The Environmental Management Division of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). J-Field is located within the Edgewood Area of APG in Harford County, Maryland. Since World War II, activities in the Edgewood Area have included the development, manufacture, testing, and destruction of chemical agents and munitions. These materials were destroyed at J-Field by open burning/open detonation. Portions of J-Field continue to be used for the detonation and disposal of unexploded ordnance (UXO) by open burning/open detonation under authority of the Resource Conservation and Recovery Act.

  1. Rationale and methods of the Prospective Study of Biomarkers, Symptom Improvement, and Ventricular Remodeling During Sacubitril/Valsartan Therapy for Heart Failure (PROVE-HF).

    Science.gov (United States)

    Januzzi, James L; Butler, Javed; Fombu, Emmanuel; Maisel, Alan; McCague, Kevin; Piña, Ileana L; Prescott, Margaret F; Riebman, Jerome B; Solomon, Scott

    2018-05-01

    Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor indicated for the treatment of patients with chronic heart failure (HF) with reduced ejection fraction; however, its mechanism of benefit remains unclear. Biomarkers that are linked to ventricular remodeling, myocardial injury, and fibrosis may provide mechanistic insight and important clinical guidance regarding sacubitril/valsartan use. This 52-week, multicenter, open-label, single-arm study is designed to (1) correlate biomarker changes with cardiac remodeling parameters, cardiovascular outcomes, and patient-reported outcome data and (2) determine short- and long-term changes in concentrations of biomarkers related to potential mechanisms of action and effects of sacubitril/valsartan therapy. Approximately 830 patients with HF with reduced ejection fraction will be initiated and titrated on sacubitril/valsartan according to United States prescribing information. Primary efficacy end points include the changes in N-terminal pro-B-type natriuretic peptide concentrations and cardiac remodeling from baseline to 1 year. Secondary end points include changes in concentrations of N-terminal pro-B-type natriuretic peptide and remodeling to 6 months, and changes in patient-reported outcomes using the Kansas City Cardiomyopathy Questionnaire-23 from baseline to 1 year. In addition, several other relevant biomarkers will be measured. Biomarker changes relative to the number of cardiovascular events in 12 months will also be assessed as exploratory end points. Results from the Prospective Study of Biomarkers, Symptom Improvement, and Ventricular Remodeling During Sacubitril/Valsartan Therapy for Heart Failure (PROVE-HF) will help establish a mechanistic understanding of angiotensin receptor-neprilysin inhibitor therapeutic benefits and provide clinicians with clarity on how to interpret information on biomarkers during treatment (PROVE-HF ClinicalTrials.gov identifier: NCT02887183). Copyright © 2018 The

  2. Cyber security risk management: public policy implications of correlated risk, imperfect ability to prove loss, and observability of self-protection.

    Science.gov (United States)

    Oğüt, Hulisi; Raghunathan, Srinivasan; Menon, Nirup

    2011-03-01

    The correlated nature of security breach risks, the imperfect ability to prove loss from a breach to an insurer, and the inability of insurers and external agents to observe firms' self-protection efforts have posed significant challenges to cyber security risk management. Our analysis finds that a firm invests less than the social optimal levels in self-protection and in insurance when risks are correlated and the ability to prove loss is imperfect. We find that the appropriate social intervention policy to induce a firm to invest at socially optimal levels depends on whether insurers can verify a firm's self-protection levels. If self-protection of a firm is observable to an insurer so that it can design a contract that is contingent on the self-protection level, then self-protection and insurance behave as complements. In this case, a social planner can induce a firm to choose the socially optimal self-protection and insurance levels by offering a subsidy on self-protection. We also find that providing a subsidy on insurance does not provide a similar inducement to a firm. If self-protection of a firm is not observable to an insurer, then self-protection and insurance behave as substitutes. In this case, a social planner should tax the insurance premium to achieve socially optimal results. The results of our analysis hold regardless of whether the insurance market is perfectly competitive or not, implying that solely reforming the currently imperfect insurance market is insufficient to achieve the efficient outcome in cyber security risk management. © 2010 Society for Risk Analysis.

  3. Continuing Care

    Science.gov (United States)

    ... Can’t Grandma Remember My Name? Artwork for Purchase Support Articles Ten Signs of Caregiver Stress Therapeutic ... loved one with Alzheimer’s may be a difficult decision. It is best to make decisions about care ...

  4. Hospice Care

    Science.gov (United States)

    ... Volunteer Donate Search Heart.org Search Get Your Local Info Find out what is happening at your ... your care. Other team members may include a music therapist, physical therapist, speech therapist or occupational therapist. ...

  5. Home Care

    Science.gov (United States)

    ... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

  6. Dyspnoea at Term in an Obese Mother

    Directory of Open Access Journals (Sweden)

    Vicky O'Dwyer

    2011-01-01

    Full Text Available Peripartum cardiomyopathy is a serious, potentially life-threatening heart disease of uncertain aetiology in previously healthy women. We report a morbidly obese woman who presented with peripartum shortness of breath. We discuss the differential diagnosis of dyspnoea in pregnancy and highlight the complexity of care of the morbidly obese woman.

  7. Characterization of Preferential Ground-Water Seepage From a Chlorinated Hydrocarbon-Contaminated Aquifer to West Branch Canal Creek, Aberdeen Proving Ground, Maryland, 2002-04

    Science.gov (United States)

    Majcher, Emily H.; Phelan, Daniel J.; Lorah, Michelle M.; McGinty, Angela L.

    2007-01-01

    Wetlands act as natural transition zones between ground water and surface water, characterized by the complex interdependency of hydrology, chemical and physical properties, and biotic effects. Although field and laboratory demonstrations have shown efficient natural attenuation processes in the non-seep wetland areas and stream bottom sediments of West Branch Canal Creek, chlorinated volatile organic compounds are present in a freshwater tidal creek at Aberdeen Proving Ground, Maryland. Volatile organic compound concentrations in surface water indicate that in some areas of the wetland, preferential flow paths or seeps allow transport of organic compounds from the contaminated sand aquifer to the overlying surface water without undergoing natural attenuation. From 2002 through 2004, the U.S. Geological Survey, in cooperation with the Environmental Conservation and Restoration Division of the U.S. Army Garrison, Aberdeen Proving Ground, characterized preferential ground-water seepage as part of an ongoing investigation of contaminant distribution and natural attenuation processes in wetlands at this site. Seep areas were discrete and spatially consistent during thermal infrared surveys in 2002, 2003, and 2004 throughout West Branch Canal Creek wetlands. In these seep areas, temperature measurements in shallow pore water and sediment more closely resembled those in ground water than those in nearby surface water. Generally, pore water in seep areas contaminated with chlorinated volatile organic compounds had lower methane and greater volatile organic compound concentrations than pore water in non-seep wetland sediments. The volatile organic compounds detected in shallow pore water in seeps were spatially similar to the dominant volatile organic compounds in the underlying Canal Creek aquifer, with both parent and anaerobic daughter compounds detected. Seep locations characterized as focused seeps contained the highest concentrations of chlorinated parent compounds

  8. Careful science?

    DEFF Research Database (Denmark)

    Jespersen, Astrid P; Bønnelycke, Julie; Eriksen, Hanne Hellerup

    2014-01-01

    Concern about obesity has prompted numerous public health campaigns that urge people to be more physically active. The campaigns often include normative statements and attempt to impose restrictions on individuals' lives without considering the complexities of daily life. We suggest that broadening...... into different exercise groups. In this article we analyse the scientific work of the trial as representing entangled processes of bodywork, where data are extracted and objectified bodies are manipulated and care practices address the emotional, social and mundane aspects of the participants' everyday lives....... Care practices are an inherent part of producing scientific facts but they are removed from the recognised results of scientific practice and thus from common public health recommendations. However, knowledge about the strategic use of care practices in lifestyle interventions is important for public...

  9. The role of radiotherapy in hospice care

    International Nuclear Information System (INIS)

    Nishimura, Tetsuo; Sugiyama, Akira; Shimizu, Teppei; Ichinohe, Kenji; Teshima, Takeshi; Kaneko, Masao; Hara, Yoshio; Chihara, Satoshi.

    1989-01-01

    The aim of palliative radiotherapy for the terminally ill is to improve the quality of the remaining span of life. From November 1982 to September 1987, 69 patients in the Seirei Hospice have been treated with such radiotherapy, and symptomatic relief was obtained in 64% of these patients. Radiotherapy also proved useful in achieving an improvement in their performance status. While the aim of hospice care is not directed towards treatment of the underlying disease, the use of radiotherapy is considered to have an important role in hospice care. (author)

  10. New and improved methods for monitoring air quality and the terrestrial environment: Applications at Aberdeen Proving Ground-Edgewood area. Annual report, 1 April--14 November 1997

    Energy Technology Data Exchange (ETDEWEB)

    Bromenshenk, J.J.; Smith, G.C.

    1998-03-01

    Honey bees (Apis mellifera L.) have been shown to be multi-media monitors of chemical exposures and resultant effects. This five-year project has developed an automated system to assess in real-time colony behavioral responses to stressors, both anthropogenic and natural, including inclement weather. Field trials at the Aberdeen Proving Ground-Edgewood included the Old O Field and J field landfills, the Canal Creek and Bush River areas, and a Churchville, MD reference site. Preliminary results show varying concentrations of bioavailable inorganic elements and chlorinated hydrocarbons in bee colonies from all Maryland sites. Industrial solvents in the air inside beehives exhibited the greatest between site differences, with the highest levels occurring in hives near landfills at Old O Field, J Field, and at some sites in the Bush River and Canal Creek areas. Compared to 1996, the 1997 levels of solvents in Old O Field hives decreased by an order of magnitude, and colony performance significantly improved, probably as a consequence of capping the landfill. Recent chemical monitoring accomplishments include development of a new apparatus to quantitatively calibrate TD/GC/MS analysis, a QA/QC assessment of factors that limit the precision of these analyses, and confirmation of transport of aqueous contaminants into the hive. Real-time effects monitoring advances include development of an extensive array of software tools for automated data display, inspection, and numerical analysis and the ability to deliver data from remote locations in real time through Internet or Intranet connections.

  11. An Electrosurgical Endoknife with a Water-Jet Function (Flushknife Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc

    Directory of Open Access Journals (Sweden)

    Yoji Takeuchi

    2013-01-01

    Full Text Available Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function could reduce the operation time of colorectal endoscopic submucosal dissection (ESD however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type were analyzed. Results. Median (95% CI operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5 min [41, 78] versus 74.0 [57, 90] min; , Hazard Ratio HR: 0.53; 95% CI (0.29–0.97. In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.1650.17; 95% CI (0.04–0.66. There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion.

  12. The Apache Longbow-Hellfire Missile Test at Yuma Proving Ground: Introduction and Problem Formulation for a Multiple Stressor Risk Assessment

    International Nuclear Information System (INIS)

    Efroymson, Rebecca Ann; Peterson, Mark J.; Jones, Daniel Steven; Suter, Glenn

    2008-01-01

    An ecological risk assessment was conducted at Yuma Proving Ground, Arizona, as a demonstration of the Military Ecological Risk Assessment Framework (MERAF). The focus of the assessment was a testing program at Cibola Range, which involved an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. The problem formulation for the assessment included conceptual models for three component activities of the test, helicopter overflight, missile firing, and tracked vehicle movement, and two ecological endpoint entities, woody desert wash communities and desert mule deer (Odocoileus hemionus crooki) populations. An activity-specific risk assessment framework was available to provide guidance for assessing risks associated with aircraft overflights. Key environmental features of the study area include barren desert pavement and tree-lined desert washes. The primary stressors associated with helicopter overflights were sound and the view of the aircraft. The primary stressor associated with Hellfire missile firing was sound. The principal stressor associated with tracked vehicle movement was soil disturbance, and a resulting, secondary stressor was hydrological change. Water loss to washes and wash vegetation was expected to result from increased ponding, infiltration and/or evaporation associated with disturbances to desert pavement. A plan for estimating integrated risks from the three military activities was included in the problem formulation

  13. X-ray fluorescence investigation of heavy-metal contamination on metal surfaces in the Pilot Plant Complex, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Brubaker, K.L.; Draugelis, A.K.; Schneider, J.F.; Billmark, K.A.; Zimmerman, R.E.

    1995-07-01

    A field program using a portable x-ray fluorescence (XRF) instrument was carried out to obtain data on loadings of RCRA-regulated heavy metals in paint on metal surfaces within the Pilot Plant Complex at Aberdeen Proving Ground, Maryland. Measured loadings of heavy metals were sufficiently small that they do not present problems for either human exposure or the disposition of building demolition rubble. An attempt to develop an external calibration of the XRF instrument for cadmium, chromium, and lead was unsuccessful. Significant substrate effects were observed for cadmium and chromium; for accurate results for these elements, it appears necessary to calibrate by using a sample of the actual metal substrate on which the paint is located. No substrate effects were observed for lead, but the use of lead L-shell x-ray emission lines in the instrument mode utilized in this study appears to result in a significant underestimate of the lead loading due to self-absorption of these emissions.

  14. Environmental geophysics: Buildings E5485, E5487, and E5489 decommissioning - the open-quotes Ghost Townclose quotes complex, Aberdeen Proving Ground, Maryland

    International Nuclear Information System (INIS)

    McGinnis, L.D.; Thompson, M.D.; Miller, S.F.

    1994-06-01

    Buildings E5485, E5487, and E5489, referred to informally as the open-quotes Ghost Townclose quotes complex, are potentially contaminated sites in the Edgewood section of Aberdeen Proving Ground. Noninvasive geophysical surveys, including magnetics, EM-31, EM-61, and ground-penetrating radar, were conducted to assist a sampling and monitoring program prior to decommissioning and dismantling of the buildings. The buildings are located on a marginal wetland bordering the west branch of Canal Creek. The dominant geophysical signature in the open-quotes Ghost Town close quotes complex is a pattern of northeast-southwest and northwest-southeast anomalies that appear to be associated with a trench/pipe/sewer system, documented by the presence of a manhole. Combinations of anomalies suggest that line sources include nonmetallic and ferromagnetic materials in trenches. On the basis of anomaly associations, the sewer lines probably rest in a trench, back-filled with conductive, amphibolitic, crushed rock. Where the sewer lines connect manholes or junctions with other lines, ferromagnetic materials are present. Isolated, unidentified magnetic anomalies litter the area around Building E5487, particularly to the north. Three small magnetic sources are located east of Building E5487

  15. Privacy as Personality Right: Why the ECtHR’s Focus on Ulterior Interests Might Prove Indispensable in the Age of “Big Data”

    Directory of Open Access Journals (Sweden)

    Bart van der Sloot

    2015-02-01

    Full Text Available Article 8 ECHR was adopted as a classic negative right, which provides the citizen protection from unlawful and arbitrary interference by the state with his private and family life, home and communication. The ECtHR, however, has gradually broadened its scope so that the right to privacy encroaches upon other provisions embodied in the Convention, includes rights and freedoms explicitly left out of the ECHR by the drafters of the Convention and functions as the main pillar on which the Court has built its practice of opening up the Convention for new rights and freedoms. Consequently, Article 8 ECHR has been transformed from a classic privacy right to a personality right, providing protection to the personal development of individuals. Apart from its theoretical significance, this shift might prove indispensable in the age of Big Data, as personality rights protect a different type of interest, which is far more easy to substantiate in the new technological paradigm than those associated with the right to privacy.

  16. Long-term ground-water monitoring program and performance-evaluation plan for the extraction system at the former Nike Missile Battery Site, Aberdeen Proving Ground, Maryland

    Science.gov (United States)

    Senus, Michael P.; Tenbus, Frederick J.

    2000-01-01

    This report presents lithologic and ground-water-quality data collected during April and May 2000 in the remote areas of the tidal wetland of West Branch Canal Creek, Aberdeen Proving Ground, Maryland. Contamination of the Canal Creek aquifer with volatile organic compounds has been documented in previous investigations of the area. This study was conducted to investigate areas that were previously inaccessible because of deep mud and shallow water, and to support ongoing investigations of the fate and transport of volatile organic compounds in the Canal Creek aquifer. A unique vibracore drill rig mounted on a hovercraft was used for drilling and ground-water sampling. Continuous cores of the wetland sediment and of the Canal Creek aquifer were collected at five sites. Attempts to sample ground water were made by use of a continuous profiler at 12 sites, without well installation, at a total of 81 depths within the aquifer. Of those 81 attempts, only 34 sampling depths produced enough water to collect samples. Ground-water samples from two sites had the highest concentrations of volatile organic compounds?with total volatile organic compound concentrations in the upper part of the aquifer ranging from about 15,000 to 50,000 micrograms per liter. Ground-water samples from five sites had much lower total volatile organic compound concentrations (95 to 2,100 micrograms per liter), whereas two sites were essentially not contaminated, with total volatile organic compound concentrations less than or equal to 5 micrograms per liter.

  17. Contamination of ground water, surface water, and soil, and evaluation of selected ground-water pumping alternatives in the Canal Creek area of Aberdeen Proving Ground, Maryland

    Science.gov (United States)

    Lorah, Michelle M.; Clark, Jeffrey S.

    1996-01-01

    Chemical manufacturing, munitions filling, and other military-support activities have resulted in the contamination of ground water, surface water, and soil in the Canal Creek area of Aberdeen Proving Ground, Maryland. Chlorinated volatile organic compounds, including 1,1,2,2-tetrachloroethane and trichloroethylene, are widespread ground-water contaminants in two aquifers that are composed of unconsolidated sand and gravel. Distribution and fate of chlorinated organic compounds in the ground water has been affected by the movement and dissolution of solvents in their dense immiscible phase and by microbial degradation under anaerobic conditions. Detection of volatile organic contaminants in adjacent surface water indicates that shallow contaminated ground water discharges to surface water. Semivolatile organic compounds, especially polycyclic aromatic hydrocarbons, are the most prevalent organic contaminants in soils. Various trace elements, such as arsenic, cadmium, lead, and zinc, were found in elevated concentrations in ground water, surface water, and soil. Simulations with a ground-water-flow model and particle tracker postprocessor show that, without remedial pumpage, the contaminants will eventually migrate to Canal Creek and Gunpowder River. Simulations indicate that remedial pumpage of 2.0 million gallons per day from existing wells is needed to capture all particles originating in the contaminant plumes. Simulated pumpage from offsite wells screened in a lower confined aquifer does not affect the flow of contaminated ground water in the Canal Creek area.

  18. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial.

    Science.gov (United States)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren

    2013-10-09

    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, pacute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. © 2013.

  19. Concepts and procedures required for successful reduction of tensor magnetic gradiometer data obtained from an unexploded ordnance detection demonstration at Yuma Proving Grounds, Arizona

    Science.gov (United States)

    Bracken, Robert E.; Brown, Philip J.

    2006-01-01

    On March 12, 2003, data were gathered at Yuma Proving Grounds, in Arizona, using a Tensor Magnetic Gradiometer System (TMGS). This report shows how these data were processed and explains concepts required for successful TMGS data reduction. Important concepts discussed include extreme attitudinal sensitivity of vector measurements, low attitudinal sensitivity of gradient measurements, leakage of the common-mode field into gradient measurements, consequences of thermal drift, and effects of field curvature. Spatial-data collection procedures and a spin-calibration method are addressed. Discussions of data-reduction procedures include tracking of axial data by mathematically matching transfer functions among the axes, derivation and application of calibration coefficients, calculation of sensor-pair gradients, thermal-drift corrections, and gradient collocation. For presentation, the magnetic tensor at each data station is converted to a scalar quantity, the I2 tensor invariant, which is easily found by calculating the determinant of the tensor. At important processing junctures, the determinants for all stations in the mapped area are shown in shaded relief map-view. Final processed results are compared to a mathematical model to show the validity of the assumptions made during processing and the reasonableness of the ultimate answer obtained.

  20. Radiation protection medical care of radiation workers

    International Nuclear Information System (INIS)

    Walt, H.

    1988-01-01

    Radiation protection medical care for radiation workers is part of the extensive programme protecting people against dangers emanating from the peaceful application of ionizing radiation. Thus it is a special field of occupational health care and emergency medicine in case of radiation accidents. It has proved helpful in preventing radiation damage as well as in early detection, treatment, after-care, and expert assessment. The medical checks include pre-employment and follow-up examinations, continued long-range medical care as well as specific monitoring of individuals and defined groups of workers. Three levels of action are involved: works medical officers specialized in radiation protection, the Institute of Medicine at the National Board for Atomic Safety and Radiation Protection, and a network of clinical departments specialized in handling cases of acute radiation damage. An account is given of categories, types, and methods of examinations for radiation workers and operators. (author)

  1. Caring Science or Science of Caring.

    Science.gov (United States)

    Turkel, Marian C; Watson, Jean; Giovannoni, Joseph

    2018-01-01

    The concepts caring science and science of caring have different meanings; however, they are often used interchangeably. The purpose of this paper is to present an overview of the synthesis of the scholarly literature on the definitions of the science of caring and caring science and to affirm the authors' perspective relating to the language of caring science. Caring science advances the epistemology and ontology of caring. Ideas related to caring science inquiry are presented, and the authors acknowledge the future of caring science as unitary caring science.

  2. Just caring.

    Science.gov (United States)

    Hussey, Trevor

    2012-01-01

    Social justice is concerned with fair distribution of the benefits and burdens of living together in society. Regarding nursing care, social justice is concerned with who should receive its benefits, how much they should receive, and who should take up the burden of providing and paying for it. A specific thesis is offered: 'Health care, including nursing care, should be distributed on the basis of need, free at the point of use, the cost being born by the community involved.' This thesis is shown to be incompatible with consequentialist (utilitarian) and libertarian approaches to social justice, but reasons are given for rejecting these theories. It is shown that it may be compatible with Rawl's liberal theory of justice and definitely compatible with a version of the teleological (Aristotelian) theory. The thesis is then defended against criticisms concerned with desert and responsibility: that the provident ought not to pay for the improvident, and that those who are responsible for their health do not deserve free care. There are answered by an epistemological argument concerning what we need to know before we can decide what people deserve, and an argument about social cohesion. The conclusion is that the thesis can be offered as a moral principle for a fair society. © 2011 Blackwell Publishing Ltd.

  3. Prenatal Care.

    Science.gov (United States)

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

    This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

  4. Enacting Care

    Czech Academy of Sciences Publication Activity Database

    Urban, Petr

    2015-01-01

    Roč. 9, č. 2 (2015), s. 216-222 ISSN 1749-6535 R&D Projects: GA ČR(CZ) GPP401/12/P544 Institutional support: RVO:67985955 Keywords : ethics of care * enactivism * autonomy * social institutions * autism * exclusion Subject RIV: AA - Philosophy ; Religion http://dx.doi.org/10.1080/17496535.2015.1022356

  5. Palliative Care in Cancer

    Science.gov (United States)

    ... care is usually provided by palliative care specialists, health care practitioners who have received special training and/or certification in palliative care. They provide holistic care to the patient and family or caregiver ...

  6. Peripartum hysterectomy: two years experience at Nelson Mandela ...

    African Journals Online (AJOL)

    EB

    2009-01-31

    Jan 31, 2009 ... secondary haemorrhage/ sepsis3 but with the use anti retro viral treatment there should be a decrease in this condition. Majority (76%) of patients had subtotal hysterectomies and the rest had total abdominal hysterectomies. Subtotal hysterectomy is routinely used for managing these patients and in a ...

  7. Emergency management of term pregnant female with decompensated peripartum cardiomyopathy

    Directory of Open Access Journals (Sweden)

    I. Lata*

    2013-12-01

    Discussion: An interesting case of 37-year-old female (primigravida G1P0L0 presented at 37 weeks gestation with chief complaint of progressively increasing breathlessness for 15 days and swelling in both lower limbs for 7 days presented in ED. Her general condition – poor, blood pressure – 180⧹110 mmHg, pulse – 136⧹ min irregular, RR 36⧹min, Pallor ++, JVP raised, pedal oedema  +  cardiovascular exam showed S3 gallop rhythm, P2 loud (pulmonary hypertension and chest with bilateral crepitation’s (pulmonary oedema. She was managing on the line of preeclampsia toxaemia elsewhere. We diagnose her having CHF due to PPCM that was managed only with timely diagnosis and prompt management and save two lives with help of multidisciplinary team. Lesson from successful case management will help others to differentiate physiological changes during pregnancy with other life threatening disease that can be with or during pregnancy. The detailed management and discussion will be presented at time of presentation.

  8. Rates and determinants of peripartum and puerperal anemia in ...

    African Journals Online (AJOL)

    2015-12-11

    Dec 11, 2015 ... The mean hemoglobin levels at term, 48 h, and 6 weeks postpartum were 11.1 .... Methods. The study took place in the University of Nigeria Teaching ..... Chinese women in a longitudinal study of maternal nutrition. Eur J Clin ...

  9. A rare case of peripartum cardiomyopathy posted for caesarean section

    Directory of Open Access Journals (Sweden)

    Nalini Kotekar

    2007-01-01

    Full Text Available Post Partum Cardiomyopathy (PPCM is a relatively rare form of heart failure associated with pregnancy. It was recognized first in the 19th century by Ritchie and is defined as the onset of acute heart failure in the last trimester or early post partum period in the absence of infections, metabolic, toxic, ischaemic or valvular causes of myocardial dysfunction. Prognosis depends on the degree of cardiomegaly at presentation and in the following 6 months. Initial high risk period carries a mortality of 25 to 50%. Keeping in mind the reduced contractility and ejection fraction with ventricular dilatation proceeding to cardiac failure, the anesthesiologist managing a case of PPCM faces the challenge of avoiding myocardial depression, hypovolemia and increased SVR, all of which may be hazardous

  10. Rates and determinants of peripartum and puerperal anemia in ...

    African Journals Online (AJOL)

    Methods: A prospective longitudinal study involving women with uncomplicated singleton pregnancies who were recruited at term at two tertiary maternity centers and were followed up with the determination of hemoglobin and ferritin concentrations till 6 weeks after delivery. Data were analyzed with descriptive and ...

  11. Reversible posterior leucoencephalopathy syndrome in a peripartum patient.

    Science.gov (United States)

    Prout, R E; Tuckey, J P; Giffen, N J

    2007-01-01

    We present the case of a multiparous parturient who developed hypertension associated with a severe headache in the immediate post-partum period. She subsequently suffered a generalised tonic clonic seizure on the fifth post-partum day. Following recovery of consciousness, she developed a left homonymous hemianopia. Apart from hypertension, headache and convulsion, she had no symptoms and no proteinuria or other biochemical or haematological changes associated with eclampsia. The magnetic resonance imaging findings were consistent with vasogenic oedema in the right posterior parieto-occipital white matter and these in turn are consistent with reversible posterior leucoencephalopathy syndrome. The differential diagnosis of convulsions in the post-partum period is discussed and the clinical and radiological features of reversible posterior leucoencephalopathy syndrome are described.

  12. Peripartum haemodynamic status of bitches with normal birth or dystocia.

    Science.gov (United States)

    Lúcio, C F; Silva, L C G; Rodrigues, J A; Veiga, G A L; Vannucchi, C I

    2009-07-01

    There has been limited investigation of parturition in the bitch and there is little information published on clinical and obstetrical examination other than opinion and anecdote. While there are substantial data on haemodynamic and vascular changes during normal parturition in humans, little is known about the physiological events in the dog. This study was aimed at maternal haemodynamic changes occurring during normal parturition and to investigate how these were modified in bitches with dystocia (DYST) treated either medically or via assisted delivery and caesarean operation. Three groups of 10 bitches were investigated; those with normal parturition, those with DYST corrected by manipulative assistance or caesarean operation and those with uterine inertia treated by oxytocin administration. Heart rate, systolic and diastolic blood pressure, electrocardiogram and blood glucose concentration were measured pre-partum, intra-partum, immediately after parturition and 1 h later. Heart rate was high at all times throughout the study and the majority of bitches had normal sinus rhythm. Blood pressure was generally within the normal range, and although systolic and diastolic blood pressure was highest during the intra-partum period and sometimes during the immediate post-partum period, there were no significant differences between groups. All bitches had blood glucose concentrations within the normal range throughout the study although pre-partum concentrations were statistically lower than many of the other time periods. The study provides useful physiological data that will facilitate monitoring and clinical management of bitches throughout normal parturition and DYST.

  13. Design and Performance of an Enhanced Bioremediation Pilot Test in a Tidal Wetland Seep, West Branch Canal Creek, Aberdeen Proving Ground, Maryland

    Science.gov (United States)

    Majcher, Emily H.; Lorah, Michelle M.; Phelan, Daniel J.; McGinty, Angela L.

    2009-01-01

    Because of a lack of available in situ remediation methods for sensitive wetland environments where contaminated groundwater discharges, the U.S. Geological Survey, in cooperation with the U.S. Army Garrison, Aberdeen Proving Ground, Maryland, conceived, designed, and pilot tested a permeable reactive mat that can be placed horizontally at the groundwater/surface-water interface. Development of the reactive mat was part of an enhanced bioremediation study in a tidal wetland area along West Branch Canal Creek at Aberdeen Proving Ground, where localized areas of preferential discharge (seeps) transport groundwater contaminated with carbon tetrachloride, chloroform, tetrachloroethene, trichloroethene, and 1,1,2,2-tetrachloroethane from the Canal Creek aquifer to land surface. The reactive mat consisted of a mixture of commercially available organic- and nutrient-rich peat and compost that was bioaugmented with a dechlorinating microbial consortium, WBC-2, developed for this study. Due to elevated chlorinated methane concentrations in the pilot test site, a layer of zero-valent iron mixed with the peat and compost was added at the base of the reactive mat to promote simultaneous abiotic and biotic degradation. The reactive mat for the pilot test area was designed to optimize chlorinated volatile organic compound degradation efficiency without altering the geotechnical and hydraulic characteristics, or creating undesirable water quality in the surrounding wetland area, which is referred to in this report as achieving geotechnical, hydraulic, and water-quality compatibility. Optimization of degradation efficiency was achieved through the selection of a sustainable organic reactive matrix, electron donor, and bioaugmentation method. Consideration of geotechnical compatibility through design calculations of bearing capacity, settlement, and geotextile selection showed that a 2- to 3-feet tolerable thickness of the mat was possible, with 0.17 feet settlement predicted for

  14. The Apache Longbow-Hellfire Missile Test at Yuma Proving Ground: Ecological Risk Assessment for Tracked Vehicle Movement across Desert Pavement

    International Nuclear Information System (INIS)

    Peterson, Mark J; Efroymson, Rebecca Ann; Hargrove, William Walter

    2008-01-01

    A multiple stressor risk assessment was conducted at Yuma Proving Ground, Arizona, as a demonstration of the Military Ecological Risk Assessment Framework. The focus was a testing program at Cibola Range, which involved an Apache Longbow helicopter firing Hellfire missiles at moving targets, M60-A1 tanks. This paper describes the ecological risk assessment for the tracked vehicle movement component of the testing program. The principal stressor associated with tracked vehicle movement was soil disturbance, and a resulting, secondary stressor was hydrological change. Water loss to washes and wash vegetation was expected to result from increased infiltration and/or evaporation associated with disturbances to desert pavement. The simulated exposure of wash vegetation to water loss was quantified using estimates of exposed land area from a digital ortho quarter quad aerial photo and field observations, a 30 30 m digital elevation model, the flow accumulation feature of ESRI ArcInfo, and a two-step process in which runoff was estimated from direct precipitation to a land area and from water that flowed from upgradient to a land area. In all simulated scenarios, absolute water loss decreased with distance from the disturbance, downgradient in the washes; however, percentage water loss was greatest in land areas immediately downgradient of a disturbance. Potential effects on growth and survival of wash trees were quantified by using an empirical relationship derived from a local unpublished study of water infiltration rates. The risk characterization concluded that neither risk to wash vegetation growth or survival nor risk to mule deer abundance and reproduction was expected. The risk characterization was negative for both the incremental risk of the test program and the combination of the test and pretest disturbances

  15. The Economics of Medicare Accountable Care Organizations

    Science.gov (United States)

    Blackstone, Erwin A.; Fuhr, Joseph P.

    2016-01-01

    Background Accountable care organizations (ACOs) have been created to improve patient care, enhance population health, and reduce costs. Medicare in particular has focused on ACOs as a primary device to improve quality and reduce costs. Objective To examine whether the current Medicare ACOs are likely to be successful. Discussion Patients receiving care in ACOs have little incentive to use low-cost quality providers. Furthermore, the start-up costs of ACOs for providers are high, contributing to the minimal financial success of ACOs. We review issues such as reducing readmissions, palliative care, and the difficulty in coordinating care, which are major cost drivers. There are mixed incentives facing hospital-controlled ACOs, whereas physician-controlled ACOs could play hospitals against each other to obtain high quality and cost reductions. This discussion also considers whether the current structure of ACOs is likely to be successful. Conclusion The question remains whether Medicare ACOs can achieve the Triple Aim of “improving the experience of care, improving the health of populations, and reducing per capita costs of health care.” Care coordination in ACOs and information technology are proving more complicated and expensive to implement than anticipated. Even if ACOs can decrease healthcare costs and increase quality, it is unclear if the current incentives system can achieve these objectives. A better public policy may be to implement a system that encompasses the best practices of successful private integrated systems rather than promoting ACOs. PMID:27066191

  16. Pharmaceutical health care and Inuit language communications in Nunavut, Canada

    OpenAIRE

    Romain, Sandra J.

    2013-01-01

    Background. Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requ...

  17. Efeito da administração de propileno glicol e cobalto associado à vitamina B12 sobre o perfil metabólico e a atividade enzimática de ovelhas da raça Santa Inês no periparto Effect of propylene glycol, cobalt and vitamin B12 on the metabolic profile and enzymatic in Santa Inês ewes in peripartum

    Directory of Open Access Journals (Sweden)

    Rogério Adriano dos Santos

    2012-12-01

    Full Text Available O presente estudo teve por objetivo avaliar a influência da administração de propileno glicol e cobalto associado à vitamina B12 sobre o perfil metabólico e a atividade enzimática de ovelhas da raça Santa Inês no período do periparto. Foram utilizadas 18 ovelhas prenhes, pesando em torno de 40kg. Aproximadamente 30 dias antes da data prevista para o parto foram separadas de maneira aleatória em três grupos e administrados os suplementos conforme a seguir: (G1/n=6 grupo que recebeu propileno glicol (30mL por via oral diariamente; (G2/n=6 grupo que recebeu cobalto (1mg de cloreto de cobalto a 1%, via oral diariamente associado a vitamina B12 (2mg via intramuscular, semanalmente e (G3/n=6 grupo controle. As amostras de sangue das ovelhas para avaliação do perfil metabólico e enzimático (glicose, β-hidroxibutirato-BHB, NEFA, proteína total, albumina, uréia, creatinina, AST, GGT, FA e CK foram colhidas 30 dias antes da data prevista para o parto, uma semana antes (ante-parto, no parto, às 24h, 72h, 5 dias, 15 dias e 30 dias após o parto. Não foi observado cetonúria nos momentos que antecederam ao parto. A administração dos suplementos não influenciou sobre o perfil metabólico, protéico e energético, assim como não houve comprometimento hepático das ovelhas no período do periparto.The aim of this study was to evaluate the influence of the administration of propylene glycol and cobalt associated with vitamin B12 on the metabolic profile and enzymatic activity of Santa Inês ewes in the peripartum period. A total of 18 pregnant ewes, weighing around 40kg were used. Approximately 30 days before the expected date of delivery were randomly separated into three groups and administered supplements as follows: (G1/n = 6 group received propylene glycol (30mL orally daily; (G2/n = 6 group receiving cobalt (1mg cobalt chloride 1%, orally daily associated with vitamin B12 (2mg intramuscular weekly and (G3/n = 6 control group. Blood

  18. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    Science.gov (United States)

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Orthogeriatric care: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Tarazona-Santabalbina FJ

    2016-06-01

    Full Text Available Francisco José Tarazona-Santabalbina,1,2 Ángel Belenguer-Varea,1,2 Eduardo Rovira,1,2 David Cuesta-Peredó1,21Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera, 2Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, SpainAbstract: Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients. Studies in this field have identified the prognostic factors present upon admission or manifesting themselves during admission and that increase the risk of patient mortality or disability. In addition, improved care afforded by orthogeriatric units has proved to reduce costs. Nevertheless, a number of management issues remain to be clarified, such as the optimum anesthetic, analgesic, and thromboprophylactic protocols; the type of diagnostic and therapeutic approach best suited to patients with cognitive problems; or the efficiency of the programs used in convalescence units or in home rehabilitation care. Randomized clinical trials are needed to consolidate the evidence in this regard. Keywords: hip fractures, geriatric assessment, orthogeriatric care, recovery of function, mortality

  20. [Quality assurance concepts in intensive care medicine].

    Science.gov (United States)

    Brinkmann, A; Braun, J P; Riessen, R; Dubb, R; Kaltwasser, A; Bingold, T M

    2015-11-01

    Intensive care medicine (ICM) is characterized by a high degree of complexity and requires intense communication and collaboration on interdisciplinary and multiprofessional levels. In order to achieve good quality of care in this environment and to prevent errors, a proactive quality and error management as well as a structured quality assurance system are essential. Since the early 1990s, German intensive care societies have developed concepts for quality management and assurance in ICM. In 2006, intensive care networks were founded in different states to support the implementation of evidence-based knowledge into clinical routine and to improve medical outcome, efficacy, and efficiency in ICM. Current instruments and concepts of quality assurance in German ICM include core intensive care data from the data registry DIVI REVERSI, quality indicators, peer review in intensive care, IQM peer review, and various certification processes. The first version of German ICM quality indicators was published in 2010 by an interdisciplinary and interprofessional expert commission. Key figures, indicators, and national benchmarks are intended to describe the quality of structures, processes, and outcomes in intensive care. Many of the quality assurance tools have proved to be useful in clinical practice, but nationwide implementation still can be improved.

  1. 52 years of kindergarten – the structure has proved successful and must not disappear – let’s save our nursery and school together!

    CERN Multimedia

    Staff Association

    2017-01-01

    Since the beginning of 2016, the Staff Association has been in discussions with the Management to save and sustain our Nursery and School, located on the CERN site in Meyrin. Where are we now with the discussions and what does the future hold for our Children’s Day-Care Centre and School (EVEE)? A closer look at the creation of the Kindergarten and its management A group of parents founded the Kindergarten at CERN in the 1960s, and in 1969, the CERN Staff Association took the structure under its aegis. This change in management resulted in a partnership agreement between CERN and the Staff Association. The agreement defined the rights and duties of both parties with regard to the Staff Association operating a kindergarten on the CERN site. Since then, the Staff Association has been the employer and manager of the structure providing early childhood services. Development of the structure over time In 1977, the Kindergarten changed premises and a new agreement was signed between CERN and the Staff As...

  2. What are the currently available and in development molecular markers for bladder cancer? Will they prove to be useful in the future?

    Science.gov (United States)

    Abdulmajed, Mohamed Ismat; Sancak, Eyüp Burak; Reşorlu, Berkan; Al-Chalaby, Gydhia Zuhair

    2014-12-01

    Urothelial carcinoma is the 9(th) most common cancer worldwide. Most urothelial tumors are non-muscle invasive on presentation. However, two-thirds of non-invasive bladder cancers will eventually recur with a 25% risk of progression to muscle-invasive bladder cancer. Tumor stage, histological grade and pathological invasion of blood vessels and lymphatic tissue are the main indicators for urothelial cancer prognosis. The gold standard for diagnosing bladder cancer is conventional white-light cystoscopy and biopsy. Urine cytology is a highly specific, sensitive test for high-grade tumors or carcinoma in situ (CIS). Urinary NMP22 has an overall sensitivity and specificity for detecting bladder cancer of 49% and 87%, respectively. However, there are false-positive results in the presence of urinary tract infection or hematuria. The detection of specific gene mutations related to urothelial cancers has been studied and employed to reproduce markers helpful for diagnosis. According to current studies, molecular markers can be used to predict tumor recurrence. From a prognostic point of view, new molecular markers have yet to be established as reliable indicators of tumor aggressiveness. We aimed to review the molecular markers with possible prognostic significance that have been discussed in the literature. This review examined the literature for various molecular markers under development for bladder cancer in an attempt to optimize patient care and reduce the costs of treating these patients.

  3. Pregnancy and Parenthood in Radiation Oncology, Views and Experiences Survey (PROVES): Results of a Blinded Prospective Trainee Parenting and Career Development Assessment.

    Science.gov (United States)

    Holliday, Emma B; Ahmed, Awad A; Jagsi, Reshma; Stentz, Natalie Clark; Woodward, Wendy A; Fuller, Clifton D; Thomas, Charles R

    2015-07-01

    Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; Pstatus. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; Pproductivity and career aspirations. Further investigation is critical to elucidate gender disparities in parenthood and career development. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. A recent Mw 4.3 earthquake proving activity of a shallow strike-slip fault in the northern part of the Western Desert, Egypt

    Science.gov (United States)

    Ezzelarab, Mohamed; Ebraheem, Mohamed O.; Zahradník, Jiří

    2018-03-01

    The Mw 4.3 earthquake of September 2015 is the first felt earthquake since 1900 A.D in the northern part of the Western Desert, Egypt, south of the El-Alamein City. The available waveform data observed at epicentral distances 52-391 km was collected and carefully evaluated. Nine broad-band stations were selected to invert full waveforms for the centroid position (horizontal and vertical) and for the focal mechanism solution. The first-arrival travel times, polarities and low-frequency full waveforms (0.03-0.08 Hz) are consistently explained in this paper as caused by a shallow source of the strike-slip mechanism. This finding indicates causal relation of this earthquake to the W-E trending South El-Alamein fault, which developed in Late Cretaceous as dextral strike slip fault. Recent activity of this fault, proven by the studied rare earthquake, is of fundamental importance for future seismic hazard evaluations, underlined by proximity (∼65 km) of the source zone to the first nuclear power plant planned site in Egypt. Safe exploration and possible future exploitation of hydrocarbon reserves, reported around El-Alamein fault in the last decade, cannot be made without considering the seismic potential of this fault.

  5. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... are chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help ...

  6. Medical Care during Pregnancy

    Science.gov (United States)

    ... for Educators Search English Español Medical Care During Pregnancy KidsHealth / For Parents / Medical Care During Pregnancy What's ... and their babies. What Is Prenatal Care Before Pregnancy? Prenatal care should start before you get pregnant. ...

  7. Oral care.

    Science.gov (United States)

    Hitz Lindenmüller, Irène; Lambrecht, J Thomas

    2011-01-01

    Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing/recovering from chemo-/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases. The use of a toothbrush is the most important measure for oral hygiene. Toothbrushes with soft bristles operated carefully by hand or via an electric device help to remove plaque and to avoid mucosal trauma. A handlebar with a grip cover can be helpful for manually disabled patients or for those with reduced motor skills. In case of oral hygiene at the bedside or of patients during/after chemo-/radiotherapy a gauze pad can be helpful for gently cleaning the teeth, gums and tongue. The use of fluoride toothpaste is imperative for the daily oral hygiene. Detergents such as sodium lauryl sulphate improve the cleaning action but may also dehydrate and irritate the mucous membrane. The use of products containing detergents and flavouring agents (peppermint, menthol, cinnamon) should therefore be avoided by bedridden patients or those with dry mouth and sensitive mucosa. Aids for suitable interdental cleaning, such as dental floss, interdental brushes or dental sticks, are often complicated to operate. Their correct use should be instructed by healthcare professionals. To support dental care, additional fluoridation with a fluoride gel or rinse can be useful. Products further containing antiseptics such as chlorhexidine or triclosan reduce the quantity of bacteria in the mouth. For patients undergoing or having undergone radio-/chemotherapy, a mouthwash that concomitantly moisturizes the oral mucosa is advisable. Copyright © 2011 S. Karger AG, Basel.

  8. Comportamiento metabolico en el periparto de vacas Hartón del Valle, bajo condiciones de trópico bajo Metabolic behaviour in the peripartum period of dairy cows Hartón del Valle creole breed, under tropical conditions

    Directory of Open Access Journals (Sweden)

    Erika Andrea Hernández

    2011-01-01

    Full Text Available El periodo de periparto o periodo de transición presenta variaciones fisiológicas significativas que inciden en posteriores sucesos productivos (pico de lactancia, reactivación ovárica). El ganado Hartón posee una excelente eficiencia reproductiva (estrecho intervalo entre partos), factor que podría originarse en procesos metabólicos relacionados con un mejor ajuste homeostático. El principal objetivo del presente trabajo fue evaluar la homeostasis en una raza bovina criolla durante el periodo postparto. Para el estudio se emplearon 10 vacas multíparas, muestreadas antes del parto (días 30 y 15 preparto) y diariamente en los tres primeros días del parto; posteriormente a partir del día 5, con intervalos de cinco días y hasta el día 60 postparto. En total para cada animal se analizaron 14 muestras, cada una de ellas correspondió a un periodo analítico. Mediante venipunción coccígea en tubos al vacío con y sin anticoagulante se colectó la muestra de sangre completa. Por centrifugación se obtuvo plasma y suero, los cuales fueron almacenados a -20°C, hasta su análisis. Las determinaciones de hormonas se realizaron mediante radioinmunoanálisis (RIA) de fase sólida. A través de pruebas enzimáticas colorimétricas en equipos automatizados, se determinaron los valores de los metabolitos para cada uno de los periodos definidos. Los valores medios fueron: BHB (β-Hidroxibutirato) 0.39 mmol/L, NEFA (ácidos Grasos No Esterificados) 0.76 mmol/L, triglicéridos 0.42 mmol/L, colesterol 2.43 mmol/L, insulina 4.77 mµl/ml, triyodotironina (T3) 2.69 nmol/L, tetrayodotironina (T4) 57.37 nmol/L, progesterona 5.54 nmol/L, cortisol 32.42 nmol/L. Los valores obtenidos para los diferentes metabolitos se encuentran dentro de los rangos reportados por la literatura para bovinos en condiciones tropicales.The peripartum period or transition period, presents significant physiological changes that affect production in subsequent production events

  9. Pregnancy and Parenthood in Radiation Oncology, Views and Experiences Survey (PROVES): Results of a Blinded Prospective Trainee Parenting and Career Development Assessment

    International Nuclear Information System (INIS)

    Holliday, Emma B.; Ahmed, Awad A.; Jagsi, Reshma; Stentz, Natalie Clark; Woodward, Wendy A.; Fuller, Clifton D.; Thomas, Charles R.

    2015-01-01

    Purpose: Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. Methods and Materials: An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. Results: A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; P<.001), had a PhD (33% vs 19.3%, respectively; P=.033), were married (99% vs 43%, respectively; P<.001), and had a partner who did not work (24.7% vs 1.9%, respectively; <.001). There were no differences in the number of manuscripts published or the number of residents who expressed likelihood of pursing an academic career by parental status. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; P<.001) and reported that their partner performed a greater percentage of childcare duties (70% [IQR: 60%-80%] vs 35% [IQR: 20%-50%], respectively; P<.001). Conclusions: Pregnancy and parenthood are common during residency. Female residents are frequently responsible for more childcare duties than males

  10. Pregnancy and Parenthood in Radiation Oncology, Views and Experiences Survey (PROVES): Results of a Blinded Prospective Trainee Parenting and Career Development Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ahmed, Awad A. [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Stentz, Natalie Clark [Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Woodward, Wendy A.; Fuller, Clifton D. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Thomas, Charles R., E-mail: thomasch@ohsu.edu [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)

    2015-07-01

    Purpose: Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. Methods and Materials: An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. Results: A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; P<.001), had a PhD (33% vs 19.3%, respectively; P=.033), were married (99% vs 43%, respectively; P<.001), and had a partner who did not work (24.7% vs 1.9%, respectively; <.001). There were no differences in the number of manuscripts published or the number of residents who expressed likelihood of pursing an academic career by parental status. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; P<.001) and reported that their partner performed a greater percentage of childcare duties (70% [IQR: 60%-80%] vs 35% [IQR: 20%-50%], respectively; P<.001). Conclusions: Pregnancy and parenthood are common during residency. Female residents are frequently responsible for more childcare duties than males

  11. Health care economy II

    International Nuclear Information System (INIS)

    Beer, G.; Slovak, K.

    2008-01-01

    In Slovakia a strange approach to the purchase of health care equipment has not been limited to ophthalmology. Suspicious procurements are symptomatic. This applies also to specialisation where the correct spending of money can make the difference between life and death and can greatly effect the quality of life. More than a year ago, the Ministry of Health started the procurement of linear accelerators for oncology units in three hospitals. This plan placed on the market a potential order worth more than 11 million EUR without VAT. Three companies produce this complex equipment. The US company, Varian, the German company, Siemens, and the Swedish company, Elekta. Three suppliers, three hospitals. What a coincidence that each hospital - in Presov, Banska Bystrica and Bratislava - received only one envelope with an offer. Each from a different supplier. If anyone wanted to prove that the suppliers did not agree on a common approach, he would soon get into trouble. Each tender was organized by Pro-Tender, Kosice. The tender for the purchase of linear accelerators observed all the legal regulations. For each hospital there was only one offer and so it won. No-one complained, because each company got an order. Amedis Piestany will deliver a Varian product to Bystrica. In Narodny onkologicky ustav in Bratislava the winner was Transkontakt with Elekta products. And in Presov it was Ad Rem from Dunajska Streda that succeeded. The small company owned by a local vet joined up with Siemens and is now opening the doors of state-owned and regional hospitals to the company. (authors)

  12. Palliative care in Africa: a global challenge.

    Science.gov (United States)

    Ntizimira, Christian R; Nkurikiyimfura, Jean Luc; Mukeshimana, Olive; Ngizwenayo, Scholastique; Mukasahaha, Diane; Clancy, Clare

    2014-01-01

    We are often asked what challenges Rwanda has faced in the development of palliative care and its integration into the healthcare system. In the past, patients have been barred from accessing strong analgesics to treat moderate to severe pain, but thanks to health initiatives, this is slowly changing. Rwanda is an example of a country where only a few years ago, access to morphine was almost impossible. Albert Einsten said 'in the middle of difficulty lies opportunity' and this sentiment could not be more relevant to the development of palliative care programmes. Through advocacy, policy, and staunch commitment to compassion, Rwandan healthcare workers are proving how palliative care can be successfully integrated into a healthcare system. As a global healthcare community, we should be asking what opportunities exist to do this across the African continent. Champions of palliative care have a chance to forge lasting collaborations between international experts and African healthcare workers. This global network could not only advocate for palliative care programmes but it would also help to create a culture where palliative care is viewed as a necessary part of all healthcare systems.

  13. Introducing Pharmaceutical Care to Primary Care in Iceland—An Action Research Study

    Directory of Open Access Journals (Sweden)

    Anna Bryndis Blondal

    2017-04-01

    Full Text Available Even though pharmaceutical care is not a new concept in pharmacy, its introduction and development has proved to be challenging. In Iceland, general practitioners are not familiar with pharmaceutical care and additionally no such service is offered in pharmacies or primary care settings. Introducing pharmaceutical care in primary care in Iceland is making great efforts to follow other countries, which are bringing the pharmacist more into patient care. General practitioners are key stakeholders in this endeavor. The aim of this study was to introduce pharmacist-led pharmaceutical care into primary care clinics in Iceland in collaboration with general practitioners by presenting different setting structures. Action research provided the framework for this research. Data was collected from pharmaceutical care interventions, whereby the pharmaceutical care practitioner ensures that each of a patient’s medications is assessed to determine if it is appropriate, effective, safe, and that the patient can take medicine as expected. Sources of data included pharmaceutical care notes on patients, researcher’s notes, meetings, and interviews with general practitioners over the period of the study. The study ran from September 2013 to October 2015. Three separate semi-structured in-depth interviews were conducted with five general practitioners from one primary health care clinic in Iceland at different time points throughout the study. Pharmaceutical care was provided to elderly patients (n = 125 before and between general practitioners’ interviews. The study setting was a primary care clinic in the Reykjavik area and the patients’ homes. Results showed that the GPs’ knowledge about pharmacist competencies as healthcare providers and their potential in patient care increased. GPs would now like to have access to a pharmacist on a daily basis. Direct contact between the pharmacist and GPs is better when working in the same physical space

  14. Maternity Care Update: Postpartum Care.

    Science.gov (United States)

    Smith, Andrew; Barr, Wendy B; Bassett-Novoa, Erin; LeFevre, Nicholas

    2018-04-01

    Family physicians are uniquely situated to play a major role in postpartum care. Postpartum issues that should be monitored and addressed include reproductive and contraceptive planning, breastfeeding counseling and support, and maternal mental health. All women should be screened for postpartum depression using a validated tool at the postpartum visit and/or at well-child visits. Patients with positive screening results should be offered support and treatment. Women are more likely to breastfeed if they are provided with breastfeeding support and counseling routinely during the prenatal and postpartum periods. All women should be asked about their reproductive life plans, counseled about potential risks associated with short and prolonged interpregnancy intervals, and offered contraception. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  15. Integrated care.

    Science.gov (United States)

    Warwick-Giles, Lynsey; Checkland, Kath

    2018-03-19

    Purpose The purpose of this paper is to try and understand how several organisations in one area in England are working together to develop an integrated care programme. Weick's (1995) concept of sensemaking is used as a lens to examine how the organisations are working collaboratively and maintaining the programme. Design/methodology/approach Qualitative methods included: non-participant observations of meetings, interviews with key stakeholders and the collection of documents relating to the programme. These provided wider contextual information about the programme. Comprehensive field notes were taken during observations and analysed alongside interview transcriptions using NVIVO software. Findings This paper illustrates the importance of the construction of a shared identity across all organisations involved in the programme. Furthermore, the wider policy discourse impacted on how the programme developed and influenced how organisations worked together. Originality/value The role of leaders from all organisations involved in the programme was of significance to the overall development of the programme and the sustained momentum behind the programme. Leaders were able to generate a "narrative of success" to drive the programme forward. This is of particular relevance to evaluators, highlighting the importance of using multiple methods to allow researchers to probe beneath the surface of programmes to ensure that evidence moves beyond this public narrative.

  16. Diabetic and Obese Patient Clinical Outcomes Improve During a Care Management Implementation in Primary Care.

    Science.gov (United States)

    Holtrop, Jodi Summers; Luo, Zhehui; Piatt, Gretchen; Green, Lee A; Chen, Qiaoling; Piette, John

    2017-10-01

    To address the increasing burden of chronic disease, many primary care practices are turning to care management and the hiring of care managers to help patients coordinate their care and self-manage their conditions. Care management is often, but not always, proving effective at improving patient outcomes, but more evidence is needed. In this pair-matched cluster randomized trial, 5 practices implemented care management and were compared with 5 comparison practices within the same practice organization. Targeted patients included diabetic patients with a hemoglobin A1c >9% and nondiabetic obese patients. Clinical values tracked were A1c, blood pressure, low-density lipoprotein, microalbumin, and weight. Clinically important improvements were demonstrated in the intervention versus comparison practices, with diabetic patients improving A1c control and obese patients experiencing weight loss. There was a 12% relative increase in the proportion of patients meeting the clinical target of A1c management practices lost 5% or more of their body weight as compared with 10% of comparison patients (adjusted relative improvement, 15%; CI, 2%-28%). These findings add to the growing evidence-base for the effectiveness of care management as an effective clinical practice with regard to improving diabetes- and obesity-related outcomes.

  17. Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

    Science.gov (United States)

    Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

    2015-11-14

    Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

  18. RFID Continuance Usage Intention in Health Care Industry.

    Science.gov (United States)

    Iranmanesh, Mohammad; Zailani, Suhaiza; Nikbin, Davoud

    Radio-frequency identification (RFID) has been proved to be an effective tool both for improving operational efficiency and for gaining competitive advantage in the health care industry despite its relatively low-usage rate in hospitals. The sustained use of RFID by health care professionals will promote its development in the long term. This study evaluates the acceptance continuance of RFID among health care professionals through technology continuance theory (TCT). Data were collected from 178 medical professionals in Malaysia and were then analyzed using the partial least squares technique. The analysis showed that the TCT model provided not only a thorough understanding of the continuance behavior of health care professionals toward RFID but also the attitudes, satisfaction, and perceived usefulness of professionals toward it. The results of this study are expected to assist policy makers and managers in the health care industry in implementing the RFID technology in hospitals by understanding the determinants of continuance of RFID usage intention.

  19. Caring for home-based care workers

    African Journals Online (AJOL)

    Winnie

    Explore the emotional impacts of care work for THBC frontline care workers to determine what ... Although rates of testing are low, 83% of participants would consider undergoing ... to promote the importance of VCT and the benefits of ARV.

  20. Palliative Care in Romania.

    Science.gov (United States)

    Mosoiu, Daniela; Mitrea, Nicoleta; Dumitrescu, Malina

    2018-02-01

    HOSPICE Casa Sperantei has been pioneering palliative care development in Romania since 1992. The have developed specialist palliative care services in home-based settings, inpatient units, day care centers, and as hospital support teams. They have provided national and international education programs for professionals in the palliative care field, as well as promoting palliative care integration in the health care system. Legislative improvements were adopted, including funding mechanisms for the reimbursement of palliative care services through the health insurance funds, review of opioid policy, and quality standards of care. By the end of 2015, Romania had 115 specialist palliative care services (78 palliative care inpatient units, 24 home-based palliative care services, five outpatient palliative care clinics, four day care centers, and four hospital support teams). A palliative care subspecialty for doctors was recognized as early as 2000, and a multidisciplinary master's degree program has been available at Transilvania University since 2010, when the first palliative care academic position was established. Nursing education includes mandatory palliative care modules in nursing schools. For coordinated development of palliative care at the national level, a national strategy was proposed defining three levels of palliative care provision, local, district, and national. The implementation of the palliative care strategy is partially funded through a World Bank loan. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Nursing Care and Parents Contribution in the Care of their Childern with Hypospadias

    Directory of Open Access Journals (Sweden)

    Marianna Orfanidou

    2010-01-01

    Full Text Available The term hypospadias is derived from the Greek language and refers to the pathological condition of urethra, which the vestibule, by the time of embryology is imperfect. Approximately 1 to 300 male births appear this problem. The aim of this study is the best quality of nursing management. It is proved that the child recover earlier when the parents involved in care, so it is important to explain the procedure, educate parents about the care after leaving the hospital and to make sure that there are no questions unanswered. The new techniques, the nursing management and the parents’ contribution in care promote to reduce hypospadias hospitalization and so, the less suffering.

  2. Infant Care--Does Anybody Care?

    Science.gov (United States)

    Mills, Belen C.; And Others

    1988-01-01

    Discusses infant care in the United States by comparing U.S. practices of infant care to that in other industrialized nations. Suggests that in comparison to several other industrialized nations, the U.S. falls behind in providing support for mothers either to stay at home or to have quality alternative child care. (RJC)

  3. Office of Child Care

    Science.gov (United States)

    ... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... about the Child Care Rule > What is the Office of Child Care (OCC)? The Office of Child ...

  4. Critical Care Team

    Science.gov (United States)

    ... often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with the patient, the family and the care team. A registered nurse (RN) who is certified in critical care is ...

  5. Respiratory Home Health Care

    Science.gov (United States)

    ... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

  6. Value of care - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Value of care displays – national data. This data set includes national-level data for the value of care displays associated with an episode of care for heart...

  7. Your Dialysis Care Team

    Science.gov (United States)

    ... A to Z Health Guide Your Dialysis Care Team Tweet Share Print Email Good health care is ... dialyzers (artificial kidneys) for reuse. Vascular Access Care Team If you are a hemodialysis patient, another group ...

  8. Your cancer care team

    Science.gov (United States)

    ... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...

  9. The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.

    Science.gov (United States)

    Alfieri, Emanuela; Ferrini, Anna Chiara; Gianfrancesco, Francesca; Lise, Gianluca; Messana, Giovanni; Tirelli, Lorenzo; Lorenzo, Ana; Sarli, Leopoldo

    2017-03-15

    's profile has been drafted on the basis of the comparative analysis conducted. It has been noted how the Case/Care Manager's professional profile can really improve relationships and communications between medical staff and patients, promoting a major unity among the working team. According to the present research, the Case/Care Manager's profile has been proved helpful in positively influencing the team activity and to elicit major satisfaction both in patients and their family.

  10. Neural networks prove effective at NOx reduction

    Energy Technology Data Exchange (ETDEWEB)

    Radl, B.J. [Pegasus Technologies, Mentor, OH (USA)

    2000-05-01

    The availability of low cost computer hardware and software is opening up possibilities for the use of artificial intelligence concepts, notably neural networks, in power plant control applications, delivering lower costs, greater efficiencies and reduced emissions. One example of a neural network system is the NeuSIGHT combustion optimisation system, developed by Pegasus Technologies, a subsidiary of KFx Inc. It can help reduce NOx emissions, improve heat rate and enable either deferral or elimination of capital expenditures. on other NOx control technologies, such as low NOx burners, SNCR and SCR. This paper illustrates these benefits using three recent case studies. 4 figs.

  11. How to prove the existence of metabolons?

    DEFF Research Database (Denmark)

    Bassard, Jean-Étienne André; Halkier, Barbara Ann

    2017-01-01

    Sequential enzymes in biosynthetic pathways are organized in metabolons. It is challenging to provide experimental evidence for the existence of metabolons as biosynthetic pathways are composed of highly dynamic protein–protein interactions. Many different methods are being applied, each with str...

  12. Proving maintenance practices at France's CETIC facility

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    CETIC, a PWR maintenance testing, training and validation centre became operational in September 1986. It is designed to meet the following basic requirements: development of plant maintenance processes to reduce work time, validation of tools for use during maintenance, training and qualification of teams for performing high-technology, high-risk operations in nuclear power plants. (U.K.)

  13. Pre-wired systems prove their worth.

    Science.gov (United States)

    2012-03-01

    The 'new generation' of modular wiring systems from Apex Wiring Solutions have been specified for two of the world's foremost teaching hospitals - the Royal London and St Bartholomew's Hospital, as part of a pounds sterling 1 billion redevelopment project, to cut electrical installation times, reduce on-site waste, and provide a pre-wired, factory-tested, power and lighting system. HEJ reports.

  14. NUPEC proves reliability of LWR fuel assemblies

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    It is very important in assuring the safety of nuclear reactors to confirm the reliability of fuel assemblies. The test program of the Nuclear Power Engineering Center on the reliability of fuel assemblies has verified the high performance and reliability of Japanese LWR fuels, and confirmed the propriety of their design and fabrication. This claim is based on the data obtained from the fuel assemblies irradiated in commercial reactors. The NUPEC program includes irradiation test which has been conducted for 11 years since fiscal 1976, and the maximum thermal loading test using the out of pile test facilities simulating a real reactor which has been continued since fiscal 1978. The irradiation test on BWR fuel assemblies in No.3 reactor in Fukushima No.1 Nuclear Power Station, Tokyo Electric Power Co., Inc., and on PWR fuel assemblies in No.3 reactor in Mihama Power Station, Kansai Electric Power Co., Inc., and the maximum thermal loading test on BWR and PWR fuel assemblies are reported. The series of postirradiation examination of the fuel assemblies used for commercial reactors was conducted for the first time in Japan, and the highly systematic data on 27 items were obtained. (Kako, I.)

  15. Vehicle Test Facilities at Aberdeen Proving Ground

    Science.gov (United States)

    1981-07-06

    warehouse and rough terrain forklifts. Two 5-ton-capacity manual chain hoists at the rear of the table regulate its slope from 0 to 40 percent. The overall...Capacity at 24-Inch Load Center. 5. TOP/ HTP 2-2-608, Braking, Wheeled Vehicles, 15 Jav.&ry 1971. 6. TOP 2-2-603, Vehicle Fuel Consumption, 1 November 1977. A-1 r -. ’,’

  16. Has the Effect of Mesotherapy Been Proved?

    OpenAIRE

    Gonca Gökdemir

    2009-01-01

    Mesotherapy is a medical technique that consist of the intracutaneous or subcutaneous injection to the diseased area. It has become as a populer treatment method in cosmetic dermatology recently. Mesotherapy has been used in the treatment of skin rejuvenation, cellulite and localized fat reduction. Substances using in mesotherapy are plant extracts, homeopathic agents, vitamins, and some pharmaceuticals. The effect of these agents are not completely known. There are few experimental and clini...

  17. Has the Effect of Mesotherapy Been Proved?

    Directory of Open Access Journals (Sweden)

    Gonca Gökdemir

    2009-06-01

    Full Text Available Mesotherapy is a medical technique that consist of the intracutaneous or subcutaneous injection to the diseased area. It has become as a populer treatment method in cosmetic dermatology recently. Mesotherapy has been used in the treatment of skin rejuvenation, cellulite and localized fat reduction. Substances using in mesotherapy are plant extracts, homeopathic agents, vitamins, and some pharmaceuticals. The effect of these agents are not completely known. There are few experimental and clinical studies evaluating the efficacy of mesotherapy in any form. In this report, it has been reviewed studies about the effect of compounds commonly used in mesotherapy in literature.

  18. Proving the ecosystem value through hydrological modelling

    International Nuclear Information System (INIS)

    Dorner, W; Spachinger, K; Metzka, R; Porter, M

    2008-01-01

    Ecosystems provide valuable functions. Also natural floodplains and river structures offer different types of ecosystem functions such as habitat function, recreational area and natural detention. From an economic stand point the loss (or rehabilitation) of these natural systems and their provided natural services can be valued as a damage (or benefit). Consequently these natural goods and services must be economically valued in project assessments e.g. cost-benefit-analysis or cost comparison. Especially in smaller catchments and river systems exists significant evidence that natural flood detention reduces flood risk and contributes to flood protection. Several research projects evaluated the mitigating effect of land use, river training and the loss of natural flood plains on development, peak and volume of floods. The presented project analysis the hypothesis that ignoring natural detention and hydrological ecosystem services could result in economically inefficient solutions for flood protection and mitigation. In test areas, subcatchments of the Danube in Germany, a combination of hydrological and hydrodynamic models with economic evaluation techniques was applied. Different forms of land use, river structure and flood protection measures were assed and compared from a hydrological and economic point of view. A hydrodynamic model was used to simulate flows to assess the extent of flood affected areas and damages to buildings and infrastructure as well as to investigate the impacts of levees and river structure on a local scale. These model results provided the basis for an economic assessment. Different economic valuation techniques, such as flood damage functions, cost comparison method and substation-approach were used to compare the outcomes of different hydrological scenarios from an economic point of view and value the ecosystem service. The results give significant evidence that natural detention must be evaluated as part of flood mitigation projects. In addition can be stated that the loss of detention due to land use and dikes can be called an externality and results in economic inefficiencies.

  19. Interval logic. Proof theory and theorem proving

    DEFF Research Database (Denmark)

    Rasmussen, Thomas Marthedal

    2002-01-01

    of a direction of an interval, and present a sound and complete Hilbert proof system for it. Because of its generality, SIL can conveniently act as a general formalism in which other interval logics can be encoded. We develop proof theory for SIL including both a sequent calculus system and a labelled natural...

  20. Historic Building Inventory, Aberdeen Proving Ground, Maryland

    Science.gov (United States)

    1982-01-01

    installation into compliance with the National Historic Preservation Act of i9bo ana its amendments, and related federal laws and regulations. To this ena, the...century. OLD BALTIMORE The first formal authorization for the establishment of a Court House was the 1674 Act of Assembly for the construction of a Court...official recorded meeting at the Court House was in 1692, at which Thomas Heath, innkeeper , filed suit for expenses incurreo by tne Justices at the 1687

  1. PROVE IDRAULICHE SU UN SEMOVENTE IRRIGUO

    Directory of Open Access Journals (Sweden)

    Giuseppe Taglioli

    2007-09-01

    Full Text Available The correct management of the irrigation is a well known factor of success in agriculture, even as regard the water saving. As a consequence it was tested here a very common medium sized hose-reel irrigation machine, known in Italy as rotolone. Several hydraulic and technical aspects were investigated, in two tests on a 3 ha field: – the hydraulic distribution on the field, measured by means of 55 rainfall meter; – the uniformity of the forward speed and the effectiveness of the controller; – the effect of the standstill times on distribution quality; – the hydraulic performance declared by the manufacturer; – the water consumption, the manpower requirements; – the quality of irrigation. Moreover a theoretical analysis of the best overlapping between the range of two adjacent sprinkler was developed. The tests have shown the importance of the regularization of the backward speed: in lack of this the variations can reach the value of 70%. The value of 85% in overlapping of wetted areas, recommended by manufacturers, was theoretically justified. The measured mean range, at the recommended pressure, was 10% lower than declared by manufacturer. The rain hourly intensity was too high for the needing of the clay soil of the field. The jet spraying was coarse in relationship to the clay fraction of the soil but not for the crop (maize. The hose-reel irrigation machine examined here, can maintain an high level of feasibility if some improvement were adopted.

  2. Eternity Variables to Prove Simulation of Specifications

    NARCIS (Netherlands)

    Hesselink, Wim H.

    2005-01-01

    Simulations of specifications are introduced as a unification and generalization of refinement mappings, history variables, forward simulations, prophecy variables, and backward simulations. A specification implements another specification if and only if there is a simulation from the first one to

  3. The Importance of Proving the Null

    Science.gov (United States)

    Gallistel, C. R.

    2009-01-01

    Null hypotheses are simple, precise, and theoretically important. Conventional statistical analysis cannot support them; Bayesian analysis can. The challenge in a Bayesian analysis is to formulate a suitably vague alternative, because the vaguer the alternative is (the more it spreads out the unit mass of prior probability), the more the null is…

  4. Proving correctness of compilers using structured graphs

    DEFF Research Database (Denmark)

    Bahr, Patrick

    2014-01-01

    it into a compiler implementation using a graph type along with a correctness proof. The implementation and correctness proof of a compiler using a tree type without explicit jumps is simple, but yields code duplication. Our method provides a convenient way of improving such a compiler without giving up the benefits...

  5. Thirteen proves lucky number at Ipswich.

    Science.gov (United States)

    Coppard, Mark

    2008-10-01

    At one of East Anglia's largest hospitals, OCS Healthcare claims to have contributed to a "remarkable climate of change" with 13 specialist services, bringing tangible benefits to the half million people served by The Ipswich Hospital NHS Trust. The head of OCS Healthcare, Mark Coppard, describes what the company dubs an "exemplar of private sector expertise supporting public healthcare excellence".

  6. Using NFC phones for proving credentials

    NARCIS (Netherlands)

    Alpár, G.; Batina, L.; Verdult, R.

    2012-01-01

    In this paper we propose a new solution for mobile payments called Tap2 technology. To use it, users need only their NFC-enabled mobile phones and credentials implemented on their smart cards. An NFC device acts like a bridge between service providers and secure elements and the secure credentials

  7. What Carroll’s Tortoise Actually Proves

    NARCIS (Netherlands)

    Wieland, J.J.W.

    2013-01-01

    Rationality requires us to have certain propositional attitudes (beliefs, intentions, etc.) given certain other attitudes that we have. Carroll's Tortoise repeatedly shows up in this discussion. Following up on Brunero (Ethical Theory Moral Pract 8:557-569, 2005), I ask what Carroll-style

  8. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  9. Community-Based Care

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

  10. Palliative or Comfort Care

    Science.gov (United States)

    ... is not under control Need help understanding your situation and coordinating care PALLIATIVE CARE Often a team of specialists provides palliative care. The team usually includes: Palliative care doctors and nurses Social workers and chaplains Pharmacists and nutritionists Counselors and others ...

  11. Workplace Financial Wellness Programs Help Employees Manage Health Care Changes.

    Science.gov (United States)

    Meyer, Cynthia; Smith, Michael C

    Employers and employees are navigating major changes in health insurance benefits, including the move to high-deductible health plans in conjunction with health savings accounts (HSAs). The HSA offers unique benefits that could prove instrumental in helping workers both navigate current health care expenses and build a nest egg for much larger health care costs in retirement. Yet employees often don't understand the HSA and how to best use it. How can employers help employees make wise benefits choices that work for their personal financial circumstances?

  12. Care Aides' Relational Practices and Caring Contributions.

    Science.gov (United States)

    Andersen, Elizabeth A; Spiers, Jude

    2016-11-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Care Aides' Relational Practices and Caring Contributions" found on pages 24-30, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Define the application of Swanson's Middle Range Theory of Caring in care aides' relational care practices for nursing home

  13. Balancing personalized medicine and personalized care.

    Science.gov (United States)

    Cornetta, Kenneth; Brown, Candy Gunther

    2013-03-01

    The current description of personalized medicine by the National Institutes of Health is "the science of individualized prevention and therapy." Although physicians are beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act on personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. Because these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care.

  14. [Medication errors in Spanish intensive care units].

    Science.gov (United States)

    Merino, P; Martín, M C; Alonso, A; Gutiérrez, I; Alvarez, J; Becerril, F

    2013-01-01

    To estimate the incidence of medication errors in Spanish intensive care units. Post hoc study of the SYREC trial. A longitudinal observational study carried out during 24 hours in patients admitted to the ICU. Spanish intensive care units. Patients admitted to the intensive care unit participating in the SYREC during the period of study. Risk, individual risk, and rate of medication errors. The final study sample consisted of 1017 patients from 79 intensive care units; 591 (58%) were affected by one or more incidents. Of these, 253 (43%) had at least one medication-related incident. The total number of incidents reported was 1424, of which 350 (25%) were medication errors. The risk of suffering at least one incident was 22% (IQR: 8-50%) while the individual risk was 21% (IQR: 8-42%). The medication error rate was 1.13 medication errors per 100 patient-days of stay. Most incidents occurred in the prescription (34%) and administration (28%) phases, 16% resulted in patient harm, and 82% were considered "totally avoidable". Medication errors are among the most frequent types of incidents in critically ill patients, and are more common in the prescription and administration stages. Although most such incidents have no clinical consequences, a significant percentage prove harmful for the patient, and a large proportion are avoidable. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  15. Kidney stones - self-care

    Science.gov (United States)

    ... self-care; Nephrolithiasis and self-care; Stones and kidney - self-care; Calcium stones and self-care; Oxalate ... provider or the hospital because you have a kidney stone. You will need to take self-care ...

  16. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.

    2014-01-01

    The aim of this study is to introduce the concept of care capital and provide an example of its application in the context of child care and maternal employment using the currently most suitable American data. We define care capital as the nexus of available, accessible, and experienced resources...... for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national context. In the presented application of care capital, we examine mothers’ entry to paid......-parental child care prior to employment is independently and positively associated with the timing of maternal employment entry. This finding applies both to first-time mothers (n = 3,800) and to mothers of multiple children (n = 6,600). Although data currently available for investigating child care capital...

  17. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  18. Let's put "care" back into health care.

    Science.gov (United States)

    Wesolowski, C E

    1990-01-01

    Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?

  19. Nursing: caring or codependent?

    Science.gov (United States)

    Caffrey, R A; Caffrey, P A

    1994-01-01

    Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.

  20. Validation of Surgical Intensive Care-Infection Registry: a medical informatics system for intensive care unit research, quality of care improvement, and daily patient care.

    Science.gov (United States)

    Golob, Joseph F; Fadlalla, Adam M A; Kan, Justin A; Patel, Nilam P; Yowler, Charles J; Claridge, Jeffrey A

    2008-08-01

    We developed a prototype electronic clinical information system called the Surgical Intensive Care-Infection Registry (SIC-IR) to prospectively study infectious complications and monitor quality of care improvement programs in the surgical and trauma intensive care unit. The objective of this study was to validate SIC-IR as a successful health information technology with an accurate clinical data repository. Using the DeLone and McLean Model of Information Systems Success as a framework, we evaluated SIC-IR in a 3-month prospective crossover study of physician use in one of our two surgical and trauma intensive care units (SIC-IR unit versus non SIC-IR unit). Three simultaneous research methodologies were used: a user survey study, a pair of time-motion studies, and an accuracy study of SIC-IR's clinical data repository. The SIC-IR user survey results were positive for system reliability, graphic user interface, efficiency, and overall benefit to patient care. There was a significant decrease in prerounding time of nearly 4 minutes per patient on the SIC-IR unit compared with the non SIC-IR unit. The SIC-IR documentation and data archiving was accurate 74% to 100% of the time depending on the data entry method used. This accuracy was significantly improved compared with normal hand-written documentation on the non SIC-IR unit. SIC-IR proved to be a useful application both at individual user and organizational levels and will serve as an accurate tool to conduct prospective research and monitor quality of care improvement programs.

  1. Empowering women and health care.

    Science.gov (United States)

    Shiva, M

    1993-02-01

    Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e

  2. Differential susceptibility to parenting and quality child care.

    Science.gov (United States)

    Pluess, Michael; Belsky, Jay

    2010-03-01

    Research on differential susceptibility to rearing suggests that infants with difficult temperaments are disproportionately affected by parenting and child care quality, but a major U.S. child care study raises questions as to whether quality of care influences social adjustment. One thousand three hundred sixty-four American children from reasonably diverse backgrounds were followed from 1 month to 11 years with repeated observational assessments of parenting and child care quality, as well as teacher report and standardized assessments of children's cognitive-academic and social functioning, to determine whether those with histories of difficult temperament proved more susceptible to early rearing effects at ages 10 and 11. Evidence for such differential susceptibility emerges in the case of both parenting and child care quality and with respect to both cognitive-academic and social functioning. Differential susceptibility to parenting and child care quality extends to late middle childhood. J. Belsky, D. L. Vandell, et al.'s (2007) failure to consider such temperament-moderated rearing effects in their evaluation of long-term child care effects misestimates effects of child care quality on social adjustment.

  3. Dementia Care: Intersecting Informal Family Care and Formal Care Systems

    Directory of Open Access Journals (Sweden)

    Prabhjot Singh

    2014-01-01

    Full Text Available Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions related to ageing. This paper is based on a qualitative study undertaken in the Australian state of Queensland and explores issues of access to and use of formal services in dementia care from the perspective of the informal family carers. It identifies three critical points at which changes in policy and practice in the formal care system could improve the capability of informal carers to continue to care for their family member with dementia: when symptoms first become apparent and a diagnosis is sought; when the condition of the person with dementia changes resulting in a change to their support needs; and when the burden of informal care being experienced by the carer is so great that some form of transition appears to be immanent in the care arrangement.

  4. Lessons from the implementation of a near patient anticoagulant monitoring service in primary care

    Directory of Open Access Journals (Sweden)

    Simon DeLusignan

    2004-02-01

    Conclusions The group, by sharing their experiences through a structured series of workshops, developed an understanding of when it might be appropriate to vary from the decision support software’s recommendations and how this could be audited. The technological solution modelled on hospital practice proved hard to implement in primary care.

  5. US EPA CARE Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...

  6. What is palliative care?

    Science.gov (United States)

    ... A Guide to Advance Directives, the Health Care Power of Attorney, and Other Key Documents . Cambridge, MA: Harvard Health Publications. 2013. Oxenham D. Palliative care and pain. In: Walker BR, Colledge NR, Ralston SH, Penman ...

  7. Skin care and incontinence

    Science.gov (United States)

    ... skin care; Incontinence - pressure sore; Incontinence - pressure ulcer Patient Instructions Preventing pressure ulcers Images Male urinary system References Holroyd S. Incontinence-associated dermatitis: identification, prevention and care. Br J Nurs . 2015;24( ...

  8. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  9. Day Care Centers

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...

  10. Child Care Program Office

    Science.gov (United States)

    Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program the proposed regulation changes, including the potential costs to private persons of complying with Heating Assistance Medicaid Senior Benefits Temporary Assistance Get Help Food Health Care Cash Child Care

  11. Dental care - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002213.htm Dental care - child To use the sharing features on ... please enable JavaScript. Proper care of your child's teeth and gums includes brushing and rinsing daily. It ...

  12. Contact Lens Care

    Science.gov (United States)

    ... Consumers Consumer Information by Audience For Women Contact Lens Care Share Tweet Linkedin Pin it More sharing ... www.fda.gov/medwatch Learn More about Contact Lens Care Other Tips on Contact Lenses Decorative Contact ...

  13. Prenatal Care Checkup

    Science.gov (United States)

    ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  14. Palliative care - managing pain

    Science.gov (United States)

    ... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... stressful for you and your family. But with treatment, pain can be managed. How Pain is Measured ...

  15. Making care affordable.

    Science.gov (United States)

    Solomon, S

    1999-01-01

    The YRG Centre for AIDS Research and Education (CARE) in Chennai, India runs an integrated care program ensuring appropriate and affordable care to everyone who needs it. The program includes both voluntary counseling/testing and hospital/home-based care. YRG CARE developed several strategies for the care program, which include 1) different fees for an HIV test, 2) free counseling service, 3) different charges for other care services, 4) a subsidized pharmacy (involving purchasing drugs directly from manufacturers and wholesalers, ordering free samples from manufacturers, and acquiring drugs through the drug component of its clinical research projects, from overseas hospitals, and from YRG CARE hospital and community-based patients who have not used them), and 5) subsidized meals.

  16. The Epital Care Model

    DEFF Research Database (Denmark)

    Phanareth, Klaus; Vingtoft, Søren; Christensen, Anders Skovbo

    2017-01-01

    BACKGROUND: There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors...... and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports...... the intentions of the World Health Organization (WHO) to have integrated people-centered care. OBJECTIVE: To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care...

  17. Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings.

    Science.gov (United States)

    Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

    2014-09-01

    To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.

  18. Who Cares? Care and the Ethical Self

    Directory of Open Access Journals (Sweden)

    Monique Lanoix

    2015-09-01

    Full Text Available Over three decades ago, Carol Gilligan’s seminal book In a Different Voice provided feminist theorists with a powerful new approach to address the shortcomings of traditional moral theories. With a focus on concrete situations, an ethics of care can attend to the specifics of moral dilemmas that might otherwise be glossed over. As feminist reflection on moral and political philosophizing has progressed, another challenge has emerged. Recent feminist scholarship proposes non-ideal theories as preferable action-guiding theories. In this paper, I examine Kittay’s call for a version of care ethics as a naturalized ethics that comes from lived experience, in order to draw out the salient characteristics of the caring agent. This allows me to show how Kittay’s key assertion that “we are all some mother’s child” resonates with Ricoeur’s framing of self-esteem, which is, in turn, anchored on a notion of solicitude. Secondly, I make the case that care ethics can benefit from Ricoeur’s little ethics as it helps buttress the goal of good caring practices. Finally, care ethics, with its emphasis on the universality of care needs, helps to strengthen the central role of solicitude for the political sphere.

  19. "Patient care in radiology"

    DEFF Research Database (Denmark)

    Bro Brask, Kirsten; Birkelund, Regner

    2014-01-01

    The aim of this study was to research how the staff experience care expressed during the brief encounter with the patients in a diagnostic imaging department. This was a qualitative study with a phenomenological and hermeneutical frame of reference. The data were collected using field observation...... was electronically forwarded. And, care expressed in between was perceived as care in the traditional sense and termed as “patient care in radiology.”...

  20. Developing nursing care plans.

    Science.gov (United States)

    Ballantyne, Helen

    2016-02-24

    This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.

  1. Consumer Directed Health Care

    OpenAIRE

    John Goodman

    2006-01-01

    Consumer driven health care (CDHC) is a potential solution to two perplexing problems: (1) How to choose between health care and other uses of money, and (2) how to allocate resources in an industry where normal market forces have been systemically suppressed. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care that they receive. From an employee benefits perspective, consumer driven health care in the broadest sense may refer to limited e...

  2. Robots in Elderly Care

    OpenAIRE

    Alessandro Vercelli; Innocenzo Rainero; Ludovico Ciferri; Marina Boido; Fabrizio Pirri

    2018-01-01

    Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general p...

  3. Empowering and caring professionals

    DEFF Research Database (Denmark)

    Hansen, Agnete Meldgaard

    to the new practice of rehabilitative elderly care. The care workers are found to be balancing complex and contradicting identities as ‘paradigm shifters’ who are reforming traditional understandings of care; as facilitators of the choices and control of citizens; as promoters of responsibility and guards...

  4. Day Care: Other Countries.

    Science.gov (United States)

    Hjartarson, Freida; And Others

    This collection of 5 bilingual papers on day care programs in foreign countries (China, the Soviet Union, and 3 Scandinavian countries) is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Paper I considers day care services in…

  5. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  6. Wound care centers

    Science.gov (United States)

    Pressure ulcer - wound care center; Decubitus ulcer - wound care center; Diabetic ulcer - wound care center; Surgical wound - wound ... Common types of non-healing wounds include: Pressure sores Surgical ... flow, or swollen legs Certain wounds may not heal well due to: ...

  7. Special informal care

    NARCIS (Netherlands)

    Y. Wittenberg; M.H. Kwekkeboom; A.H. de Boer

    2012-01-01

    Original title: Bijzondere mantelzorg The notion of informal care generally conjures up a picture of care provided to older persons by relatives and friends. However, people with psychiatric problems or intellectual disabilities also receive a great deal of care from those close to them. As

  8. Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care.

    Science.gov (United States)

    Klop, Hanna T; de Veer, Anke J E; van Dongen, Sophie I; Francke, Anneke L; Rietjens, Judith A C; Onwuteaka-Philipsen, Bregje D

    2018-04-24

    Homeless people often suffer from complex and chronic comorbidities, have high rates of morbidity and die at much younger ages than the general population. Due to a complex combination of physical, psychosocial and addiction problems at the end of life, they often have limited access to palliative care. Both the homeless and healthcare providers experience a lot of barriers. Therefore, providing palliative care that fits the needs and concerns of the homeless is a challenge to healthcare providers. This systematic review aims to summarize evidence about the concerns, palliative care needs and preferences of homeless people, as well as barriers and facilitators for delivering high quality palliative care. PubMed, Embase, PsycINFO, CINAHL and Web of Science were searched up to 10 May 2016. Included were studies about homeless people with a short life expectancy, their palliative care needs and the palliative care provided, that were conducted in Western countries. Data were independently extracted by two researchers using a predefined extraction form. Quality was assessed using a Critical Appraisal instrument. The systematic literature review was based on the PRISMA statement. Twenty-seven publications from 23 different studies met the inclusion criteria; 15 studies were qualitative and eight were quantitative. Concerns of the homeless often related to end-of-life care not being a priority, drug dependence hindering adequate care, limited insight into their condition and little support from family and relatives. Barriers and facilitators often concerned the attitude of healthcare professionals towards homeless people. A respectful approach and respect for dignity proved to be important in good quality palliative care. A patient-centred, flexible and low-threshold approach embodying awareness of the concerns of homeless people is needed so that appropriate palliative care can be provided timely. Training, education and experience of professionals can help to

  9. Managing Cancer Care - Finding Health Care Services

    Science.gov (United States)

    ... my condition? Has it been rated by state, consumer, or other groups for its quality of care? ... be both rewarding and demanding. It can change relationships and require families to cope with all aspects ...

  10. Care respite: taking care of the caregivers

    OpenAIRE

    Alonso, Fernando; Baró, Xavier; Escalera, Sergio; Gonzàlez, Jordi; MacKay, Martha; Serrahima, Anna

    2016-01-01

    Introduction: With an ageing population, the issue of care provision is becoming increasingly critical. Since the aspiration of the majority of older people is to live safely and well at home, housing monitoring will be part of health & care integration in the next decades. As a consequence, a higher proportion of people will have to rely on family, friends or neighbours as their informal caregivers, providing that this group already count as around 80% of all caregivers in the EU). The v...

  11. Palliative care and neurology

    Science.gov (United States)

    Boersma, Isabel; Miyasaki, Janis; Kutner, Jean

    2014-01-01

    Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

  12. Neuroeconomics and Integrated Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    Background: Fragmented specialized care for the frail elderly as claimed by WHO needs horizontal integration across settings. The home of the patient seems to be a promising place to integrate hospital care, primary care and social services for high-risk discharges where the quality...... of rehabilitation makes a difference. Objective: The study aims to reveal how integrated home care may be organised to improve quality of care as compared to usual hospital care. Method: A qualitative case study of the use of a neuroeconomic model in relation to multidisciplianry collaboration on a RCT...... of integrated home care for stroke patients. Results: (1) The classical understanding of CNS is that of a dual system of ANS and Cortex. The new neuroeconomic understanding is that of a reciprocal balance of Limbic System (LS) and Neocortex (NC). This applies directly in favour of integrated homecare compared...

  13. Using wound care algorithms: a content validation study.

    Science.gov (United States)

    Beitz, J M; van Rijswijk, L

    1999-09-01

    Valid and reliable heuristic devices facilitating optimal wound care are lacking. The objectives of this study were to establish content validation data for a set of wound care algorithms, to identify their associated strengths and weaknesses, and to gain insight into the wound care decision-making process. Forty-four registered nurse wound care experts were surveyed and interviewed at national and regional educational meetings. Using a cross-sectional study design and an 83-item, 4-point Likert-type scale, this purposive sample was asked to quantify the degree of validity of the algorithms' decisions and components. Participants' comments were tape-recorded, transcribed, and themes were derived. On a scale of 1 to 4, the mean score of the entire instrument was 3.47 (SD +/- 0.87), the instrument's Content Validity Index was 0.86, and the individual Content Validity Index of 34 of 44 participants was > 0.8. Item scores were lower for those related to packing deep wounds (P valid and reliable definitions. The wound care algorithms studied proved valid. However, the lack of valid and reliable wound assessment and care definitions hinders optimal use of these instruments. Further research documenting their clinical use is warranted. Research-based practice recommendations should direct the development of future valid and reliable algorithms designed to help nurses provide optimal wound care.

  14. Reconciliation of work and care among lone mothers of adults with intellectual disabilities: the role and limits of care capital.

    Science.gov (United States)

    Chou, Yueh-Ching; Kröger, Teppo

    2014-07-01

    In this study, the concept of social capital is applied to an exploration of Guanxi (social networking to create good relationships) among working lone mothers of adults with intellectual disabilities (ID) in Taiwan. Using in-depth interviews, this study explores the role of social capital, here referred to as 'care capital', in making it possible for working lone mothers to combine their roles as family carers and workers. Eleven divorced or widowed mothers combining their paid work with long-term care responsibilities were recruited from a survey or through NGOs and were interviewed at their home between October 2008 and July 2010. An interpretative phenomenological approach was adopted for data analysis. The findings revealed that the mothers' care capital was extremely limited and was lost, gained and lost again during their life-cycles of long-term care-giving. Guanxi, especially in relation to their employers, proved to be the sole source of care capital for these mothers, making reconciliation between work and care responsibilities possible. In the absence of formal or informal support, religion and the mother-child relationship seemed also to become a kind of care capital for these lone mothers, helping them to get by with their life-long care responsibilities. For formal social and healthcare services, not just in Taiwan but in every country, it is important to develop support for lone mothers of adults with ID who have long-term care responsibilities and low levels of care capital and thus face care poverty. © 2014 John Wiley & Sons Ltd.

  15. Nonverbal accommodation in health care communication.

    Science.gov (United States)

    D'Agostino, Thomas A; Bylund, Carma L

    2014-01-01

    This exploratory study examined patterns of nonverbal accommodation within health care interactions and investigated the impact of communication skills training and gender concordance on nonverbal accommodation behavior. The Nonverbal Accommodation Analysis System (NAAS) was used to code the nonverbal behavior of physicians and patients within 45 oncology consultations. Cases were then placed in one of seven categories based on patterns of accommodation observed across the interaction. Results indicated that across all NAAS behavior categories, physician-patient interactions were most frequently categorized as joint convergence, followed closely by asymmetrical-patient convergence. Among paraverbal behaviors, talk time, interruption, and pausing were most frequently characterized by joint convergence. Among nonverbal behaviors, eye contact, laughing, and gesturing were most frequently categorized as asymmetrical-physician convergence. Differences were predominantly nonsignificant in terms of accommodation behavior between pre- and post-communication skills training interactions. Only gesturing proved significant, with post-communication skills training interactions more likely to be categorized as joint convergence or asymmetrical-physician convergence. No differences in accommodation were noted between gender-concordant and nonconcordant interactions. The importance of accommodation behavior in health care communication is considered from a patient-centered care perspective.

  16. Green Care: A Review of the Benefits and Potential of Animal-Assisted Care Farming Globally and in Rural America

    Science.gov (United States)

    Artz, Brianna; Bitler Davis, Doris

    2017-01-01

    Simple Summary The term Green Care encompasses a number of therapeutic strategies that can include farm-animal-assisted therapy, horticultural therapy, and general, farm-based therapy. This review article provides an overview of how Green Care has been used as part of the therapeutic plan for a variety of psychological disorders and related physical disabilities in children, adolescents and adults. While many countries have embraced Green Care, and research-based evidence supports its efficacy in a variety of therapeutic models, it has not yet gained widespread popularity in the United States. We suggest that Green Care could prove to be an effective approach to providing mental health care in the U.S., particularly in rural areas that are typically underserved by more traditional mental health facilities, but have an abundance of farms, livestock, and green spaces where care might be effectively provided. Abstract The term Green Care includes therapeutic, social or educational interventions involving farming; farm animals; gardening or general contact with nature. Although Green Care can occur in any setting in which there is interaction with plants or animals, this review focuses on therapeutic practices occurring on farms. The efficacy of care farming is discussed and the broad utilization of care farming and farm care communities in Europe is reviewed. Though evidence from care farms in the United States is included in this review, the empirical evidence which could determine its efficacy is lacking. For example, the empirical evidence supporting or refuting the efficacy of therapeutic horseback riding in adults is minimal, while there is little non-equine care farming literature with children. The health care systems in Europe are also much different than those in the United States. In order for insurance companies to cover Green Care techniques in the United States, extensive research is necessary. This paper proposes community-based ways that Green Care

  17. Timely and Effective Care - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Timely and Effective Care measures - national data. This data set includes national-level data for measures of heart attack care, heart failure care, pneumonia care,...

  18. Timely and Effective Care - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Timely and Effective Care measures - state data. This data set includes state-level data for measures of heart attack care, heart failure care, pneumonia care,...

  19. Allergic rhinitis - self-care

    Science.gov (United States)

    Hay fever - self-care; Seasonal rhinitis - self-care; Allergies - allergic rhinitis - self-care ... in a row. Talk to your child's health care provider before giving your child decongestants. Nasal corticosteroid ...

  20. Broken toe - self-care

    Science.gov (United States)

    Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

  1. Genital herpes - self-care

    Science.gov (United States)

    Herpes - genital - self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... Genital herpes cannot be cured. Antiviral medicine (acyclovir and related drugs) may relieve pain and discomfort and help ...

  2. Taking Care of Your Hair

    Science.gov (United States)

    ... Educators Search English Español Taking Care of Your Hair KidsHealth / For Teens / Taking Care of Your Hair ... role in how healthy it looks. Caring for Hair How you take care of your hair depends ...

  3. Grounds of necessity to carry out reforms in health care system in Ukraine: historical aspect

    Directory of Open Access Journals (Sweden)

    I. P. Krynychna

    2015-03-01

    Full Text Available The article studies the historical experience of reforming the health care system in Ukraine, which allow clearing up the basic problems of public administration. Thus, the health care legislation is characterized as a fragmentary and complex thing with common overlaps and vaguely defined areas of accountability of financial and material resources and a significant deficit of funding. In turn, there is an urgent need for a fundamental change in strategy of the state policy concerning the restructuring of the health care system, which would involve fundamentally new mechanisms of public administration that must be adapted to the specific social problems and opportunities, particularly in conditions of limited resources. It is determined that reforming the health care systems of the former Soviet Union countries has similar nature with Ukraine, namely: the lack of government funding, poor quality of medical care, high level of medical services payment by citizens, the low level of wages of health care employees, and, as a consequence, the limited availability of the population to qualitative health services. On the basis of the results of the analysis of existing and not solved problems of the health care system it is proved the necessity to introduce new mechanisms of control in this field: the development of a system of compulsory medical insurance; the combination of budget and insurance sources of financing the health care system; the growing funding for the health care system; the development of initial care; adjustment of the state guarantees, according to the state financial opportunities; increasing the wages of health care employees; search for new organizational forms of health care institutions; increase the efficiency of health care resources; privatization and improvement of the structure of the medical care system . Keywords: public administration, health care reform, health insurance, initial care, medical care, medical services

  4. The demise of primary care: a diatribe from the trenches.

    Science.gov (United States)

    Norenberg, David D

    2009-05-19

    Medical school graduates are avoiding primary care. The very aspects that once attracted students have been subverted. The breadth of practice that was once appealing has become the breadth of heavy-handed scrutiny, as politicians and business leaders have demanded quality--simplistically defined as dogmatic adherence to a standard. Individualized clinical judgment has been devalued; thinking has been replaced by algorithms. Practice guidelines have been usurped by pay-for-performance police, on patrol for deviations--not understanding that knowing and allowing for exceptions is the heart and soul of primary care. The coercive surveillance of "Quality Improvement" has become oppressive, making single organ-system specialties increasingly attractive (or at least more tolerable). Generalists are spending so much time proving they are good doctors, they don't have time to be good doctors. A remedy is suggested: a pilot project of volunteer salaried internists (more trusted, less audited) commissioned to our expandable national health care program, Medicare.

  5. Group prenatal care.

    Science.gov (United States)

    Mazzoni, Sara E; Carter, Ebony B

    2017-06-01

    Patients participating in group prenatal care gather together with women of similar gestational ages and 2 providers who cofacilitate an educational session after a brief medical assessment. The model was first described in the 1990s by a midwife for low-risk patients and is now practiced by midwives and physicians for both low-risk patients and some high-risk patients, such as those with diabetes. The majority of literature on group prenatal care uses CenteringPregnancy, the most popular model. The first randomized controlled trial of CenteringPregnancy showed that it reduced the risk of preterm birth in low-risk women. However, recent meta-analyses have shown similar rates of preterm birth, low birthweight, and neonatal intensive care unit admission between women participating in group prenatal care and individual prenatal care. There may be subgroups, such as African Americans, who benefit from this type of prenatal care with significantly lower rates of preterm birth. Group prenatal care seems to result in increased patient satisfaction and knowledge and use of postpartum family planning as well as improved weight gain parameters. The literature is inconclusive regarding breast-feeding, stress, depression, and positive health behaviors, although it is theorized that group prenatal care positively affects these outcomes. It is unclear whether group prenatal care results in cost savings, although it may in large-volume practices if each group consists of approximately 8-10 women. Group prenatal care requires a significant paradigm shift. It can be difficult to implement and sustain. More randomized trials are needed to ascertain the true benefits of the model, best practices for implementation, and subgroups who may benefit most from this innovative way to provide prenatal care. In short, group prenatal care is an innovative and promising model with comparable pregnancy outcomes to individual prenatal care in the general population and improved outcomes in some

  6. [Primary care in Ireland].

    Science.gov (United States)

    Sánchez-Sagrado, T

    Spanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. National audit of continence care: laying the foundation.

    Science.gov (United States)

    Mian, Sarah; Wagg, Adrian; Irwin, Penny; Lowe, Derek; Potter, Jonathan; Pearson, Michael

    2005-12-01

    National audit provides a basis for establishing performance against national standards, benchmarking against other service providers and improving standards of care. For effective audit, clinical indicators are required that are valid, feasible to apply and reliable. This study describes the methods used to develop clinical indicators of continence care in preparation for a national audit. To describe the methods used to develop and test clinical indicators of continence care with regard to validity, feasibility and reliability. A multidisciplinary working group developed clinical indicators that measured the structure, process and outcome of care as well as case-mix variables. Literature searching, consensus workshops and a Delphi process were used to develop the indicators. The indicators were tested in 15 secondary care sites, 15 primary care sites and 15 long-term care settings. The process of development produced indicators that received a high degree of consensus within the Delphi process. Testing of the indicators demonstrated an internal reliability of 0.7 and an external reliability of 0.6. Data collection required significant investment in terms of staff time and training. The method used produced indicators that achieved a high degree of acceptance from health care professionals. The reliability of data collection was high for this audit and was similar to the level seen in other successful national audits. Data collection for the indicators was feasible to collect, however, issues of time and staffing were identified as limitations to such data collection. The study has described a systematic method for developing clinical indicators for national audit. The indicators proved robust and reliable in primary and secondary care as well as long-term care settings.

  8. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care

    DEFF Research Database (Denmark)

    Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard

    2017-01-01

    the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention...... was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. CONCLUSION: The intervention proved feasible and useful. Still, we identified barriers...

  9. Translation, adaptation and psychometric validation of the Good Perioperative Nursing Care Scale (GPNCS) with surgical patients in perioperative care

    DEFF Research Database (Denmark)

    Hertel-Joergensen, Michala; Abrahamsen, Charlotte; Jensen, Carsten

    2018-01-01

    patients were screened for eligibility; 215 were included. The full-scale model fit estimates were moderate. Factor loadings typically ranged from 0.65 to 0.97, except for the questions concerning Technical Skills (0.38-0.63) and Nursing Process (0.28). The Cronbach's alpha value for the total scale score......AIM: To test the psychometric validity of the Good Perioperative Nursing Care Scale (GPNCS), a self-administered questionnaire, following translation and adaptation. INTRODUCTION: Patients' satisfaction with and experience of nursing care in orthopaedic or perioperative settings are currently...... was 0.92, with subfactors ranging from 0.72 to 0.87. CONCLUSION: Providing evidence for quality, or lack thereof, the Danish version of the GPNCS is a valid tool for measuring surgical patients' experiences with perioperative nursing care. The electronic version proved practical. RELEVANCE TO CLINICAL...

  10. Caring Science and the Development of Forensic Psychiatric Caring.

    Science.gov (United States)

    Hörberg, Ulrica

    2015-10-01

    This study aimed to discuss how caring science can contribute and provide a theoretical foundation for the development of caring within forensic psychiatric care. It is not only a challenge but also a great opportunity to use caring science theory within forensic psychiatric care when caring for the patients and supporting their health processes. There is a need for more knowledge about, understanding of, and willingness to care for patients within forensic psychiatric settings in a "true caring" way. In order to achieve this, a caring culture is required, one that supports carers and provides them with opportunities to further develop a caring attitude. © 2014 Wiley Periodicals, Inc.

  11. Enhanced safety features of CHASHMA NPP UNIT-2 to encounter selected severe accidents, various challenges involved to prove the adequacy of severe accidents prevention/mitigation measures and to write management guidelines with one possible solution to these challenges

    International Nuclear Information System (INIS)

    Iqbal, Z.; Minhaj, A.

    2007-01-01

    This paper describes enhanced safety features of Chashma Nuclear Power Plant Unit-2 (C-2), a 325 MWe PWR to encounter selected severe accidents and discusses various challenges involved to prove the adequacy of severe accidents encountering measures and to write severe accident management guidelines (SAMGs) in compliance with the recently introduced national regulations based on the new IAEA nuclear safety standards. C-2 is being built by China National Nuclear Corporation (CNNC) for Pakistan Atomic Energy Commission (PAEC). Its twin, Unit-1 (C-1) also a 325 MWe PWR, was commissioned in 2000. Nuclear power safety with reference to severe accidents should be treated as a global issue and therefore the developed countries should include the people of developing countries in nuclear power industry's various severe accidents based research and development programs. The implementation of this idea may also deliver few other useful and mutually beneficial byproducts. (author)

  12. Effectiveness and Cost Efficiency of Different Surveillance Components for Proving Freedom and Early Detection of Disease: Bluetongue Serotype 8 in Cattle as Case Study for Belgium, France and the Netherlands.

    Science.gov (United States)

    Welby, S; van Schaik, G; Veldhuis, A; Brouwer-Middelesch, H; Peroz, C; Santman-Berends, I M; Fourichon, C; Wever, P; Van der Stede, Y

    2017-12-01

    Quick detection and recovery of country's freedom status remain a constant challenge in animal health surveillance. The efficacy and cost efficiency of different surveillance components in proving the absence of infection or (early) detection of bluetongue serotype 8 in cattle populations within different countries (the Netherlands, France, Belgium) using surveillance data from years 2006 and 2007 were investigated using an adapted scenario tree model approach. First, surveillance components (sentinel, yearly cross-sectional and passive clinical reporting) within each country were evaluated in terms of efficacy for substantiating freedom of infection. Yearly cross-sectional survey and passive clinical reporting performed well within each country with sensitivity of detection values ranging around 0.99. The sentinel component had a sensitivity of detection around 0.7. Secondly, how effective the components were for (early) detection of bluetongue serotype 8 and whether syndromic surveillance on reproductive performance, milk production and mortality data available from the Netherlands and Belgium could be of added value were evaluated. Epidemic curves were used to estimate the timeliness of detection. Sensitivity analysis revealed that expected within-herd prevalence and number of herds processed were the most influential parameters for proving freedom and early detection. Looking at the assumed direct costs, although total costs were low for sentinel and passive clinical surveillance components, passive clinical surveillance together with syndromic surveillance (based on reproductive performance data) turned out most cost-efficient for the detection of bluetongue serotype 8. To conclude, for emerging or re-emerging vectorborne disease that behaves such as bluetongue serotype 8, it is recommended to use passive clinical and syndromic surveillance as early detection systems for maximum cost efficiency and sensitivity. Once an infection is detected and eradicated

  13. Patient care in radiography

    International Nuclear Information System (INIS)

    Ehrlich, R.A.; McCloskey, E.D.

    1989-01-01

    This book focuses on patient care procedures for radiographers. The authors focus on the role of the radiographer as a member of the health care team. The authors report on such topics as communication in patient care: safety, medico-legal considerations, transfer and positioning; physical needs; infection control; medication; CPR standards, acute situations; examination of the GI tract; contrast media; special imaging techniques and bedside radiography

  14. Minimal and careful processing

    OpenAIRE

    Nielsen, Thorkild

    2004-01-01

    In several standards, guidelines and publications, organic food processing is strongly associated with "minimal processing" and "careful processing". The term "minimal processing" is nowadays often used in the general food processing industry and described in literature. The term "careful processing" is used more specifically within organic food processing but is not yet clearly defined. The concept of carefulness seems to fit very well with the processing of organic foods, especially if it i...

  15. [Primary care in France].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2016-01-01

    The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Peri-operative care.

    Science.gov (United States)

    Baston, Helen

    2004-05-01

    This is the third 'midwifery basics' series aimed at student midwives, and focuses on midwifery care during labour. This article provides a summary of peri-operative care for women who experience caesarean birth. Students are encouraged to seek further information through a series of activities, and to link theory with practice by considering the issues relating to the care of the woman described in the short vignette.

  17. Primary care ... where?

    Science.gov (United States)

    Adcock, G B

    1999-07-01

    Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

  18. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

  19. Integrated and interprofessional care

    Directory of Open Access Journals (Sweden)

    Hugh Barr

    2012-07-01

    Full Text Available No wonder two movements described in such similar terms are so often confused. One strives to knit services together, the other to cultivate collaborative practice amongst their workers.  Dedicated though both of them are to the improvement of health and social care, integrated care falters without engaging the workforce actively as partners in change whilst interprofessional care falters without organisational support. Neither stands alone. Each depends on the other.

  20. Penis care (uncircumcised)

    Science.gov (United States)

    Uncircumcised penis - bathing; Cleaning an uncircumcised penis ... An uncircumcised penis has its foreskin intact. An infant boy with an uncircumcised penis does not need special care. Normal bathing ...

  1. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care we...... document pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for assessment and benchmarking the clinical management of HIV-patients in any setting worldwide....

  2. Specialized traumatological and orthopedic care for children through public-private partnership programs in the Novosibirsk region

    Directory of Open Access Journals (Sweden)

    Tamara A Mylnikova

    2016-03-01

    Conclusions: Implementation of an organizational model of specialized traumatological and orthopedic care for children in the Novosibirsk region using mechanisms associated with public–private partnerships has proved to be very positive. Application of the model allowed improvements in the availability of specialized traumatological and orthopedic care for children to ensure succession in the stages of medical care and to increase the number of cases entering rehabilitation. Therefore, this model demonstrates the viability of providing medical care to the population through the mechanisms of public–private partnership.

  3. The meaning of care dependency as shared by care givers and care recipients : a concept analysis

    NARCIS (Netherlands)

    Boggatz, Thomas; Dijkstra, Ate; Lohrmann, Christa; Dassen, Theo

    2007-01-01

    Aim. This paper is a report of a concept analysis to identify a meaning of care dependency that can be shared by both care givers and care recipients. Background. Care dependency can be perceived from the care recipient's and the care giver's perspective. To allow for comparisons, both sides should

  4. Quality of care for people with multimorbidity - a case series.

    Science.gov (United States)

    Schiøtz, Michaela L; Høst, Dorte; Christensen, Mikkel B; Domínguez, Helena; Hamid, Yasmin; Almind, Merete; Sørensen, Kim L; Saxild, Thomas; Holm, Rikke Høgsbro; Frølich, Anne

    2017-11-18

    Multimorbidity is becoming increasingly prevalent and presents challenges for healthcare providers and systems. Studies examining the relationship between multimorbidity and quality of care report mixed findings. The purpose of this study was to investigate quality of care for people with multimorbidity in the publicly funded healthcare system in Denmark. To investigate the quality of care for people with multimorbidity different groups of clinicians from the hospital, general practice and the municipality reviewed records from 23 persons with multimorbidity and discussed them in three focus groups. Before each focus group, clinicians were asked to review patients' medical records and assess their care by responding to a questionnaire. Medical records from 2013 from hospitals, general practice, and health centers in the local municipality were collected and linked for the 23 patients. Further, two clinical pharmacologists reviewed the appropriateness of medications listed in patient records. The review of the patients' records conducted by three groups of clinicians revealed that around half of the patients received adequate care for the single condition which prompted the episode of care such as a hospitalization, a visit to an outpatient clinic or the general practitioner. Further, the care provided to approximately two-thirds of the patients did not take comorbidities into account and insufficiently addressed more diffuse symptoms or problems. The review of the medication lists revealed that the majority of the medication lists contained inappropriate medications and that there were incongruity in medication listed in the primary and secondary care sector. Several barriers for providing high quality care were identified. These included relative short consultation times in general practice and outpatient clinics, lack of care coordinators, and lack of shared IT-system proving an overview of the treatment. Our findings reveal quality of care deficiencies for

  5. Improving Care for Children With Complex Needs

    Science.gov (United States)

    2017-10-10

    Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

  6. [Primary care in Italy].

    Science.gov (United States)

    Sánchez-Sagrado, T

    Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Use of a Shared Mental Model by a Team Composed of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision Making in a Patient With Advanced Cancer.

    Science.gov (United States)

    D'Ambruoso, Sarah F; Coscarelli, Anne; Hurvitz, Sara; Wenger, Neil; Coniglio, David; Donaldson, Dusty; Pietras, Christopher; Walling, Anne M

    2016-11-01

    Our case describes the efforts of team members drawn from oncology, palliative care, supportive care, and primary care to assist a woman with advanced cancer in accepting care for her psychosocial distress, integrating prognostic information so that she could share in decisions about treatment planning, involving family in her care, and ultimately transitioning to hospice. Team members in our setting included a medical oncologist, oncology nurse practitioner, palliative care nurse practitioner, oncology social worker, and primary care physician. The core members were the patient and her sister. Our team grew organically as a result of patient need and, in doing so, operationalized an explicitly shared understanding of care priorities. We refer to this shared understanding as a shared mental model for care delivery, which enabled our team to jointly set priorities for care through a series of warm handoffs enabled by the team's close proximity within the same clinic. When care providers outside our integrated team became involved in the case, significant communication gaps exposed the difficulty in extending our shared mental model outside the integrated team framework, leading to inefficiencies in care. Integration of this shared understanding for care and close proximity of team members proved to be key components in facilitating treatment of our patient's burdensome cancer-related distress so that she could more effectively participate in treatment decision making that reflected her goals of care.

  8. Health Care Services

    Science.gov (United States)

    Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , 2017 Warning - A phone number that was once used for the Denali KidCare program is now being used to ask people for their credit card number in order to win a prize. The phone number related to this

  9. Metabonomics and Intensive Care

    OpenAIRE

    Antcliffe, D; Gordon, AC

    2016-01-01

    This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

  10. Prevention IS Care

    Centers for Disease Control (CDC) Podcasts

    2009-03-26

    This podcast provides an overview of the Prevention IS Care campaign, which provides HIV prevention tools for medical care providers to use on a daily basis with patients who are living with HIV.  Created: 3/26/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/26/2009.

  11. Educating to Care

    Science.gov (United States)

    Mortari, Luigina

    2004-01-01

    The root of the ecological crisis lies in an ethic of nature consumption. In order to reconstruct our cultural framework, it is necessary to cultivate another ethical approach, an ethic of care. It is the responsibility of school to encourage students to learn how to care for not only the human world, but also for the natural world. This paper is…

  12. Robots that care

    NARCIS (Netherlands)

    Looije, R.; Arendsen, J.; Saldien, J.; Vanderborght, B.; Broekens, J.; Neerincx, M.

    2010-01-01

    Many countries face pressure on their health care systems. To alleviate this pressure, 'self care' and 'self monitoring' are often stimulated with the use of new assistive technologies. Social robotics is a research area where robotic technology is optimized for various social functions. One of

  13. Palliative care in Romania

    NARCIS (Netherlands)

    Dumitrescu, Luminita

    2006-01-01

    Palliative care concentrates on supporting and helping people with an incurable disease and aims to improve patient’s quality of life by reducing or eliminating pain and other physical symptoms. Palliative care is a new phenomenon in Romania . PhD student Luminita Dumitrescu describes the

  14. Physician self-care

    African Journals Online (AJOL)

    impact on patient care, increasing the number of medical errors, lowering both patient and physician satisfaction and lengthening the recovery phase.[1-3]. Joan Halifax[4] has taught at programmes in palliative care for health professional caregivers for many years. She identified frequent challenges facing healthcare ...

  15. Do We Value Caring?

    Science.gov (United States)

    Weissbourd, Richard; Anderson, Trisha Ross

    2016-01-01

    When asked about their child-rearing priorities, parents in the United States are likely to say it's more important to raise children who are caring than to raise high achievers. Schools, too, typically trumpet values such as caring, honesty, and fairness. These values are posted on walls, reiterated in assemblies, and included in mission…

  16. Improved wound care product

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention pertains to use of sodium diacetate (NaHAc 2) as an antimicrobial agent against bacteria growing in biofilms. The aspects of the invention include a wound care product comprising sodium diacetate, a kit comprising a wound care product,and a methodof treating an infected wound....

  17. Alliance in Youth Care

    NARCIS (Netherlands)

    Linda Rothman; H. Pijnenburg; Rinie van Rijsingen

    2015-01-01

    This article introduces the concept of alliance in youth care. The concept of (therapeutic) alliance originates in adult psychotherapy and related research. Alliance refers to the working relationship between youth care workers and their clients. Within this concept, personal (emotional) and task

  18. Emergency care of raptors.

    Science.gov (United States)

    Graham, Jennifer E; Heatley, J Jill

    2007-05-01

    Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.

  19. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  20. Care, Europeanization and Gender

    DEFF Research Database (Denmark)

    This book adresses the recent underexamined developments concerning care in Europe, including the negotiations about care at the top EU level to that of individual workers. Through a comparative and interdisciplinary approach, this collection examines and further develops current theoretical and ...