The relationship between older Americans act in-home services and low-care residents in nursing homes.

Science.gov (United States)

Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

38 CFR 14.634 - Banks or trust companies acting as guardians.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Banks or trust companies acting as guardians. 14.634 Section 14.634 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... guardians. Banks or trust companies, corporate entities, acting as guardians for claimants, may be...

US residency training before and after the 1997 Balanced Budget Act.

Science.gov (United States)

Salsberg, Edward; Rockey, Paul H; Rivers, Kerri L; Brotherton, Sarah E; Jackson, Gregory R

2008-09-10

Graduate medical education (GME) determines the size and characteristics of the future workforce. The 1997 Balanced Budget Act (BBA) limited Medicare funding for additional trainees in GME. There has been concern that because Medicare is the primary source of GME funding, the BBA would discourage growth in GME. To examine the number of residents in training before and after the BBA, as well as more recent changes in GME by specialty, sex, and type and location of education. Descriptive study using the American Medical Association/Association of American Medical Colleges National GME Census on physicians in Accreditation Council for Graduate Medical Education (ACGME)-accredited programs to examine changes in the number and characteristics of residents before and after the BBA. Differences in the number of physicians in ACGME-accredited training programs overall, by specialty, and by location and type of education. The number of residents and fellows changed little between academic year (AY) 1997 (n = 98,143) and AY 2002 (n = 98,258) but increased to 106,012 in AY 2007, a net increase of 7869 (8.0%) over the decade. The annual number of new entrants into GME increased by 7.6%, primarily because of increasing international medical graduates (IMGs). United States medical school graduates (MDs) comprised 44.0% of the overall growth from 2002 to 2007, followed by IMGs (39.2%) and osteopathic school graduates (18.8%). United States MD growth largely resulted from selection of specialties with longer training periods. From 2002 to 2007, US MDs training in primary care specialties decreased by 2641, while IMGs increased by 3286. However, increasing subspecialization rates led to fewer physicians entering generalist careers. After the 1997 BBA, there appears to have been a temporary halt in the growth of physicians training in ACGME programs; however, the number increased from 2002 to 2007.

Positive Prerequisites for the Use of Reliefs in the Payment of Dues on Social Insurance Contributions

Directory of Open Access Journals (Sweden)

Zbigniew Ofiarski

2014-06-01

Full Text Available It is permissible to use reliefs in the payment of social security contributions, based either on a definitive waiver by the creditor of the whole or relevant part of the amount due (partial or complete remission or only a temporary waiver of such amounts (payment deferral or payment in installments. The use of such reliefs is possible upon the occurrence of conditions laid down in the Act, for example, in the case of total non-recovery of contributions, for economic or other reasons worth considering, if justified by important interests of the person concerned. The prerequisites mentioned above have a nature of general clauses, allowing for their flexible adjustment to specific situations. Entities authorized to grant reliefs in the payment of social security contributions act within the limits of administrative discretion. But it is not a fully free operation, because the economic impact resulting from the use of such reliefs has a direct impact on the financial balance of earmarked funds which finance social security benefits, in particular pensions, disability allowances and other benefits.

Modeling the onset and offset of dental pain relief by ibuprofen.

Science.gov (United States)

Li, Hanbin; Mandema, Jaap; Wada, Russell; Jayawardena, Shyamalie; Desjardins, Paul; Doyle, Geraldine; Kellstein, David

2012-01-01

Onset and offset of dental pain relief by ibuprofen following third molar extraction were modeled in a randomized, double-blind, placebo-controlled, parallel-group, 8-hour study of patients receiving either a novel effervescent ibuprofen tablet (400 mg; N = 30), standard ibuprofen tablets (Nurofen(®) 2 × 200 mg; N = 22), or placebo (N = 37). An Emax model was fit to pain relief scores. Linear hazard models were used to analyze the time to first perceptible relief (TFPR), the time to meaningful pain relief (TMPR), and time to remedication (REMD). Nomograms were created to correlate TFPR, TMPR, and REMD with different ibuprofen pharmacokinetic profiles. Effervescent ibuprofen was absorbed rapidly with 95% completion within 15 minutes. Maximum pain relief score by ibuprofen was 1.8 units greater than placebo, with an EC50 (effect-site) for ibuprofen concentration of 10.2 µg·mL(-1). The likelihood to achieve TFPR and TMPR was doubled for every 10 µg·mL(-1) increase in ibuprofen plasma concentration. REMD risk decreased 40-fold as the categorical pain relief score increased from 0 to 3. Rapid absorption of ibuprofen effervescent resulted in an earlier TFPR and TMPR, and a lower REMD rate than standard ibuprofen. The nomograms may be useful in predicting the onset and offset of new faster acting ibuprofen formulations, based on pharmacokinetic profiles.

Alternative medicine - pain relief

Science.gov (United States)

Acupuncture - pain relief; Hypnosis - pain relief; Guided imagery - pain relief ... neck, shoulder, knee, or elbow) Osteoarthritis Rheumatoid arthritis Hypnosis is a focused state of concentration. With self- ...

77 FR 64514 - Sunshine Act Meeting; Open Commission Meeting; Wednesday, October 17, 2012

Science.gov (United States)

2012-10-22

... Middle Class Tax Relief and Job AFFAIRS. Creation Act of 2012 (CG Docket No. 12-129); Establishment of a... Class Tax Relief and Job Creation Act of 2012. 3 OFFICE OF Title: Amendment of Part 27 of ENGINEERING... other mobility aids. Sign language interpreters, open captioning, and assistive listening devices will...

What has been brought to residents and communities by the nuclear power plant accident? Special and serious disaster relief procedure modification after the 2011 Tohoku earthquake and tsunami in Fukushima

International Nuclear Information System (INIS)

Ishikawa, Kazunobu

2012-01-01

After the catastrophic 2011 Tohoku earthquake and tsunami which struck cities and towns on the Japanese Pacific coast, Fukushima has been the focus of special and serious disaster relief procedures modification regarding nuclear power plant accidents. To date, the Japanese government has repeatedly issued evacuation orders to more than 100,000 residents. Huge numbers of refugees are still uncertain if they can return home and re-cultivate their farm land. Ambiguous public announcements concerning the radiation risks seem to have aggravated feelings of insecurity, fear and the desire to escape, both at home and abroad. This disaster has seriously undermined trust internationally and locally in Fukushima. Harmful rumors added further difficulties. In response to this disaster, local government, medical institutions, care facilities, police, emergency services and the self-defense forces continue to put their utmost effort into reconstruction. This seismic disaster has reminded us that supplies of water, electricity, gas, gasoline and telephone communication facilities are essential prerequisites for reconstruction and daily life. Disaster and radiation medical association teams actively participated in the rescue efforts, and a number of organized medical teams cared for about 15,000 refugees in 100 shelters. We also visited homebound patients, who were unable to evacuate from the 20-30 km inner evacuation area. In this relief role, we need to consider the following; (1) professionals, both healthcare and nuclear engineers, must always be prepared for unexpected circumstances, (2) the daily organic cooperation of individuals and units is closely linked to readiness against sudden risks, and (3) appropriate accountability is essential to assuage the fears of residents and refugees. A sincere learning process may benefit those innocent refugees who may be forced to abandon their homes permanently. (author)

Workplace bullying of general surgery residents by nurses.

Science.gov (United States)

Schlitzkus, Lisa L; Vogt, Kelly N; Sullivan, Maura E; Schenarts, Kimberly D

2014-01-01

Workplace bullying is at the forefront of social behavior research, garnering significant media attention. Most of the medical research has addressed bullying of nurses by physicians and demonstrates that patient care and outcomes may suffer. The intent of this study was to determine if general surgery residents are bullied by nurses. A survey instrument previously validated (Negative Acts Questionnaire-Revised) to evaluate for workplace bullying was modified to reflect the resident-nurse relationship. After institutional review board approval, the piloted online survey was sent to general surgery program directors to forward to general surgery residents. Demographic data are presented as percentages, and for negative acts, percentages of daily, weekly, and monthly frequencies are combined. Allopathic general surgery residencies in the United States. General surgery residents. The response rate was 22.1% (n = 452). Most respondents were men (55%) and had a mean age of 29 years (standard deviation = 7). Although 27.0% of the respondents were interns, the remaining classes were equally represented (12%-18% of responses/class). The respondents were primarily from medium-sized residency programs (45%), in the Midwest (28%), training in university programs (72%), and rotating primarily in a combined private and county hospital that serves both insured and indigent patients (59%). The residents had experienced each of the 22 negative acts (11.5%-82.5%). Work-related bullying occurs more than person-related bullying and physical intimidation. Ignoring of recommendations or orders by nurses occurs on a daily, weekly, or monthly basis for 30.2% of residents (work-related bullying). The most frequent person-related bullying act is ignoring the resident when they approach or reacting in a hostile manner (18.0%), followed by ignoring or excluding the resident (17.1%). Workplace bullying of general surgery residents by nurses is prominent. Future research is needed to determine

38 CFR 3.42 - Compensation at the full-dollar rate for certain Filipino veterans residing in the United States.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Compensation at the full-dollar rate for certain Filipino veterans residing in the United States. 3.42 Section 3.42 Pensions... Filipino veterans residing in the United States. (a) Definitions. For purposes of this section: (1) United...

Understanding nurses' decisions to treat pain in nursing home residents with dementia.

Science.gov (United States)

Gilmore-Bykovskyi, Andrea L; Bowers, Barbara J

2013-04-01

Nursing home (NH) residents with dementia continue to receive inadequate pain treatment. The purpose of this qualitative study was to examine how nurses make decisions to pharmacologically treat pain in NH residents with dementia. Using Grounded Dimensional Analysis, 15 in-depth interviews were conducted with 13 nurses from four skilled nursing facilities in Wisconsin. Nurses experienced varying levels of certainty regarding suspected pain in response to particular resident characteristics and whether pain was perceived as visible/obvious or nonvisible/not obvious. Nurses felt highly uncertain about pain in residents with dementia. Suspected pain in residents with dementia was nearly always conceptualized as a change in behavior to which nurses responded by trialing multiple interventions in attempts to return the resident to baseline, which despite current recommendations, did not include pain relief trials. Residents with dementia were described as being at greatest risk for experiencing underassessment, undertreatment, and delayed treatment for pain Copyright 2013, SLACK Incorporated.

Tax justice of the reform of higher education: tuition fees or tax relief?

Directory of Open Access Journals (Sweden)

Pavel Semerád

2012-01-01

Full Text Available This paper deals with the current reform of higher education which is now being discussed in the Czech Republic. The Government and the Ministry of Education, Youth and Sports propose a tuition fee for students at universities but there is still no clear concept of it. University leaders and students are against the tuition fee because of their fear of getting into debt during their study. The aim of this paper is to show an alternative way of funding higher education without tuition fee loans and from the point of view of tax justice. According to the concept of horizontal justice (Mankiw, 1999 taxpayers should pay taxes at the same rate, but it does not work this way. The result of research is that changes in Act 586/1992 Coll., on income tax and in Act 117/1995 Coll., on state social welfare are required. Abolition of tax relief is proposed where discrimination against other taxpayers and groups of students could occur. By abolition of tax relief for a student and tax relief for a dependent child the amounts of 4,020 CZK and 13,404 CZK respectively could be saved. Changes in legislation could be politically more acceptable than the tuition fee. The solution could also lead to simplification for taxpayers. The target should be equal access to higher education for all students.

78 FR 19357 - Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy

Science.gov (United States)

2013-03-29

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Allocation of Public Transportation...) announces the allocation of $2,000,000,000 under the Public Transportation Emergency Relief Program... after an emergency or major disaster that affects public transportation systems. The Appropriations Act...

77 FR 58150 - Granting of Relief; Federal Firearms Privileges (2011R-13T)

Science.gov (United States)

2012-09-19

... the disabilities imposed by Federal laws by the Director of ATF with respect to the acquisition...: The Attorney General is responsible for enforcing the provisions of the Gun Control Act of 1968 (GCA... subsidiary of NGC), is granted relief from the disabilities imposed by Federal laws with respect to the...

28 CFR 36.504 - Relief.

Science.gov (United States)

2010-07-01

... COMMERCIAL FACILITIES Enforcement § 36.504 Relief. (a) Authority of court. In a civil action under § 36.503, the court— (1) May grant any equitable relief that such court considers to be appropriate, including... disabilities; (2) May award other relief as the court considers to be appropriate, including monetary damages...

38 CFR 3.43 - Burial benefits at the full-dollar rate for certain Filipino veterans residing in the United...

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Burial benefits at the full-dollar rate for certain Filipino veterans residing in the United States on the date of death. 3.43... for certain Filipino veterans residing in the United States on the date of death. (a) Definitions. For...

78 FR 38975 - Sunshine Act Meetings

Science.gov (United States)

2013-06-28

...-Implementation Section 6401 of the Middle Class Tax Relief and Job Creation Act of 2012 Related to the 1915-1920.... The meeting site is fully accessible to people using wheelchairs or other mobility aids. Sign language...

78 FR 32296 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

Science.gov (United States)

2013-05-29

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public... disaster that affects public transportation systems. The Disaster Relief Appropriations Act provides $10.9... projected total recovery costs for the four most severely affected public transportation systems, not...

Analysis of inservice inspection relief requests

International Nuclear Information System (INIS)

Aldrich, D.A.; Cook, J.F.

1989-08-01

Nuclear Regulatory Commission (NRC) regulations require inspection (ISI) of boiling or pressurized water-cooled nuclear power plants be performed in accordance with a referenced edition and addenda of Section XI, ''Rules for Inservice Inspection of Nuclear Power Plant components,'' of the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code. The regulations permit licensees to request relief from the NRC from specific ASME Code requirements that are determined to be impractical for the specific licensee. The NRC evaluates these requests and may grant such relief, but the NRC may also impose alternative or augmented inspections to assure structural reliability. The purpose,of this task was to evaluate the basis for ISI nondestructive examination (NDE) relief requests and to evaluate the effect of proposed ASME Code changes that would reduce the need for such requests or provide for more complete information in relief requests. This report contains the results of an analysis of an ISI relief request data base that has been expanded to include 1195 ISI relief requests versus the 296 relief requests covered in the first report in April 1987, EGG-SD-7430. Also relief requests were added to the data base which came from both first and second 10-year inspection intervals for several facilities. This provided the means to analyze the effect of recently approved ASME Code cases and updated Code requirements, some of which have been published as a result of earlier work on this task

Laparoscopic Adhesiolysis and Relief of Chronic Pelvic Pain

OpenAIRE

Nezhat, Farr R.; Crystal, Ruth Ann; Nezhat, Ceana H.; Nezhat, Camran R.

2000-01-01

Objective: To evaluate the short- and long-term results of laparoscopic enterolysis in patients with chronic pelvic pain following hysterectomy. Methods: Forty-eight patients were evaluated at time intervals from 2 weeks to 5 years after laparoscopic enterolysis. Patients were asked to rate postoperative relief of their pelvic pain as complete/near complete relief (80-100% pain relief), significant relief (50-80% pain relief), or less than 50% or no pain relief. Results: We found that after 2...

75 FR 56858 - Improvements to the Supplemental Security Income Program-Heroes Earnings Assistance and Relief...

Science.gov (United States)

2010-09-17

... number, 1-800-772-1213, or TTY 1-800-325-0778, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2009-0017] RIN 0960-AH00 Improvements to the Supplemental Security Income Program--Heroes Earnings Assistance and Relief Tax Act of 2008...

30 CFR 203.60 - Who may apply for royalty relief on a case-by-case basis in deep water in the Gulf of Mexico or...

Science.gov (United States)

2010-07-01

...-case basis in deep water in the Gulf of Mexico or offshore of Alaska? 203.60 Section 203.60 Mineral... basis in deep water in the Gulf of Mexico or offshore of Alaska? You may apply for royalty relief under... REDUCTION IN ROYALTY RATES OCS Oil, Gas, and Sulfur General Royalty Relief for Pre-Act Deep Water Leases and...

Workplace Violence and Harassment Against Emergency Medicine Residents.

Science.gov (United States)

Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A

2016-09-01

Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

Social Work or Relief Work? A Crisis in Professional Social Work

Directory of Open Access Journals (Sweden)

Adhikari Harasankar

2015-07-01

Full Text Available Social work is a sharing and caring profession based on scientific methods. This problem solving profession makes people self-reliant and self-dependent when he/she is in any sorts of crises. Thus, it differs from relief work, social services or social welfare delivered during emergence crises. This paper examined the application of professional social work as relief work, which did not bring any change among the beneficiaries; rather it set their mind as opportunist. For this purpose, the programme sponsored by the government of India and implemented by nongovernmental organizations for rehabilitation of the street children (i.e., pavements and slums dwellers, children of sex workers, and so forth of Metro cities like Kolkata had priority. This evaluative study assessed the progress and changes among 500 street children who were the beneficiaries for 10 years of the programme, selected according to their parental residents/occupation through stratified sampling. Interviews, case studies and group interaction were used to collect data on various aspects, i.e. personal background, education, and occupation of these children. It revealed that after almost 10 years of services, the problem of children was static. Firstly, service delivery system was as relief work. The methods of social work were not implied while the professionals were in implementation. On the other hand, the scope of monitoring and evaluation of the programme by government was suspended due to several reasons. Definitely, the politicalization in human development would be restricted. The problems of suffering would be root out and it should not be a continued process.

Alkem instruction: Legal relief of a Federal State against instructions under the Atomic Energy Act issued by the Federal Government

International Nuclear Information System (INIS)

Steinberg, R.

1987-01-01

The German Federal Minister for the Environment, Protection of Nature, and Reactor Safety instructed the Hesse State Minister for Economics and Technology to grant the applications filed by Alkem GmbH for a first partial permit of the construction and operation of a fuel element factory, and to grant it on the basis of a draft working document discussed between the two ministries. The new feature is the refusal of the Hesse State Minister to follow these instructions. This has given rise to a conflict between the State and Federal Governments. The article deals with one aspect of the multifaceted legal controversy, i.e., the question of the possibilities of legal relief open to a Federal State against an instruction under the Atomic Energy Act issued by the Federal Government. First, the rank of this instruction within the scope of administration on behalf of the Federal Government will be discussed. Next, the central problem of the preconditions under which an instruction may violate rights of a Federal State will be investigated. Finally, the possibilities of litigation will be briefly referred to. (orig./HP) [de

Impact of Tax Relief on Public Finance

Directory of Open Access Journals (Sweden)

Bikas Egidijus

2016-12-01

Full Text Available Tax reliefs are optional, but a very important element of the taxation system. This element is used for different purposes by a country’s government institutions. Tax reliefs are a form of tax expenditure that helps to reduce budget revenues. Tax reliefs influence individual and corporate financial behaviour and can have positive or negative effects on the economic and social factors. In the last few years, expansion of tax relief has attracted worldwide attention because of the fact that, after the global financial crisis, many countries are still suffering from fiscal deficits, and expansion of tax relief has not contributed to solving this problem. Tax reliefs are presupposed to be a fiscal policy tool of significance in various subsystems of public finances. The main aim of this article is to examine the impact of personal income tax reliefs on Lithuanian public finances. To achieve this aim, statistical information was systemized; Monte Carlo method was used to group data by horizontal rows and logical links analysed, which helped to evaluate the influence of tax reliefs on public finances. In the simulations, the Monte Carlo method helped to simulate random samples, which were then examined by adapting the conclusions of the theory of probability and mathematical statistics methods.

19 CFR 172.12 - Petitions acted on at Customs Headquarters.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Petitions acted on at Customs Headquarters. 172.12 Section 172.12 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Petitions § 172.12 Petitions acted on at Customs Headquarters. Upon receipt of a petition for relief filed...

Workplace Violence and Harassment Against Emergency Medicine Residents

OpenAIRE

Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

2016-01-01

Introduction: Several studies have shown that workplace violence in the emergency department (ED) iscommon. Residents may be among the most vulnerable staff, as they have the least experience with thesevolatile encounters. The goal for this study was to quantify and describe acts of violence against emergencymedicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at mul...

Crygenic performance of a superfluid helium relief valve for the LHC superconducting magnets

International Nuclear Information System (INIS)

Danielsson, H.; Ferlin, G.; Luguet, C.

1996-01-01

The high-field superconducting magnets of the Large Hadron Collider (LHC) project at CERN will operate below 1.9 K in static baths of pressurized helium II. In case of resistive transition (open-quotes quenchclose quotes), the resulting pressure rise in the cryostats must be limited to below their 2 MPa design pressure. This is achieved by discharging helium at high flow-rates into a cold recovery header, normally maintained at 20 K. For this purpose, the authors have designed, built and tested a cryogenic quench relief valve with a nominal diameter of 50 mm and an opening time of below 0.1 s. The valve, which can be opened on an external trigger, also acts as a relief device actuated by the upstream pressure when it exceeds 0.4 MPa. In normal operation, the closed poppet must be helium-tight, for hydraulic and thermal separation of the magnet baths from the recovery header. Following mechanical qualification tests under vacuum, the authors have mounted the relief valve in a dedicated cryogenic measuring bench, in order to perform precision thermal measurements with pressurized helium II

Workplace Violence and Harassment Against Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Benjamin H. Schnapp

2016-09-01

Full Text Available Introduction: Several studies have shown that workplace violence in the emergency department (ED is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results: A majority of residents (66%, 78/119 reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119 experienced verbal harassment, 78% (93/119 had experienced verbal threats, and 52% (62/119 reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion: Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

Workplace Violence and Harassment Against Emergency Medicine Residents

Science.gov (United States)

Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

2016-01-01

Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

Application of acoustic telemetry to assess residency and movements of rockfish and lingcod at created and natural habitats in Prince William Sound.

Directory of Open Access Journals (Sweden)

Brad F Reynolds

Full Text Available Loss and/or degradation of nearshore habitats have led to increased efforts to restore or enhance many of these habitats, particularly those that are deemed essential for marine fishes. Copper rockfish (Sebastes caurinus and lingcod (Ophiodon enlongatus are dominant members of the typical reef fish community that inhabit rocky and high-relief substrates along the Pacific Northwest. We used acoustic telemetry to document their residency and movements in the nearshore waters of Prince William Sound, Alaska in order to assess use of created reef habitat in an individual-based manner. A total of 57 fish were surgically implanted with acoustic transmitters. Forty-five fish were captured and monitored in three habitats: artificial reef, low-relief natural reef, and patchy high-relief natural reef. Within each habitat, both rockfish and lingcod exhibited long periods of residency with limited movements. Twelve rockfish were captured at the natural reefs and displaced a distance of 4.0 km to the artificial reef. Five of the 12 rockfish returned within 10 d of their release to their initial capture site. Another five of the 12 displaced fish established residency at the artificial reef through the duration of our study. Our results suggest the potential for artificial reefs to provide rockfish habitat in the event of disturbances to natural habitat.

Pain relief by Cyberknife radiosurgery for spinal metastasis.

Science.gov (United States)

Lee, Sunyoung; Chun, Mison

2012-01-01

To report pain relief effect in patients with spinal metastases treated with Cyberknife® and to analyze the factors associated with pain relapse after initial pain relief. We retrospectively analyzed patients with spinal metastasis treated with stereotactic body radiosurgery between April 2007 and June 2009. A total of 57 patients with 73 lesions were available for analysis with a median follow-up of 6.8 months (range, 1-30). Pain was assessed by a verbal/visual analogue scale at each visit: from 0 to 10. Pain relief was defined as a decrease of at least three levels of the pain score without an increase in analgesic use. Complete relief was defined as no analgesics or a score 0 or 1. Pain relief was achieved in 88% of the lesions, with complete relief in 51% within 7 days from the start of radiosurgery. The median duration of pain relief was 3.2 months (range, 1-30). Pain reappeared in 16 patients (27%). Spinal cord compression (P = 0.001) and performance status (P = 0.01) were predictive of pain relapse by multivariate Cox analysis. All 6 patients treated with solitary spinal metastasis experienced pain relief; 5 of them were alive without evidence of disease at a median of 16 months (range, 7-30). As previous studies have shown, our study confirms that pain relief with spinal radiosurgery is around 90%. In particular, long-term pain relief and disease control was observed in patients with solitary spinal metastasis.

Parental leave for residents and pediatric training programs.

Science.gov (United States)

2013-02-01

The American Academy of Pediatrics (AAP) is committed to the development of rational, equitable, and effective parental leave policies that are sensitive to the needs of pediatric residents, families, and developing infants and that enable parents to spend adequate and good-quality time with their young children. It is important for each residency program to have a policy for parental leave that is written, that is accessible to residents, and that clearly delineates program practices regarding parental leave. At a minimum, a parental leave policy for residents and fellows should conform legally with the Family Medical Leave Act as well as with respective state laws and should meet institutional requirements of the Accreditation Council for Graduate Medical Education for accredited programs. Policies should be well formulated and communicated in a culturally sensitive manner. The AAP advocates for extension of benefits consistent with the Family Medical Leave Act to all residents and interns beginning at the time that pediatric residency training begins. The AAP recommends that regardless of gender, residents who become parents should be guaranteed 6 to 8 weeks, at a minimum, of parental leave with pay after the infant's birth. In addition, in conformance with federal law, the resident should be allowed to extend the leave time when necessary by using paid vacation time or leave without pay. Coparenting, adopting, or fostering of a child should entitle the resident, regardless of gender, to the same amount of paid leave (6-8 weeks) as a person who takes maternity/paternity leave. Flexibility, creativity, and advanced planning are necessary to arrange schedules that optimize resident education and experience, cultivate equity in sharing workloads, and protect pregnant residents from overly strenuous work experiences at critical times of their pregnancies.

Personal Therapy in Psychiatry Residency Training: A National Survey of Canadian Psychiatry Residents.

Science.gov (United States)

Hadjipavlou, George; Halli, Priyanka; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

2016-02-01

The authors collected nationally representative data on Canadian residents' experiences with and perspectives on personal psychotherapy in their psychiatric training. A 43-item questionnaire was distributed electronically to all current psychiatry residents in Canada (N = 839). Four hundred residents from every program across Canada returned the survey (response rate 47.7%). The prevalence of personal therapy at any time was 55.3%, with 42.8% receiving personal therapy during residency. Of residents who undertook personal psychotherapy, 59.3% engaged in weekly therapy, 74.1% received psychodynamic psychotherapy, and 81.5% participated in long-term therapy (>1 year). Personal growth, self-understanding, and professional development were the most common reasons for engaging in personal therapy; however, one-third of residents did so to alleviate symptoms of depression, anxiety, or other mental health concerns. Time was the most important factor impeding residents from personal therapy; only 8.8% found stigma to act as a barrier. The vast majority of residents rated their experience with personal therapy as having a positive or very positive impact on their personal life (84.8%) and overall development as psychiatrists (81.8%). For 64% of respondents, personal therapy had an important or very important role in psychiatry residency training. Residents who received personal therapy rated themselves as better able to understand what happens moment by moment during therapy sessions, detect and deal with patients' emotional reactions, and constructively use their personal reactions to patients. Interest in personal therapy remains strong among psychiatry trainees in Canada. Residents who engaged in psychotherapy endorsed greater confidence in psychotherapy and rated their psychotherapy skills more favorably than those who had never been in the patient role, supporting the view of personal therapy as an important adjunct to psychotherapy training during residency.

48 CFR 252.229-7001 - Tax relief.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Tax relief. 252.229-7001... Clauses 252.229-7001 Tax relief. As prescribed in 229.402-70(a), use the following clause: Tax Relief (JUN 1997) (a) Prices set forth in this contract are exclusive of all taxes and duties from which the United...

Performance of balanced bellows safety relief valves

International Nuclear Information System (INIS)

Lai, Y.S.

1992-01-01

By the nature of its design, the set point and lift of a conventional spring loaded safety relief valve are sensitive to back pressure. One way to reduce the adverse effects of the back pressure on the safety relief valve function is to install a balanced bellows in a safety relief valve. The metallic bellows has a rather wide range of manufacturing tolerance which makes the design of the bellows safety relief valve very complicated. The state-of-the-art balanced bellows safety relief valve can only substantially minimize, but cannot totally eliminate the back pressure effects on its set point and relieving capacity. Set point change is a linear function of the back pressure to the set pressure ratio. Depending on the valve design, the set point correction factor can be either greater or smaller than unity. There exists an allowable back pressure and critical back pressure for each safety relief valve. When total back pressure exceeds the R a , the relieving capacity will be reduced mainly resulting from the valve lift being reduced by the back pressure and the capacity reduction factor should be applied in valve sizing. Once the R c is exceeded, the safety relief valve becomes unstable and loses its over pressure protection capability. The capacity reduction factor is a function of system overpressure, but their relationship is non-linear in nature. (orig.)

Effectiveness of Property Tax Relief in Oregon.

Science.gov (United States)

Hartman, William T.; Hwang, C. S.

This study examines the effects of the 1979 Oregon Property Tax Relief Plan on 1980-81 school district budget decisions by comparing the available tax relief, the school expenditures, and the tax levies in the state for the years 1975-81. The history of direct and indirect property tax relief in Oregon is sketched for the years prior to 1979; the…

Radiology residents' experience with intussusception reduction

International Nuclear Information System (INIS)

Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L.; Li, Chin-Shang

2011-01-01

Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P < 0.0001), and 336 (62.2%) thought they would benefit from a computer-assisted training model simulating intussusception reduction (P < 0.0001). Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model. (orig.)

Relief valve testing study

International Nuclear Information System (INIS)

BROMM, R.D.

2001-01-01

Reclosing pressure-actuated valves, commonly called relief valves, are designed to relieve system pressure once it reaches the set point of the valve. They generally operate either proportional to the differential between their set pressure and the system pressure (gradual lift) or by rapidly opening fully when the set pressure is reached (pop action). A pop action valve allows the maximum fluid flow through the valve when the set pressure is reached. A gradual lift valve allows fluid flow in proportion to how much the system pressure has exceeded the set pressure of the valve (in the case of pressure relief) or has decreased below the set pressure (vacuum relief). These valves are used to protect systems from over and under pressurization. They are used on boilers, pressure vessels, piping systems and vacuum systems to prevent catastrophic failures of these systems, which can happen if they are under or over pressurized beyond the material tolerances. The construction of these valves ranges from extreme precision of less than a psi tolerance and a very short lifetime to extremely robust construction such as those used on historic railroad steam engines that are designed operate many times a day without changing their set pressure when the engines are operating. Relief valves can be designed to be immune to the effects of back pressure or to be vulnerable to it. Which type of valve to use depends upon the design requirements of the system

19 CFR 210.52 - Motions for temporary relief.

Science.gov (United States)

2010-04-01

....52 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.52 Motions for temporary relief... issuance of temporary relief, the Commission will be guided by practice under Rule 65 of the Federal Rules...

30 CFR 203.66 - What happens if MMS does not act in the time allowed?

Science.gov (United States)

2010-07-01

... Relief for Pre-Act Deep Water Leases and for Development and Expansion Projects § 203.66 What happens if MMS does not act in the time allowed? If we do not act within the timeframes established under § 203... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What happens if MMS does not act in the time...

78 FR 44599 - Notice of Lodging of Proposed Consent Decree Under the Clean Water Act

Science.gov (United States)

2013-07-24

... DEPARTMENT OF JUSTICE Notice of Lodging of Proposed Consent Decree Under the Clean Water Act On... seeking permanent injunctive relief and civil penalties under the Clean Water Act (``CWA''), 33 U.S.C..., manganese, potassium, sodium, strontium, bromide, chloride, [[Page 44600

Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.

Science.gov (United States)

Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B

2018-02-01

To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; https://www.r-project.org). The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively). This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents. Copyright © 2017 North American Society for

Crisis Communication Practices at an International Relief Agency

Science.gov (United States)

Genova, Gina L.

2006-01-01

When a disaster strikes, the affected population relies upon the swift response and aid rendered by relief organizations such as the California-based Direct Relief International. Since 1948, Direct Relief's mission has been to provide essential material resources to locally run health programs in areas affected by natural disasters, wars, and…

Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

Science.gov (United States)

McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

2011-12-01

An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

77 FR 23278 - Notice of Lodging of Consent Decree Under the Clean Air Act

Science.gov (United States)

2012-04-18

... accept small appliances, motor vehicle air conditioners (``MVACs''), or MVAC- like appliances with cut... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Air Act Notice is hereby... Agency (``U.S. EPA''), sought penalties and injunctive relief under the Clean Air Act (``CAA'') against...

Brain Circuits Encoding Reward from Pain Relief.

Science.gov (United States)

Navratilova, Edita; Atcherley, Christopher W; Porreca, Frank

2015-11-01

Relief from pain in humans is rewarding and pleasurable. Primary rewards, or reward-predictive cues, are encoded in brain reward/motivational circuits. While considerable advances have been made in our understanding of reward circuits underlying positive reinforcement, less is known about the circuits underlying the hedonic and reinforcing actions of pain relief. We review findings from electrophysiological, neuroimaging, and behavioral studies supporting the concept that the rewarding effect of pain relief requires opioid signaling in the anterior cingulate cortex (ACC), activation of midbrain dopamine neurons, and the release of dopamine in the nucleus accumbens (NAc). Understanding of circuits that govern the reward of pain relief may allow the discovery of more effective and satisfying therapies for patients with acute or chronic pain.

Relief memory consolidation requires protein synthesis within the nucleus accumbens.

Science.gov (United States)

Bruning, Johann E A; Breitfeld, Tino; Kahl, Evelyn; Bergado-Acosta, Jorge R; Fendt, Markus

2016-06-01

Relief learning refers to the association of a stimulus with the relief from an aversive event. The thus-learned relief stimulus then can induce, e.g., an attenuation of the startle response or approach behavior, indicating positive valence. Previous studies revealed that the nucleus accumbens is essential for the acquisition and retrieval of relief memory. Here, we ask whether the nucleus accumbens is also the brain site for consolidation of relief memory into a long-term form. In rats, we blocked local protein synthesis within the nucleus accumbens by local infusions of anisomycin at different time points during a relief conditioning experiment. Accumbal anisomycin injections immediately after the relief conditioning session, but not 4 h later, prevented the consolidation into long-term relief memory. The retention of already consolidated relief memory was not affected by anisomycin injections. This identifies a time window and site for relief memory consolidation. These findings should complement our understanding of the full range of effects of adverse experiences, including cases of their distortion in humans such as post-traumatic stress disorder and/or phobias. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bas-Relief Modeling from Normal Images with Intuitive Styles.

Science.gov (United States)

Ji, Zhongping; Ma, Weiyin; Sun, Xianfang

2014-05-01

Traditional 3D model-based bas-relief modeling methods are often limited to model-dependent and monotonic relief styles. This paper presents a novel method for digital bas-relief modeling with intuitive style control. Given a composite normal image, the problem discussed in this paper involves generating a discontinuity-free depth field with high compression of depth data while preserving or even enhancing fine details. In our framework, several layers of normal images are composed into a single normal image. The original normal image on each layer is usually generated from 3D models or through other techniques as described in this paper. The bas-relief style is controlled by choosing a parameter and setting a targeted height for them. Bas-relief modeling and stylization are achieved simultaneously by solving a sparse linear system. Different from previous work, our method can be used to freely design bas-reliefs in normal image space instead of in object space, which makes it possible to use any popular image editing tools for bas-relief modeling. Experiments with a wide range of 3D models and scenes show that our method can effectively generate digital bas-reliefs.

76 FR 76762 - Notice of Lodging of Consent Decree Under the Clean Air Act

Science.gov (United States)

2011-12-08

... recovery at no additional cost; (2) no longer accept small appliances, motor vehicle air conditioners... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Air Act Notice is hereby.... Environmental Protection Agency (``U.S. EPA''), sought penalties and injunctive relief under the Clean Air Act...

76 FR 57764 - Notice of Lodging of Consent Decree Under the Clean Air Act

Science.gov (United States)

2011-09-16

... recovery at no additional cost; (2) no longer accept small appliances, motor vehicle air conditioners... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Air Act Notice is hereby... Agency (``U.S. EPA''), sought penalties and injunctive relief under the Clean Air Act (``CAA'') against...

Reward, motivation and emotion of pain and its relief

Science.gov (United States)

Porreca, Frank; Navratilova, Edita

2016-01-01

The experience of pain depends on interpretation of context and past experience that guide the choice of an immediate behavioral response and influence future decisions of actions to avoid harm. The aversive qualities of pain underlie its physiological role in learning and motivation. In this review, we highlight findings from human and animal investigations that suggest that both pain, and the relief of pain, are complex emotions that are comprised of feelings and their motivational consequences. Relief of aversive states, including pain, is rewarding. How relief of pain aversiveness occurs is not well understood. Termination of aversive states can directly provide relief as well as reinforce behaviors that result in avoidance of pain. Emerging preclinical data also suggests that relief may elicit a positive hedonic value that results from activation of neural cortical and mesolimbic brain circuits that may also motivate behavior. Brain circuits mediating the reward of pain relief, as well as relief-induced motivation are significantly impacted as pain becomes chronic. In chronic pain states, the negative motivational value of nociception may be increased while the value of the reward of pain relief may decrease. As a consequence, the impact of pain on these ancient, and conserved brain limbic circuits suggest a path forward for discovery of new pain therapies. PMID:28106670

Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief?

Science.gov (United States)

Schneider, Byron J; Huynh, Lisa; Levin, Josh; Rinkaekan, Pranathip; Kordi, Ramin; Kennedy, David J

2018-02-01

To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief. Prospective observational cohort. An institutional review board-approved prospective study from a single academic medical center. Patients with clinical diagnosis of sacroiliac (SIJ) pain and referred for SIJ injection were enrolled; 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg/mL were injected into the SIJ. Pain score on 0-10 numeric rating scale (NRS) during provocation maneuvers was recorded immediately before injection, immediately after injection, and at two and four weeks of follow-up. Oswestry Disability Index (ODI) was also recorded. Various cutoffs were identified to establish positive anesthetic response and successful outcomes at follow-up. These were used to calculated likelihood ratios. Of those with 100% anesthetic response, six of 11 (54.5%, 95% confidence interval [CI]+/-29.4%, +LR 2.6, 95% CI = 1.1-5.9) demonstrated 50% or greater pain relief at follow-up, and four of 11 (36.5%, 95% CI+/-28.4%, +LR 3.00, 95% CI = 1.4-5.1) had 100% relief at two to four weeks. Fourteen of 14 (100%, 95% CI+/-21.5%, -LR 0.0, 95% CI = 0.0-2.1) with an initial negative block failed to achieve 100% relief at follow-up. Patients who fail to achieve initial relief after SIJ injection with anesthetic and steroid are very unlikely to achieve significant pain relief at follow-up; negative likelihood ratios (LR) in this study, based on how success is defined, range between 0 and 0.9. Clinically significant positive likelihood ratios of anesthetic response to SIJ injection are more limited and less robust, but are valuable in predicting 50% relief or 100% relief at two to four weeks. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Late-Cenozoic relief evolution under evolving climate: A review

OpenAIRE

Champagnac Jean Daniel; Valla Pierre G.; Herman Frédéric

2014-01-01

The present review paper is an attempt to summarize quantitative evidence of Late Cenozoic changes in topographic relief. Different meanings of the word "relief" as it is commonly used and detail the metrics used to quantify it. We then specify methodological tools used to quantify relief change (primarily low temperature thermochronometry and terrestrial cosmogenic nuclides) and analyze published evidence for different regions.Our review first shows that relief changes and rates of changes a...

A sigh of relief or a sigh to relieve: The psychological and physiological relief effect of deep breaths.

Science.gov (United States)

Vlemincx, Elke; Van Diest, Ilse; Van den Bergh, Omer

2016-10-15

Both animal and human research have revealed important associations between sighs and relief. Previously we argued to conceive of sighs as resetters which temporarily induce relief. The present study aimed to investigate the psychological and physiological relief effect of sighs by instructed deep breaths and spontaneous sighs compared to a control breathing maneuver. Participants completed three blocks of 40 trials during which uncertainty cues were followed by either safety cues followed by a positive picture, or danger cues followed by a negative picture. One block was presented without breathing instructions, two subsequent blocks with breathing instructions. During the presentation of the safety and danger cues, an instruction was given to either 'take a deep breath' or 'postpone the next inhalation for 2 s (breath hold). Continuously, participants rated relief and Frontalis electromyography was recorded. Trait anxiety sensitivity was assessed by the Anxiety Sensitivity Index. Self-reported relief and physiological tension were compared 5s before and after instructed deep breaths and breath holds, and before and after spontaneous deep breaths and breath holds in the respective blocks. Results show that self-reported relief following an instructed deep breath was higher than before. Physiological tension decreased following a spontaneous sigh in high anxiety sensitive persons and following a spontaneous breath hold in low anxiety sensitive persons. These results are the first to show that a deep breath relieves and, in anxiety sensitive persons, reduces physiological tension. These findings support the hypothesis that sighs are psychological and physiological resetters. Copyright © 2016 Elsevier Inc. All rights reserved.

Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition

Science.gov (United States)

Becker, Susanne; Gandhi, Wiebke; Kwan, Saskia; Ahmed, Alysha-Karima; Schweinhardt, Petra

2015-01-01

When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience ("liking") of a reward by the motivation to obtain a reward ("wanting"), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief "won" in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality.

The First State Dream Act: In-State Resident Tuition and Immigration in Texas

Science.gov (United States)

Flores, Stella M.

2010-01-01

In 2001, Texas became the first state to pass an in-state resident tuition policy that benefits undocumented immigrant students, a majority of whom are of Latino/a origin. This analysis estimates the effect of the Texas in-state resident tuition policy on students likely to be undocumented. Using a differences-in-differences strategy and two…

Teacher in Residence: Bringing Science to Students

CERN Multimedia

Daisy Yuhas

CERN welcomes its first Teacher in Residence, Terrence Baine of the University of Oslo. Baine, who originally hails from Canada, will be concurrently completing his PhD in Physics Education during his time at CERN. Like CERN’s High School Teacher Programme (HST), of which Baine is an alumnus, the Teacher in Residence position is designed to help educators spread the science of CERN in a form that is accessible to students and can encourage them to pursue physics throughout their education.   Terrence Baine, first 'teacher in residence' at CERN Baine explains, “It’s very important to have a teacher present who can be that middle person between the young peoplecoming here, whom we are trying to enlighten, and the physicists who work at CERN. The Teacher in Residence can act as an on-site educational consultant.” As Teacher in Residence, Baine’s primary project will be to develop teaching modules, or a series of lesson plans, that can help high schoo...

Humanitarian assistance and disaster relief: changing the face of defense.

Science.gov (United States)

Laraby, Patrick R; Bourdeaux, Margaret; Casscells, S Ward; Smith, David J; Lawry, Lynn

2009-01-01

The US Department of Defense (DOD) is evolving to meet new security challenges in the twenty-first century. Today's challenges result from growing political, environmental, and economic instability in important areas of the globe that threaten national and global security. Immediate outreach to foreign nations in times of violent instability or natural disaster fosters security and stability both for the affected country and for the United States. Foreign humanitarian assistance (FHA) is a rapidly evolving military mission that addresses conflict prevention, conflict, postconflict, and natural disasters. With DOD's extensive global medical resources, it is often uniquely qualified to execute a critical role in relief and/or public health efforts. When and how the American military will act in FHA and disaster relief is a still evolving doctrine with three issues deserving particular attention: aligning operations with host government leadership, preserving humanitarian space, and tailoring the US military's unique resources to the specific political and medical situation at hand. The DOD's response to a large-scale earthquake in Peru suggests useful approaches to these three issues, provides a template for future FHA mission, and points to strategic decisions and operational capabilities that need further development to establish the FHA mission firmly within DOD's repertoire of security engagement activities.

Recent performance experience with US light water reactor self-actuating safety and relief valves

Energy Technology Data Exchange (ETDEWEB)

Hammer, C.G.

1996-12-01

Over the past several years, there have been a number of operating reactor events involving performance of primary and secondary safety and relief valves in U.S. Light Water Reactors. There are several different types of safety and relief valves installed for overpressure protection of various safety systems throughout a typical nuclear power plant. The following discussion is limited to those valves in the reactor coolant systems (RCS) and main steam systems of pressurized water reactors (PWR) and in the RCS of boiling water reactors (BWR), all of which are self-actuating having a setpoint controlled by a spring-loaded disk acting against system fluid pressure. The following discussion relates some of the significant recent experience involving operating reactor events or various testing data. Some of the more unusual and interesting operating events or test data involving some of these designs are included, in addition to some involving a number of similar events and those which have generic applicability.

Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

Science.gov (United States)

Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

2018-05-23

The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

Glovebox pressure relief and check valve

Energy Technology Data Exchange (ETDEWEB)

Blaedel, K.L.

1986-03-17

This device is a combined pressure relief valve and check valve providing overpressure protection and preventing back flow into an inert atmosphere enclosure. The pressure relief is embodied by a submerged vent line in a mercury reservior, the releif pressure being a function of the submerged depth. The pressure relief can be vented into an exhaust system and the relieving pressure is only slightly influenced by the varying pressure in the exhaust system. The check valve is embodied by a ball which floats on the mercury column and contacts a seat whenever vacuum exists within the glovebox enclosure. Alternatively, the check valve is embodied by a vertical column of mercury, the maximum back pressure being a function of the height of the column of mercury.

Glovebox pressure relief and check valve

International Nuclear Information System (INIS)

Blaedel, K.L.

1986-01-01

This device is a combined pressure relief valve and check valve providing overpressure protection and preventing back flow into an inert atmosphere enclosure. The pressure relief is embodied by a submerged vent line in a mercury reservior, the releif pressure being a function of the submerged depth. The pressure relief can be vented into an exhaust system and the relieving pressure is only slightly influenced by the varying pressure in the exhaust system. The check valve is embodied by a ball which floats on the mercury column and contacts a seat whenever vacuum exists within the glovebox enclosure. Alternatively, the check valve is embodied by a vertical column of mercury, the maximum back pressure being a function of the height of the column of mercury

USN/USMC Commander’s Quick Reference Handbook for Legal Issues

Science.gov (United States)

2012-04-01

active duty. DOMICILE and TAXATION : The Military Spouse Residency Relief Act (MSRRA) now allows the non-military spouses of servicemembers to...a dishonorable discharge (DD) or more than one year’s confinement is not authorized at a general court martial.  “ DOUBLE PUNISHMENT... DUAL

47 CFR 52.19 - Area code relief.

Science.gov (United States)

2010-10-01

... meetings to which the telecommunications industry and the public are invited on area code relief for a... 47 Telecommunication 3 2010-10-01 2010-10-01 false Area code relief. 52.19 Section 52.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING...

75 FR 29569 - Recovery Policy RP9526.1, Hazard Mitigation Funding Under Section 406 (Stafford Act)

Science.gov (United States)

2010-05-26

...] Recovery Policy RP9526.1, Hazard Mitigation Funding Under Section 406 (Stafford Act) AGENCY: Federal... the final Recovery Policy RP9526.1, Hazard Mitigation Funding Under Section 406 (Stafford Act), which... mitigation discretionary funding available under Section 406 of the Robert T. Stafford Disaster Relief and...

Paper relief architecture

NARCIS (Netherlands)

Latka, J.F.

2014-01-01

The article presents two contemporary projects of paper structures relief architecture designed and built by Shigeru Ban Architects and Voluntary Architect Network. Author of the article took part in design and construction process of one of the projects. The project of Yaan Nursery School, which

Digital Shaded-Relief Image of Alaska

Science.gov (United States)

Riehle, J.R.; Fleming, Michael D.; Molnia, B.F.; Dover, J.H.; Kelley, J.S.; Miller, M.L.; Nokleberg, W.J.; Plafker, George; Till, A.B.

1997-01-01

Introduction One of the most spectacular physiographic images of the conterminous United States, and the first to have been produced digitally, is that by Thelin and Pike (USGS I-2206, 1991). The image is remarkable for its crispness of detail and for the natural appearance of the artificial land surface. Our goal has been to produce a shaded-relief image of Alaska that has the same look and feel as the Thelin and Pike image. The Alaskan image could have been produced at the same scale as its lower 48 counterpart (1:3,500,000). But by insetting the Aleutian Islands into the Gulf of Alaska, we were able to print the Alaska map at a larger scale (1:2,500,000) and about the same physical size as the Thelin and Pike image. Benefits of the 1:2,500,000 scale are (1) greater resolution of topographic features and (2) ease of reference to the U.S. Geological Survey (USGS) (1987) Alaska Map E and the statewide geologic map (Beikman, 1980), which are both 1:2,500,000 scale. Manually drawn, shaded-relief images of Alaska's land surface have long been available (for example, Department of the Interior, 1909; Raisz, 1948). The topography depicted on these early maps is mainly schematic. Maps showing topographic contours were first available for the entire State in 1953 (USGS, 1:250,000) (J.H. Wittmann, USGS, written commun., 1996). The Alaska Map E was initially released in 1954 in both planimetric (revised in 1973 and 1987) and shaded-relief versions (revised in 1973, 1987, and 1996); topography depicted on the shaded-relief version is based on the 1:250,000-scale USGS topographic maps. Alaska Map E was later modified to include hypsometric tinting by Raven Maps and Images (1989, revised 1993) as copyrighted versions. Other shaded-relief images were produced for The National Geographic Magazine (LaGorce, 1956; 1:3,000,000) or drawn by Harrison (1970; 1:7,500,000) for The National Atlas of the United States. Recently, the State of Alaska digitally produced a shaded-relief image

Iraq's Debt Relief: Procedure and Potential Implications for International Debt Relief

National Research Council Canada - National Science Library

Weiss, Martin A

2009-01-01

.... Reducing this debt to a sustainable level has been a priority of the U.S. government. Since 2003, debt relief negotiations have taken place in a variety of fora and led to the cancellation of a significant amount of Iraq's external debt...

Increasing the Useful Life of Quench Reliefs with Inconel Bellows

Energy Technology Data Exchange (ETDEWEB)

Soyars, W. M. [Fermilab

1999-01-01

Reliable quench relief valves are an important part of superconducting magnet systems. Fermilab developed bellows-actuated cryogenic quench reliefs which have been in use since the early l 980's. The original design uses a stainless steel bellows. A high frequency, low amplitude vibration during relieving events has resulted in fatigue failures in the original design. To take advantage of the improved resistance to fatigue of Inconel, a nickel-chromium alloy, reliefs using Inconel 625 bellows were made. Design, development, and testing of the new version reliefs will be discussed. Tests show that relief valve lifetimes using Inconel bellows are more than five times greater than when using the original stainless steel bellows. Inconel bellows show great promise in increasing the lifetime of quench relief valves, and thus the reliability of accelerator cryogenic systems.

Optimal Laser Phototherapy Parameters for Pain Relief.

Science.gov (United States)

Kate, Rohit J; Rubatt, Sarah; Enwemeka, Chukuka S; Huddleston, Wendy E

2018-03-27

Studies on laser phototherapy for pain relief have used parameters that vary widely and have reported varying outcomes. The purpose of this study was to determine the optimal parameter ranges of laser phototherapy for pain relief by analyzing data aggregated from existing primary literature. Original studies were gathered from available sources and were screened to meet the pre-established inclusion criteria. The included articles were then subjected to meta-analysis using Cohen's d statistic for determining treatment effect size. From these studies, ranges of the reported parameters that always resulted into large effect sizes were determined. These optimal ranges were evaluated for their accuracy using leave-one-article-out cross-validation procedure. A total of 96 articles met the inclusion criteria for meta-analysis and yielded 232 effect sizes. The average effect size was highly significant: d = +1.36 (confidence interval [95% CI] = 1.04-1.68). Among all the parameters, total energy was found to have the greatest effect on pain relief and had the most prominent optimal ranges of 120-162 and 15.36-20.16 J, which always resulted in large effect sizes. The cross-validation accuracy of the optimal ranges for total energy was 68.57% (95% CI = 53.19-83.97). Fewer and less-prominent optimal ranges were obtained for the energy density and duration parameters. None of the remaining parameters was found to be independently related to pain relief outcomes. The findings of meta-analysis indicate that laser phototherapy is highly effective for pain relief. Based on the analysis of parameters, total energy can be optimized to yield the largest effect on pain relief.

Medications for Pain Relief during Labor and Delivery

Science.gov (United States)

... FAQ086 LABOR, DELIVERY, AND POSTPARTUM CARE Medications for Pain Relief During Labor and Delivery • What types of medications for pain relief are used during labor and delivery? • What are ...

Impacts of repetitive floods and satisfaction with flood relief efforts: A case study of the flood-prone districts in Thailand’s Ayutthaya province

Directory of Open Access Journals (Sweden)

Nawhath Thanvisitthpon

2017-01-01

Full Text Available This research investigates the impacts of the repetitive flooding on the inhabitants of the four flood-prone districts in Thailand’s central province of Ayutthaya: Pranakorn Si Ayutthaya, Sena, Bang Ban, and Pak Hai. In addition, the residents’ satisfaction levels with the flood relief efforts and operations of the local authorities were examined and analyzed. The research revealed that most local residents have adapted to co-exist with the repetitive floods, an example of which is the elevation of the houses a few meters above the ground where the living quarter is on the upper level. The findings also indicated that the repetitive flooding incurred substantial post-flood repair costs, in light of the low income-earning capabilities of the locals. However, the flood-recovery financial aids was incommensurate with the actual expenditures, contributing to the lowest average satisfaction score among the inhabitants with regard to the adequacy of the post-flood repair and restoration financial aid. Furthermore, the research identified the differences between districts on the satisfaction with the flood relief efforts. The disparity could be attributed to the extent of coordination and participation of the local residents and their local leaders in the flood-related measures.

Pain relief at the end of life: nurses' experiences regarding end-of-life pain relief in patients with dementia.

Science.gov (United States)

Brorson, Hanna; Plymoth, Henrietta; Örmon, Karin; Bolmsjö, Ingrid

2014-03-01

Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients' pain. This study aimed to describe nurses' experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard's content analysis inspired the data analysis. Two main categories were identified: (1) nurses' experience of difficulties concerning pain relief and (2) nurses' experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

30 CFR 204.201 - Who may obtain accounting and auditing relief?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Who may obtain accounting and auditing relief... MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.201 Who may obtain accounting and auditing relief? (a) You may obtain accounting and auditing relief under...

Politeness Strategies and Levels In Tourism-Service Language in Surakarta Residency

Directory of Open Access Journals (Sweden)

Budi Purnomo

2016-07-01

Full Text Available In tourism industry, tourists act as guests and tourism industry practitioners act as hosts. Typically tourism industry practitioners will try to act politely and follow politeness strategies as well as possible when serving tourists to ensure their satisfaction. Levels of satisfaction could be determined by the politeness of the hosts' behaviour towards their guests, including the politeness levels of their tourism-service language. This research was done in Surakarta Residency, the main tourist destination in Central Java. Data sources of this research came from (1 informants and (2 events.  The data were analyzed by Brown and Levinson’s politeness strategies (1987. The results of this research show that the tourism industry practitioners in Surakarta Residency use various politeness strategies and levels in tourism-service language to serve their guests.

46 CFR 154.801 - Pressure relief systems.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Pressure relief systems. 154.801 Section 154.801 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... Vent Systems § 154.801 Pressure relief systems. (a) Each cargo tank that has a volume of 20m3 (706 ft.3...

Problem neurology residents: a national survey.

Science.gov (United States)

Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

2011-06-14

Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

The control of tonic pain by active relief learning

Science.gov (United States)

Mano, Hiroaki; Lee, Michael; Yoshida, Wako; Kawato, Mitsuo; Robbins, Trevor W

2018-01-01

Tonic pain after injury characterises a behavioural state that prioritises recovery. Although generally suppressing cognition and attention, tonic pain needs to allow effective relief learning to reduce the cause of the pain. Here, we describe a central learning circuit that supports learning of relief and concurrently suppresses the level of ongoing pain. We used computational modelling of behavioural, physiological and neuroimaging data in two experiments in which subjects learned to terminate tonic pain in static and dynamic escape-learning paradigms. In both studies, we show that active relief-seeking involves a reinforcement learning process manifest by error signals observed in the dorsal putamen. Critically, this system uses an uncertainty (‘associability’) signal detected in pregenual anterior cingulate cortex that both controls the relief learning rate, and endogenously and parametrically modulates the level of tonic pain. The results define a self-organising learning circuit that reduces ongoing pain when learning about potential relief. PMID:29482716

The control of tonic pain by active relief learning.

Science.gov (United States)

Zhang, Suyi; Mano, Hiroaki; Lee, Michael; Yoshida, Wako; Kawato, Mitsuo; Robbins, Trevor W; Seymour, Ben

2018-02-27

Tonic pain after injury characterises a behavioural state that prioritises recovery. Although generally suppressing cognition and attention, tonic pain needs to allow effective relief learning to reduce the cause of the pain. Here, we describe a central learning circuit that supports learning of relief and concurrently suppresses the level of ongoing pain. We used computational modelling of behavioural, physiological and neuroimaging data in two experiments in which subjects learned to terminate tonic pain in static and dynamic escape-learning paradigms. In both studies, we show that active relief-seeking involves a reinforcement learning process manifest by error signals observed in the dorsal putamen. Critically, this system uses an uncertainty ('associability') signal detected in pregenual anterior cingulate cortex that both controls the relief learning rate, and endogenously and parametrically modulates the level of tonic pain. The results define a self-organising learning circuit that reduces ongoing pain when learning about potential relief. © 2018, Zhang et al.

Refuge alternatives relief valve testing and design with updated test stand.

Science.gov (United States)

Lutz, T J; Bissert, P T; Homce, G T; Yonkey, J A

2018-03-01

Underground refuge alternatives require an air source to supply breathable air to the occupants. This requires pressure relief valves to prevent unsafe pressures from building up within the refuge alternative. The U.S. Mine Safety and Health Administration (MSHA) mandates that pressure relief valves prevent pressure from exceeding 1.25 kPa (0.18 psi), or as specified by the manufacturer, above mine atmospheric pressure when a fan or compressor is used for the air supply. The U.S. National Institute for Occupational Safety and Health (NIOSH) tested a variety of pressure relief valves using an instrumented test fixture consisting of data acquisition equipment, a centrifugal blower, ductwork and various sensors to determine if the subject pressure relief valves meet the MSHA requirement. Relief pressures and flow characteristics, including opening pressure and flow rate, were measured for five different pressure relief valves under a variety of conditions. The subject pressure relief valves included two off-the-shelf modified check valves, two check valves used in MSHA-approved built-in-place refuge alternatives, and a commercially available valve that was designed for a steel refuge alternative and is currently being used in some built-in-place refuge alternatives. The test results showed relief pressures ranging from 0.20 to 1.53 kPa (0.03 to 0.22 psi) and flow rates up to 19.3 m 3 /min (683 scfm). As tested, some of the pressure relief valves did not meet the 1.25 kPa (0.18 psi) relief specification.

The Relationship between Stress, Job Performance, and Burnout in College Student Resident Assistants.

Science.gov (United States)

Nowak, Kenneth M.; Hanson, Alan L.

1983-01-01

Examined the relationship of stress, personality characteristics, and cognitive hardiness to job performance, burnout, and physical illness in resident assistants (N=37). Results indicated cognitive hardiness acts as a buffer against burnout and physical illness. Resident assistants rating themselves as Type A received poorer job performance…

Does pain relief by CT-guided indirect cervical nerve root injection with local anesthetics and steroids predict pain relief after decompression surgery for cervical nerve root compression?

Science.gov (United States)

Antoniadis, Alexander; Dietrich, Tobias J; Farshad, Mazda

2016-10-01

The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post-injection effects to the short- and long-term outcomes after surgical decompression, specifically in regard to pain relief. Patients (n = 39, age 47 ± 10 years) who had undergone CT-guided indirect injection with local anesthetics and steroids as an initial treatment for single cervical nerve root radiculopathy and who subsequently needed surgical decompression were included retrospectively. Pain levels (VAS scores) were monitored before, immediately after, and 6 weeks after injection (n = 34), as well as 6 weeks (n = 38) and a mean of 25 months (SD ± 12) after surgical decompression (n = 36). Correlation analysis was performed to find potential associations of pain relief after injection and after surgery to investigate the predictive value of post-injection pain relief. There was no correlation between immediate pain relief after injection (-32 ± 27 %) and 6 weeks later (-7 ± 19 %), (r = -0.023, p = 0.900). There was an association by tendency between immediate pain relief after injection and post-surgical pain relief at 6 weeks (-82 ± 27 %), (r = 0.28, p = 0.08). Pain relief at follow-up remained high at -70 ± 21 % and was correlated with the immediate pain amelioration effect of the injection (r = 0.37, p = 0.032). Five out of seven patients who reported no pain relief from injection had a pain relief from surgery in excess of 50 %. The amount of immediate radiculopathic pain relief after indirect cervical nerve root injection is associated with the amount of pain relief achieved at long-term follow-up after surgical decompression of single-level cervical radiculopathy

30 CFR 204.205 - How do I obtain accounting and auditing relief?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I obtain accounting and auditing relief... MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.205 How do I obtain accounting and auditing relief? (a) To take cumulative reports and payments relief...

How absent negativity relates to affect and motivation: an integrative relief model.

Science.gov (United States)

Deutsch, Roland; Smith, Kevin J M; Kordts-Freudinger, Robert; Reichardt, Regina

2015-01-01

The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation - a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO.

How absent negativity relates to affect and motivation: an integrative relief model

Science.gov (United States)

Deutsch, Roland; Smith, Kevin J. M.; Kordts-Freudinger, Robert; Reichardt, Regina

2015-01-01

The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO. PMID:25806008

30 CFR 204.211 - When may MMS rescind relief for a property?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When may MMS rescind relief for a property? 204... MMS rescind relief for a property? (a) MMS may retroactively rescind the relief for your property if MMS determines that your property was not eligible for the relief obtained under this subpart because...

21 CFR 882.5840 - Implanted intracerebral/subcortical stimulator for pain relief.

Science.gov (United States)

2010-04-01

... pain relief. 882.5840 Section 882.5840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 882.5840 Implanted intracerebral/subcortical stimulator for pain relief. (a) Identification. An implanted intracerebral/subcortical stimulator for pain relief is a device that applies electrical current...

A neurogenetic dissociation between punishment-, reward- and relief-learning in Drosophila

Directory of Open Access Journals (Sweden)

ayse Yarali

2010-12-01

Full Text Available What is particularly worth remembering about a traumatic experience is what brought it about, and what made it cease. For example, fruit flies avoid an odour which during training had preceded electric shock punishment; on the other hand, if the odour had followed shock during training, it is later on approached as a signal for the relieving end of shock. We provide a neurogenetic analysis of such relief learning. Blocking, using UAS-shibirets1, the output from a particular set of dopaminergic neurons defined by the TH-Gal4 driver partially impaired punishment learning, but left relief learning intact. Thus, with respect to these particular neurons, relief learning differs from punishment learning. Targeting another set of dopaminergic/ serotonergic neurons defined by the DDC-Gal4 driver on the other hand affected neither punishment nor relief learning. As for the octopaminergic system, the tbhM18 mutation, compromising octopamine biosynthesis, partially impaired sugar-reward learning, but not relief learning. Thus, with respect to this particular mutation, relief learning and reward learning are dissociated. Finally, blocking output from the set of octopaminergic/ tyraminergic neurons defined by the TDC2-Gal4 driver affected neither reward, nor relief learning. We conclude that regarding the used genetic tools, relief learning is neurogenetically dissociated from both punishment and reward learning.

My Life as a DREAMer Who ACTed beyond the Barriers: From Growing up "Undocumented" in Arizona to a Master's Degree from Harvard

Science.gov (United States)

Vega, Silvia P. Rodriguez

2011-01-01

In this article, the author shares the story of her life as a DREAM Act student who acted beyond the barriers. The DREAM Act, defined as the Development, Relief, and Education for Alien Minors Act, is an effort to establish a path to citizenship for some children of illegal immigrants. Her story begins like the thousands of other students who are…

Deepwater royalty relief product of 3 1/2 year U.S. political effort

International Nuclear Information System (INIS)

Davis, R.E.; Neff, S.

1996-01-01

Against the backdrop of more than 20 years of increasingly stringent environmental regulation, ever-expanding exploration and development moratoria on the Outer Continental Shelf (OCS), and reductions in producer tax incentives, oil and natural gas exploration companies active in deep waters of the Gulf of Mexico recently won a significant legislative victory. On Nov. 28, 1995, President Clinton signed into law S.395, the Alaska Power Administration Sale Act. Title 3 of S.395 embodies the Outer Continental Shelf Deep Water Royalty Relief Act. This landmark legislation provides substantial incentives for oil and natural gas production in the gulf of Mexico by temporarily eliminating royalties on certain deepwater leases. It is the first direct incentive for oil and gas production enacted at the federal level in many years. This paper reviews the elements used to arrive at this successful legislation including the congressional leadership. It describes debates, cabinet level discussions, and use of parlimentary procedures

Analysis of preservice inspection relief requests and recommendations for ASME code changes

International Nuclear Information System (INIS)

Cook, J.F.

1985-05-01

NRC regulations require that preservice inspection (PSI) of nuclear plants be performed in accordance with referenced editions and addenda of Division 1 rules of Section XI, ''Rules for Inservice Inspection of Nuclear Power Plant Components'', of the ASME Boiler and Pressure Vessel Code (ASME Code). The regulations permit applicants to request and obtain relief from the NRC from specific ASME Code requirements that are determined to be impractical. Applicant requests for relief from preservice inspection (PSI) requirements were compiled and analyzed. From this data, covering a total of 178 relief requests, common problems with examination requirements were identified. Changes to examination requirements to solve selected problems are proposed. By following later ASME Code requirements, 46 out of the 178 relief requests can be eliminated. Implementing proposed Code changes would eliminate another 25 relief requests, leaving 107 relief requests out of the original 178 relief requests covered by this survey

21 CFR 882.5890 - Transcutaneous electrical nerve stimulator for pain relief.

Science.gov (United States)

2010-04-01

... pain relief. 882.5890 Section 882.5890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 882.5890 Transcutaneous electrical nerve stimulator for pain relief. (a) Identification. A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to...

The roles of special proresolving mediators in pain relief.

Science.gov (United States)

Zhang, Lan-Yu; Jia, Ming-Rui; Sun, Tao

2018-02-08

The resolution of acute inflammation, once thought to be a passive process, is now recognized as an active one. The productions of endogenous special proresolving mediators (SPMs) are involved in this process. SPMs, including lipoxins, resolvins, protectins, and maresins, are endogenous lipid mediators generated from ω-6 arachidonic acid or ω-3 poly-unsaturated fatty acids during the resolution phase of acute inflammation. They have potent anti-inflammatory and proresolving actions in various inflammatory disorders. Due to the potent proresolving and anti-inflammatory effects, SPMs are also used for pain relief. This review focuses on the mechanisms by which SPMs act on their respective G-protein-coupled receptors in immune cells and nerve cells to normalize pain via regulating inflammatory mediators, transient receptor potential ion channels, and central sensitization. SPMs may offer novel therapeutic approaches for preventing and treating pain conditions associated with inflammation.

How Absent Negativity Relates to Affect and Motivation: An Integrative Relief Model

Directory of Open Access Journals (Sweden)

Roland eDeutsch

2015-03-01

Full Text Available The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion and motivational systems (Carver & Scheier, 1990; Gray & McNaughton, 2000; Higgins, 1997; Lang, Bradley, & Cuthbert, 1990. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors (Mowrer, 1951; Ostafin & Brooks, 2011, self destructive behaviors (Favazza, 1998; Franklin, Lee, Hanna, & Prinstein, 2013, and social influence (Dolinski & Nawrat, 1998. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO.

21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve...

Opportunities in the American Recovery and Reinvestment Act for Supports and Services for Youth Transitioning from Foster Care

Science.gov (United States)

Flynn-Khan, Margaret; Langford, Barbara Hanson

2009-01-01

To address the economic crisis facing the country, the President signed the American Recovery and Reinvestment Act (ARRA) into law on February 17, 2009. This sweeping legislation provides $789 billion to jumpstart the economy and boost employment. This act includes $463 billion in new spending and $326 billion in tax relief directed at those…

Southern Alaska Coastal Relief Model

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NOAA's National Geophysical Data Center (NGDC) is building coastal-relief models (CRM) for select U.S. coastal regions. Bathymetric, topographic, and shoreline data...

Non-Drug Pain Relief: Imagery

Science.gov (United States)

PATIENT EDUCATION patienteducation.osumc.edu Non-Drug Pain Relief: Imagery Relaxation helps lessen tension. One way to help decrease pain is to use imagery. Imagery is using your imagination to create a ...

32 CFR Appendix G to Part 323 - Privacy Act Enforcement Actions

Science.gov (United States)

2010-07-01

... right granted by this DLAR will be permitted to seek relief through appropriate administrative channels... damages, court cost, and attorney fees in some cases. D. Criminal Penalties— 1. The Privacy Act also provides for criminal penalties (see 5 U.S.C. 552a(1).) Any official or employee may be found guilty of a...

48 CFR 33.205 - Relationship of the Act to Pub. L. 85-804.

Science.gov (United States)

2010-10-01

... relief under the law of Federal contracts. Due to the complex legal issues likely to be associated with... submitted to the contracting officer for consideration under the Contract Disputes Act of 1978 because the... REGULATION GENERAL CONTRACTING REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.205...

Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?

International Nuclear Information System (INIS)

Deshmukh, Ajit J.; Rodriguez, Jose A.; Panagopoulos, Georgia; Alizadeh, Ahmadreza; Klein, Devon A.

2011-01-01

Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration. This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren-Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient. Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80, p < 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief. Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty. (orig.)

Annual Report to Parliament Access to Information Act International ...

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

leonardi

Part 6: Completion time of consultations on Cabinet confidences . ... The Act gives Canadian citizens and permanent residents the right to have access to federal government ... The ATIP Coordinator works with IDRC's Information Management .... to its employees on the Act. However, a training program was developed and.

Allergy Relief for Your Child

Science.gov (United States)

... Products For Consumers Home For Consumers Consumer Updates Allergy Relief for Your Child Share Tweet Linkedin Pin ... at the FDA. Avoid Pollen, Mold and Other Allergy Triggers If your child has seasonal allergies, pay ...

U.S. Coastal Relief Model

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

The dynamic implications of debt relief for low-income countries

Directory of Open Access Journals (Sweden)

Alma Lucía Romero-Barrutieta

2015-06-01

Full Text Available Debt relief provides low-income countries with an incentive to accumulate debt, boost consumption, and reduce investment over time. We quantify this incentive effect employing a dynamic stochastic general equilibrium model, calibrated to 1982–2006 Ugandan data, and find that long-run debt and consumption-to-GDP ratios are about twice as high with debt relief than without it, while the investment-to-GDP ratio is sixty percent lower. Our simulations show that debt-relief episodes are likely to have only a temporary impact on debt levels but may have a lasting effect over the size of the economy, lowering GDP growth up to twenty percent over time. These results fill a gap in the debt relief literature since, to the best of our knowledge, the quantification of incentive effects is rather scarce. The paper further contributes to the literature by constructing a tractable structural model that is able to replicate the data well and captures key features of low-income countries facing the possibility of debt relief.

Studies on the visualization of the fine relief of the colon

International Nuclear Information System (INIS)

Persigehl, M.; Niemann, G.; Klose, K.C.

1983-01-01

The possibility of visualizing the fine relief of the colon was examined by studying human intestinal segments removed post mortem. The visualization depends, among other things, on the extent of expansion of the colon wall. The visualization of the fine relief structure becomes progressively poorer, the greater the extension of the wall. This might indicate that fold formation of the mucosa through a state of contraction of the tunica mucosa is done of the responsible factors for the visualization of the fine relief structures. The article discusses, apart from this factor, the course of the vessels as an anatomical basic pattern determining the manifestation of the fine relief structure; for this purpose, the course of the vessels in the intestine of the dog was visualized by intra-arterial contrast medium injection and then compared with the human fine relief. (orig.) [de

Spontaneous formation of optically induced surface relief gratings

International Nuclear Information System (INIS)

Leblond, H; Barille, R; Ahmadi-Kandjani, S; Nunzi, J-M; Ortyl, E; Kucharski, S

2009-01-01

We develop a model based on Fick's law of diffusion as a phenomenological description of the molecular motion, and on the coupled mode theory, to describe single-beam surface relief grating formation in azopolymer thin films. The model allows us to explain the mechanism of spontaneous patterning, and self-organization. It allows us to compute the surface relief profile and its evolution, with good agreement with experiments.

Integration of real-time mapping technology in disaster relief distribution.

Science.gov (United States)

2013-02-01

Vehicle routing for disaster relief distribution involves many challenges that distinguish this problem from those in commercial settings, given the time sensitive and resource constrained nature of relief activities. While operations research approa...

Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition1,2,3

Science.gov (United States)

Kwan, Saskia; Schweinhardt, Petra

2015-01-01

Abstract When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience (“liking”) of a reward by the motivation to obtain a reward (“wanting”), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief “won” in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality. PMID:26464995

Elevation-relief ratio, hypsometric integral, and geomorphic area-altitude analysis.

Science.gov (United States)

Pike, R. J.; Wilson, S. E.

1971-01-01

Mathematical proof establishes identity of hypsometric integral and elevation-relief ratio, two quantitative topographic descriptors developed independently of one another for entirely different purposes. Operationally, values of both measures are in excellent agreement for arbitrarily bounded topographic samples, as well as for low-order fluvial watersheds. By using a point-sampling technique rather than planimetry, elevation-relief ratio (defined as mean elevation minus minimum elevation divided by relief) is calculated manually in about a third of the time required for the hypsometric integral.

Decongestants: OTC Relief for Congestion

Science.gov (United States)

... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

Synapsin determines memory strength after punishment- and relief-learning.

Science.gov (United States)

Niewalda, Thomas; Michels, Birgit; Jungnickel, Roswitha; Diegelmann, Sören; Kleber, Jörg; Kähne, Thilo; Gerber, Bertram

2015-05-13

Adverse life events can induce two kinds of memory with opposite valence, dependent on timing: "negative" memories for stimuli preceding them and "positive" memories for stimuli experienced at the moment of "relief." Such punishment memory and relief memory are found in insects, rats, and man. For example, fruit flies (Drosophila melanogaster) avoid an odor after odor-shock training ("forward conditioning" of the odor), whereas after shock-odor training ("backward conditioning" of the odor) they approach it. Do these timing-dependent associative processes share molecular determinants? We focus on the role of Synapsin, a conserved presynaptic phosphoprotein regulating the balance between the reserve pool and the readily releasable pool of synaptic vesicles. We find that a lack of Synapsin leaves task-relevant sensory and motor faculties unaffected. In contrast, both punishment memory and relief memory scores are reduced. These defects reflect a true lessening of associative memory strength, as distortions in nonassociative processing (e.g., susceptibility to handling, adaptation, habituation, sensitization), discrimination ability, and changes in the time course of coincidence detection can be ruled out as alternative explanations. Reductions in punishment- and relief-memory strength are also observed upon an RNAi-mediated knock-down of Synapsin, and are rescued both by acutely restoring Synapsin and by locally restoring it in the mushroom bodies of mutant flies. Thus, both punishment memory and relief memory require the Synapsin protein and in this sense share genetic and molecular determinants. We note that corresponding molecular commonalities between punishment memory and relief memory in humans would constrain pharmacological attempts to selectively interfere with excessive associative punishment memories, e.g., after traumatic experiences. Copyright © 2015 Niewalda et al.

Synapsin Determines Memory Strength after Punishment- and Relief-Learning

Science.gov (United States)

Niewalda, Thomas; Michels, Birgit; Jungnickel, Roswitha; Diegelmann, Sören; Kleber, Jörg; Kähne, Thilo

2015-01-01

Adverse life events can induce two kinds of memory with opposite valence, dependent on timing: “negative” memories for stimuli preceding them and “positive” memories for stimuli experienced at the moment of “relief.” Such punishment memory and relief memory are found in insects, rats, and man. For example, fruit flies (Drosophila melanogaster) avoid an odor after odor-shock training (“forward conditioning” of the odor), whereas after shock-odor training (“backward conditioning” of the odor) they approach it. Do these timing-dependent associative processes share molecular determinants? We focus on the role of Synapsin, a conserved presynaptic phosphoprotein regulating the balance between the reserve pool and the readily releasable pool of synaptic vesicles. We find that a lack of Synapsin leaves task-relevant sensory and motor faculties unaffected. In contrast, both punishment memory and relief memory scores are reduced. These defects reflect a true lessening of associative memory strength, as distortions in nonassociative processing (e.g., susceptibility to handling, adaptation, habituation, sensitization), discrimination ability, and changes in the time course of coincidence detection can be ruled out as alternative explanations. Reductions in punishment- and relief-memory strength are also observed upon an RNAi-mediated knock-down of Synapsin, and are rescued both by acutely restoring Synapsin and by locally restoring it in the mushroom bodies of mutant flies. Thus, both punishment memory and relief memory require the Synapsin protein and in this sense share genetic and molecular determinants. We note that corresponding molecular commonalities between punishment memory and relief memory in humans would constrain pharmacological attempts to selectively interfere with excessive associative punishment memories, e.g., after traumatic experiences. PMID:25972175

76 FR 51869 - Privacy Act Implementation

Science.gov (United States)

2011-08-19

... permanent residence. Maintain includes collect, use, disseminate, or control. Privacy Act means the Privacy... announces the creation, deletion, or amendment of one or more system of records. System of records notices... reference and university libraries or electronically at the [[Page 51873

Flying Real-Time Network to Coordinate Disaster Relief Activities in Urban Areas

Directory of Open Access Journals (Sweden)

Matias Micheletto

2018-05-01

Full Text Available While there have been important advances within wireless communication technology, the provision of communication support during disaster relief activities remains an open issue. The literature in disaster research reports several major restrictions to conducting first response activities in urban areas, given the limitations of telephone networks and radio systems to provide digital communication in the field. In search-and-rescue operations, the communication requirements are increased, since the first responders need to rely on real-time and reliable communication to perform their activities and coordinate their efforts with other teams. Therefore, these limitations open the door to improvisation during disaster relief efforts. In this paper, we argue that flying ad-hoc networks can provide the communication support needed in these scenarios, and propose a new solution towards that goal. The proposal involves the use of flying witness units, implemented using drones, that act as communication gateways between first responders working at different locations of the affected area. The proposal is named the Flying Real-Time Network, and its feasibility to provide communication in a disaster scenario is shown by presenting both a real-time schedulability analysis of message delivery, as well as simulations of the communication support in a physical scenario inspired by a real incident. The obtained results were highly positive and consistent, therefore this proposal represents a step forward towards the solution of this open issue.

Groundbreaking approach to disaster relief

OpenAIRE

2008-01-01

The humanitarian response to Cyclone Nargis, which struck Myanmar on 2 and 3 May, heralds a fundamentally new approach to relief coordination. As a result, a unique survey showed what really happened to the survivors. Sarah Cumberland reports.

30 CFR 203.53 - What relief will MMS grant?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What relief will MMS grant? 203.53 Section 203.53 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE...-Life Leases § 203.53 What relief will MMS grant? (a) If we approve your application and you meet...

Spontaneous formation of optically induced surface relief gratings

Energy Technology Data Exchange (ETDEWEB)

Leblond, H; Barille, R; Ahmadi-Kandjani, S; Nunzi, J-M [Laboratoire POMA, Universite d' Angers, CNRS FRE 2988, 2, Bd Lavoisier, 49045 Angers (France); Ortyl, E; Kucharski, S, E-mail: herve.leblond@univ-angers.f [Wroclaw University of Technology, Faculty of Chemistry, Department of Polymer Engineering and Technology, 50-370 Wroclaw (Poland)

2009-10-28

We develop a model based on Fick's law of diffusion as a phenomenological description of the molecular motion, and on the coupled mode theory, to describe single-beam surface relief grating formation in azopolymer thin films. The model allows us to explain the mechanism of spontaneous patterning, and self-organization. It allows us to compute the surface relief profile and its evolution, with good agreement with experiments.

RELIEF JENIS-JENIS FAUNA DAN SETTING LINGKUNGANNYA PADA PAHATAN DINDING CANDI BOROBUDUR (Fauna and Environmental Setting Reliefs on Sculptured Wall of the Borobudur Temple

Directory of Open Access Journals (Sweden)

Bambang Agus Suripto

2001-04-01

Full Text Available ABSTRAK Dalam perkembangan kebudayaannya, manusia selalu akrab dengan fauna yang hidup di sekitar lingkungannya. Pada dinding gua yang pernah dihuni oleh manusia, bangunan candi, piramid, sphinx dsb. dijumpai gambaran tentang fauna. Pada dinding Candi Borobudur banyak dijumpai relief berbagai kelompok fauna tetapi belum diketahui apakah fauna itu semuanya berasal dari India atau terdapat pula kelompok yang ada atau pernah ada di Pulau Jawa. Tujuan penelitian ini adalah untuk mengetahui relief jenis-jenis fauna yang dipahat pada dinding candi Borobudur, dan mengetahui asal-usul jenis yang tergarnbar pada relief itu dari Pulau Jawa atau dari India. Informasi itu diharapkan dapat diungkapkan ada tidaknya gambaran setting lingkungan Pulau Jawa tercermin pada pahatan di dinding Candi itu. Relief fauna pada pahatan dinding langkan, dinding utama bagian atas-bawah di tingkatan Rupadhatu dipotret dan nama kelompok fauna diindentifikasi dengan buku-buku kunci identifikasi bergambar, kemudian penyebaran alami masing-masing kelompok fauna diketahui melalui kajian pustaka. Data yang diperoleh dianalisis secara deskriptif untuk mengungkap ada atau tidaknya gambaran setting lingkungan Pulau Jawa yang tercermin pada pahatan di dinding Candi Borsbudur. Pada dinding Candi Borobudur terdapat relief paling sedikit 25 jenis anggota Osteichthyes, Reptilia, Aves dan Mammalia yang dipahat secara natural, dan terdapat paling sedikit 5 jenis hewan yang dipahat secara setilir. Semua jenis fauna itu terdapat di Asia Selatan, dan beberapa di anlaranya secara alami tidak pernah hidup di Pulau Jawa, misalnya singa Pantera leo. Setting lingkungan India Abad VII tervisualisasi dengan baik pada relief pahatan dinding Candi Borobudur, tetapi setting lingkungan Pulau Jawa sampai sebelum masa penjajahan Belanda tidak tergambar dengan baik.   ABSTRACT In the cource of culture development, human was always close to fauna in their surrounding areas. Pictures of fauna are found in

Simultaneous Provision of Flexible Ramping Product and Demand Relief by Interruptible Loads Considering Economic Incentives

Directory of Open Access Journals (Sweden)

Jiahua Hu

2017-12-01

Full Text Available To cope with the net load variability in real time, sufficient ramp capability from controllable resources is required. To address the issue of insufficient ramp capacity in real time operations, flexible ramping products (FRPs have been adopted by some Independent System Operators (ISOs in the USA as a new market design. The inherent variability and uncertainty caused by renewable energy sources (RESs call for new FRP providers apart from conventional generating units. The so-called interruptible load (IL has proved to be useful in maintaining the supply-demand balance by providing demand relief and can be a viable FRP provider in practice. Given this background, this work presents a stochastic real-time unit commitment model considering ramp requirement and simultaneous provision of IL for FRP and demand relief. Load serving entities (LSEs are included in the proposed model and act as mediators between the ISO and multiple ILs. In particular, incentive compatible contracts are designed to encourage customers to reveal their true outage costs. Case studies indicate both the system and LSEs can benefit by employing the proposed method and ILs can gain the highest profits by signing up a favorable contract.

Analysis of residual stress relief mechanisms in post-weld heat treatment

International Nuclear Information System (INIS)

Dong, Pingsha; Song, Shaopin; Zhang, Jinmiao

2014-01-01

This paper presents a recent study on weld residual stress relief mechanisms associated with furnace-based uniform post-weld heat treatment (PWHT). Both finite element and analytical methods are used to quantitatively examine how plastic deformation and creep relaxation contribute to residual stress relief process at different stages of PWHT process. The key contribution of this work to an improved understanding of furnace based uniform PWHT can be summarized as follows: (1)Plastic deformation induced stress relief during PWHT can be analytically expressed by the change in material elastic deformation capacity (or elastic deformation limit) measured in terms of material yield strength to Young's modulus ratio, which has a rather limited role in overall residual stress relief during furnace based uniform PWHT. (2)The most dominant stress relief mechanism is creep strain induced stress relaxation, as expected. However, a rapid creep strain development accompanied by a rapid residual stress reduction during heating stage before reaching PWHT temperature is shown to contribute to most of the stress relief seen in overall PWHT process, suggesting PWHT hold time can be significantly reduced as far as residual stress relief is concerned. (3)A simple engineering scheme for estimating residual stress reduction is proposed based on this study by relating material type, PWHT temperature, and component wall thickness. - Highlights: • The paper clarified effects of plastic deformation and creep relaxation on weld residual stress relief during uniform PWHT. • Creep strain development is far more important than plastic strain, mostly completed even before hold time starts. • Plastic strain development is insignificant and be analytically described by a material elastic deformation capacity parameter. • An engineering estimation scheme is proposed for determining residual stress reduction resulted from furnace based PWHT

Columbia River System Operation Review final environmental impact statement. Appendix K: Resident fish

International Nuclear Information System (INIS)

1995-11-01

The System Operation Review (SOR) is a study and environmental compliance process being used by the three Federal agencies to analyze future operations of the system and river use issues. The goal of the SOR is to achieve a coordinated system operation strategy for the river that better meets the needs of all river users. This technical appendix addresses only the effects of alternative system operating strategies for managing the Columbia River system. In this appendix the Resident Fish Work Group (RFWG) has attempted to characterize and evaluate impacts of dam operation on an extremely complex and diverse integrated resource. Not only is this required under the National Environmental Policy Act (NEPA) for SOR, there are resident fish populations that have status under the Federal Endangered Species Act (ESA) or equivalent state regulations (Kootenai River white sturgeon, Snake River white sturgeon, sandroller, shorthead and torrent sculpins, bull trout, westslope cutthroat trout, redband trout, and burbot). The RFWG has also attempted to develop operating alternatives that benefit not only resident fish, but anadromous fish, wildlife, and other human interests as well. The authors have recognized the co-evolution of resident fish, anadromous fish, and other integrated resources in the basin

Music for pain relief.

Science.gov (United States)

Cepeda, M S; Carr, D B; Lau, J; Alvarez, H

2006-04-19

The efficacy of music for the treatment of pain has not been established. To evaluate the effect of music on acute, chronic or cancer pain intensity, pain relief, and analgesic requirements. We searched The Cochrane Library, MEDLINE, EMBASE, PsycINFO, LILACS and the references in retrieved manuscripts. There was no language restriction. We included randomized controlled trials that evaluated the effect of music on any type of pain in children or adults. We excluded trials that reported results of concurrent non-pharmacological therapies. Data was extracted by two independent review authors. We calculated the mean difference in pain intensity levels, percentage of patients with at least 50% pain relief, and opioid requirements. We converted opioid consumption to morphine equivalents. To explore heterogeneity, studies that evaluated adults, children, acute, chronic, malignant, labor, procedural, or experimental pain were evaluated separately, as well as those studies in which patients chose the type of music. Fifty-one studies involving 1867 subjects exposed to music and 1796 controls met inclusion criteria. In the 31 studies evaluating mean pain intensity there was a considerable variation in the effect of music, indicating statistical heterogeneity ( I(2) = 85.3%). After grouping the studies according to the pain model, this heterogeneity remained, with the exception of the studies that evaluated acute postoperative pain. In this last group, patients exposed to music had pain intensity that was 0.5 units lower on a zero to ten scale than unexposed subjects (95% CI: -0.9 to -0.2). Studies that permitted patients to select the music did not reveal a benefit from music; the decline in pain intensity was 0.2 units, 95% CI (-0.7 to 0.2). Four studies reported the proportion of subjects with at least 50% pain relief; subjects exposed to music had a 70% higher likelihood of having pain relief than unexposed subjects (95% CI: 1.21 to 2.37). NNT = 5 (95% CI: 4 to 13). Three

Experiences from tsunami relief activity: implications for medical education.

Science.gov (United States)

Balasubramaniam, Sudharsanam Manni; Mohan, Yogesh; Roy, Gautam

2012-01-01

A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER) in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills.

Patient expectations predict greater pain relief with joint arthroplasty.

Science.gov (United States)

Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

2009-08-01

We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

Mechanical Designs for Relief Valves for Cryogenic Apparatuses and Installations

CERN Multimedia

CERN. Geneva

2016-01-01

There are also pressure relief valves with warm seat available on which the set pressure is based on an adjustment of forces by permanent magnets. Pressure vessel rules allows also the choice for an active triggered pressure relief valve (Cont...

76 FR 15998 - Notice of Lodging of Consent Decree Under the Clean Water Act

Science.gov (United States)

2011-03-22

..., treatment plant, and landfill. To address two mines with discharges into the Ohio River Basin, Defendants... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Water Act Notice is..., Defendants will perform injunctive relief with two components. To address four mines with discharges into the...

Pictorial relief for equiluminant images

NARCIS (Netherlands)

Van Doorn, A.J.; De Ridder, H.; Koenderink, J.J.

2005-01-01

Pictorial relief depends strongly on “cues” in the image. For isoluminant renderings some cues are missing, namely all information that is related to luminance contrast (e.g., shading, atmospheric perspective). It has been suggested that spatial discrimination and especially pictorial space suffer

Service Learning Through Disaster Relief

Directory of Open Access Journals (Sweden)

Donna J. Duerst

2010-06-01

Full Text Available The Rock County 4-H Disaster Relief Committee raised $1,550 to aid tsunami victims in Sri Lanka and then turned its attention to Hurricane Katrina relief efforts. Thirty-one 4-H youth participated in a service learning trip to the South with the objectives of helping hurricane victims, learning about new cultures and achieving personal growth during three days of service projects in Louisiana and Mississippi. Their written reflections and other evaluative measures revealed they learned about southern culture, gained a greater appreciation for their lives, gained self confidence and developed a desire to help others more often. The trip was a valuable developmental experience for the youth, and information from the trip could be utilized to create similar experiences based on service learning. This article provides an overview of the trip and describes the evaluation methods used to measure learning and assess personal growth.

Elder abuse and neglect in institutional settings: the resident's perspective.

Science.gov (United States)

Charpentier, Michèle; Soulières, Maryse

2013-01-01

This article strives to share research findings concerning the rights and empowerment of the elderly living in various long-term care (LTC) or residential care facilities (public and private sectors) in Quebec, Canada. Inspired by the theories of constructivism, the research aims to understand the residents' perception of abuse, as well as the strategies they are developing to exercise their rights and liberties. Data from semistructured interviews with 20 residents, mostly very old women aged 80 to 98, are presented. Results show that residents' perception of abuse: (1) is conditioned by sensationalistic media coverage; (2) is limited to physical mistreatment; and (3) tends to legitimize day-to-day infringements of their rights, as these "minor" violations seem inoffensive when compared to the "real" acts of violence reported in the media. Tensions that can build up among residents, sometimes resulting in intimidation or even bullying, were addressed.

Epidural morphine for postoperative pain relief in children

DEFF Research Database (Denmark)

Henneberg, S W; Hole, P; Haas, Inge Madsen De

1993-01-01

Epidural morphine for postoperative pain relief is in general use, and has proved to be very efficient in adults. The epidural technique and the use of epidural morphine are much less frequent in children. For 2 years we have prospectively followed 76 children who had epidural morphine...... for postoperative pain relief after major abdominal surgery. The age distribution was from newborn to 13 years, with a median age of 12 months. It was estimated that 94% of the patients had good analgesia for the first 24 postoperative hours and no other opioids were given. The side effects were few, but one case...... the investigation. We observed a change in the sleeping pattern with an increased number of sleep-induced myoclonia during the administration of epidural morphine. In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been...

Multinarasi Relief Yeh Pulu Basis Penciptaan Seni Lukis Kontemporer

Directory of Open Access Journals (Sweden)

I Wayan Adnyana

2018-05-01

Full Text Available Kajian ini merupakan skema penelitian terapan, yang bertujuan untuk mengungkap konsep multinarasi relief Yeh Pulu, Bedulu, Gianyar, Bali, sebagai basis penciptaan seni lukis kontemporer. Secara metodologis penelitian ini dilakukan dalam dua tahapan: penelitian lapangan (kajian atas narasi relief berdasar perspektif ikonologi Panofsky (1971, dan berikutnya penelitian eksperimen terkait penciptaan seni lukis kontemporer berdasar perspektif ‘art practice as a research’ (Sullivan, 2005 yang menunjuk pada tiga tahapan: eksperimen medium, bahasa visual, dan penyusunan konteks yang relevan. Berdasar kajian ikonologi, terutama tahap analisis ikonografi, ditemukan bahwa narasi relief Yeh Pulu bersifat multinarasi, yakni pahatan relief yang memiliki beragam jenis tema cerita, seperti praktik pertanian, berburu, meditasi, pesta, asmara, dan lain-lain. Kemudian konsep multinarasi dalam penciptaan seni lukis kontemporer, menjadi: (a secara medium menggunakan multiteknik dan medium; (b bahasa visual, menghadirkan berbagai adegan secara berulang, terpadu dan bahkan terkesan saling berlawanan; (c konteks yang relevan, dengan memasukan ikon tokok-toko pahlawan dunia pop, seperti superman, superwomen, dan lain-lain. Secara ikonologis, bangunan visual yang mempertemukan adegan multinarasi relief Yeh Pulu dengan narasi kepahlawanan dunia pop, menjadi semakin menguatkan konsep multinarasi dalam membangun pesan kepahlawanan dunia sehari-hari dalam karya seni lukis kontemporer semakin berhasil. Penelitian ini melibatkan: Anak Agung Rai Remawa (pengumpul data, dan  Ni Luh Desi In Diana Sari (fotografi dan layout. This paper serves as an applied research scheme which aims to reveal the concept of multiple narratives of Yeh Pulu Relief, located in Bedulu, Bali, as the basis for the creation of contemporary painting. Methodologically speaking, this study was conducted in two stages: a field research (a field study on the relief narratives based on Panofsky�

Donation to disaster relief campaigns: underlying social cognitive factors exposed

NARCIS (Netherlands)

Oosterhof, Liesbeth; Heuvelman, A.; Peters, O.

2009-01-01

number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on

OnabotulinumtoxinA (Botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial.

Science.gov (United States)

Khambati, Aziz; Lau, Susan; Gordon, Allan; Jarvi, Keith A

2014-12-01

Chronic scrotal pain (CSP) is a common, often debilitating, condition affecting approximately 4.75% of men. While nerve blocks using local anesthetics usually provide temporary pain relief, there are no publications on the use of longer acting nerve blocks to provide more durable pain relief for men with CSP. The aim of this study was to determine if onabotulinumtoxinA (Botox) cord blocks provide durable pain relief for men with CSP. In this pilot open-label study, men with CSP who had failed medical management but experienced temporary pain relief from a standard cord block underwent a cord block with 100U Botox. The outcomes measured were changes 1, 3, and 6 months post-Botox injection in (i) a 10-point visual analog scale (VAS) pain score; (ii) scrotal tenderness on a three-point scale as rated by physical examination; and (iii) the Chronic Epididymitis Symptom Index (CESI) to measure the severity and impact of scrotal pain on men. Paired t-tests were used to compare groups. Eighteen patients with CSP seen between April and September 2013 had Botox injected as a cord block. At the 1-month follow-up, pain reduction was reported by 72% of patients (mean VAS score: 7.36 vs. 5.61, P pain reduction and reduced tenderness based on the VAS score (mean: 7.36 vs. 6.02, P pain and tenderness. Our pilot study found that Botox cord blocks provide pain reduction for 3 months or more for most men with CSP. © 2014 International Society for Sexual Medicine.

Ultrasonic evaluation of heat treatment for stress relief in steel

International Nuclear Information System (INIS)

Bittencourt, Marcelo de S.Q.; Lamy, Carlos A.; Goncalves Filho, Orlando J.A.; Payao Filho, Joao da C.

2000-01-01

Residual stresses in materials arise due to the manufacturing processes. As a consequence, in the nuclear area some components must suffer a stress relief treatment according to strict criteria. Although these treatments are carefully carried on, concern with nuclear safety is constantly growing. This work proposes a nondestructive ultrasonic method to guarantee the efficiency of the heat treatment. It was used a short peened steel plate with tensile and compressive stresses which was submitted to a stress relief treatment. The results show that the proposed ultrasonic method could be used to confirm the efficiency of the stress relief heat treatment. (author)

19 CFR 210.69 - Approval of complainant's temporary relief bond.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Approval of complainant's temporary relief bond. 210.69 Section 210.69 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.69 Approval of...

ASSESSMENT OF SURFACE QUALITY FOR CHOSEN MILLING STRATEGIES WHEN PRODUCING RELIEF SURFACES

OpenAIRE

Jan Varga; Jozef Stahovec; Jozef Beno; Marek Vrabeľ

2014-01-01

The paper deals with design and modeling of the relief surfaces that are produced in milling. Modeled and real surface quality is presented for the chosen fragments of the relief surfaces. Fragmentation of the relief surfaces has been made by the surface sampling. Milling strategies are compared with regard to surface formation. Surface quality was checked with regard to applied cutting conditions.

8 CFR 216.3 - Termination of conditional resident status.

Science.gov (United States)

2010-01-01

..., whichever is applicable, are true, or it becomes known to the government that an alien entrepreneur who was... applicable, are true, or that an alien entrepreneur who was admitted pursuant to section 203(b)(5) of the Act... immigration laws or an alien entrepreneur obtained permanent resident status through a commercial enterprise...

Flying Real-Time Network to Coordinate Disaster Relief Activities in Urban Areas †

Science.gov (United States)

Micheletto, Matias; Orozco, Javier; Mosse, Daniel

2018-01-01

While there have been important advances within wireless communication technology, the provision of communication support during disaster relief activities remains an open issue. The literature in disaster research reports several major restrictions to conducting first response activities in urban areas, given the limitations of telephone networks and radio systems to provide digital communication in the field. In search-and-rescue operations, the communication requirements are increased, since the first responders need to rely on real-time and reliable communication to perform their activities and coordinate their efforts with other teams. Therefore, these limitations open the door to improvisation during disaster relief efforts. In this paper, we argue that flying ad-hoc networks can provide the communication support needed in these scenarios, and propose a new solution towards that goal. The proposal involves the use of flying witness units, implemented using drones, that act as communication gateways between first responders working at different locations of the affected area. The proposal is named the Flying Real-Time Network, and its feasibility to provide communication in a disaster scenario is shown by presenting both a real-time schedulability analysis of message delivery, as well as simulations of the communication support in a physical scenario inspired by a real incident. The obtained results were highly positive and consistent, therefore this proposal represents a step forward towards the solution of this open issue. PMID:29789458

Dynamic load in suppression pool during BWR main steam safety relief valve actuation

International Nuclear Information System (INIS)

Tsukada, Hiroshi; Yamaguchi, Hirokatsu; Morita, Terumichi

1979-01-01

BWRs are so designed that the exhaust steam from main steam safety relief valves is led to pressure suppression pools, and the steam is condensed in pool water, but at this time, dynamic load seems to arise in the pool water. In Tokai No. 2 Power Station, a Mark-2 containment vessel was adopted to improve the reliability as much as possible and to obtain the design with margin. In this report, the result of actual machine test in Tokai No. 2 Power Station and the method of reducing the load are described. When a relief valve works, the discharge of water in exhaust pipes into a suppression pool, the exhaust of air in exhaust pipes and repeated expansion and contraction of bubbles in pool water, and the exhaust of steam and condensation occur. As for the construction of the suppression pool in Tokai No. 2 Power Station, cross-shaped quencher and the structure with jet deflector were installed. The test plan and the test result with an actual machine are reported. The soundness of the Mark-2 containment vessel and the structures in the pool was proved. The differential pressure acting on the structures was negligibly small. The measured pulsating pressure was in the range from 0.84 to -0.39 kg/cm 2 . (Kako, I.)

Estimation of Erosion Dissection of North-Eastern Caucasus Relief for Recreational Land Use

Directory of Open Access Journals (Sweden)

Zagir V. Ataev

2012-02-01

Full Text Available The digital model of the relief (DMR of North-East Caucasus relief was used for an estimation of an erosive partition of territory. The card of usages of erosive forms and density of an erosive partition of a relief was made on basis of GIS-technology. The analysis of these parameters has allowed to estimate the potential of a relief of studied territory for such kinds of touristic and recreational activity, as foot and a cycle tourism

Lake Bathymetric DEM Shaded Relief Image

Data.gov (United States)

Minnesota Department of Natural Resources — Geo-referenced, shaded relief image of lake bathymetry classified at 5-foot depth intervals. This dataset has a cell resolution of 5 meters (occasionally 10m) as...

Asthma Patients in US Overuse Quick-Relief Inhalers, Underuse Control Medications

Science.gov (United States)

... quick-relief inhalers, underuse control medications Share | Asthma patients in US overuse quick-relief inhalers, underuse control ... and uncontrolled asthma result in poor health outcomes. Patients with well-controlled asthma are at lower risk ...

The Team Approach to Pain Relief

Science.gov (United States)

... Navigation Bar Home Current Issue Past Issues The Team Approach to Pain Relief Past Issues / Fall 2007 ... Roberts is seen here with some of the team members, (left to right) Dr. Berger, Jacques Bolle, ...

30 CFR 204.204 - What accounting and auditing relief will MMS not allow?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What accounting and auditing relief will MMS... INTERIOR MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.204 What accounting and auditing relief will MMS not allow? MMS will not approve your request for...

Direct Magnetic Relief Recording Using As40S60: Mn-Se Nanocomposite Multilayer Structures.

Science.gov (United States)

Stronski, A; Achimova, E; Paiuk, O; Meshalkin, A; Prisacar, A; Triduh, G; Oleksenko, P; Lytvyn, P

2017-12-01

Processes of holographic recording of surface relief structures using As 2 S 3 :Mn-Se multilayer nanostructures as registering media were studied in this paper. Optical properties of As 2 S 3 :Mn, Se layers, and As 2 S 3 :Mn-Se multilayer nanostructures were investigated. Values of optical bandgaps were obtained from Tauc dependencies. Surface relief diffraction gratings were recorded. Direct one-stage formation of surface relief using multilayer nanostructures is considered. For the first time, possibility of direct formation of magnetic relief simultaneous with surface relief formation under optical recording using As 2 S 3 :Mn-Se multilayer nanostructures is shown.

Tectonics, climate and mountain building in the forearc of southern Peru recorded in the 10Be chronology of low-relief surface abandonment

Science.gov (United States)

Hall, S. R.; Farber, D.; Audin, L.; Finkel, R. C.

2009-12-01

Regional low-relief surfaces have long been recognized as key features to understanding the response of landscapes to surface uplift. The canonical models of low-relief surface formation involve an extended period of tectonic quiescence during which, the fluvial systems bevel the landscape to a uniform elevation. This quiescent period is punctuated by a period(s) of surface uplift, which causes fluvial incision thereby abandoning the low-relief landscape. Over time, as rivers continue to incise in response to changes in sediment supply, river discharge, and base level fall, pieces of the relict low-relief landscape are left as abandoned remnants stranded above active channels. By determining the age of abandoned surfaces, previous workers have identified the onset of a change in the tectonic or climatic setting. One key assumption of this model is that the low-relief surfaces are truly abandoned with no current processes further acting on the surface. To improve our understanding of the underlying assumptions and problems of low-relief surface formation, we have used detailed mapping and absolute dating with cosmogenic 10Be to investigate surfaces in the hyperarid forearc region of southern Peru between ~14° and 18°S. Within this region, marine terraces and strath terraces reflect Plio-Pleistocene surface uplift, and together with the hyperarid climate, ongoing surface uplift provides a perfect natural laboratory to examine the processes affecting low-relief surface abandonment and preservation. With our new chronology we address: 1) the space and time correlations of surfaces, 2) incision rates of streams in response to base-level fall, and 3) surface erosion rates. Multiple surfaces have yielded 10Be surface abandonment ages that span >2 Ma - ~35 ka. While most of the surfaces we have dated are considerably less than 1 Ma, we have located two surfaces which are likely older than 2 Ma and constrain regional erosion rates to be chronology of Pleistocene surface

U.S. Coastal Relief Model - Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

Inventory slack routing application in emergency logistics and relief distributions.

Science.gov (United States)

Yang, Xianfeng; Hao, Wei; Lu, Yang

2018-01-01

Various natural and manmade disasters during last decades have highlighted the need of further improving on governmental preparedness to emergency events, and a relief supplies distribution problem named Inventory Slack Routing Problem (ISRP) has received increasing attentions. In an ISRP, inventory slack is defined as the duration between reliefs arriving time and estimated inventory stock-out time. Hence, a larger inventory slack could grant more responsive time in facing of various factors (e.g., traffic congestion) that may lead to delivery lateness. In this study, the relief distribution problem is formulated as an optimization model that maximize the minimum slack among all dispensing sites. To efficiently solve this problem, we propose a two-stage approach to tackle the vehicle routing and relief allocation sub-problems. By analyzing the inter-relations between these two sub-problems, a new objective function considering both delivery durations and dispensing rates of demand sites is applied in the first stage to design the vehicle routes. A hierarchical routing approach and a sweep approach are also proposed in this stage. Given the vehicle routing plan, the relief allocation could be easily solved in the second stage. Numerical experiment with a comparison of multi-vehicle Traveling Salesman Problem (TSP) has demonstrated the need of ISRP and the capability of the proposed solution approaches.

Measuring Paleolandscape Relief in Alluvial River Systems from the Stratigraphic Record

Science.gov (United States)

Hajek, E. A.; Trampush, S. M.; Chamberlin, E.; Greenberg, E.

2017-12-01

Aggradational alluvial river systems sometimes generate relief in the vicinity of their channel belts (i.e. alluvial ridges) and it has been proposed that this process may define important thresholds in river avulsion. The compensation scale can be used to estimate the maximum relief across a landscape and can be connected to the maximum scale of autogenic organization in experimental and numerical systems. Here we use the compensation scale - measured from outcrops of Upper Cretaceous and Paleogene fluvial deposits - to estimate the maximum relief that characterized ancient fluvial landscapes. In some cases, the compensation scale significantly exceeds the maximum channel depth observed in a deposit, suggesting that aggradational alluvial systems organize to sustain more relief than might be expected by looking only in the immediate vicinity of the active channel belt. Instead, these results indicate that in some systems, positive topographic relief generated by multiple alluvial ridge complexes and/or large-scale fan features may be associated with landscape-scale autogenic organization of channel networks that spans multiple cycles of channel avulsion. We compare channel and floodplain sedimentation patterns among the studied ancient fluvial systems in an effort to determine whether avulsion style, channel migration, or floodplain conditions influenced the maximum autogenic relief of ancient landscapes. Our results emphasize that alluvial channel networks may be organized at much larger spatial and temporal scales than previously realized and provide an avenue for understanding which types of river systems are likely to exhibit the largest range of autogenic dynamics.

[Disaster relief through inter-professional collaboration --from the standpoint of a dietitian].

Science.gov (United States)

Inamura, Yukiko

2013-01-01

The present study examined disaster relief efforts by registered and other dietitians following the Great East Japan Earthquake to identify related problems. Based on this, the study discussed what is required to develop a "disaster relief system through inter-professional collaboration" to cope with unanticipated disasters. On March 15, 2011, the Japan Dietetic Association (JDA) independently established the "Great East Japan Earthquake relief emergency headquarters". The association along with these volunteers was committed to the establishment of a system for disaster relief activities with the support of Iwate, Miyagi, and Fukushima Prefectures: the number of registered volunteers was 978; a total of 1,588 dietitians were dispatched; and 602 became involved in relief work in the disaster-stricken areas. Registered and other dietitians dispatched for disaster relief provided support and home care for evacuation centers, elderly facilities, and temporary housing, including dietary and nutrition advice and consultation, in cooperation and collaboration with administrative dietitians in disaster areas, registered and other dietitians of disaster headquarters in disaster-stricken prefectures, the Primary Care for All Teams (PCAT) of the Japan Primary Care Association, disaster medical assistance teams (DMATs), and volunteer groups. Through the course of the relief activities, the following problems were identified: difficulties in responding to varying needs in different phases, nutritional measures (population-based and high-risk approaches), nutritional disparities among evacuation centers, necessity of a section to collect ever-changing information on disaster areas in a comprehensive manner, importance of working cooperatively to establish a support system, and differences in volunteers' support skills. To facilitate disaster relief through inter-professional collaboration, it is necessary for many different organizations to understand each other's capabilities

Adequacy of Flood Relief Shelters: A Case Study in Perak, Malaysia

Science.gov (United States)

Zawani Zahari, Nur; Mustafa Hashim, Ahmad

2018-03-01

The recent flood event occurred in 2014 had caused disastrous effects in Peninsular Malaysia in states of Kelantan, Pahang, Terengganu, Perak, Johor and Perlis. Perak state was reported with 12,115 victims from 2,896 families registered at 77 relief shelters. There are several issues encountered by the victims and related agencies which caused inconveniences and interruptions during the flooding period. Besides, the usage of public buildings as relief shelters contributes to deterioration of the infrastructures whereby their suitability, convenient, capacity and safety might not be optimum for longer period of time. This paper focuses on the assessment of relief shelters established in Perak Tengah district, Perak. Standards and guidelines for relief shelters were reviewed according to the most relevant agreed principles for humanitarian response. Data and information in this study were obtained from survey activities, interview sessions and observations. In Perak Tengah, more than 50% of the previous relief shelters were public buildings with low capacity areas. Strategic location of shelters with proper design standards should be established to ensure safe and healthy environment for the victims. Findings from this paper provide important outcomes to serve as better preparation in handling future disaster.

Numerical investigation on cavitation in pressure relief valve for coal liquefaction

International Nuclear Information System (INIS)

Ou, G F; Li, W Z; Xiao, D H; Zheng, Z J; Dou, H S; Wang, C

2015-01-01

The pressure relief valve for regulating the level of the high-pressure separator works under a pressure difference up to 15 MPa in the temperature of 415 °C. Severe cavitation erosion and particle impact lead to the valve disc's mass loss. In this paper, three-dimensional turbulent cavitating flows in the pressure relief valve are numerically simulated to reveal the mechanism of mass loss at valve disc. The RNG k-ε turbulence model and the mixture model with a mass transfer for cavitation are employed to simulate the cavitating flow in the pressure relief valve. The result shows that there is phase change in the pressure relief process and cavitation bubbles would be transported by high-velocity backflow to the head of valve disc. For the local pressure higher than the saturated vapor pressure, the bubbles collapse at the head of disc and cavitation erosion is formed at the head of the disc. By comparing the cases of opening of 40%, 50%, and 60%, backflow velocity and cavitation region in front of the disc decrease with the opening increase. Therefore, during the actual operation, the pressure relief valve should be kept to a relatively large opening

Shaded Relief of Minnesota Elevation - Color

Data.gov (United States)

Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

Suicide Prevention for Local Public and Volunteer Relief Workers in Disaster-Affected Areas.

Science.gov (United States)

Wang, Xiao Lu; Yip, Paul S F; Chan, Cecilia L W

2016-01-01

Local workforces play a critical role in disaster relief and reconstruction. However, the mental health of local relief workers might be affected by disasters, threatening the sustainability of local workforces. In this study, we tried to address this concern by investigating the well-being of local relief workers and its association with suicidal ideation. A retrospective study was conducted. Surveys were designed to collect data from a purposive sample of local disaster relief workers who survived a disaster. Binary logistic regression analysis was performed to test hypotheses. The study sample was from a population of local relief workers in the worst quake-hit regions in China in 2008. The respondents were local relief workers from a town in these regions. All of the 83 local relief workers were invited 11 months after the earthquake, and 70 joined the study, resulting in a response rate of 84.3%. The dependent variable was postdisaster suicidal ideation. The independent variables were bereavement, depression and posttraumatic stress, daily work hours, job burnout, work-family conflict, and work engagement. Approximately 21.4% of participants reported suicidal ideation after the earthquake in comparison with 7.1% before the earthquake. One potential risk factor was an interaction effect of job burnout and work-family conflict (odds ratio [OR] = 3.738; 95% confidence interval [CI], 1.086-12.868). Potential protective factors included daily work hours (OR = 0.317; 95% CI, 0.106-0.952) and work engagement (OR = 0.297; 95% CI, 0.091-0.969). Findings suggest that for local relief workers who are also disaster survivors, meaningful engagement such as participation in disaster relief could be salutary to their mental health, but overwork and interference with personal life could be harmful and increase the risk of suicidal ideation. Discretion is needed in managing local workforces, particularly with long work hours and work-family balance.

Employment discrimination implications of genetic screening in the workplace under Title VII and the Rehabilitation Act.

Science.gov (United States)

Canter, E F

1984-01-01

The emergence of genetic screening techniques will permit employers to exclude hypersusceptible individuals from potentially hazardous workplace environments. The denial of employment opportunities to these individuals, however, may constitute discrimination. This Note analyzes genetic screening cases with respect to currently available remedies contained in Title VII of the Civil Rights Act of 1964 and the Rehabilitation Act of 1973. The Note concludes that Title VII claims may succeed but only in limited circumstances and that Rehabilitation Act claims will encounter numerous obstacles to relief. Additionally, the Note discusses some of the implications of the use of genetic screening in the workplace.

Eksplorasi Pose dalam Pemotretan Model Melalui Kajian Visual Relief Karmawibhangga

Directory of Open Access Journals (Sweden)

Noor Latif CM

2015-10-01

Full Text Available Karmawibhangga Relief panel located at the foot of Borobudur is a relic of the visual artifacts that contains fragments of past life with a very high historical value. 160 Karmawibhangga panels tell the reality of people's lives at the time wrapped with a moral message plight. The relief provides a lot of visual references to be excavated and reconstructed again for the benefit of the creative industries today. This research digged one small part of the masterpieces of the past through photography. Understanding visual artists who create these reliefs will be beauty in the show gestures in building a very interesting story to be re-examined. Visual communication through gestures in relief Karmawibhangga enables new assumptions about body language dialect differences to current conditions. Through model genre photography, it is very useful in connection with the development of local nuanced scientific photography. Efforts to develop the traditions and culture through new media are expected to be creative commodity with a very strong product differentiation. 

Relief Evolution in Tectonically Active Mountain Ranges

Science.gov (United States)

Whipple, Kelin X.

2004-01-01

The overall aims of this 3-yr project, as originally proposed were to: (1) investigate quantitatively the roles of fluvial and glacial erosion in the evolution of relief in mountainous regions, and (2) test rigorously the quality and accuracy of SRTM topographic data in areas of rugged relief - both the most challenging and of greatest interest to geomorphic, neotectonic, and hazards applications. Natural laboratories in both the western US and the Southern Alps of New Zealand were identified as most promising. The project has been both successful and productive, despite the fact that no SRTM data for our primary field sites in New Zealand were released on the time frame of the work effort. Given the delayed release of SRTM data, we pursued the scientific questions of the roles of fluvial and, especially, glacial erosion in the evolution of relief in mountainous regions using available digital elevation models (DEMs) for the Southern Alps of New Zealand (available at both 25m and 50m pixel sizes), and USGS 10m and 30m DEMs within the Western US. As emphasized in the original proposal, we chose the emphasis on the role of glacial modification of topographic relief because there has been little quantitative investigation of glacial erosion processes at landscape scale. This is particularly surprising considering the dramatic sculpting of most mid- and high-latitude mountain ranges, the prodigious quantities of glacially-derived sediment in terrestrial and marine basins, and the current cross-disciplinary interest in the role of denudational processes in orogenesis and the evolution of topography in general. Moreover, the evolution of glaciated landscapes is not only a fundamental problem in geomorphology in its own right, but also is at the heart of the debate over Late Cenozoic linkages between climate and tectonics.

The Chicago Fire of 1871: A Bottom Up Approach to Disaster Relief

OpenAIRE

Skarbek, Emily C.

2014-01-01

Can bottom-up relief efforts lead to recovery after disasters? Conventional wisdom and contemporary public policy suggest that major crises require centralized authority to provide disaster relief goods. Using a novel set of comprehensive donation and expenditure data collected from archival records, this paper examines a bottom-up relief effort following one of the most devastating natural disasters of the nineteenth century: the Chicago Fire of 1871. Findings show that while there was no ce...

Lessons from DoD Disaster Relief Efforts in the Asia-Pacific Region

Science.gov (United States)

2013-01-01

Orientation & Review,” USARPAC briefing, undated; “USARPAC OSInt Support to Cyclone nargis Relief Efforts in Burma 2008,” USARPAC briefing, undated; phone...all organizations relied, to a large extent, on the staff and national partners they already had 71 “USARPAC OSINT Support to Cyclone Nargis Relief...undated. As of September 8, 2012: http://www.kadena.af.mil/shared/media/document/AFD-120426-002.pdf “USARPAC OSINT Support to Cyclone Nargis Relief

31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Relief on account of loss, theft or... BILLS § 309.12 Relief on account of loss, theft or destruction, etc. (a) Relief on account of the loss, theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of...

27 CFR 25.282 - Beer lost by fire, theft, casualty, or act of God.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Beer lost by fire, theft... TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Refund or Adjustment of Tax or Relief From Liability § 25.282 Beer lost by fire, theft, casualty, or act of God. (a) General. The tax paid by...

Evaluation of an International Disaster Relief Team After Participation in an ASEAN Regional Forum Disaster Relief Exercise.

Science.gov (United States)

Lee, Jeong Il; Lee, Kang Hyun; Kim, Oh Hyun; Cha, Yong Sung; Hwang, Sung Oh; Kim, Hyun; Cha, Kyung Chul

2016-10-01

Devastating disasters around the world directly contribute to significant increases in human mortality and economic costs. The objective of this study was to examine the current state of the Korea Disaster Relief Team that participated in an international training module. The whole training period was videotaped in order to observe and evaluate the respondents. The survey was carried out after completion of the 3-day training, and the scores were reported by use of a 5-point Likert scale. A total of 43 respondents were interviewed for the survey, and the results showed that the overall preparedness score for international disasters was 3.4±1.6 (mean±SD). The awareness of the Incident Command System for international disasters was shown to be low (3.5±1.1). Higher scores were given to personnel who took on leadership roles in the team and who answered "I knew my duty" (4.4±0.6) in the survey, as well as to the training participants who answered "I clearly knew my duty" (4.5±0.5). The preparedness level of the Korea Disaster Relief Team was shown to be insufficient, whereas understanding of the roles of leaders and training participants in the rescue team was found to be high. It is assumed that the preparedness level for disaster relief must be improved through continued training. (Disaster Med Public Health Preparedness. 2016;1-5).

[Motivation and learning strategies in pediatric residents].

Science.gov (United States)

Sepúlveda-Vildósola, Ana Carolina; Carrada-Legaria, Sol; Reyes-Lagunes, Isabel

2015-01-01

Motivation is an internal mood that moves individuals to act, points them in certain directions, and maintains them in activities, playing a very important role in self-regulated learning and academic performance. Our objective was to evaluate motivation and self-regulation of knowledge in pediatric residents in a third-level hospital, and to determine if there are differences according to the type of specialty and sociodemographic variables. All residents who agreed to participate responded to the Motivated Strategies for Learning Questionnaire. Cronbach alpha was performed to determine reliability. The mean value of each subscale was compared with Student's t test or ANOVA, correlation of subscales with Pearson test. A value of p≤0.05 was considered significant. We included 118 residents. The questionnaire was highly reliable (α=0.939). There were no significant differences in motivation or learning strategies according to sex, marital status, or age. Those residents studying a second or third specialization had significantly higher scores in elaboration, critical thinking, and peer learning. There were significant correlations between intrinsic motivation and self-efficacy with the development of knowledge strategies such as elaboration, critical thinking, and metacognitive self-regulation. Our students present average-to-high scores of motivation and knowledge strategies, with a significant difference according to type of specialization. There is a high correlation between motivation and knowledge strategies.

Optimization and Simulation Modeling of Disaster Relief Supply Chain: A Literature Review

OpenAIRE

Feng, Keli; Bizimana, Emmanuel; Agu, Deedee D.; Issac, Tana T.

2012-01-01

Recent natural and man-made disasters underscore the need of a resilient and agile disaster relief supply chain to mitigate the damages and save people’s lives. Optimization and simulation modeling have become powerful and useful tools to help decision makers tackle problems related to disaster relief supply chain. This paper reviews optimization and simulation models used in the field of disaster relief supply chain. We review the literature of the facility location optimization problems of ...

Feeling worse to feel better: pain-offset relief simultaneously stimulates positive affect and reduces negative affect.

Science.gov (United States)

Franklin, Joseph C; Lee, Kent M; Hanna, Eleanor K; Prinstein, Mitchell J

2013-04-01

Although pain itself induces negative affect, the removal (or offset) of pain induces a powerful state of relief. Despite being implicated in a wide range of psychological and behavioral phenomena, relief remains a poorly understood emotion. In particular, some theorists associate relief with increased positive affect, whereas others associate relief with diminished negative affect. In the present study, we examined the affective nature of relief in a pain-offset paradigm with psychophysiological measures that were specific to negative valence (startle eyeblink reactivity) and positive valence (startle postauricular reactivity). Results revealed that pain offset simultaneously stimulates positive affect and diminishes negative affect for at least several seconds. Results also indicated that pain intensity differentially affects the positive and negative valence aspects of relief. These findings clarify the affective nature of relief and provide insight into why people engage in both normal and abnormal behaviors associated with relief.

Resident fatigue in otolaryngology residents: a Web based survey.

Science.gov (United States)

Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

2016-01-01

Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

Fraktalnist deformational relief polycrystalline aluminum

Directory of Open Access Journals (Sweden)

М.В. Карускевич

2006-02-01

Full Text Available  The possibility of the fractal geometry method application for the analisys of surface deformation structures under cyclic loading is presented.It is shown, that deformation relief of the alclad aluminium alloyes meets the criteria of the fractality. For the fractal demention estimation the method of  “box-counting”can be applied.

Unmanned Aerial Vehicle Systems for Disaster Relief: Tornado Alley

Science.gov (United States)

DeBusk, Wesley M.

2009-01-01

Unmanned aerial vehicle systems are currently in limited use for public service missions worldwide. Development of civil unmanned technology in the United States currently lags behind military unmanned technology development in part because of unresolved regulatory and technological issues. Civil unmanned aerial vehicle systems have potential to augment disaster relief and emergency response efforts. Optimal design of aerial systems for such applications will lead to unmanned vehicles which provide maximum potentiality for relief and emergency response while accounting for public safety concerns and regulatory requirements. A case study is presented that demonstrates application of a civil unmanned system to a disaster relief mission with the intent on saving lives. The concept utilizes unmanned aircraft to obtain advanced warning and damage assessments for tornados and severe thunderstorms. Overview of a tornado watch mission architecture as well as commentary on risk, cost, need for, and design tradeoffs for unmanned aerial systems are provided.

Paracetamol for pain relief after surgical removal of lower wisdom teeth

NARCIS (Netherlands)

Weil, K.; Hooper, L.; Afzal, Z.; Esposito, M.; Worthington, H.V.; van Wijk, A.J.; Coulthard, P.

2008-01-01

Background: Paracetamol has been commonly used for the relief of postoperative pain following oral surgery. In this review we investigated the optimal dose of paracetamol and the optimal time for drug administration to provide pain relief, taking into account the side effects of different doses of

Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

Science.gov (United States)

Broby, Nicolette; Lassetter, Jane H; Williams, Mary; Winters, Blaine A

2018-04-01

Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

Impact of Intervention to Improve Nursing Home Resident-Staff Interactions and Engagement.

Science.gov (United States)

Hartmann, Christine W; Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Allen, Rebecca S; Zhao, Shibei; Wewiorski, Nancy J; Sullivan, Jennifer L; Dillon, Kristen; Clark, Valerie; Berlowitz, Dan R; Snow, Andrea Lynn

2018-04-30

For nursing home residents, positive interactions with staff and engagement in daily life contribute meaningfully to quality of life. We sought to improve these aspects of person-centered care in an opportunistic snowball sample of six Veterans Health Administration nursing homes (e.g., Community Living Centers-CLCs) using an intervention that targeted staff behavior change, focusing on improving interactions between residents and staff and thereby ultimately aiming to improve resident engagement. We grounded this mixed-methods study in the Capability, Opportunity, Motivation, Behavior (COM-B) model of behavior change. We implemented the intervention by (a) using a set of evidence-based practices for implementing quality improvement and (b) combining primarily CLC-based staff facilitation with some researcher-led facilitation. Validated resident and staff surveys and structured observations collected pre and post intervention, as well as semi-structured staff interviews conducted post intervention, helped assess intervention success. Sixty-two CLC residents and 308 staff members responded to the surveys. Researchers conducted 1,490 discrete observations. Intervention implementation was associated with increased staff communication with residents during the provision of direct care and decreased negative staff interactions with residents. In the 66 interviews, staff consistently credited the intervention with helping them (a) develop awareness of the importance of identifying opportunities for engagement and (b) act to improve the quality of interactions between residents and staff. The intervention proved feasible and influenced staff to make simple enhancements to their behaviors that improved resident-staff interactions and staff-assessed resident engagement.

21 CFR 882.5870 - Implanted peripheral nerve stimulator for pain relief.

Science.gov (United States)

2010-04-01

....5870 Implanted peripheral nerve stimulator for pain relief. (a) Identification. An implanted peripheral nerve stimulator for pain relief is a device that is used to stimulate electrically a peripheral nerve... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted peripheral nerve stimulator for pain...

32 CFR 516.19 - Injunctive relief.

Science.gov (United States)

2010-07-01

... Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.19 Injunctive relief. (a) General. Plaintiffs...). Because these actions can quickly impede military functions, immediate and decisive action must be taken...

Mental health risks in the local workforce engaged in disaster relief and reconstruction.

Science.gov (United States)

Wang, Xiao L; Chan, Cecilia L W; Shi, Zhan B; Wang, Bin

2013-02-01

To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

Bridging the sanitation gap between disaster relief and development.

Science.gov (United States)

Lai, Ka-Man; Ramirez, Claudia; Liu, Weilong; Kirilova, Darina; Vick, David; Mari, Joe; Smith, Rachel; Lam, Ho-Yin; Ostovari, Afshin; Shibakawa, Akifumi; Liu, Yang; Samant, Sidharth; Osaro, Lucky

2015-10-01

By interpreting disasters as opportunities to initiate the fulfilment of development needs, realise the vulnerability of the affected community and environment, and extend the legacy of relief funds and effort, this paper builds upon the concept linking relief, rehabilitation and development (LRRD) in the sanitation sector. It aims to use a composite of case studies to devise a framework for a semi-hypothetical scenario to identify critical components and generic processes for a LRRD action plan. The scenario is based on a latrine wetland sanitation system in a Muslim community. Several sub-frameworks are developed: (i) latrine design; (ii) assessment of human waste treatment; (iii) connective sanitation promotion strategy; and (iv) ecological systems and environmental services for sanitation and development. This scenario illustrates the complex issues involved in LRRD in sanitation work and provides technical notes and references for a legacy plan for disaster relief and development. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Stress relief of transition zones

International Nuclear Information System (INIS)

Woodward, J.; van Rooyen, D.

1984-01-01

This paper considers the problem of intergranular stress corrosion cracking, initiated on the primary side, in the expansion transition region of roller expanded Alloy 600 tubing. In general it is believed that residual stresses, arising from the expansion process, are the cause of the problem. The work reported here concentrated on the identification of an optimal, in-situ stress relief treatment

Petroleum industry assists hurricane relief

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports that the petroleum industry is aiding victims of last month's Hurricane Andrew with cash, clothing, food, water, and other supplies. Cash contributions announced as of last week totaled more than $2.7 million for distribution in South Florida and South Louisiana. Petroleum industry employees were collecting relief items such as bottled water and diapers for distribution in those areas

Oscillatory neural representations in the sensory thalamus predict neuropathic pain relief by deep brain stimulation.

Science.gov (United States)

Huang, Yongzhi; Green, Alexander L; Hyam, Jonathan; Fitzgerald, James; Aziz, Tipu Z; Wang, Shouyan

2018-01-01

Understanding the function of sensory thalamic neural activity is essential for developing and improving interventions for neuropathic pain. However, there is a lack of investigation of the relationship between sensory thalamic oscillations and pain relief in patients with neuropathic pain. This study aims to identify the oscillatory neural characteristics correlated with pain relief induced by deep brain stimulation (DBS), and develop a quantitative model to predict pain relief by integrating characteristic measures of the neural oscillations. Measures of sensory thalamic local field potentials (LFPs) in thirteen patients with neuropathic pain were screened in three dimensional feature space according to the rhythm, balancing, and coupling neural behaviours, and correlated with pain relief. An integrated approach based on principal component analysis (PCA) and multiple regression analysis is proposed to integrate the multiple measures and provide a predictive model. This study reveals distinct thalamic rhythms of theta, alpha, high beta and high gamma oscillations correlating with pain relief. The balancing and coupling measures between these neural oscillations were also significantly correlated with pain relief. The study enriches the series research on the function of thalamic neural oscillations in neuropathic pain and relief, and provides a quantitative approach for predicting pain relief by DBS using thalamic neural oscillations. Copyright © 2017 Elsevier Inc. All rights reserved.

Surrogate Parenthood Act 1988 (No. 65 of 1988), 6 October 1988.

Science.gov (United States)

1988-01-01

This document contains provisions of the 1988 Queensland Australia Act prohibiting surrogate parenthood contracts. The Act defines "surrogate parent" and "prescribed contract" and prohibits the publication of any type of document which intends to induce a person to act as a surrogate parent, to seek such a person, or to state willingness to act as a surrogate. Offering to enter into a prescribed contract holds a penalty of 100 penalty units or three years' imprisonment or both. This Act applies if the offense occurs in Queensland or if the offender is normally a resident of Queensland, irrespective of where the offense occurs.

Evaluation of radiation therapy for bone metastases: pain relief and quality of life

International Nuclear Information System (INIS)

Gilbert, H.A.; Kagan, A.R.; Nussbaum, H.; Rao, A.R.; Satzman, J.; Chan, P.; Allen, B.; Forsythe, A.

1977-01-01

The records of 158 patients irradiated for bone metastases were reviewed to evaluate the effectiveness of pain relief and to judge the effect of treatment on overall quality of life. Within 3 months 73% of the sites treated had pain relief, with 55 to 65% having sustained relief up to 1 year or death. Of patients surviving more than 3 months, 63% maintained a satisfactory quality of life and were able to take care of most personal needs. The median survival of all patients was 1 year from initial treatment for bone metastasis. Radiation dose and the primary tumor site do not seem to be significant prognostic factors for initial pain relief or quality of life

Impact of the Medicare Catastrophic Coverage Act on nursing homes.

Science.gov (United States)

Laliberte, L; Mor, V; Berg, K; Intrator, O; Calore, K; Hiris, J

1997-01-01

The Medicare Catastrophic Coverage Act (MCCA) of 1988 altered eligibility and coverage for skilled nursing facility (SNF) care and changed Medicaid eligibility rules for nursing-home residents. Detailed data on the residents of a for-profit nursing-home chain and Medicare claims for a 1 percent sample of beneficiaries were used to examine the impact of the MCCA on nursing homes. The case mix of nursing-home admissions was scrutinized, specifically for length of stay, discharge disposition, rate of hospitalization, and changes in payer source. Findings revealed that, although the proportion of Medicare-financed nursing-home care increased, as did the case-mix severity of residents during the MCCA period, there was no corollary reduction in hospital use by nursing-home residents.

Evaluating acute pain intensity relief: challenges when using an 11-point numerical rating scale.

Science.gov (United States)

Chauny, Jean-Marc; Paquet, Jean; Lavigne, Gilles; Marquis, Martin; Daoust, Raoul

2016-02-01

Percentage of pain intensity difference (PercentPID) is a recognized way of evaluating pain relief with an 11-point numerical rating scale (NRS) but is not without flaws. A new metric, the slope of relative pain intensity difference (SlopePID), which consists in dividing PercentPID by the time between 2 pain measurements, is proposed. This study aims to validate SlopePID with 3 measures of subjective pain relief: a 5-category relief scale (not, a little, moderate, very, complete), a 2-category relief question ("I'm relieved," "I'm not relieved"), and a single-item question, "Wanting other medication to treat pain?" (Yes/No). This prospective cohort study included 361 patients in the emergency department who had an initial acute pain NRS > 3 and a pain intensity assessment within 90 minutes after analgesic administration. Mean age was 50.2 years (SD = 19.3) and 59% were women. Area under the curves of receiver operating characteristic curves analyses revealed similar discriminative power for PercentPID (0.83; 95% confidence interval [CI], 0.79-0.88) and SlopePID (0.82; 95% CI, 0.77-0.86). Considering the "very" category from the 5-category relief scale as a substantial relief, the average cutoff for substantial relief was a decrease of 64% (95% CI, 59-69) for PercentPID and of 49% per hour (95% CI, 44-54) for SlopePID. However, when a cutoff criterion of 50% was used as a measure of pain relief for an individual patient, PercentPID underestimated pain-relieved patients by 12.1% (P pain intensity at baseline was an odd number compared with an even number (32.9% vs 45.0%, respectively). SlopePID should be used instead of PercentPID as a metric to evaluate acute pain relief on a 0 to 10 NRS.

The Unintended Consequences of Property Tax Relief: New York's STAR Program

Science.gov (United States)

Eom, Tae Ho; Duncombe, William; Nguyen-Hoang, Phuong; Yinger, John

2014-01-01

New York's School Tax Relief Program, STAR, provides state-funded property tax relief for homeowners. Like a matching grant, STAR changes the price of education, thereby altering the incentives of voters and school officials and leading to unintended consequences. Using data for New York State school districts before and after STAR was…

Supply Chain Management in Humanitarian Relief Logistics

National Research Council Canada - National Science Library

Rodman, William

2004-01-01

Hundreds of millions of people are affected by disasters each year. This thesis explores the use of supply chain management techniques to overcome the barriers encountered by logistics managers during humanitarian relief operations...

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents.

Science.gov (United States)

Braun, Sarah E; Auerbach, Stephen M; Rybarczyk, Bruce; Lee, Bennett; Call, Stephanie

2017-01-01

Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents. Residents (n = 38) completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory. Overall, 71.1% (n = 27) of the residents met criteria for burnout during the study. Lower scores on the "acting with awareness" facet of dispositional mindfulness significantly predicted meeting burnout criteria χ 2 (5) = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the "system-based practices" and "professionalism" domains and negative effects on a milestone from the "patient care" domain. Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional mindfulness was supported as a protective factor against burnout. Importantly, results from the exploratory investigation of the relationship between burnout and resident evaluations suggested that burnout may improve performance on some domains of resident evaluations while compromising performance on other domains. Implications and directions for future research are discussed.

Beyond formal groups: neighboring acts and watershed protection in Appalachia

Directory of Open Access Journals (Sweden)

Heather Lukacs

2016-09-01

Full Text Available This paper explores how watershed organizations in Appalachia have persisted in addressing water quality issues in areas with a history of coal mining. We identified two watershed groups that have taken responsibility for restoring local creeks that were previously highly degraded and sporadically managed. These watershed groups represent cases of self-organized commons governance in resource-rich, economically poor Appalachian communities. We describe the extent and characteristics of links between watershed group volunteers and watershed residents who are not group members. Through surveys, participant observation, and key-informant consultation, we found that neighbors – group members as well as non-group-members – supported the group's function through informal neighboring acts. Past research has shown that local commons governance institutions benefit from being nested in supportive external structures. We found that the persistence and success of community watershed organizations depends on the informal participation of local residents, affirming the necessity of looking beyond formal, organized groups to understand the resources, expertise, and information needed to address complex water pollution at the watershed level. Our findings augment the concept of nestedness in commons governance to include that of a formal organization acting as a neighbor that exchanges informal neighboring acts with local residents. In this way, we extend the concept of neighboring to include interactions between individuals and a group operating in the same geographic area.

Food-Derived Natural Compounds for Pain Relief in Neuropathic Pain.

Science.gov (United States)

Lim, Eun Yeong; Kim, Yun Tai

2016-01-01

Neuropathic pain, defined as pain caused by a lesion or disease of the somatosensory nervous system, is characterized by dysesthesia, hyperalgesia, and allodynia. The number of patients with this type of pain has increased rapidly in recent years. Yet, available neuropathic pain medicines have undesired side effects, such as tolerance and physical dependence, and do not fully alleviate the pain. The mechanisms of neuropathic pain are still not fully understood. Injury causes inflammation and immune responses and changed expression and activity of receptors and ion channels in peripheral nerve terminals. Additionally, neuroinflammation is a known factor in the development and maintenance of neuropathic pain. During neuropathic pain development, the C-C motif chemokine receptor 2 (CCR2) acts as an important signaling mediator. Traditional plant treatments have been used throughout the world for treating diseases. We and others have identified food-derived compounds that alleviate neuropathic pain. Here, we review the natural compounds for neuropathic pain relief, their mechanisms of action, and the potential benefits of natural compounds with antagonistic effects on GPCRs, especially those containing CCR2, for neuropathic pain treatment.

30 CFR 204.202 - What is the cumulative royalty reports and payments relief option?

Science.gov (United States)

2010-07-01

... Auditing Relief § 204.202 What is the cumulative royalty reports and payments relief option? (a) The... information on Form MMS-2014 for the calendar year, the same as if it were a monthly report; and (5) Report... section until the date MMS receives it. (d) If you take relief you are not qualified for, you may be...

Resident physicians in Mexico: tradition or humiliation

Directory of Open Access Journals (Sweden)

Donovan Casas Patiño

2013-08-01

Full Text Available Mexico has a great history and tradition in relation to the training of resident physicians, but what we find behind this process?, Power relations implied and not implied, unnoticed or ignored for convenience by the academic and health institutions, with the aggravation of forgetting its commitment to the training of men and women "professionals" and limited to meet another indicator of "human resources for health." The resident physician in academic and scientific training is immersed in this dehumanized maelstrom and ends up becoming a character for the domain of knowledge as power, forgetting that his act and its rationale lies in the principle of "primum non nocere" to that we would add: nor your person, nor your fellowman, much less whom you have the moral, ethical and civic responsibility to convey some of your knowledge and your experience, that is, part of your essence”.

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

Science.gov (United States)

Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

2017-10-01

The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

Anticipation and choice heuristics in the dynamic consumption of pain relief.

Science.gov (United States)

Story, Giles W; Vlaev, Ivo; Dayan, Peter; Seymour, Ben; Darzi, Ara; Dolan, Raymond J

2015-03-01

Humans frequently need to allocate resources across multiple time-steps. Economic theory proposes that subjects do so according to a stable set of intertemporal preferences, but the computational demands of such decisions encourage the use of formally less competent heuristics. Few empirical studies have examined dynamic resource allocation decisions systematically. Here we conducted an experiment involving the dynamic consumption over approximately 15 minutes of a limited budget of relief from moderately painful stimuli. We had previously elicited the participants' time preferences for the same painful stimuli in one-off choices, allowing us to assess self-consistency. Participants exhibited three characteristic behaviors: saving relief until the end, spreading relief across time, and early spending, of which the last was markedly less prominent. The likelihood that behavior was heuristic rather than normative is suggested by the weak correspondence between one-off and dynamic choices. We show that the consumption choices are consistent with a combination of simple heuristics involving early-spending, spreading or saving of relief until the end, with subjects predominantly exhibiting the last two.

Anticipation and Choice Heuristics in the Dynamic Consumption of Pain Relief

Science.gov (United States)

Story, Giles W.; Vlaev, Ivo; Dayan, Peter; Seymour, Ben; Darzi, Ara; Dolan, Raymond J.

2015-01-01

Humans frequently need to allocate resources across multiple time-steps. Economic theory proposes that subjects do so according to a stable set of intertemporal preferences, but the computational demands of such decisions encourage the use of formally less competent heuristics. Few empirical studies have examined dynamic resource allocation decisions systematically. Here we conducted an experiment involving the dynamic consumption over approximately 15 minutes of a limited budget of relief from moderately painful stimuli. We had previously elicited the participants’ time preferences for the same painful stimuli in one-off choices, allowing us to assess self-consistency. Participants exhibited three characteristic behaviors: saving relief until the end, spreading relief across time, and early spending, of which the last was markedly less prominent. The likelihood that behavior was heuristic rather than normative is suggested by the weak correspondence between one-off and dynamic choices. We show that the consumption choices are consistent with a combination of simple heuristics involving early-spending, spreading or saving of relief until the end, with subjects predominantly exhibiting the last two. PMID:25793302

Barriers to spousal contribution to childbirth pain relief in Nigeria.

Science.gov (United States)

Emelonye, A U; Pitkäaho, T; Aregbesola, A; Vehviläinen-Julkunen, K

2017-12-01

The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. A cross-sectional survey conducted in four hospitals in Nigeria involving midwives (n = 100), women (n = 142) and their spouses (n = 142) from June to December 2014 using pretested questionnaires. Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. © 2016 International Council of Nurses.

U.S. Coastal Relief Model - Northwest Pacific

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Southeast Atlantic

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Central Pacific

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Southern California

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Northeast Atlantic

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Puerto Rico

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

An Analysis of Publication Productivity During Residency for 1506 Neurosurgical Residents and 117 Residency Departments in North America.

Science.gov (United States)

Khan, Nickalus R; Saad, Hassan; Oravec, Chesney S; Norrdahl, Sebastian P; Fraser, Brittany; Wallace, David; Lillard, Jock C; Motiwala, Mustafa; Nguyen, Vincent N; Lee, Siang Liao; Jones, Anna V; Ajmera, Sonia; Kalakoti, Piyush; Dave, Pooja; Moore, Kenneth A; Akinduro, Olutomi; Nyenwe, Emmanuel; Vaughn, Brandy; Michael, L Madison; Klimo, Paul

2018-05-30

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery continues to evolve. To calculate a number of publication productivity measures for almost all neurosurgical residents and departments within North America. These measures were correlated with survey results on the educational environment within residency programs. During May to June 2017, data were collected from departmental websites and Scopus to compose a bibliometric database of neurosurgical residents and residency programs. Data related to authorship value and study content were collected on all articles published by residents. A survey of residency program research and educational environment was administered to program directors and coordinators; results were compared with resident academic productivity. The median number of publications in residency was 3; median h-index and Resident index were 1 and 0.17 during residency, respectively. There was a statistically significant difference in academic productivity among male neurosurgical residents compared with females. The majority of articles published were tier 1 clinical articles. Residency program research support was significantly associated with increased resident productivity (P productivity. This study represents the most comprehensive bibliometric assessment of neurosurgical resident academic productivity during training to date. New benchmarks for individual and department academic productivity are provided. A supportive research environment for neurosurgical residents is associated with increased academic productivity, but a scholarly activity requirement was, surprisingly, not shown to have a positive effect.

knowledge, attitude and use of pain relief in labour among women

African Journals Online (AJOL)

2014-07-01

Jul 1, 2014 ... Objective: To find out the knowledge, attitude and practice of pain relief methods during labour among ... all of which could adversely affect uterine blood flow. Pain relief in ... knowledge was low among women who did not use any form of ... Niven et al found that memories of labour pains can evoke intense ...

Anti-Seizure Medications: Relief from Nerve Pain

Science.gov (United States)

Anti-seizure medications: Relief from nerve pain Anti-seizure drugs often are used to help control the type of ... by damaged nerves. By Mayo Clinic Staff Anti-seizure medications were originally designed to treat people with ...

Incorporating resident research into the dermatology residency program

Science.gov (United States)

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

Incorporating resident research into the dermatology residency program.

Science.gov (United States)

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.

Modeling attitude towards drug treament: the role of internal motivation, external pressure, and dramatic relief.

Science.gov (United States)

Conner, Bradley T; Longshore, Douglas; Anglin, M Douglas

2009-04-01

Motivation for change has historically been viewed as the crucial element affecting responsiveness to drug treatment. Various external pressures, such as legal coercion, may engender motivation in an individual previously resistant to change. Dramatic relief may be the change process that is most salient as individuals internalize such external pressures. Results of structural equation modeling on data from 465 drug users (58.9% male; 21.3% Black, 34.2% Hispanic/Latino, and 35.1% White) entering drug treatment indicated that internal motivation and external pressure significantly and positively predicted dramatic relief and that dramatic relief significantly predicted attitudes towards drug treatment: chi (2) = 142.20, df = 100, p relief is also likely to be high. When dramatic relief is high, attitudes towards drug treatment are likely to be positive. The findings indicate that interventions to get individuals into drug treatment should include processes that promote Dramatic Relief. Implications for addictions health services are discussed.

Effects of surface relief on the high-dose sputtering of amorphous silicon and graphite by Ar ions

International Nuclear Information System (INIS)

Shulga, V.I.

2014-01-01

The effects of ion-induced surface relief on high-dose sputtering of amorphous silicon and graphite targets have been studied using binary-collision computer simulation. The relief was modeled as a wavelike surface along two mutually perpendicular surface axes (a 3D hillock-and-valley relief). Most simulations were carried out for normally-incident 30-keV Ar ions. It was shown that the surface relief can both increase and decrease the sputtering yield compared to that for a flat surface. The results of simulations suggest that stabilization of the surface relief is possible even in the absence of any smoothing processes such as surface diffusion of atoms. Effects of a surface relief on the experimentally measurable angular and energy distributions of sputtered atoms are also considered. The fitting parameters of these distributions are shown to be non-monotonic functions of the relief aspect ratio. The angular distribution of atoms sputtered from a relief surface is modulated to a great extent by the shape of the relief. For a rough surface, azimuthal isotropy of the angular distribution of sputtered atoms was found, but at high bombarding energies only

Shaded Relief of Minnesota Elevation - Black & White

Data.gov (United States)

Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

The Actively Caring for People Movement at Virginia Tech and Beyond: Cultivating Compassion and Relationships in Residence Halls

Science.gov (United States)

McCarty, Shane M.; Mullins, Taris G.; Geller, E. Scott; Shushok, Frank, Jr.

2013-01-01

A professor and a group of student leaders initiated the Actively Caring for People (AC4P) Movement to establish a more civil, compassionate, and inclusive culture by inspiring intentional acts of kindness. This article explores the AC4P Movement in a first-year residence hall at Virginia Tech and a second-year residence hall at University of…

Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

Science.gov (United States)

Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

2015-01-01

Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education.

Smartphone Usage Patterns by Canadian Neurosurgery Residents: A National Cross-Sectional Survey.

Science.gov (United States)

Kameda-Smith, Michelle Masayo; Iorio-Morin, Christian; Winkler-Schwartz, Alexander; Ahmed, Uzair S; Bergeron, David; Bigder, Mark; Dakson, Ayoub; Elliott, Cameron A; Guha, Daipayan; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Tso, Michael; Wang, Bill; Fortin, David

2018-03-01

Smartphones and their apps are used ubiquitously in medical practice. However, in some cases their use can be at odds with current patient data safety regulations such as Canada's Personal Health Information Protection Act of 2004. To assess current practices and inform mobile application development, we sought to better understand mobile device usage patterns among Canadian neurosurgery residents. Through the Canadian Neurosurgery Research Collaborative, an online survey characterizing smartphone ownership and usage patterns was developed and sent to all Canadian neurosurgery resident in April of 2016. Questionnaires were collected and completed surveys analyzed. Of 146 eligible residents, 76 returned completed surveys (52% response rate). Of these 99% of respondents owned a smartphone, with 79% running on Apple's iOS. Four general mobile uses were identified: 1) communication between members of the medical team, 2) decision support, 3) medical reference, and 4) documentation through medical photography. Communication and photography were areas where the most obvious breaches in the Canadian Personal Health Information Protection Act were noted, with 89% of respondents taking pictures of patients' radiologic studies and 75% exchanging them with Short Message System. Hospital policies had no impact on user behaviors. Smartphones are used daily by most neurosurgery residents. Identified usage patterns are associated with perceived gains in efficacy and challenges in privacy and data reliability. We believe creating and improving workflows that address these usage patterns has a greater potential to improve privacy than changing policies and enforcing regulations. Copyright © 2017 Elsevier Inc. All rights reserved.

Double Dividend Taxation Relief: A New View From The Corporate Income Tax Perspective

OpenAIRE

Sebastian Lazar

2010-01-01

Double taxation of dividends is a matter of great interest in the actual context of globalization and free movement of capital and persons. As the classical system is more and more abandoned, new solutions for the relief of double taxation are put into practice as a mean to reduce the fiscal burden on shareholders. With few exceptions, all these solutions are based on dividend tax relief. The paper aims at providing alternative solutions for double dividend taxation relief by taking some acti...

Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit.

Science.gov (United States)

Battaglioli, Nicole; Ankel, Felix; Doty, Christopher I; Chung, Arlene; Lin, Michelle

2018-03-01

Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM). Through a joint collaboration involving Academic Life in Emergency Medicine's (ALiEM) Wellness Think Tank, Essentials of Emergency Medicine (EEM), and the Emergency Medicine Residents' Association (EMRA), a one-day Resident Wellness Consensus Summit (RWCS) was organized. The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

19 CFR 210.70 - Forfeiture or return of complainant's temporary relief bond.

Science.gov (United States)

2010-04-01

... relief bond. 210.70 Section 210.70 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.70... and the Commission will be guided by practice under Rule 65 of the Federal Rules of Civil Procedure...

Delineation of a shallow subsurface aquiclude relief with aero electromagnetic data

Science.gov (United States)

Römer, A.; Winkler, E.; Bieber, G.; Motschka, K.; Reitner, H.

2009-04-01

Within a governmental groundwater remediation project in Austria, a new (overworked) characterization of a large catchment area (600 km2) with aeroelectromagnetics (AEM) was carried out. This catchment area is a large and important zone of subsurface water resources for currently and future municipal and rural water supply. Conflicts in future land use between e.g. agricultura, excavigation of mass materials, city and regional planning, ect. are preassigned and have impacts concerning the quality and quantity of available groundwater. The geology of the investigation area is a typical post-glacial region, characterized by aggradational deposition areas. The thickness of the wide-spread terrace gravels ranges from 10m to 40m, being the preferred ground water aquifer. The subsurface of the investigation area is built up by a Neogen basement, the so called Molasse and is acting as an aquiclude relative to the overlying quaternary sediments. Aeroelectromagnetic data from a former aerogeophysical survey were reinterpreted with a new processing and interpretation approach for the determination of this geological 3 layer case. This aeroelectromagnetic inversion integrates results from borehole data, ground geoelectric surveys and from geological mapping as a priori input information. The inversion result for a measured AEM data value is determined by a combination of geostatistically weighted additional information and likelihood weighted theoretical models. The primary aim of the study was the delineation of the aquiclude relief. The ground water circulation within the different terrace gravels is substantially affected by this Neogen relief. Depressions and prequaternary (tertiary) riverbeds within the Molasse often show other trends of water flow than the surficial, recent vales. The knowledge of the hydrogeological framework is essential for identification and definition of water protection and catchment areas as a decision base for national land use regulations. The

An Engineered Resupply System for Humanitarian Assistance and Disaster Relief Operations

Science.gov (United States)

2017-09-01

relevant and timely relief. Conduct Supply refers to the procurement, warehousing, and managing of relief supplies. Conduct Deployment and Distribution ...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. AN ENGINEERED...Approved OMB No. 0704–0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time

Negotiating the Lack of Intimacy in Assisted Living: Resident Desires, Barriers, and Strategies.

Science.gov (United States)

Bender, Alexis A; Burgess, Elisabeth O; Barmon, Christina

2017-12-01

Despite continuity in the desire for sex and partnership, many older adults experience a lack of intimacy in late life. The use of assisted living is a complicating factor for understanding issues of partnership, sex, and intimacy for older adults. Using in-depth interviews with 23 assisted living residents and grounded theory methods, we examined how residents negotiate a lack of intimacy in assisted living. The process of negotiation entailed three factors: desire, barriers, and strategies. Although some residents continued to desire intimacy, there was a marked absence of dating or intimacy in our study sites. Findings highlight unique barriers to acting on desire and the strategies residents used as aligning actions between desire and barriers. This research expands previous studies of sexuality and older adults by examining the complex ways in which they balanced desire and barriers through the use of strategies within the assisted living environment.

Sharing Information among Various Organizations in Relief Efforts

National Research Council Canada - National Science Library

Costur, Gurkan

2005-01-01

.... An analysis is presented of the December 2004 Indian Ocean tsunami relief effort; specifically, how different organizations such as the military, United Nations, and non-governmental organizations...

48 CFR 252.229-7010 - Relief from customs duty on fuel (United Kingdom).

Science.gov (United States)

2010-10-01

..., February 1973, entitled “Relief from Customs Duty and/or Value Added Tax on United States Government... Office. (b) Specific information should be included in the request for tax relief, such as the number of...

Fluid-structure interaction dynamic simulation of spring-loaded pressure relief valves under seismic wave

Science.gov (United States)

Lv, Dongwei; Zhang, Jian; Yu, Xinhai

2018-05-01

In this paper, a fluid-structure interaction dynamic simulation method of spring-loaded pressure relief valve was established. The dynamic performances of the fluid regions and the stress and strain of the structure regions were calculated at the same time by accurately setting up the contact pairs between the solid parts and the coupling surfaces between the fluid regions and the structure regions. A two way fluid-structure interaction dynamic simulation of a simplified pressure relief valve model was carried out. The influence of vertical sinusoidal seismic waves on the performance of the pressure relief valve was preliminarily investigated by loading sine waves. Under vertical seismic waves, the pressure relief valve will flutter, and the reseating pressure was affected by the amplitude and frequency of the seismic waves. This simulation method of the pressure relief valve under vertical seismic waves can provide effective means for investigating the seismic performances of the valves, and make up for the shortcomings of the experiment.

The Rehabilitation Act of 1973--its impact on employee selection practices.

Science.gov (United States)

Guy, J H

1978-01-01

The employee selection practices of private and public enterprises that contract with the federal government or receive federal financial assistance have been subjected to extensive regulation by the agencies administering sections 503 and 504 of the 1973 Rehabilitation Act, which provide protection to qualified handicapped individuals. The author discusses the nature and significance of these restrictions and gives practical guidance on compliance. She cautions that the enforcement powers of the agencies administering the Act--the power to cut off federal funds, debar from future contracts, award back pay, and provide equitable relief--make it necessary for employers to show good faith and proper justification when a decision is made to reject a handicapped person for a job or a promotion.

Improved SURF Algorithm and Its Application in Seabed Relief Image Matching

Directory of Open Access Journals (Sweden)

Zhang Hong-Mei

2017-01-01

Full Text Available The matching based on seabed relief image is widely used in underwater relief matching navigation and target recognition, etc. However, being influenced by various factors, some conventional matching algorithms are difficult to obtain an ideal result in the matching of seabed relief image. SURF(Speeded Up Robust Features algorithm is based on feature points pair to achieve matching, and can get good results in the seabed relief image matching. However, in practical applications, the traditional SURF algorithm is easy to get false matching, especially when the area’s features are similar or not obvious, the problem is more seriously. In order to improve the robustness of the algorithm, this paper proposes an improved matching algorithm, which combines the SURF, and RANSAC (Random Sample Consensus algorithms. The new algorithm integrates the two algorithms advantages, firstly, the SURF algorithm is applied to detect and extract the feature points then to pre-match. Secondly, RANSAC algorithm is utilized to eliminate mismatching points, and then the accurate matching is accomplished with the correct matching points. The experimental results show that the improved algorithm overcomes the mismatching problem effectively and have better precision and faster speed than the traditional SURF algorithm.

Japanese women's experiences of pharmacological pain relief in New Zealand.

Science.gov (United States)

Doering, Keiko; Patterson, Jean; Griffiths, Christine R

2014-06-01

In Japan, most women manage labour pain without pharmacological interventions. However, New Zealand statistics show a high percentage of epidural use amongst Asian women. Entonox (a gas mixture of nitrous oxide and oxygen) and pethidine are also available to women in New Zealand. This article investigates how Japanese women in New Zealand respond to the use of pharmacological pain relief in labour. The study was guided by two research questions: (1) How do Japanese women experience and manage labour pain in New Zealand? (2) How do they feel about the use of pharmacological pain relief? Thirteen Japanese women who had given birth in New Zealand were interviewed individually or in a focus group. The conversations were analysed using thematic analysis. Although in Japan very few women use pain relief, nine women received epidural and/or Entonox out of 11 women who experienced labour pain. The contrast between their Japanese cultural expectations and their birth experiences caused some of the women subsequent personal conflict. Japanese women's cultural perspectives and passive attitudes were demonstrated to influence the decision-making process concerning pain relief. It was concluded that understanding Japanese cultural worldviews and approaches to the role of pain in labour would help maternity providers in their provision of appropriate care for Japanese women. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

29 CFR 1601.23 - Preliminary or temporary relief.

Science.gov (United States)

2010-07-01

..., or political subdivision. (b) In a case involving a government, governmental agency, or political... private individuals from exercising their rights to seek temporary or preliminary relief on their own...

Simulation of durability the evaluation of relief-dot Braille images

Directory of Open Access Journals (Sweden)

Svitlana Havenko

2016-07-01

Full Text Available The paper presents a model of factors that influence on the quality of relief-dot Braille inscriptions in their intensive use by blind people. It was constructed matrix of depending and distancing by using a directed graph. It allowed establish a hierarchy between studied criteria’s of impact the on durability of relief prints. It was developed a basic structure of digital system of assessment the conformity of Braille symbols to applicable international standards and definition of operational stability.

Maslow Hierarchy of Needs and OBRA 1987: Toward Need Satisfaction by Nursing Home Residents.

Science.gov (United States)

Umoren, Joseph A.

1992-01-01

To improve well-being of nursing home residents and ensure compliance with the Omnibus Budget Reconciliation Act, programs aimed at improving quality of life must strive to satisfy higher level needs of the elderly as identified in Maslow's hierarchy. (SK)

Exploring the Association of Deliberate Self-Harm With Emotional Relief Using a Novel Implicit Association Test

Science.gov (United States)

Gratz, Kim L.; Chapman, Alexander L.; Dixon-Gordon, Katherine L.; Tull, Matthew T.

2017-01-01

Despite the growing consensus that negative reinforcement in the form of emotional relief plays a key role in the maintenance of deliberate self-harm (DSH), most of the research in this area has relied exclusively on self-report measures of the perceived motives for and emotional consequences of DSH. Thus, the primary aim of this study was to extend extant research on the role of emotional relief in DSH by examining the strength of the association of DSH with emotional relief using a novel version of the Implicit Association Test (IAT). The strength of the DSH-relief association among both participants with (vs. without) DSH and self-harming participants with (vs. without) BPD, as well as its associations with relevant clinical constructs (including DSH characteristics, self-reported motives for DSH, BPD pathology, and emotion dysregulation and avoidance) were examined in a community sample of young adults (113 with recent recurrent DSH; 135 without DSH). As hypothesized, results revealed stronger associations between DSH and relief among participants with versus without DSH, as well as among DSH participants with versus without BPD. Moreover, the strength of the DSH-relief association was positively associated with DSH frequency and versatility (both lifetime and at 6-month follow-up), BPD pathology, emotion dysregulation, experiential avoidance, and self-reported emotion relief motives for DSH. Findings provide support for theories emphasizing the role of emotional relief in DSH (particularly among individuals with BPD), as well as the construct validity, predictive utility, and incremental validity (relative to self-reported emotion relief motives) of this IAT. PMID:26147069

Topology-optimized broadband surface relief transmission grating

DEFF Research Database (Denmark)

Andkjær, Jacob; Ryder, Christian P.; Nielsen, Peter C.

2014-01-01

We propose a design methodology for systematic design of surface relief transmission gratings with optimized diffraction efficiency. The methodology is based on a gradient-based topology optimization formulation along with 2D frequency domain finite element simulations for TE and TM polarized plane...

Early resident-to-resident physics education in diagnostic radiology.

Science.gov (United States)

Kansagra, Akash P

2014-01-01

The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

Science.gov (United States)

Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

2018-04-11

Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy

Use of social media by residency program directors for resident selection.

Science.gov (United States)

Cain, Jeff; Scott, Doneka R; Smith, Kelly

2010-10-01

Pharmacy residency program directors' attitudes and opinions regarding the use of social media in residency recruitment and selection were studied. A 24-item questionnaire was developed, pilot tested, revised, and sent to 996 residency program directors via SurveyMonkey.com. Demographic, social media usage, and opinions on social media data were collected and analyzed. A total of 454 residency program directors completed the study (response rate, 46.4%). The majority of respondents were women (58.8%), were members of Generation X (75.4%), and worked in a hospital or health system (80%). Most respondents (73%) rated themselves as either nonusers or novice users of social media. Twenty percent indicated that they had viewed a pharmacy residency applicant's social media information. More than half (52%) had encountered e-professionalism issues, including questionable photos and posts revealing unprofessional attitudes, and 89% strongly agreed or agreed that information voluntarily published online was fair game for judgments on character, attitudes, and professionalism. Only 4% of respondents had reviewed applicants' profiles for residency selection decisions. Of those respondents, 52% indicated that the content had no effect on resident selection. Over half of residency program directors were unsure whether they will use social media information for future residency selection decisions. Residency program directors from different generations had different views regarding social media information and its use in residency applicant selections. Residency program directors anticipated using social media information to aid in future decisions for resident selection and hiring.

An audit of aspects of informed consent and pain relief in general ...

African Journals Online (AJOL)

They were asked what they knew or had been informed about their diagnosis, operation and complications of surgery. On pain relief, patients were asked about their experiences on the first post-operative day and what relief they had from analgesics. Twenty four did not know the diagnosis and 36 were not told what ...

Spatially Uniform ReliefF (SURF for computationally-efficient filtering of gene-gene interactions

Directory of Open Access Journals (Sweden)

Greene Casey S

2009-09-01

Full Text Available Abstract Background Genome-wide association studies are becoming the de facto standard in the genetic analysis of common human diseases. Given the complexity and robustness of biological networks such diseases are unlikely to be the result of single points of failure but instead likely arise from the joint failure of two or more interacting components. The hope in genome-wide screens is that these points of failure can be linked to single nucleotide polymorphisms (SNPs which confer disease susceptibility. Detecting interacting variants that lead to disease in the absence of single-gene effects is difficult however, and methods to exhaustively analyze sets of these variants for interactions are combinatorial in nature thus making them computationally infeasible. Efficient algorithms which can detect interacting SNPs are needed. ReliefF is one such promising algorithm, although it has low success rate for noisy datasets when the interaction effect is small. ReliefF has been paired with an iterative approach, Tuned ReliefF (TuRF, which improves the estimation of weights in noisy data but does not fundamentally change the underlying ReliefF algorithm. To improve the sensitivity of studies using these methods to detect small effects we introduce Spatially Uniform ReliefF (SURF. Results SURF's ability to detect interactions in this domain is significantly greater than that of ReliefF. Similarly SURF, in combination with the TuRF strategy significantly outperforms TuRF alone for SNP selection under an epistasis model. It is important to note that this success rate increase does not require an increase in algorithmic complexity and allows for increased success rate, even with the removal of a nuisance parameter from the algorithm. Conclusion Researchers performing genetic association studies and aiming to discover gene-gene interactions associated with increased disease susceptibility should use SURF in place of ReliefF. For instance, SURF should be

Prolonged knee pain relief by saphenous block (new technique

Directory of Open Access Journals (Sweden)

Rajeev Harshe

2013-01-01

Full Text Available Pain in the knee joint can be from a variety of reasons. It can be either from the joint itself, it can be myofascial or it can be neuropathy, radicular pain. The myofascial component can be in different forms, namely, collateral ligament pain, bursitis, tendinitis, and so on. This responds well to local injections of steroids. Pain from the joint can be because of osteoarthritis (OA, rheumatoid arthritis or any other variety of arthritis. Among these osteoarthritis is the most common and naturally occurring pain. There are several modalities used for managing pain in the knee joint. They include medicines and physiotherapy, intra-articular steroid injection, intra-articular Hyalgan, Synvisc injection, prolotherapy, genicular nerve block, ablation, intra-articular pulsed radio frequency (PRF ablation, acupuncture, injection of platelet-rich plasma in the joint, total knee replacement, high tibial osteotomy, arthroscopy and lavage, and so on. All these modalities have their pros and cons. Literature and experience state that the pain relief provided may last for a few months with these modalities except in surgical interventions in advanced OA. The saphenous nerve is termination of femoral nerve and it is essentially sensory nerve. It supplies the medial compartment and some part of the anterior compartment of the knee joint. This nerve has been blocked near the knee joint by way of infiltration by surgeons and anesthetists, for relief of pain after knee surgery, with varying pain relief of postoperative pain. When we block the saphenous in the mid thigh in the sartorial canal, the fluid tends to block the medial branch of the anterior femoral cutaneous nerve also. It is hypothesized that this may give complete medial and anterior knee pain relief and as most of the knee OA patients have medial and anterior knee pain, this may prove useful. Use of ultrasonography helps to locate the nerve better, ensuring perfection. An effort has been made to

Higher Education: More Information Could Help Education Determine the Extent to Which Eligible Servicemembers Serving on Active Duty Benefited from Relief Provided by Lenders and Schools. Report to Congressional Requesters. GAO-07-11

Science.gov (United States)

Ashby, Cornelia M.

2006-01-01

Since September 11, 2001, over 1.3 million members of the armed forces have been deployed in service to the United States. Congress enacted the Higher Education Relief Opportunities for Students (HEROES) Act to recognize the needs of those servicemembers who are deployed in the midst of pursuing postsecondary education or repaying student loans.…

Emergency networking: famine relief in ant colonies

NARCIS (Netherlands)

Sendova-Franks, A.B.; Hayward, R.; Wulf, B.; Klimek, T.; James, R.; Planque, R.; Britton, N.F.; Franks, N.R.

2009-01-01

Resource distribution is fundamental to social organization, but it poses a dilemma. How to facilitate the spread of useful resources but restrict harmful substances? This dilemma reaches a zenith in famine relief. Survival depends on distributing food fast but that could increase vulnerability to

Women's preferences and received pain relief in childbirth - A prospective longitudinal study in a northern region of Sweden.

Science.gov (United States)

Lindholm, Annika; Hildingsson, Ingegerd

2015-06-01

A range of alternatives in pain management during childbirth are available in the western countries. Women's preferences for and use of pain relief methods during labour is not fully investigated. The aim of this study was to describe what pain relief methods pregnant women preferred when asked in late pregnancy and to identify factors associated with preferred and received pain relief methods. A prospective longitudinal study in a northern region of Sweden (n = 936). Data were collected by three questionnaires. Odds ratios with a 95% confidence interval were calculated between preferred and received pain relief methods for several explanatory variables. The most preferred pain relief methods were also the most common received pain relief methods; nitrous oxide, bathing, breathing techniques, epidural analgesia and massage. The strongest factors for using different pain relief methods were primiparity and preferences. Women who used epidural analgesia, regardless of preference, were two to four times more likely to have a less positive birth experience. Women's preferences for a certain pain relief method were largely met. Greater differences were seen between background factors and preferences than the received pain relief methods. Preferences and primiparity were the most important factors for actually using pain relief. Epidural analgesia was associated with a less positive birth experience. Copyright © 2014 Elsevier B.V. All rights reserved.

Motor and Executive Function Profiles in Adult Residents ...

Science.gov (United States)

Objective: Exposure to elevated levels of manganese (Mn) may be associated with tremor, motor and executive dysfunction (EF), clinically resembling Parkinson’s disease (PD). PD research has identified tremor-dominant (TD) and non-tremor dominant (NTD) profiles. NTD PD presents with bradykinesia, rigidity, and postural sway, and is associated with EF impairment with lower quality of life (QoL). Presence and impact of tremor, motor, and executive dysfunction profiles on health-related QoL and life satisfaction were examined in air-Mn exposed residents of two Ohio, USA towns. Participants and Methods: From two Ohio towns exposed to air-Mn, 186 residents (76 males) aged 30-75 years were administered measures of EF (Animal Naming, ACT, Rey-O Copy, Stroop Color-Word, and Trails B), motor and tremor symptoms (UPDRS), QoL (BRFSS), life satisfaction (SWLS), and positive symptom distress (SCL-90-R). Air-Mn exposure in the two towns was modeled with 10 years of air-monitoring data. Cluster analyses detected the presence of symptom profiles by grouping together residents with similar scores on these measures. Results: Overall, mean air-Mn concentration for the two towns was 0.53 µg/m3 (SD=.92). Two-step cluster analyses identified TD and NTD symptom profiles. Residents in the NTD group lacked EF impairment; EF impairment represented a separate profile. An unimpaired group also emerged. The NTD and EF impairment groups were qualitatively similar, with relatively lo

Strain relief InGaN/GaN MQW micro-pillars for high brightness LEDs

KAUST Repository

Shen, Chao

2013-01-01

Micro-structured group-III-nitrides are considered as promising strain relief structures for high efficiency solid state lighting. In this work, the strain field in InGaN/GaN multi-quantum wells (MQWs) micro-pillars is investigated using micro-Raman spectroscopy and the design of micro-pillars were studied experimentally. We distinguished the strained and strain-relieved signatures of the GaN layer from the E2 phonon peak split from the Raman scattering signatures at 572 cm-1 and 568 cm-1, respectively. The extent of strain relief is examined considering the height and size of micro-pillars fabricated using focused ion beam (FIB) micro-machining technique. A significant strain relief can be achieved when one micro-machined through the entire epi-layers, 3 μm in our study. The dependence of strain relief on micro-pillar diameter (D) suggested that micro-pillar with D < 3 μm showed high degree of strain relief. Our results shed new insights into designing strain-relieved InGaN/GaN microstructures for high brightness light emitting diode arrays. © 2013 IEEE.

Experimental investigation of processes in primary circuit relief system

International Nuclear Information System (INIS)

Tomas, Z.; Simo, T.; Konecny, A.

1989-01-01

The protective condenser (direct contact condenser) is one of the basic components of the primary circuit relief system of WWER power plants. The steam flowing from the surge tank through relief valves into the subcooled water condensates in the protective condenser vessel. Two simple physical models were designed and constructed for investigation of bubbling through (contact condensation). An experimental program was performed with the aim of determining the distribution of temperatures in the axis of the steam jet and its vicinity, determining the velocity field of water into vicinity of steam jets, observing the geometrical shape of jets and their interaction and determining important values for mathematical model. (orig.)

The psychological and physiological stress relief effect of the green roof

Energy Technology Data Exchange (ETDEWEB)

Lee, H.; Koshimizu, H. [Meiji Univ., Tokyo (Japan). Dept. of Agriculture

2007-07-01

The visual sense influences human psychology and physiology. As such, green gardens in urban environments are touted as being healing gardens that lead to stress relief and improved work efficiency. This paper focused on the visual aspects of such rehabilitation sites. Psychological and physiological experiments were conducted on human response to green roofs in order to quantify the stress relief effect of the green roof scenery. In addition, different green roof designs were tested to determine whether they change the stress relief effect. A 360 degrees panorama photograph of green roofs was shown to 3 male and 3 female students in Meiji University. The experiment was followed by a questionnaire survey based on the semantic differential (SD) method as a psychological evaluation. The SD method is a representative psychological measurement to quantify an image of people for a scene. The changes in heart rate were studied along with blood pressure, and stress degree as a physiological evaluation. The relation between the results of the SD method-based psychological evaluation and the physiological experiment was determined using multiple regression analysis. It was concluded that the stress relief effect can be improved by changing linear scenery to a more curvy one. 15 refs., 4 tabs., 20 figs.

Proactive pressure relief system management of life cycle and ageing in nuclear power plants

International Nuclear Information System (INIS)

Kolenc, J.; Ferrar, S.

2011-01-01

The last major power nuclear station built in North America was built when the Altair Company introduced the first microcomputer sparking the PC frenzy. It is safe to assume that there have been a great many changes since 1977 on both accounts. As the world's aging nuclear plants continue to be challenged with maintenance and replacement issues (obsolescence), as well making improvements within their facilities, proper pressure relief system management looms as a growing concern. This problem grows more acute as new engineering best practices are promulgated across industries and regulatory standards become more rigorous with much stricter enforcements. Unlike most pieces of operating equipment in a nuclear facility, pressure relief devices demand an extra level of consideration; as they form the 'last line of defense'. Combine the on-going obsolescence issue, with today's ever increasing demands for overall plant and public safety; pressure relief safety management will require increasing 'proactive' efforts to ensure safe facilities. This paper has been written to address some global pressure relief system management issues with respect the worlds aging nuclear facilities. This paper reflects findings we have discovered while conducting engineering pressure relief system audits on various nuclear power stations. It should be noted that these finding are not atypical of similar findings in pressure relief systems in the hydrocarbon processing world. (author)

CCF analysis of high redundancy systems safety/relief valve data analysis and reference BWR application

International Nuclear Information System (INIS)

Mankamo, T.; Bjoere, S.; Olsson, Lena

1992-12-01

Dependent failure analysis and modeling were developed for high redundancy systems. The study included a comprehensive data analysis of safety and relief valves at the Finnish and Swedish BWR plants, resulting in improved understanding of Common Cause Failure mechanisms in these components. The reference application on the Forsmark 1/2 reactor relief system, constituting of twelve safety/relief lines and two regulating relief lines, covered different safety criteria cases of reactor depressurization and overpressure protection function, and failure to re close sequences. For the quantification of dependencies, the Alpha Factor Model, the Binomial Probability Model and the Common Load Model were compared for applicability in high redundancy systems

Ubiquitous Creation of Bas-Relief Surfaces with Depth-of-Field Effects Using Smartphones

Directory of Open Access Journals (Sweden)

Bong-Soo Sohn

2017-03-01

Full Text Available This paper describes a new method to automatically generate digital bas-reliefs with depth-of-field effects from general scenes. Most previous methods for bas-relief generation take input in the form of 3D models. However, obtaining 3D models of real scenes or objects is often difficult, inaccurate, and time-consuming. From this motivation, we developed a method that takes as input a set of photographs that can be quickly and ubiquitously captured by ordinary smartphone cameras. A depth map is computed from the input photographs. The value range of the depth map is compressed and used as a base map representing the overall shape of the bas-relief. However, the resulting base map contains little information on details of the scene. Thus, we construct a detail map using pixel values of the input image to express the details. The base and detail maps are blended to generate a new depth map that reflects both overall depth and scene detail information. This map is selectively blurred to simulate the depth-of-field effects. The final depth map is converted to a bas-relief surface mesh. Experimental results show that our method generates a realistic bas-relief surface of general scenes with no expensive manual processing.

Prediction of renal functional recovery after relief of upper urinary tract obstruction

International Nuclear Information System (INIS)

Kalika, V.; Bard, R.H.; Iloreta, A.; Freeman, L.M.; Heller, S.; Blaufox, M.D.

1981-01-01

Renal cortical regions of interest were used prospectively to predict recoverability of renal function in 27 patients with unilateral or bilateral urinary tract obstruction. In these 27 patients 36 kidneys with short-term or long-term obstruction were studied. The 131iodine radiohippuran renogram curves were generated from areas of interest from the renal cortex and from the whole kidney. Curves generated during obstruction were evaluated qualitatively to determine if regional cortical renograms exhibited a more normal appearance than total kidney curves. After relief of obstruction renograms generated from the whole kidney were evaluated for evidence of renal functional recovery. Cortical curves obtained before relief obstruction were judged normal, with an abnormal whole kidney renogram in 20 of 36 kidneys. The whole kidney renogram improved after relief of obstruction in all 20 cases. Cortical curves for the remaining 16 kidneys before relief of obstruction had the same abnormal appearance as the whole kidney renogram. After relief of obstruction no evidence of kidney function improvement as measured by the renogram was evident in 14 kidneys. The over-all accuracy of this test of renal functional recoverability was 94 per cent. These data support the hypothesis that when cortical curves appear more normal than total kidney curves there is a strong likelihood of postoperative improvement in renal function when the obstruction is relieved. Abnormal cortical curves are associated with a poor prognosis for renal functional improvement

Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

Science.gov (United States)

Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

2018-04-17

Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

Pain relief and clinical outcome: from opioids to balanced analgesia

DEFF Research Database (Denmark)

Kehlet, H

1996-01-01

If it is generally accepted that adequate postoperative pain relief will improve outcome from surgery, several controlled trials demonstrated this only for lower body surgical procedures with epidural and spinal anesthetics. Important effects on outcome were not shown when postoperative opioids...... were administered with patient controlled (PCA) or epidural techniques. However, the most optimal pain relief seems to be best achieved with balanced analgesia techniques using combinations of epidural opioids and local anesthetics and systemic non-steroidal antiinflammatory drugs. Future efforts...... should aim at including physical rehabilitation programs in the pain treatment regimen....

The Application of Electroanalgesia Current for the Relief of Orofacial Pain.

Science.gov (United States)

1981-09-01

A-A124 939 THE APPLICATION OF ELECTRORNALGESIA CURRENT FOR THE i/1 RELIEF OF OROFACIAL PAIN (U) OREGON UNIV HEALTH SCIENCES CENTER PORTLAND BIOPHYSICS...COVERED THE APPLICATION OF ELECTROANALGESIA CURRENT FOR Fnl-Fbur 90 and evelpmen Conand September 198 THE RELIEF OF OROFACIAL PAIN Spebr18 27. PERFORMING...of a suitable animal preparation. An excellent site to initiate orofacial pain is found in the tissue vhich also has o - timal relevance, the tooth

Photobiomodulation: Implications for Anesthesia and Pain Relief.

Science.gov (United States)

Chow, Roberta T; Armati, Patricia J

2016-12-01

This review examines the evidence of neural inhibition as a mechanism underlying pain relief and anesthetic effect of photobiomodulation (PBM). PBM for pain relief has also been used for more than 30 years; however, the mechanism of its effectiveness has not been well understood. We review electrophysiological studies in humans and animal models and cell culture studies to examine neural responses to PBM. Evidence shows that PBM can inhibit nerve function in vivo, in situ, ex vivo, and in culture. Animal studies using noxious stimuli indicate nociceptor-specific inhibition with other studies providing direct evidence of local conduction block, leading to inhibited translation of pain centrally. Evidence of PBM-disrupted neuronal physiology affecting axonal flow, cytoskeleton organization, and decreased ATP is also presented. PBM changes are reversible with no side effects or nerve damage. This review provides strong evidence in neuroscience identifying inhibition of neural function as a mechanism for the clinical application of PBM in pain and anesthesia.

Safety and relief valves in light water reactors

International Nuclear Information System (INIS)

Singh, A.

1985-12-01

Information is presented to: provide an introduction to and descriptions of various types of safety and relief valves in both PWR and BWR plants; describe anticipated operating conditions for these valves; describe the test facilities, procedures, and major results for both types of valves; present an extensive discussion of modeling and analysis of safety and relief valve performance, including the prediction of flow capacity and stability during operation; deal with the analyses related to the prediction of thermal-hydraulic loads on discharge piping and comparison against test data; discuss results of small-scale valve tests and flow visualization studies through transparent valve models; and describe an EPRI study for optimizing a typical PWR over-pressure protection system to enhance the availability and reliability of plant operation and thus reduce operation costs

29 CFR 1975.6 - Policy as to domestic household employment activities in private residences.

Science.gov (United States)

2010-07-01

... private residences. 1975.6 Section 1975.6 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) COVERAGE OF EMPLOYERS UNDER THE WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 § 1975.6 Policy as to domestic household...

State Dream Acts: The Effect of In-State Resident Tuition Policies and Undocumented Latino Students

Science.gov (United States)

Flores, Stella M.

2010-01-01

This study examines the effect of in-state resident tuition legislation across the United States on the college enrollment odds of individuals likely to be undocumented Latino immigrants. The study employs a differences-indifferences strategy using data from the Current Population Survey's Merged Outgoing Rotation Groups. Foreign-born noncitizen…

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

Science.gov (United States)

Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

1996-06-01

To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p sexual harassment to someone (p sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

The pre-positioning of warehouses at regional and local levels for a humanitarian relief organisation

OpenAIRE

Roh, Saeyeon; Pettit, Stephen John; Harris, Irina; Beresford, Anthony Kenneth Charles

2015-01-01

Using pre-positioned warehouses at strategic locations around the world is an approach commonly taken by some humanitarian relief organisations to improve their capacities to deliver sufficient relief aid within a relatively short time frame, and to provide shelter and assistance to disaster victims. Although research into the facility location problem is extensive in both theory and application, such approaches have received little attention from the humanitarian relief perspective. In this ...

Anesthesiology resident personality type correlates with faculty assessment of resident performance.

Science.gov (United States)

Schell, Randall M; Dilorenzo, Amy N; Li, Hsin-Fang; Fragneto, Regina Y; Bowe, Edwin A; Hessel, Eugene A

2012-11-01

To study the association between anesthesiology residents' personality preference types, faculty evaluations of residents' performance, and knowledge. Convenience sample and prospective study. Academic department of anesthesiology. Consenting anesthesiology residents (n = 36). All participants completed the Myers Briggs Type Indicator® (MBTI®). All residents' 6-month summation of daily focal evaluations completed by faculty [daily performance score (DPS); 1 = unsatisfactory, 2 = needs improvement, 3 = meets expectations, 4 = exceeds expectations], as well as a global assessment of performance (GAP) score based on placement of each resident into perceived quartile compared with their peers (ie,1 = first, or top, quartile) by senior faculty (n = 7) who also completed the MBTI, were obtained. The resident MBTI personality preferences were compared with the DPS and GAP scores, the United States Medical Licensing Examination (USMLE) I and II scores, and faculty MBTI personality type. There was no association between personality preference type and performance on standardized examinations (USMLE I, II). The mean GAP score was better (higher quartile score) for Extraverts than Introverts (median 2.0 vs 2.6, P = 0.0047) and for Sensing versus Intuition (median 2.0 vs 2.6, P = 0.0206) preference. Faculty evaluator MBTI preference type did not influence the GAP scores they assigned residents. Like GAP, the DPS was better for residents with Sensing versus Intuition preference (median 3.5 vs 3.3, P = 0.0111). No difference in DPS was noted between Extraverts and Introverts. Personality preference type was not associated with resident performance on standardized examinations, but it was associated with faculty evaluations of resident performance. Residents with Sensing personality preference were evaluated more favorably on global and focal faculty evaluations than those residents who chose the Intuition preference. Extraverted residents were evaluated more favorably on

Rotorcraft Use in Disaster Relief and Mass Casualty Incidents - Case Studies

Science.gov (United States)

1990-06-01

Disaster Relief and Mass 6. Performing Organization Code C asuallty Incidents- C ase Studies 8._P rfo minOr ani ati nR porNo 7. Author (s) 8...disaster planning process; and 3) produce a color video tape promoting the need for and the use of rotorcraft and heliports in disaster relief. 17...disaster prepaLedness ageicies for use in the integration of local helicopter assets into the disaster planning process; and 3) produce a color video tape

Opponent appetitive-aversive neural processes underlie predictive learning of pain relief.

Science.gov (United States)

Seymour, Ben; O'Doherty, John P; Koltzenburg, Martin; Wiech, Katja; Frackowiak, Richard; Friston, Karl; Dolan, Raymond

2005-09-01

Termination of a painful or unpleasant event can be rewarding. However, whether the brain treats relief in a similar way as it treats natural reward is unclear, and the neural processes that underlie its representation as a motivational goal remain poorly understood. We used fMRI (functional magnetic resonance imaging) to investigate how humans learn to generate expectations of pain relief. Using a pavlovian conditioning procedure, we show that subjects experiencing prolonged experimentally induced pain can be conditioned to predict pain relief. This proceeds in a manner consistent with contemporary reward-learning theory (average reward/loss reinforcement learning), reflected by neural activity in the amygdala and midbrain. Furthermore, these reward-like learning signals are mirrored by opposite aversion-like signals in lateral orbitofrontal cortex and anterior cingulate cortex. This dual coding has parallels to 'opponent process' theories in psychology and promotes a formal account of prediction and expectation during pain.

A Review of Long-Term Pain Relief after Genicular Nerve Radiofrequency Ablation in Chronic Knee Osteoarthritis.

Science.gov (United States)

Iannaccone, Ferdinand; Dixon, Samuel; Kaufman, Andrew

2017-03-01

Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB). Chart review and follow-up was performed on all patients who underwent genicular nerve RFA during the period of February 2014 through August of 2015. During this inclusion period 41 genicular nerve RFAs were performed on 31 patients, 5 patients received RFA procedure in both knees. Patient follow-up was performed via telephone interview or in-office visit at least 3 months and 6 months post RFA. Procedures were performed in Medical Special Procedures at University Hospital in Newark, NJ, and the Pain Management Center at Overlook Medical Arts Center in Summit, NJ. Chart review and study design was approved by Newark Health Sciences IRB. Chart review was performed from February 2014 and continued through August 2015. Patient follow-up was conducted at 3 and at least 6 months post treatment to gauge degree of pain relief (0 - none, 100% - complete), their current day's pain score, other treatment modalities tried before RFA, and the medications used. Patients were asked to quantify their satisfaction with procedure length, pre-procedure anxiety, complications, and if they would recommend this procedure to others. Primary and secondary goals were the duration of pain relief after RFA, the quality of pain relief, and the efficacy of our approach for RFA of genicular nerves versus prior published techniques. At 3 month follow-up, the average pain relief was 67% improvement from baseline knee pain, 0% being no relief and 100% being complete relief, and average 0 - 10 pain score was 2.9. At 6 month follow-up, of those who

Impact of radiotherapy on pain relief and recalcification in plasma cell neoplasms. Long-term experience

International Nuclear Information System (INIS)

Balducci, Mario; Chiesa, Silvia; Manfrida, Stefania

2011-01-01

Purpose: To evaluate the impact of radiotherapy on pain relief and on recalcification in patients with osteolytic lesions due to plasma cell neoplasm. Patients and Methods: Pain relief was evaluated according to a 0-10 verbal numerical rating scale (NRS) and recalcification was measured using radiological imaging. Results: From 1996-2007, 52 patients were treated. Median total dose was 38 Gy (range, 16-50 Gy). Pain before radiotherapy was reported by 45 of 52 (86.5%) patients as being severe (8 ≤ NRS ≤ 10) in 5 (11%), moderate (5 ≤ NRS ≤ 7) in 27 (60%), and mild in 13 (29%). Pain relief was achieved in 41 of 45 patients (91%): complete relief was obtained in 21 (51.2%) and partial relief in 20 patients (48.8%); patients with severe pain experienced resolution and none presented an increase of pain. Drugs reduction/suspension was achieved in 7 of the 21 patients with complete response. Of 42 patients evaluable for recalcification, 21 (50%) presented a radiological response, which was identified as complete in 16 (38%). Conclusion: Our data confirm the effectiveness of radiotherapy for pain relief, including a reduction in drug intake, and on recalcification, thus, supporting its use in a multidisciplinary approach. (orig.)

Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit

Directory of Open Access Journals (Sweden)

Felix Ankel

2018-02-01

Full Text Available Introduction: Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM. Through a joint collaboration involving Academic Life in Emergency Medicine’s (ALiEM Wellness Think Tank, Essentials of Emergency Medicine (EEM, and the Emergency Medicine Residents’ Association (EMRA, a one-day Resident Wellness Consensus Summit (RWCS was organized. Methods: The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Results: Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. Conclusion: The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

Bas-relief map using texture analysis with application to live enhancement of ultrasound images.

Science.gov (United States)

Du, Huarui; Ma, Rui; Wang, Xiaoying; Zhang, Jue; Fang, Jing

2015-05-01

For ultrasound imaging, speckle is one of the most important factors in the degradation of contrast resolution because it masks meaningful texture and has the potential to interfere with diagnosis. It is expected that researchers would explore appropriate ways to reduce the speckle noise, to find the edges of structures and enhance weak borders between different organs in ultrasound imaging. Inspired by the principle of differential interference contrast microscopy, a "bas-relief map" is proposed that depicts the texture structure of ultrasound images. Based on a bas-relief map, an adaptive bas-relief filter was developed for ultrafast despeckling. Subsequently, an edge map was introduced to enhance the edges of images in real time. The holistic bas-relief map approach has been used experimentally with synthetic phantoms and digital ultrasound B-scan images of liver, kidney and gallbladder. Based on the visual inspection and the performance metrics of the despeckled images, it was found that the bas-relief map approach is capable of effectively reducing the speckle while significantly enhancing contrast and tissue boundaries for ultrasonic images, and its speckle reduction ability is comparable to that of Kuan, Lee and Frost filters. Meanwhile, the proposed technique could preserve more intra-region details compared with the popular speckle reducing anisotropic diffusion technique and more effectively enhance edges. In addition, the adaptive bas-relief filter was much less time consuming than the Kuan, Lee and Frost filter and speckle reducing anisotropic diffusion techniques. The bas-relief map strategy is effective for speckle reduction and live enhancement of ultrasound images, and can provide a valuable tool for clinical diagnosis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies.

Science.gov (United States)

Griffin, Sarah C; Curran, Sean; Chan, Annie W Y; Finn, Sacha B; Baker, Chris I; Pasquina, Paul F; Tsao, Jack W

2017-04-01

Research indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy. Data from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n=33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire. The severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (ppain relief by session 14 of treatment, and those with high baseline PLP experienced pain relief by session 21 of treatment. Mirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms. The degree of PLP at baseline predicts when mirror therapy relieves pain. This article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain. ClinicalTrials.gov numbers:NCT00623818 and NCT00662415. Copyright © 2017 Scandinavian Association for the Study of Pain. All rights reserved.

Combined approaches for the relief of spinal cord injury-induced neuropathic pain.

Science.gov (United States)

Gwak, Young S; Kim, Hee Young; Lee, Bong Hyo; Yang, Chae Ha

2016-04-01

The adequate treatment of spinal cord injury (SCI)-induced neuropathic pain still remains an unresolved problem. The current medications predominantly used in the SCI-induced neuropathic pain therapy are morphine, anticonvulsants, antidepressants, and antiepileptics, which suggests that psychiatric aspects might be important factors in the treatment of neuropathic pain. It is well documented that the modulation of the sensory events is not a unique way for achieving pain relief. In addition, pain patients still express dissatisfaction and complain of unwanted effects of the medications, suggesting that alternative approaches for the treatment of neuropathic pain are essential. In psychiatry, pain relief represents relaxation and a feeling of comfort and satisfaction, which suggests that cognitive and emotional motivations are important factors in the treatment of neuropathic pain. The comorbidity of chronic pain and psychiatric disorders, which is well recognized, suggests that the effective therapeutic relief for neuropathic pain induced by SCI can be achieved in conjunction with the management of the sensory and psychiatric aspects of patient. In this review, we address the feasibility of a combined acupuncture and pharmacotherapy treatment for the relief of neuropathic pain behavior following SCI. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antiemetic Medicines: OTC Relief for Nausea and Vomiting

Science.gov (United States)

... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

A novel robust chance constrained possibilistic programming model for disaster relief logistics under uncertainty

Directory of Open Access Journals (Sweden)

Maryam Rahafrooz

2016-09-01

Full Text Available In this paper, a novel multi-objective robust possibilistic programming model is proposed, which simultaneously considers maximizing the distributive justice in relief distribution, minimizing the risk of relief distribution, and minimizing the total logistics costs. To effectively cope with the uncertainties of the after-disaster environment, the uncertain parameters of the proposed model are considered in the form of fuzzy trapezoidal numbers. The proposed model not only considers relief commodities priority and demand points priority in relief distribution, but also considers the difference between the pre-disaster and post-disaster supply abilities of the suppliers. In order to solve the proposed model, the LP-metric and the improved augmented ε-constraint methods are used. Second, a set of test problems are designed to evaluate the effectiveness of the proposed robust model against its equivalent deterministic form, which reveales the capabilities of the robust model. Finally, to illustrate the performance of the proposed robust model, a seismic region of northwestern Iran (East Azerbaijan is selected as a case study to model its relief logistics in the face of future earthquakes. This investigation indicates the usefulness of the proposed model in the field of crisis.

Legal Issues of A Surrogacy Contract Based on Iranian Acts

Directory of Open Access Journals (Sweden)

Amir Pirouz

2011-06-01

Full Text Available Assistive technologies have always opened new horizons in human's life, posed solutions to problemsand brought relief and prosperity for human beings. Iranian judicial authorities have recently recognizedthe importance of medical technologies. Accordingly, Iranian legal system has recognized surrogacy anda surrogacy contract seems unavoidable for surrogacy to be legally valid, socially acceptable andreligiously legitimate. As a legal defense of including a typical surrogacy contract in contract law, thisreview studies the four building blocks of a valid contract: the intention and consent of parties, theirlegal capacity, the subject of the contract and its legitimacy. Discussing related Iranian Acts concerningcontracts and responsibilities of parties, the authors of the present article deal with main commitmentsand responsibilities of the parties to a typical surrogacy contract: infertile couples, surrogate, fertilityclinic or medical institute, and surrogate's husband. The authors conclude that a surrogacy contract isaccepted based on article 10 of Iranian Civil Act 1928, pose some suggestions to be included in such acontract, and emphasize that a specific Act concerning surrogacy should be approved to cover rights andlegal needs of all parties to a surrogacy contract.

Shaded Relief of Rio Sao Francisco, Brazil

Science.gov (United States)

2000-01-01

This topographic image acquired by SRTM shows an area south of the Sao Francisco River in Brazil. The scrub forest terrain shows relief of about 400 meters (1300 feet). Areas such as these are difficult to map by traditional methods because of frequent cloud cover and local inaccessibility. This region has little topographic relief, but even subtle changes in topography have far-reaching effects on regional ecosystems. The image covers an area of 57 km x 79 km and represents one quarter of the 225 km SRTM swath. Colors range from dark blue at water level to white and brown at hill tops. The terrain features that are clearly visible in this image include tributaries of the Sao Francisco, the dark-blue branch-like features visible from top right to bottom left, and on the left edge of the image, and hills rising up from the valley floor. The San Francisco River is a major source of water for irrigation and hydroelectric power. Mapping such regions will allow scientists to better understand the relationships between flooding cycles, forestation and human influences on ecosystems.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Shaded relief maps are commonly used in applications such as geologic mapping and land use planning.The Shuttle Radar Topography Mission (SRTM), launched on February 11, 2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200

Ear Acupuncture versus  local anaestethic for pain relief during perineal repair - a randomised controlled trial

DEFF Research Database (Denmark)

Kindberg, Sara

2007-01-01

ACUPUNCTURE OR LOCAL ANAESTETICS FOR PAIN RELIEF DURING PERINEAL REPAIR AFTER VAGINAL DELIVERY: A RANDOMISED CONTROLLED TRIAL.   By:  Sara Kindberg. Midwife and PhD student, Sønderborg Hospital, Denmark. Objective: To evaluate acupuncture as a new method of pain relief for postpartum perineal...... as photos of the acupuncture points. Perspectives:  Basic midwifery services such as providing sufficient pain relief during perineal repair still need improvement. Clinical practice should be improved continuously and thus produce reliable evidence on different pain relief methods. Website:        http...

Measuring resident well-being: impostorism and burnout syndrome in residency.

Science.gov (United States)

Legassie, Jenny; Zibrowski, Elaine M; Goldszmidt, Mark A

2008-07-01

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy

Directory of Open Access Journals (Sweden)

Michael C. Pitter

2015-01-01

Full Text Available Objective. To examine success of robot-assisted laparoscopic myomectomy (RALM measured by sustained symptom relief and fertility. Methods. This is a retrospective survey of 426 women who underwent RALM for fibroids, symptom relief, or infertility at three practice sites across the US. We examined rates of symptom recurrence and pregnancy and factors associated with these outcomes. Results. Overall, 70% of women reported being symptom-free, with 62.9% free of symptoms after three years. At >3 years, 66.7% of women who underwent surgery to treat infertility and 80% who were also symptom-free reported achieving pregnancy. Factors independently associated with symptom recurrence included greater time after surgery, preoperative dyspareunia, multiple fibroid surgeries, smoking after surgery, and preexisting diabetes. Factors positively correlated with achieving pregnancy included desiring pregnancy, prior pregnancy, greater time since surgery, and Caucasian race. Factors negatively correlated with pregnancy were advanced age and symptom recurrence. Conclusions. This paper, the first to examine symptom recurrence after RALM, demonstrates both short- and long-term effectiveness in providing symptom relief. Furthermore, RALM may have the potential to improve the chance of conception, even in a population at high risk of subfertility, with greater benefits among those who remain symptom-free. These findings require prospective validation.

Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

Directory of Open Access Journals (Sweden)

Shweiki E

2015-04-01

Full Text Available Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

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Ogboli-Nwasor E

2011-08-01

Full Text Available E Ogboli-Nwasor1, SE Adaji2, SB Bature2, OS Shittu21Department of Anesthesia, 2Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, NigeriaBackground: The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria.Methods: This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data.Results: Most respondents (94.8% agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7% had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1% took place during labor. Less than half of the respondents (48.4% had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5% had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief.Conclusion: Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers

77 FR 71448 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

Science.gov (United States)

2012-11-30

...' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... types of accounting and auditing relief for Federal onshore or Outer Continental Shelf lease production... auditing requirements. States make an annual determination of whether or not to allow relief. Two options...

75 FR 1654 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

Science.gov (United States)

2010-01-12

...' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... participate in accounting and auditing relief for Federal oil and gas marginal properties located within the... the Code of Federal Regulations (CFR), to provide two types of accounting and auditing relief for...

Acupucture as pain relief during delivery - a randomized controlled trial

DEFF Research Database (Denmark)

Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten

2009-01-01

Background: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery...... with respect to pain intensity, birth experience, and obstetric outcome. Methods: A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain...... to existing pain relief methods. (BIRTH 36:1 March 2009)...

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

Science.gov (United States)

Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

2016-04-01

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

STM study on surface relief, ultra-fine structure and transformation mechanism of bainite in steels

International Nuclear Information System (INIS)

Fang, H.S.; Yang, Z.G.; Wang, J.J.; Zheng, Y.K.

1995-01-01

The surface reliefs accompanying lower bainite transformation in steels have been studied by scanning tunneling microscopy (STM). With the exclusive vertical resolution of STM, we observed that the surface relief associated with bainite is a group of surface reliefs related to subplates, subunits and sub-subunits. From the bainite plate to the sub-subunit in it, the reliefs are in a tent shape, not of invariant plane strain (IPS) type. The fine structure of bainite in a steel has also been shown by STM and TEM that bainite plate is composed of subplates, subunits and sub-subunits. On the basis of the fine structure inside a bainitic ferrite plate observed under STM, sympathetic-ledgewise mechanism of bainite formation is proposed. (orig.)

76 FR 6819 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

Science.gov (United States)

2011-02-08

...' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... or not participate in accounting and auditing relief for Federal oil and gas marginal properties... September 13, 2004 (69 FR 55076), provide two types of accounting and auditing relief for Federal onshore or...

Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

Science.gov (United States)

Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

2015-01-01

Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

19 CFR 210.68 - Complainant's temporary relief bond.

Science.gov (United States)

2010-04-01

... Section 210.68 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.68 Complainant's temporary... by Individual Surety United States International Trade Commission Affidavit by Individual Surety 19...

[War Relief of Japanese Red Cross Nurses in the Lost Battle of Burma].

Science.gov (United States)

Kawahara, Yukari

2015-12-01

This paper aims to reveal changes in the relief support of the Japanese Red Cross relief units dispatched to Burma during the Second World War, from the beginning of fighting in Burma to the Japanese withdrawal. Japanese Red Cross relief units began their relief support when Japan invaded Burma in February of 1942. Counterattacks by the British, Indian and Chinese armies from December 1942 caused an increase in the number of patients. There were also many cases of malnutrition and malaria due to the extreme shortage of medical supplies as a result of the Battle of Imphal, which began in March of 1944. Bomb raids became even more intense after the battle ended in July 1944, and patients were carried into bomb shelters and caves on a daily basis. Just prior to invasion by enemy troops, they were ordered to evacuate to neighboring Thailand. Nurses from the Wakayama group hid their identity as members of the Red Cross and evacuated, with 15 out of 23 dying or being reported missing in action.

Patient Preference Before and After Arthroscopic Rotator Cuff Repair: Which Is More Important, Pain Relief or Strength Return?

Science.gov (United States)

Virk, Mandeep S; Levy, David M; Kuhns, Benjamin D; Krecher, James S; Parsley, Billy K; Burkhart, Stephen S; Romeo, Anthony A; Verma, Nikhil N; Cole, Brian J

Our understanding of patients' desired outcomes and expectations of arthroscopic rotator cuff repair (ARCR) is limited, particularly regarding the importance of pain relief and strength return relative to each other. We conducted a study of patient's ratings of the importance of pain relief and strength return after ARCR. Before undergoing surgery, 60 patients completed a shoulder questionnaire on which they assessed severity of symptoms and rated, on a 10-point scale, the importance of postoperative improvements in pain relief and strength return. After surgery, they completed the same questionnaire, again rating the importance of pain relief and strength return. About 50% of the patients valued pain relief and strength return equally before and after ARCR. However, overall patient ratings were higher for strength return over pain relief, both before surgery, mean (SD), 9.2 (2.1) vs 8.6 (2.3) (P = .02), and afterward, at a follow-up of 5.2 (0.2) years, 8.9 (1.9) vs 8.2 (3.1) (P = .03). This significant preference for strength return held irrespective of sex, age, active sports involvement, preoperative self-assessed pain score, and subjective shoulder weakness. Before surgery, increasing age was associated with a stronger preference for pain relief (r = 0.33, P = .01), and retirees preferred pain relief over strength return. These results show the patterns of patient preference for pain relief and strength return after ARCR. Improved understanding of these patients' expectations will allow meaningful changes in patient satisfaction.

30 CFR 204.207 - Who will approve, deny, or modify my request for accounting and auditing relief?

Science.gov (United States)

2010-07-01

... for accounting and auditing relief? 204.207 Section 204.207 Mineral Resources MINERALS MANAGEMENT... Accounting and Auditing Relief § 204.207 Who will approve, deny, or modify my request for accounting and auditing relief? (a) If there is not a State concerned for your marginal property, only MMS will decide...

Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

Science.gov (United States)

Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

2011-03-01

Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents

Directory of Open Access Journals (Sweden)

Braun SE

2017-08-01

Full Text Available Sarah E Braun,1 Stephen M Auerbach,1 Bruce Rybarczyk,1 Bennett Lee,2 Stephanie Call2 1Department of Psychology, School of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA; 2Department of Internal Medicine, Division of General Medicine, Virginia Commonwealth University, Richmond, VA, USA Purpose: Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents.Methods: Residents (n = 38 completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory.Results: Overall, 71.1% (n = 27 of the residents met criteria for burnout during the study. Lower scores on the “acting with awareness” facet of dispositional mindfulness significantly predicted meeting burnout criteria χ2(5 = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the “system-based practices” and “professionalism” domains and negative effects on a milestone from the “patient care” domain.Conclusion: Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional

27 CFR 24.158 - Extent of relief.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Extent of relief. 24.158 Section 24.158 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT..., until all tax is fully paid. (d) Wine vinegar plant bond. The surety will be relieved of liability for...

Elective time during dermatology residency: A survey of residents and program directors.

Science.gov (United States)

Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

2017-12-15

Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

IPI tax relief policy and its impact on automotive and related sectors

Directory of Open Access Journals (Sweden)

Luiz Antônio Abrantes

2017-09-01

Full Text Available The policy of IPI tax relief in the automotive industry came from the need of answers to the Global Financial Crisis of 2008, which affected Brazil. This way, Brazilian Government set the reduction of the percentages of rates applied to automotive products and related sectors, according to several factors such as engine power, fuel type and production site, in order to restore the sector demand and stimulate the economy. In this context, this work aims to evaluate the implications of IPI tax relief policy, since 2009, on the turnover of joint-stock companies of the automotive and related sectors. The methodology was a multiple regression analysis model with Dynamic Panel data, in order to explain the variations of companies' turnover in the sector, regarding IPI tax relief. The data used were of 84 companies of this sector, for the period from 1998 to 2015, based on the software Economática. The results showed a decrease of IPI tax collection in the periods of relief, both in general and specific scope. In addition, we verified that the adoption of the policy had a negative influence on the turnover of the evaluated companies. Thus, we concluded that the tax policy under analysis did not contribute to an increase of automotive sector companies' turnover.

Neural mechanisms underlying the induction and relief of perceptual curiosity

Directory of Open Access Journals (Sweden)

Marieke eJepma

2012-02-01

Full Text Available Curiosity is one of the most basic biological drives in both animals and humans, and has been identified as a key motive for learning and discovery. Despite the importance of curiosity and related behaviors, the topic has been largely neglected in human neuroscience; hence little is known about the neurobiological mechanisms underlying curiosity. We used functional magnetic resonance imaging (fMRI to investigate what happens in our brain during the induction and subsequent relief of perceptual curiosity. Our core findings were that (i the induction of perceptual curiosity, through the presentation of ambiguous visual input, activated the anterior insula and anterior cingulate cortex, brain regions sensitive to conflict and arousal; (ii the relief of perceptual curiosity, through visual disambiguation, activated regions of the striatum that have been related to reward processing; and (iii the relief of perceptual curiosity was associated with hippocampal activation and enhanced incidental memory. These findings provide the first demonstration of the neural basis of human perceptual curiosity. Our results provide neurobiological support for a classic psychological theory of curiosity, which holds that curiosity is an aversive condition of increased arousal whose termination is rewarding and facilitates memory.

Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder.

Science.gov (United States)

Lin, Ching-Hua; Yen, Yung-Chieh; Chen, Ming-Chao; Chen, Cheng-Chung

2013-12-02

The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine. A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL. One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027). Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD. © 2013 Elsevier Inc. All rights reserved.

Physical aggressive resident behavior during hygienic care.

Science.gov (United States)

Farrell Miller, M

1997-05-01

Management of aggressive behavior has been identified as a concern for nursing staff who provide institutional care for cognitively impaired elderly. The Omnibus Reconciliation Act (OBRA '87) mandates a trial reduction in the use of chemical and physical restraints, and the development of nursing interventions for the management of behavioral disorders of institutionalized cognitively impaired elderly. Most skilled nursing facilities, however, are limited in their ability to provide environmental and behavioral programs to manage aggressive patient behavior. For the purposes of this study, physically aggressive behavior was identified as threatened or actual aggressive patient contact which has taken place between a patient and a member of the nursing staff. This study explored the nursing staff's responses to patient physical aggression and the effects that physical aggression had on them and on nursing practice from the perspective of the nursing staff. Nursing staff employed on one Dementia Special Care Unit (DSCU) were invited to participate. Interviews with nursing staff were analyzed using qualitative descriptive methods described by Miles and Huberman (1994). Nursing staff reported that they were subjected to aggressive patient behaviors ranging from verbal threats to actual physical violence. Nursing staff reported that showering a resident was the activity of daily living most likely to provoke patient to staff physical aggression. The findings revealed geropsychiatric nursing practices for the management of physically aggressive residents, and offered recommendations for improving the safety of nursing staff and residents on a secured DSCU.

The opium poppy as a symbol of sleep in Bertel Thorvaldsen's relief of 1815.

Science.gov (United States)

Tekiner, Halil; Kosar, Muberra

2016-03-01

Danish sculptor Bertel Thorvaldsen (1770-1844) is one of the most remarkable representatives of Neoclassicist sculptural art in Europe, which was largely inspired by the classical art and culture of Greek and Roman antiquity. A pair of marble reliefs, Night and Day, exhibited in the Thorvaldsen Museum (Copenhagen), marks the culmination of Thorvaldsen's relief art and is of particular interest to the history of sleep medicine. In the first relief, Night, an angel with her neck bent and eyes closed has two babies in her embrace and seems to be floating down in grief, with an owl hovering behind her. Her hair is also twined with opium poppies, the symbol of sleep and death in antiquity. Our findings suggest that this relief not only indicates a mythological association between the opium poppy and sleep but also has a strong connotation with the poppy's medicinal use for inducing sleep throughout the centuries. Copyright © 2015 Elsevier B.V. All rights reserved.

Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

Science.gov (United States)

Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

2015-01-01

Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

Coordinating Robot Teams for Disaster Relief

Science.gov (United States)

2015-05-01

eventually guide vehicles in cooperation with its Operator(s), but in this paper we assume static mission goals, a fixed number of vehicles, and a...is tedious and error prone. Kress-Gazit et al. (2009) instead synthesize an FSA from an LTL specification using a game theory approach (Bloem et al...helping an Operator coordinate a team of vehicles in Disaster Relief. Acknowledgements Thanks to OSD ASD (R&E) for sponsoring this research. The

Accounting for professionalism: an innovative point system to assess resident professionalism

Directory of Open Access Journals (Sweden)

Gary L. Malakoff

2014-04-01

Full Text Available Background: Professionalism is a core competency for residency required by the Accreditation Council of Graduate Medical Education. We sought a means to objectively assess professionalism among internal medicine and transitional year residents. Innovation: We established a point system to document unprofessional behaviors demonstrated by internal medicine and transitional year residents along with opportunities to redeem such negative points by deliberate positive professional acts. The intent of the policy is to assist residents in becoming aware of what constitutes unprofessional behavior and to provide opportunities for remediation by accruing positive points. A committee of core faculty and department leadership including the program director and clinic nurse manager determines professionalism points assigned. Negative points might be awarded for tardiness to mandatory or volunteered for events without a valid excuse, late evaluations or other paperwork required by the department, non-attendance at meetings prepaid by the department, and inappropriate use of personal days or leave. Examples of actions through which positive points can be gained to erase negative points include delivery of a mentored pre-conference talk, noon conference, medical student case/shelf review session, or a written reflection. Results: Between 2009 and 2012, 83 residents have trained in our program. Seventeen categorical internal medicine and two transitional year residents have been assigned points. A total of 55 negative points have been assigned and 19 points have been remediated. There appears to be a trend of fewer negative points and more positive points being assigned over each of the past three academic years. Conclusion: Commitment to personal professional behavior is a lifelong process that residents must commit to during their training. A professionalism policy, which employs a point system, has been instituted in our programs and may be a novel tool to

Vibration stress relief treatment in welded samples of ST-3 steel

International Nuclear Information System (INIS)

Suarez, J.C.; Fernandez, L.M.; Echevarria, J.F.; Estevez, A.; Perez, A.; Aragon, B.

1996-01-01

The presented work is aimed to find the optimal vibration frequency and treatment duration for ST-3 steel welded test pieces. In the experiment transversal stresses were not virtually relieved by the application of vibrations at the three natural frecuencies. With regard to the optimal frequency for our system, the firths natural frequency appears to be most effective one, wherewith a maximum 35-70 % longitudinal stress relief was obtained. The influence of the propagation direction (transversal or longitudinal) of vibrations on stress relief in a welded joint was confirmed

Centralized cooperative spectrum sensing for ad-hoc disaster relief network clusters

DEFF Research Database (Denmark)

Pratas, Nuno; Marchetti, Nicola; Prasad, Neeli R.

2010-01-01

Disaster relief networks have to be highly adaptable and resilient. Cognitive radio enhanced ad-hoc architecture have been put forward as a candidate to enable such networks. Spectrum sensing is the cornerstone of the cognitive radio paradigm, and it has been the target of intensive research....... The main common conclusion was that the achievable spectrum sensing accuracy can be greatly enhanced through the use of cooperative sensing schemes. When considering applying Cognitive Radio to ad-hoc disaster relief networks, spectrum sensing cooperative schemes are paramount. A centralized cluster...

A Surface Relief Meter Based on Trinocular Vision

NARCIS (Netherlands)

Ernst, V.G.S.; Sablik, P.W.; Balendonck, J.; Houkes, Z.; Regtien, Paulus P.L.

1995-01-01

The concept for the relief meter being developed, appears to function well, when used with the artificial images. The described matching criterion leads to high matching percentages, and accurate results. The percentage of mismatches is reduced to practically zero for the tested scenes. Future work

Selection criteria of residents for residency programs in Kuwait.

Science.gov (United States)

Marwan, Yousef; Ayed, Adel

2013-01-19

In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

Factors influencing resident's decision to reside in gated and guarded community

Science.gov (United States)

Shamsudin, Zarina; Shamsudin, Shafiza; Zainal, Rozlin

2017-10-01

Gated communities are residential areas developed with restricted access with strictly controlled entrances and surrounded by a close perimeter of wall or fences. Developers, conscious of the need to fulfill the requirement of living in modern and sophisticated lifestyle and gated properties become the trend and mushroomed over the past decade. Nowadays, it is obvious that gated and guarded communities become almost a dominant feature of Malaysia housing development projects. The focus of this paper is to identify the factors contribute resident's decision to reside in gated and guarded community and to study social interaction among gated communities' residents. 150 questionnaires were distributed to the residents of selected gated and guarded community area in order to achieve the objectives and analyzed by using Statistical Package for Social Science (SPSS) and descriptive analysis. The result was tabulated and presented in charts and graphs for a clear and better understanding. The five main factors contribute to resident decision to reside in gated communities were identified and ranked; there are privacy, security, location, lifestyle and prestige. Besides, the residents are feeling neutral towards the facilities and services provided in their gated and guarded residential area. A comprehensive improvement towards the facilities and services is needed to reach higher satisfaction from the residents.

Non-destructive Assessment of Relief Marking Parameters of Heat Shrinkable Installation Parts for Aviation Technology

Directory of Open Access Journals (Sweden)

Kondratov Aleksandr P.

2017-01-01

Full Text Available The article explains a new method of relief marking of heat-shrinkable tubing and sleeves made of polymer materials with “shape memory effect.” Method of instrument evaluation of relief marking stereometry of installation parts for aviation equipment, made of polyvinyl chloride, polyethyleneterephthalate and polystyrene was developed and the results were explained. Parameters of pin-point relief marking and compliance of point forms to the Braille font standard were determined with the use of the non-destructive method based on the color of interference pattern with precision of 0.02 mm.

Results of the 2003 Association of Residents in Radiation Oncology (ARRO) surveys of residents and chief residents in the United States

International Nuclear Information System (INIS)

Jagsi, Reshma; Buck, David A.; Singh, Anurag K.; Engleman, Mark; Thakkar, Vipul; Frank, Steven J.; Flynn, Daniel

2005-01-01

Purpose: To document demographic characteristics of current residents, career motivations and aspirations, and training program policies and resources. Methods: In 2003, the Association of Residents in Radiation Oncology (ARRO) conducted two nationwide surveys: one of all U.S. radiation oncology residents and one of chief residents. Results: The Chief Residents' Survey was completed by representatives from all 77 programs (response rate, 100%). The Residents' Survey was returned by 229 respondents (response rate, 44%). In each, 32% of respondents were female. The most popular career after residency was private practice (46%), followed by permanent academic practice (28%). Changes that would entice those choosing private practice to consider an academic career included more research experience as a resident (76%), higher likelihood of tenure (69%), lesser time commitment (66%), and higher salary (54%). Although the majority of respondents were satisfied with educational experience overall, a number of programs were reported to provide fewer resources than required. Conclusions: Median program resources and numbers of outliers are documented to allow residents and program directors to assess the relative adequacy of experience in their own programs. Policy-making bodies and individual programs should consider these results when developing interventions to improve educational experiences of residents and to increase retention of radiation oncologists in academic practice

Epidural morphine for postoperative pain relief in children

DEFF Research Database (Denmark)

Henneberg, S W; Hole, P; Haas, Inge Madsen De

1993-01-01

the investigation. We observed a change in the sleeping pattern with an increased number of sleep-induced myoclonia during the administration of epidural morphine. In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been...

Quantifying relief on alluvial fans using airborne lidar to reveal patterns of sediment accumulation

Science.gov (United States)

Morelan, A. E., III; Oskin, M. E.

2017-12-01

We present a method of quantifying detailed surface relief on alluvial fans from high-resolution topography. Average slope and curvature of the fan are used together to empirically derive an idealized, radially symmetric fan surface, from which we compute residual topography. Maps produced using this technique highlight spatial patterns of fan deposition and avulsion. Regions of high residual topography reveal active and abandoned sediment lobes accumulated from recent depositional events, often with well-defined channels at their apex. Preliminary observations suggest that surface relief is uniform across a collection of fans in a given region and source lithology. Alluvial fans with granitic catchment lithologies in eastern California (n=12), each with varying source catchment size and mean fan slope, all show relief of around 4 meters. A collection of fans from the Carrizo Plain in central California (n=12), with source catchments set within Miocene marine and nonmarine sedimentary rocks, show significantly lower relief values around 2 meters. We hypothesize that particle grain size determines this contrasting relief through its control on the thickness of fan-building debris flows. In both settings we find that sediment lobes tend to extend toward the fan toe. This pattern supports a process, observed in analog experiments, of fan deposition dominated by back-filling and overtopping of distributary channels by debris-flows.

The resident's view of residency training in Canada.

Science.gov (United States)

Fish, D G

1966-04-09

In the view of residents in their last year of specialty training, the Fellowship is now becoming the operative standard for obtaining hospital privileges in urban centres and they felt that this implied that the two standards, the Certificate and the Fellowship of the Royal College, were not achieving the purpose for which they were designed. Although 80% of the residents intended to write the Fellowship, few viewed a year in a basic science department or in research as of intrinsic value in terms of their future practice.The examinations of the Royal College were the subject of criticism, most residents feeling that the examinations did not test the knowledge and ability gained in training. Most expressed a desire for ongoing evaluation during the training period.Service responsibilities were generally regarded as too heavy.Despite the criticism of both training and examination, most residents felt that their training had provided them with the experience and background they needed to practise as specialists.

Prescription opioid use among addictions treatment patients: nonmedical use for pain relief vs. other forms of nonmedical use.

Science.gov (United States)

Bohnert, Amy S B; Eisenberg, Anna; Whiteside, Lauren; Price, Amanda; McCabe, Sean Esteban; Ilgen, Mark A

2013-03-01

Differences between those who engage in nonmedical prescription opioid use for reasons other than pain relief and those who engage in nonmedical use for reasons related to pain only are not well understood. Adults in a residential treatment program participated in a cross-sectional self-report survey. Participants reported whether they used opioids for reasons other than pain relief (e.g., help sleep, improve mood, or relieve stress). Within those with past-month nonmedical opioid use (n=238), logistic regression tested differences between those who reported use for reasons other than pain relief and those who did not. Nonmedical use of opioids for reasons other than pain relief was more common (66%) than nonmedical use for pain relief only (34%), and those who used for reasons other than pain relief were more likely to report heavy use (43% vs. 11%). Nonmedical use for reasons other than pain relief was associated with having a prior overdose (odds ratio [OR]=2.54, 95% CI: 1.36-4.74) and use of heroin (OR=4.08, 95% CI: 1.89-8.79), barbiturates (OR=6.44, 95% CI: 1.47, 28.11), and other sedatives (OR=5.80, 95% CI: 2.61, 12.87). Individuals who reported nonmedical use for reasons other than pain relief had greater depressive symptoms (13.1 vs. 10.5) and greater pain medication expectancies across all three domains (pleasure/social enhancement, pain reduction, negative experience reduction). Among patients in addictions treatment, individuals who report nonmedical use of prescription opioids for reasons other than pain relief represent an important clinical sub-group with greater substance use severity and poorer mental health functioning. Published by Elsevier Ltd.

U.S. Coastal Relief Model - Western Gulf of Mexico

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Central Gulf of Mexico

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

U.S. Coastal Relief Model - Southern California Version 2

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides a comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a seamless...

Reward and motivation in pain and pain relief

Science.gov (United States)

Navratilova, Edita; Porreca, Frank

2015-01-01

Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain. PMID:25254980

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

Science.gov (United States)

Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

Exploring Heat Stress Relief Measures among the Australian Labour Force.

Science.gov (United States)

Zander, Kerstin K; Mathew, Supriya; Garnett, Stephen T

2018-02-26

Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature

Exploring Heat Stress Relief Measures among the Australian Labour Force

Directory of Open Access Journals (Sweden)

Kerstin K. Zander

2018-02-01

Full Text Available Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%, 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected

Postinterview communication with residency applicants: a call for clarity!

Science.gov (United States)

Frishman, Gary N; Matteson, Kristen A; Bienstock, Jessica L; George, Karen E; Ogburn, Tony; Rauk, Phillip N; Schnatz, Peter F; Learman, Lee A

2014-10-01

The residency match is an increasingly competitive process. Communication from medical student applicants to programs varies, and the effect this has on their rank status is unclear. We assessed how obstetrics and gynecology program directors interpret and act on postinterview communication initiated by applicants by conducting an anonymous cross-sectional web-based survey of allopathic obstetrics and gynecology program directors. One hundred thirty-seven program directors (55%) responded to the survey. Twenty-nine percent would consider ranking an applicant more favorably if the applicant expressed interest (beyond a routine thank you) or if a faculty mentor personally known to the program director stated that the applicant was ranking the program first. Fifty-two percent indicated that they would rank an applicant more favorably if a mentor known to them endorsed the applicant as outstanding. Approximately 30% responded that applicants who did not communicate with their program were disadvantaged compared with those who did. Approximately 17% stated it was desirable to create additional specialty-specific guidelines regarding postinterview contact between programs and applications. Based on the wide variation in how program directors interpret and act on postinterview communication from applicants, residency programs should formulate and communicate a clear policy about whether they request and how they respond to postinterview communication from applicants and their mentors. This will establish a more level playing field and eliminate potential inequities resulting from inconsistent communication practices. Copyright © 2014 Elsevier Inc. All rights reserved.

Resident and attending physician perception of maladaptive response to stress in residents

Directory of Open Access Journals (Sweden)

Lee Ann Riesenberg

2014-11-01

Full Text Available Background: Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress. Methods: A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape. A total of 438 respondents from multiple institutions completed surveys. Results: Attending physicians were more likely than residents to agree that the resident on the trigger tape was impaired, p<0.0001; needed to seek professional counseling, p=0.0003; should be removed from the service, p=0.002; was not receiving adequate support from the attending physician, p=0.007; and was a risk to patient safety, p=0.02. Attending physicians were also less likely to agree that the resident was a good role model, p=0.001, and that the resident should be able to resolve these issues herself/himself, p<0.0001. Conclusion: Our data suggest that resident physicians may not be able to adequately detect maladaptive responses to stress and that attending physicians may be more adept at recognizing this problem. More innovative faculty and resident development workshops should be created to teach and encourage physicians to better observe and detect residents who are displaying maladaptive responses to stress.

Discovery and characterization of ACT-335827, an orally available, brain penetrant orexin receptor type 1 selective antagonist.

Science.gov (United States)

Steiner, Michel A; Gatfield, John; Brisbare-Roch, Catherine; Dietrich, Hendrik; Treiber, Alexander; Jenck, Francois; Boss, Christoph

2013-06-01

Stress relief: Orexin neuropeptides regulate arousal and stress processing through orexin receptor type 1 (OXR-1) and 2 (OXR-2) signaling. A selective OXR-1 antagonist, represented by a phenylglycine-amide substituted tetrahydropapaverine derivative (ACT-335827), is described that is orally available, penetrates the brain, and decreases fear, compulsive behaviors and autonomic stress reactions in rats. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

Directory of Open Access Journals (Sweden)

Nicole Battaglioli

2018-02-01

Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS focused on wellness program innovations and initiatives in emergency medicine (EM residency programs. Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. Results: An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern’s model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. Conclusion: The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME’s expanded focus on resident wellbeing.

Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

Science.gov (United States)

Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

2017-06-01

Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

8 CFR 245.3 - Adjustment of status under section 13 of the Act of September 11, 1957, as amended.

Science.gov (United States)

2010-01-01

..., any alien who is prima facie eligible for adjustment of status to that of a lawful permanent resident... Act who performed diplomatic or semi-diplomatic duties and to their immediate families, and who... residence would be in the national interest. Aliens whose duties were of a custodial, clerical, or menial...

Modeling of normal contact of elastic bodies with surface relief taken into account

Science.gov (United States)

Goryacheva, I. G.; Tsukanov, I. Yu

2018-04-01

An approach to account the surface relief in normal contact problems for rough bodies on the basis of an additional displacement function for asperities is considered. The method and analytic expressions for calculating the additional displacement function for one-scale and two-scale wavy relief are presented. The influence of the microrelief geometric parameters, including the number of scales and asperities density, on additional displacements of the rough layer is analyzed.

Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

Directory of Open Access Journals (Sweden)

Victor O. Kolade

2014-07-01

Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

Modelling the Influence of Ground Surface Relief on Electric Sounding Curves Using the Integral Equations Method

Directory of Open Access Journals (Sweden)

Balgaisha Mukanova

2017-01-01

Full Text Available The problem of electrical sounding of a medium with ground surface relief is modelled using the integral equations method. This numerical method is based on the triangulation of the computational domain, which is adapted to the shape of the relief and the measuring line. The numerical algorithm is tested by comparing the results with the known solution for horizontally layered media with two layers. Calculations are also performed to verify the fulfilment of the “reciprocity principle” for the 4-electrode installations in our numerical model. Simulations are then performed for a two-layered medium with a surface relief. The quantitative influences of the relief, the resistivity ratios of the contacting media, and the depth of the second layer on the apparent resistivity curves are established.

An influence of ion and sputtered atom flows inhomogeneity on time evolution of the target surface relief in glow discharge

International Nuclear Information System (INIS)

Bondarenko, G G; Kristya, V I

2008-01-01

A mathematical model of ion and sputtered atom transport in the vicinity of the target with a periodical surface relief in glow discharge in pure gas is developed. Under the assumption that the relief amplitude is small, analytical expressions for their flows are found by the perturbation method and an equation describing the relief amplitude time evolution is derived. It is shown that intensity of sputtering exceeds intensity of sputtered material re-deposition at the relief tops, and relief smoothing always takes place in the process of homogeneous target treatment in glow discharge in pure gas

Engineering and Design. Design, Construction, and Maintenance of Relief Wells

National Research Council Canada - National Science Library

1992-01-01

The objective of this manual is to provide guidance and information on the design, construction, and maintenance of pressure relief wells installed for the purpose of relieving subsurface hydrostatic...

The prevalence and characterization of self-medication for obtaining pain relief among undergraduate nursing students.

Science.gov (United States)

Souza, Layz Alves Ferreira; da Silva, Camila Damázio; Ferraz, Gisely Carvalho; Sousa, Fátima Aparecida Emm Faleiros; Pereira, Lílian Varanda

2011-01-01

This study investigates the prevalence of self-medication among undergraduate nursing students seeking to relieve pain and characterizes the pain and relief obtained through the used medication. This epidemiological and cross-sectional study was carried out with 211 nursing students from a public university in Goiás, GO, Brazil. A numerical scale (0-10) measured pain intensity and relief. The prevalence of self-medication was 38.8%. The source and main determining factor of this practice were the student him/herself (54.1%) and lack of time to go to a doctor (50%), respectively. The most frequently used analgesic was dipyrone (59.8%) and pain relief was classified as good (Md=8.5;Max=10;Min=0). The prevalence of self-medication was higher than that observed in similar studies. Many students reported that relief obtained through self-medication was good, a fact that can delay the clarification of a diagnosis and its appropriate treatment.

Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey.

Science.gov (United States)

Tchantchaleishvili, Vakhtang; LaPar, Damien J; Stephens, Elizabeth H; Berfield, Kathleen S; Odell, David D; DeNino, Walter F

2015-03-01

After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development. A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency. The survey was distributed nationwide to all residents in I-6 programs approved by the Accreditation Council for Graduate Medical Education. Of a total of 88 eligible I-6 residents, 49 completed the survey (55.7%). Career choice satisfaction was high (75.5%), as was overall satisfaction with integrated training (83.7%). The majority (77.6%) were interested in cardiac surgery. Overall, the responders reported sufficient time for life outside of the hospital (57.1%), but experienced conflicts between work obligations and personal life at least sometimes (75.5%). Early exposure to cardiothoracic surgery was reported as the dominant advantage of the I-6 model, whereas variable curriculum structure and unclear expectations along with poor integration with general surgery training ranked highest among perceived disadvantages. Current I-6 residents are largely satisfied with the integrated training model and report a reasonable work/life balance. The focused nature of training is the primary perceived advantage of the integrated pathway. Curriculum variability and poor integration with general surgery training are identified by residents as primary areas of concern. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

Science.gov (United States)

Hsieh, Cindy M; Nolan, Norris J

2015-01-01

To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

Immediate pain relief effect of low level laser therapy for sports injuries: Randomized, double-blind placebo clinical trial.

Science.gov (United States)

Takenori, A; Ikuhiro, M; Shogo, U; Hiroe, K; Junji, S; Yasutaka, T; Hiroya, K; Miki, N

2016-12-01

To determine the immediate pain relief effect of low-level laser therapy on sports injuries in athletes and degree of pain relief by the therapy. Double-blind, randomized, comparative clinical study. Participants were 32 college athletes with motion pain at a defined site. Participants were randomized into two groups in which the tested or placebo laser therapy was administered to determine pain intensity from painful action before and after laser irradiation, using the Modified Numerical Rating Scale. The post-therapeutic Modified Numerical Rating Scale score was subtracted from the pre-therapeutic Modified Numerical Rating Scale score to determine pain intensity difference, and the rate of pain intensity difference to pre-therapeutic Modified Numerical Rating Scale was calculated as pain relief rate. Low-level laser therapy was effective in 75% of the laser group, whereas it was not effective in the placebo group, indicating a significant difference in favor of the laser group (p<0.001). Pain relief rate was significantly higher in the laser group than in the placebo group (36.94% vs. 8.20%, respectively, p<0.001), with the difference in pain relief rate being 28.74%. Low-level laser therapy provided an immediate pain relief effect, reducing pain by 28.74%. It was effective for pain relief in 75% of participants. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Ibuprofen is superior to paracetamol for pain relief following third molar removal.

Science.gov (United States)

Ferraiolo, Debra M; Veitz-Keenan, Analia

2014-12-01

The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and the metaRegister of Controlled Trials were searched with no language restrictions. Randomised controlled double-blinded clinical trials using the third molar model were included. Two review authors independently and in duplicate extracted data. The proportion of patients with at least 50% pain relief (based on total pain relief (TOTPAR) and summed pain intensity difference (SPID) data) was calculated for all three drugs at both two and six hours post-dosing and meta-analysed for comparison. Seven studies involving 2241 patients were included. Two studies were considered to be at low risk of bias, three at high risk and two unclear risk of bias. Ibuprofen was found to be a superior analgesic to paracetamol at several doses, with high quality evidence suggesting that ibuprofen 400 mg is superior to 1000 mg paracetamol based on pain relief (estimated from TOTPAR data) and the use of rescue medication meta-analyses. Risk ratio (RR) for at least 50% pain relief (based on TOTPAR) at six hours was 1.47 (95% confidence interval (CI) 1.28 to 1.69; five trials) favouring 400 mg ibuprofen over 1000 mg paracetamol, RR for not using rescue medication (also favouring ibuprofen) was 1.50 (95% CI 1.25 to 1.79; four trials). For combined drug RR for at least 50% of the maximum pain relief over six hours of 1.77 (95% CI 1.32 to 2.39) (paracetamol 1000 mg and ibuprofen 400 mg) (one trial; moderate quality evidence). RR not using rescue medication 1.60 (95% CI 1.36 to 1.88) (two trials; moderate quality evidence). Adverse events were comparable between the treatment groups, but no formal analysis could be undertaken. There is high quality evidence that ibuprofen is superior to paracetamol at doses of 200 mg to 512 mg and 600 mg to 1000 mg respectively based on pain relief and use of rescue medication data collected at six hours postoperatively. The

Prediction of critical flow rates through power-operated relief valves

International Nuclear Information System (INIS)

Abdollahian, D.; Singh, A.

1983-01-01

Existing single-phase and two-phase critical flow models are used to predict the flow rates through the power-operated relief valves tested in the EPRI Safety and Relief Valve test program. For liquid upstream conditions, Homogeneous Equilibrium Model, Moody, Henry-Fauske and Burnell two-phase critical flow models are used for comparison with data. Under steam upstream conditions, the flow rates are predicted either by the single-phase isentropic equations or the Homogeneous Equilibrium Model, depending on the thermodynamic condition of the fluid at the choking plane. The results of the comparisons are used to specify discharge coefficients for different valves under steam and liquid upstream conditions and evaluate the existing approximate critical flow relations for a wide range of subcooled water and steam conditions

Comparison of epidural butorphanol versus epidural morphine in postoperative pain relief.

Science.gov (United States)

Parikh, Geeta P; Veena, Shah R; Vora, Kalpana; Parikh, Beena; Joshi, Anish

2014-02-01

Epidural route is preferable for postoperative pain relief in thoraco-abdominal and lower limb surgeries. We aimed to compare epidural butorphanol versus morphine for postoperative analgesia up to 24 hours in open nephrectomy surgery. 80 ASA physical status I and II adult patients were selected for this randomized double blind prospective study. A standard balanced general anesthesia technique was applied for all patients. Epidural catheter was placed in lower thoracic inter-vertebral space before the start of surgery. Injection butorphanol 0.04 mg/kg in group B (n = 40) or morphine 0.06 mg/kg in group M (n = 40) was given in a double blind manner after completion of surgery and before extubation through the epidural catheter. Patients were observed for pain relief by Visual Analogue Scale (VAS) for the next 24 hours. Dose was repeated when VAS was > 4. The onset and peak effect of pain relief, duration of analgesia of 1st dose, frequency of drug administration and side effects if any were observed. The average onset of analgesia was 26.5 +/- 7.61 minutes with butorphanol and 62.5 +/- 13.4 minutes with morphine group which was statistically significant (p < 0.05). The mean peak effect of pain relief following 1st dose was 173 +/- 51.25 minutes with butorphanol and 251 +/- 52.32 minutes with morphine group. The duration of pain relief after 1st dose was statistically significant and was 339.13 +/- 79.57 minutes in group B and 709.75 +/- 72.12 minutes in group M which was gradually increased on repeated dosing in group B while it was almost same in Group M. Number of doses required in 24 hours was significantly higher (p < 0.05) in butorphanol group than morphine group. Somnolence was the main side effect in group B while pruritus was the main side effect with group M. Epidural butorphanol appears to provide safer and faster postoperative analgesia without much untoward effects but its analgesic action is short so more repeated doses are required than morphine via

Assessment of plantar pressure in forefoot relief shoes of different designs.

Science.gov (United States)

Carl, Hans-Dieter; Pfander, David; Swoboda, Bernd

2006-02-01

After reconstructive forefoot surgery, patients require complete or partial forefoot relief, which can be obtained with a variety of shoe designs. The aim of this study was to evaluate the effectiveness of two different types of forefoot-relief shoes frequently used after surgery, especially their safety against unintentional forefoot load. Ten healthy volunteers were asked to perform five trials on a treadmill at self-selected speeds. In the first trial, mean peak pressure values in mass-produced shoes and insoles were evaluated and considered as 100%. Two different shoe designs (short heel-short sole, ii: short heel-complete sole) were compared in two trials each with appropriate and inappropriate use (attempting to put weight on the forefoot) gait pattern. Plantar pressure values were obtained using the Pedar cable system (Novel Inc., Munich, Germany). For analysis, pedobarographic pictures were subdivided into midfoot (31% to 60% of the total insole length) and forefoot (61% to 100% of the total insole length). ANOVA was used for statistical analysis, and p values less than 0.01 were considered significant. With the short-soled shoe, forefoot and midfoot relief was 100% in both compliant and in noncompliant use. With wearing a complete sole, compliant use led to a significant reduction (p shoe produced mean peak pressure values significantly higher (p shoes under the forefoot, but not under the midfoot. Forefoot-relief shoes are effective in reducing both mean and peak plantar pressures. Shoes with a nonsupported midfoot and forefoot may be safer with inappropriate use than shoes with a complete sole. The kind of forefoot shoe should be carefully chosen to regulate weightbearing after reconstructive forefoot surgery.

KNOWLEDGE, ATTITUDE AND USE OF PAIN RELIEF IN LABOUR AMONG WOMEN ATTENDING ANTE-NATAL CLINIC AT SHALOM COMMUNITY HOSPITAL, ATHI RIVER.

Science.gov (United States)

Njiru, J N; Esiromo, M A; Omari, H O

2014-07-01

To find out the knowledge, attitude and practice of pain relief methods during labour among mothers attending antenatal clinics at Shalom Community Hospital, Athi River, Kenya. Cross Sectional study. Shalom Community Hospital, Athi River, Kenya. Two hundred and seven participants attending antenatal clinics at the facility were recruited. The median age of the participants was 28 years and a median parity of one. Most of the study participants, 89.4%, were not aware of any pain relief method during labour. Among the 10.6% patients that were of a pain relief method, 54% had gotten the knowledge from the doctors. All the patients had experienced pain in labour with 72% rating the pain as severe pain. Only 37% of the patients were offered a pain relief method and the intramuscular injectable was offered to all. Majority (88%) of those offered a form of pain relief rated the pain relief method as ineffective. A majority of the women 93% would use a pain relief method in the next labour with epidural method being the most preferred method. The level of knowledge of pain relief methods among mothers islow. There is need to integrate information on pain relief options in labour as part of antenatal services offered routinely. Epidural analgesia services should be enhanced.

Teambuilding and leadership training in an internal medicine residency training program.

Science.gov (United States)

Stoller, James K; Rose, Mark; Lee, Rita; Dolgan, Colleen; Hoogwerf, Byron J

2004-06-01

The purpose of this report is to describe and evaluate the impact of a 1-day retreat focused on developing leadership skills and teambuilding among postgraduate year 1 residents in an internal medicine residency. A group of organizers, including members of the staff, the chief medical residents, administrative individuals in the residency office, and an internal organizational development consultant convened to organize an off-site retreat with activities that would provide experiential learning regarding teamwork and leadership, including a "reef survival exercise" and table discussions regarding the characteristics of ideal leaders. In addition, several energizing activities and recreational free time was provided to enhance the interaction and teamwork dimensions of the retreat. To evaluate the impact of the retreat, attendees completed baseline and follow-up questionnaires regarding their experience of the retreat. Attendees universally regarded the retreat as having value for them. Comparison of baseline to postretreat responses indicated that attendees felt that the retreat enhanced their abilities to be better physicians, resident supervisors, and leaders. Follow-up responses indicated significant increases in attendees' agreement that good leaders challenge the process, make decisions based on shared visions, allow others to act, recognize individual contributions, and serve as good role models. Results on the survival exercise indicated a high frequency with which team-based decisions surpassed individual members' decisions, highlighting the importance and value of teamwork to attendees. Our main findings were that: participants universally found this 1-day retreat beneficial in helping to develop teamwork and leadership skills and the experiential learning aspects of the retreat were more especially highly rated and highlighted the advantages of teamwork. In the context that this 1-day retreat was deemed useful by faculty and residents alike, further

Teambuilding and Leadership Training in an Internal Medicine Residency Training Program

Science.gov (United States)

Stoller, James K; Rose, Mark; Lee, Rita; Dolgan, Colleen; Hoogwerf, Byron J

2004-01-01

OBJECTIVE The purpose of this report is to describe and evaluate the impact of a 1-day retreat focused on developing leadership skills and teambuilding among postgraduate year 1 residents in an internal medicine residency. METHOD A group of organizers, including members of the staff, the chief medical residents, administrative individuals in the residency office, and an internal organizational development consultant convened to organize an off-site retreat with activities that would provide experiential learning regarding teamwork and leadership, including a “reef survival exercise” and table discussions regarding the characteristics of ideal leaders. In addition, several energizing activities and recreational free time was provided to enhance the interaction and teamwork dimensions of the retreat. To evaluate the impact of the retreat, attendees completed baseline and follow-up questionnaires regarding their experience of the retreat. RESULTS Attendees universally regarded the retreat as having value for them. Comparison of baseline to postretreat responses indicated that attendees felt that the retreat enhanced their abilities to be better physicians, resident supervisors, and leaders. Follow-up responses indicated significant increases in attendees’ agreement that good leaders challenge the process, make decisions based on shared visions, allow others to act, recognize individual contributions, and serve as good role models. Results on the survival exercise indicated a high frequency with which team-based decisions surpassed individual members’ decisions, highlighting the importance and value of teamwork to attendees. CONCLUSIONS Our main findings were that: participants universally found this 1-day retreat beneficial in helping to develop teamwork and leadership skills and the experiential learning aspects of the retreat were more especially highly rated and highlighted the advantages of teamwork. In the context that this 1-day retreat was deemed useful

Does resident ranking during recruitment accurately predict subsequent performance as a surgical resident?

Science.gov (United States)

Fryer, Jonathan P; Corcoran, Noreen; George, Brian; Wang, Ed; Darosa, Debra

2012-01-01

While the primary goal of ranking applicants for surgical residency training positions is to identify the candidates who will subsequently perform best as surgical residents, the effectiveness of the ranking process has not been adequately studied. We evaluated our general surgery resident recruitment process between 2001 and 2011 inclusive, to determine if our recruitment ranking parameters effectively predicted subsequent resident performance. We identified 3 candidate ranking parameters (United States Medical Licensing Examination [USMLE] Step 1 score, unadjusted ranking score [URS], and final adjusted ranking [FAR]), and 4 resident performance parameters (American Board of Surgery In-Training Examination [ABSITE] score, PGY1 resident evaluation grade [REG], overall REG, and independent faculty rating ranking [IFRR]), and assessed whether the former were predictive of the latter. Analyses utilized Spearman correlation coefficient. We found that the URS, which is based on objective and criterion based parameters, was a better predictor of subsequent performance than the FAR, which is a modification of the URS based on subsequent determinations of the resident selection committee. USMLE score was a reliable predictor of ABSITE scores only. However, when we compared our worst residence performances with the performances of the other residents in this evaluation, the data did not produce convincing evidence that poor resident performances could be reliably predicted by any of the recruitment ranking parameters. Finally, stratifying candidates based on their rank range did not effectively define a ranking cut-off beyond which resident performance would drop off. Based on these findings, we recommend surgery programs may be better served by utilizing a more structured resident ranking process and that subsequent adjustments to the rank list generated by this process should be undertaken with caution. Copyright © 2012 Association of Program Directors in Surgery

78 FR 33467 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

Science.gov (United States)

2013-06-04

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy: Response, Recovery & Resiliency; Correction... allocation of $3.7 billion under the Public Transportation Emergency Relief Program to the four FTA...

The role of hydromorphone and OPRM1 in postoperative pain relief with hydrocodone.

Science.gov (United States)

Boswell, Mark V; Stauble, M Elaine; Loyd, Gary E; Langman, Loralie; Ramey-Hartung, Bronwyn; Baumgartner, Richard N; Tucker, William W; Jortani, Saeed A

2013-01-01

Postoperative pain management remains a challenge for clinicians due to unpredictable patient responses to opioid therapy. Some of this variability may result from single nucleotide polymorphisms (SNPs) of the human opioid mu-1 receptor (OPRM1) that modify receptor binding or signal transduction. The OPRM1 variant with the highest frequency is the A118G SNP. However, previous studies have produced inconsistent results regarding the clinical effects of A118G on opioid response. We hypothesized that measurement of serum opioid concentrations, in addition to determining total opioid consumption, may provide a more precise method of assessing the effects of A118G on analgesic response. The current study evaluated the relationship of analgesia, side effects, total hydrocodone consumption, quantitative serum hydrocodone and hydromorphone concentrations, and A118G SNP in postoperative patients following Cesarean section. 158 women scheduled for Cesarean section were enrolled prospectively in the study. The patients had bupivacaine spinal anesthesia for surgery and received intrathcal morphine with the spinal anesthetic or parenteral morphine for the first 24 hours after surgery. Thereafter, patients received hydrocodone/acetaminophen for postoperative pain control. On postoperative day 3, venous blood samples were obtained for OPRM1 A118G genotyping and serum opioid concentrations. 131 (82.9%) of the subjects were homozygous for the 118A allele of OPRM1 (AA) and 27 (17.1%) carried the G allele (AG/GG). By regression analysis, pain relief was significantly associated with total hydrocodone dose in the AA group (P = 0.01), but not in the AG/GG group (P = 0.554). In contrast, there was no association between pain relief and serum hydrocodone concentration in either group. However, pain relief was significantly associated with serum hydromorphone concentration (a metabolite of hydrocodone) in the AA group (P = 0.004), but not in the AG/GG group (P = 0.724). Conversely, side

Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

Directory of Open Access Journals (Sweden)

Patten Scott

2005-06-01

Full Text Available Abstract Background Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. Methods A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. Results In total 415 (51 % residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p Residents highly valued their colleagues (67%, program directors (60% and external psychiatrist/psychologist (49% as well-being resources. Over one third of residents wished to have a career counselor (39% and financial counselor (38%. Conclusion Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

Food provision among food relief agencies in rural Australia, and perceived barriers and enablers to provide healthy food.

Science.gov (United States)

Bortolin, Natalia; Priestly, Jaqueline; Sangster, Janice

2018-04-01

Food insecurity affects 4-14% of Australians, and up to 82% of vulnerable groups. Food relief agencies commonly provide food parcels or food vouchers. Little research has been undertaken on food relief agencies within rural Australia. This study determined the type of food assistance provided by rural food relief agencies, and barriers and enablers to provide healthy food. Cross-sectional study, using telephone questionnaires with qualitative and quantitative aspects. Data were analysed using descriptive statistics and thematic analysis. Rural New South Wales, Australia. Representatives of 10 food relief agencies. Types of food assistance and food provided, and the barriers and enablers to provide healthy food to clients. Most agencies provided food hampers and perishable and non-perishable food. Rural food relief agencies had a greater capacity to provide non-perishable compared to perishable food. Grains, breads and cereals, and canned fruit and vegetables were most popular. Nine key themes emerged including 'Ability to purchase and provide healthy food', 'Ability to regulate food purchased or chosen by clients', 'Financial constraints of the agency' and 'Lack of storage'. There are many variables to consider in order to understand the capacity of rural food relief agencies to provide healthy food. There are also opportunities for food relief agencies to appraise current practices and make changes. Initiatives to improve storage facilities and food availability are key and include networking with local businesses, community organisations and government. Rural food relief agency clients could benefit from accessing food literacy and health programs like FoodREDi, OzHarvest NEST and SecondBite Fresh NED. © 2017 National Rural Health Alliance Inc.

Poverty Relief or Poverty Eradication? | Kritzinger | Acta Theologica

African Journals Online (AJOL)

The author challenges the reader to make two mindshifts: from a focus on poverty relief to an emphasis on poverty eradication; and from viewing the poor as the objects of poverty alleviation to accepting them as the subjects of poverty eradication. The case is argued and a practical approach towards poverty eradication is ...

Balancing Urban Biodiversity Needs and Resident Preferences for Vacant Lot Management

Directory of Open Access Journals (Sweden)

Christine C. Rega-Brodsky

2018-05-01

Full Text Available Urban vacant lots are often a contentious feature in cities, seen as overgrown, messy eyesores that plague neighborhoods. We propose a shift in this perception to locations of urban potential, because vacant lots may serve as informal greenspaces that maximize urban biodiversity while satisfying residents’ preferences for their design and use. Our goal was to assess what kind of vacant lots are ecologically valuable by assessing their biotic contents and residents’ preferences within a variety of settings. We surveyed 150 vacant lots throughout Baltimore, Maryland for their plant and bird communities, classified the lot’s setting within the urban matrix, and surveyed residents. Remnant vacant lots had greater vegetative structure and bird species richness as compared to other lot origins, while vacant lot settings had limited effects on their contents. Residents preferred well-maintained lots with more trees and less artificial cover, support of which may increase local biodiversity in vacant lots. Collectively, we propose that vacant lots with a mixture of remnant and planted vegetation can act as sustainable urban greenspaces with the potential for some locations to enhance urban tree cover and bird habitat, while balancing the needs and preferences of city residents.

Putting Qumran, Jesus and his movement into relief

Directory of Open Access Journals (Sweden)

Eben Scheffler

2016-11-01

Full Text Available After referring briefly to the fantasies regarding the origins of Christianity as elicited by the discovery of the Dead Sea Scrolls in 1947 (Dupont-Sommer, Allegro, Thiering, the purpose of the contribution is to put the Jesus movement into relief in the context of first-century Judaism. The identity of the Qumranites is argued to be Essene scribes. The identity, ideology and practices of the latter are compared with those of Jesus of Nazareth and the movement he elicited using the following rubrics: (1 Jesus, the teacher of righteousness and the powers that be; (2 asceticism versus itinerary charismaticism; (3 caring versus lack of caring for the sick, poor and marginalised; (4 elitist priests and scribes versus lower-class peasants; (5 the interpretation of the law; (6 religious and daily practices (baptism, ritual meal, sacrifice, prayer, community of possessions, scribal activity; (7 religious views or ideology (kingdom of God, the new covenant, light and darkness, politics. The result is a picture of Jesus (with his focus on human suffering in sharp relief versus Qumran and facets of the early church.

Mining Act 1968-1983 with regulations and an index (compiled to 1 January, 1984)

Energy Technology Data Exchange (ETDEWEB)

1984-01-01

This consolidation of the Queensland Mining Act covers the Mining Act 1968 - 1983, Mining Act Amendment Act 1971 (No.2) No.82: Mining Act Amendment Act 1980, No.13: Mining Acts Amendment Act of 1929, 20 Geo. 5 of No.35: Regulations. The Act is arranged in 13 parts. Part I. Preliminary; II. Meaning of Terms; III. Mining districts and mining fields; IV. Authorities conferring rights to mine and prospect - Division I. Miner's right; IA. Mining claim; II. Authority to prospect; III. Mining Lease; IV. Compensation for damage caused by mining on Crown land; V. Caveats: Part V. Mining on reserves, residence areas and business areas; Part VI. Constructions and carriage through, over, or under alien land; VII. Sludge abatement; VIII. Royalties; IX. Administration - Division I. Appointment of officers; II. Wardens courts; III. Special powers of wardens and wardens courts; IV. Appeals from wardens courts: Part X. General Provisions; XI. Regulations; XII. Mining on private land; XIII. Rights independent of this Act preserved: Schedule.

Permanent resident

Directory of Open Access Journals (Sweden)

John F. Fisher

2016-05-01

Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis

DEFF Research Database (Denmark)

Henriksen, Marius; Simonsen, Erik B; Alkjaer, T

2006-01-01

Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis....... Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes....

Shaded relief of Bahia State, Brazil

Science.gov (United States)

2000-01-01

This topographic image is the first to show the full 240-kilometer-wide (150 mile)swath collected by the Shuttle Radar Topography Mission (SRTM). The area shown is in the state of Bahia in Brazil. The semi-circular mountains along the left side of the image are the Serra Da Jacobin, which rise to 1100 meters (3600 feet) above sea level. The total relief shown is approximately 800 meters (2600 feet). The top part of the image is the Sertao, a semi-arid region, that is subject to severe droughts during El Nino events. A small portion of the San Francisco River, the longest river (1609 kilometers or 1000 miles) entirely within Brazil, cuts across the upper right corner of the image. This river is a major source of water for irrigation and hydroelectric power. Mapping such regions will allow scientists to better understand the relationships between flooding cycles, drought and human influences on ecosystems.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Colors show the elevation as measured by SRTM. Colors range from green at the lowest elevations to reddish at the highest elevations. Shaded relief maps are commonly used in applications such as geologic mapping and land use planning.The Shuttle Radar Topography Mission (SRTM), launched on February 11, 2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, an additional C-band imaging

Knowledge of and attitude towards pain relief during labour of ...

African Journals Online (AJOL)

This study determined women's knowledge of and attitudes to pain relief during labour. Methods ... Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa .... Breathing exercises. 25.

Reward and relief craving tendencies in patients with alcohol use disorders: results from the PREDICT study.

Science.gov (United States)

Glöckner-Rist, Angelika; Lémenager, Tagrid; Mann, Karl

2013-02-01

Previous research suggests that patients' tendencies toward either reward or relief craving are distinct continuous factorial dimensions of craving for alcohol. According to these tendencies patients with alcohol use disorders (AUD) might also be allocated into distinct subgroups. In personalized treatment, patients of such different subgroups might respond differently to various psychotherapeutic and pharmacological interventions aimed at relapse prevention. To establish that the items of the subscale Temptation to Drink of the Alcohol Abstinence Self-Efficacy Scale (AASE) capture two continuous dimensions of reward and relief craving, and that they allow the identification of respective discrete class factors and subgroups of patients with AUD. Nonlinear confirmatory factor analysis (CFA) and latent class factor analysis (LCFA) were performed with data from 426 detoxified patients with AUD. The validity of continuous relief and reward dimensions, discrete class factors, and subtypes with different craving tendencies was established by including past drinking in positive and negative settings, gender, trait anxiety and perceived stress as covariates in the finally accepted CFA and LCFA measurement models. The AASE temptation items formed two continuous relief and reward craving factors. They also associated themselves to two binary class factors, which defined four craving subgroups. Two of them (21% and 29% of patients) were characterized by high levels of either reward or relief craving tendencies. A third subgroup (31%) rated both tendencies in an equal high measure, while a fourth (18%) reported almost no craving tendencies at all. Past drinking in negative and positive settings was significantly associated with relief or reward craving tendencies. Male patients reported reward drinking more frequently than female patients. Trait anxiety was positively related only to the relief craving tendency. Unexpectedly, patients' level of perceived stress was associated

Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review

Science.gov (United States)

Carlson, Cathy L

2016-01-01

Inadequate cancer pain relief has been documented extensively across historical records. In response, in 1986, the World Health Organization (WHO) developed guidelines for cancer pain treatment. The purpose of this paper is to disseminate the results of a comprehensive, integrative review of studies that evaluate the effectiveness of the WHO guidelines. Studies were included if they: 1) identified patients treated with the guidelines, 2) evaluated self-reported pain, 3) identified instruments used, 4) provided data documenting pain relief, and 5) were written in English. Studies were coded for duration of treatment, definition of pain relief, instruments used, findings related to pain intensity or relief, and whether measures were used other than the WHO analgesic ladder. Twenty-five studies published since 1987 met the inclusion criteria. Evidence indicates 20%–100% of patients with cancer pain can be provided pain relief with the use of the WHO guidelines – while considering their status of treatment or end-of-life care. Due to multiple limitations in included studies, analysis was limited to descriptions. Future research to examine the effectiveness of the WHO guidelines needs to consider recommendations to facilitate study comparisons by standardizing outcome measures. Recent studies have reported that patients with cancer experience pain at moderate or greater levels. The WHO guidelines reflect the knowledge and effectual methods to relieve most cancer pain, but the guidelines are not being adequately employed. Part of the explanation for the lack of adoption of the WHO guidelines is that they may be considered outdated by many because they are not specific to the pharmacological and interventional options used in contemporary pain management practices. The conundrum of updating the WHO guidelines is to encompass the latest pharmacological and interventional innovations while maintaining its original simplicity. PMID:27524918

Flood, disaster, and turmoil: social issues in cleft and craniofacial care and crisis relief.

Science.gov (United States)

Strauss, Ronald P; van Aalst, John A; Fox, Lynn; Stein, Margot; Moses, Michael; Cassell, Cynthia H

2011-11-01

To examine social issues in the conduct of cleft and craniofacial care through relief programs in disrupted crisis contexts. Social, health policy, and ethical analyses. At best, craniofacial team care is multidisciplinary, coordinated, and sustained, requiring a long-term relationship between team members, patients, and families. Disasters and societal turmoil interrupt such relationships, causing craniofacial care to become a secondary concern. Providing craniofacial team care in a crisis setting requires rebuilding disrupted coordination and communication. Crisis relief care involves a complex set of expectations and responsibilities and raises issues such as (1) quality assurance, infection control, appropriate standards of care, and follow-up care/continuity; (2) equity of access to services and clinical ethics in the context of war and/or deprivation; (3) training of visitors in the local nation or site; (4) disciplinary composition of teams, interprofessional communication/rivalry, and credentials of clinicians; (5) ownership of the site and local visitor relations; (6) fundraising and marketing strategies; and (7) ethical issues in the doctor-patient relationship. Specific ethical standards for international cleft and craniofacial care delivery also apply to domestic and global crisis relief contexts. Guidance on issues related to professional experience, informed consent, and continuity of care will help care providers address social and ethical issues raised in crisis relief programs. This paper proposes that the Position Paper of the American Cleft Palate-Craniofacial Association (ACPA) on International Treatment Programs should be used as a template to develop and disseminate a set of standards that apply to crisis relief.

108 AN ASSESSMENT OF TAX RELIEFS AND ECONOMIC ...

African Journals Online (AJOL)

As advantageous as the payment of taxes to the government is, as a result of its ... Therefore, this study seeks to examine the nature of tax reliefs available to tax ... in the level of economic activity or tax payer's behaviour, then the tax policy ... The implication of this is that any tax payer that receives earned income shall be.

Seismic assessment of the Pickering pressure relief duct

International Nuclear Information System (INIS)

Ghobarah, A.

1995-05-01

The objectives of the study are to examine the structural response of the Pickering pressure relief duct when subjected to earthquake ground motion and to estimate the seismic withstand capacity of various components of the structural system on the basis of performance criteria consistent with the safety function of the duct. (author). 24 refs., 16 tabs., 31 figs

Relationship between onset of pain relief and patient satisfaction with fentanyl pectin nasal spray for breakthrough pain in cancer.

Science.gov (United States)

Torres, Luis M; Revnic, Julia; Knight, Alastair D; Perelman, Michael

2014-10-01

Satisfaction with pain relief in patients with breakthrough pain in cancer (BTPc) has typically been assessed by overall efficacy without consideration of the rapidity of that response. To determine the relationship between speed of onset of pain relief and patient satisfaction for treated BTPc episodes overall and for individual treatments. Pooled data from two randomized, double-blinded crossover studies. Patients having 1-4 BTPc episodes per day on ≥60 mg/day oral morphine or equivalent. Episodes treated with fentanyl pectin nasal spray (FPNS; 100-800 μg), immediate-release morphine sulfate (IRMS), or placebo. Pain intensity was measured on an 11-point scale (5-60 minutes posttreatment); satisfaction was measured on a 4-point scale (30 and 60 minutes). The primary analysis assessed the overall relationship of time to onset of pain relief (pain intensity difference [PID]≥1) or time to clinically meaningfully reduction in pain (PID≥2) versus patient satisfaction and overall pain intensity (summed pain intensity difference at 30 [SPID30] and 60 minutes [SPID60]) assessed by analysis of variance (ANOVA). A secondary analysis assessed whether satisfaction was different between treatments using a within-patient comparison. Eight hundred thirty-one FPNS-treated, 368 IRMS-treated, and 200 placebo-treated episodes were analyzed. Overall, within the pool there was a statistically significant relationship between time to onset of pain relief (PID≥1 and PID≥2) and patient satisfaction (both speed of relief and overall) at 30 and 60 minutes (ppain intensity reduction. When treatment groups were compared using within-patient data, FPNS provided earlier onset of pain relief than IRMS or placebo (ppain relief resulted in greater patient satisfaction and overall relief of pain; between-treatment comparisons showed that FPNS provided earlier pain relief and greater satisfaction than IRMS or placebo.

Mechanical behavior of multipass welded joint during stress relief annealing

International Nuclear Information System (INIS)

Ueda, Yukio; Fukuda, Keiji; Nakacho, Keiji; Takahashi, Eiji; Sakamoto, Koichi.

1978-01-01

An investigation into mechanical behavior of a multipass welded joint of a pressure vessel during stress relief annealing was conducted. The study was performed theoretically and experimentally on idealized research models. In the theoretical analysis, the thermal elastic-plastic creep theory developed by the authors was applied. The behavior of multipass welded joints during the entire thermal cycle, from welding to stress relief annealing, was consistently analyzed by this theory. The results of the analysis show a good, fundamentally coincidence with the experimental findings. The outline of the results and conclusions is as follows. (1) In the case of the material (2 1/4Cr-1Mo steel) furnished in this study, the creep strain rate during stress relief annealing below 575 0 C obeys the strain-hardening creep law using the transient creep and the one above 575 0 C obeys the power creep law using the stational creep. (2) In the transverse residual stress (σsub(x)) distribution after annealing, the location of the largest tensile stress on the top surface is about 15 mm away from the toe of weld, and the largest at the cross section is just below the finishing bead. These features are similar to those of welding residual stresses. But the stress distribution after annealing is smoother than one from welding. (3) The effectiveness of stress relief annealing depends greatly on the annealing temperature. For example, most of residual stresses are relieved at the heating stage with a heating rate of 30 0 C/hr. to 100 0 C/hr. if the annealing temperature is 650 0 C, but if the annealing temperature is 550 0 C, the annealing is not effective even with a longer holding time. (4) In the case of multipass welding residual stresses studied in this paper, the behaviors of high stresses during annealing are approximated by ones during anisothermal relaxation. (auth.)

Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career?

Science.gov (United States)

Laliberté, Vincent; Rapoport, Mark J.; Andrew, Melissa; Davidson, Marla

2016-01-01

Objectives: Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Method: Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents’ future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Results: Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Conclusions: Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. PMID:27253699

Predictors of early dyspnoea relief in acute heart failure and the association with 30-day outcomes: findings from ASCEND-HF

Science.gov (United States)

Mentz, Robert J.; Hernandez, Adrian F.; Stebbins, Amanda; Ezekowitz, Justin A.; Felker, G. Michael; Heizer, Gretchen M.; Atar, Dan; Teerlink, John R.; Califf, Robert M.; Massie, Barry M.; Hasselblad, Vic; Starling, Randall C.; O'Connor, Christopher M.; Ponikowski, Piotr

2013-01-01

Aims To examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30-day outcomes. Methods and results ASCEND-HF was a randomized trial of nesiritide vs. placebo in 7141 patients hospitalized with acute HF in which dyspnoea relief at 6 h was measured on a 7-point Likert scale. Patients were classified as having early dyspnoea relief if they experienced moderate or marked dyspnoea improvement at 6 h. We analysed the clinical characteristics, geographical variation, and outcomes (mortality, mortality/HF hospitalization, and mortality/hospitalization at 30 days) associated with early dyspnoea relief. Early dyspnoea relief occurred in 2984 patients (43%). In multivariable analyses, predictors of dyspnoea relief included older age and oedema on chest radiograph; higher systolic blood pressure, respiratory rate, and natriuretic peptide level; and lower serum blood urea nitrogen (BUN), sodium, and haemoglobin (model mean C index = 0.590). Dyspnoea relief varied markedly across countries, with patients enrolled from Central Europe having the lowest risk-adjusted likelihood of improvement. Early dyspnoea relief was associated with lower risk-adjusted 30-day mortality/HF hospitalization [hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.68–0.96] and mortality/hospitalization (HR 0.85; 95% CI 0.74–0.99), but similar mortality. Conclusion Clinical characteristics such as respiratory rate, pulmonary oedema, renal function, and natriuretic peptide levels are associated with early dyspnoea relief, and moderate or marked improvement in dyspnoea was associated with a lower risk for 30-day outcomes. PMID:23159547

Stress relief of austenitic weldments: microstructural and mechanical property effects

International Nuclear Information System (INIS)

Thomas, R.G.

1982-01-01

Two consumables suitable for welding AISI 316 have been studied. Both contained 3-8% delta-ferrite in the as-welded state but were of different nominal compositions, namely 19Cr-12Ni-3Mo and 17Cr-8Ni-2Mo. The results of a series of uniaxial stress relaxation tests carried out over a range of temperatures from 650 to 850 0 C indicate that it was practicable to achieve acceptable residual stress levels even at the lower end of this temperature range; the inference was, therefore, that the final choice of stress relief treatment will be determined by the metallurgical changes that simultaneously occur. The isothermal transformation kinetics of the delta-ferrite were determined over the temperature range 600-800 0 C for both weld metals and the nature and morphology of the phases formed was studied. Transformation proceeded more rapidly in the 19Cr-12Ni-3Mo deposit than in the 17Cr-8Ni-2Mo deposit. Electron microscopy revealed that in both weld metals the delta-ferrite acted as a focus for a series of complex precipitation reactions involving initially the simultaneous formation of M 23 C 6 and reversion of delta to #betta# followed by precipitation of intermetallic phases chi and σ. Tensile impact and creep properties of aged material have been determined and are discussed in terms of the structural features observed. (author)

Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

International Nuclear Information System (INIS)

Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; Amorim Bernstein, Karen L. de; Dad, Luqman K.; Li, Linna; Poppe, Matthew M.; Strauss, Jonathan B.; Chollet, Casey T.

2011-01-01

Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

Ontario Radiation Oncology Residents' Needs in the First Postgraduate Year-Residents' Perspective Survey

International Nuclear Information System (INIS)

Szumacher, Ewa; Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Voruganti, Sachi; Rappolt, Susan

2007-01-01

Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies

Residency Allocation Database

Data.gov (United States)

Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

Science.gov (United States)

Bern-Klug, Mercedes

2008-01-01

Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

Counterfactually Mediated Emotions: A Developmental Study of Regret and Relief in a Probabilistic Gambling Task

Science.gov (United States)

Habib, M.; Cassotti, M.; Borst, G.; Simon, G.; Pineau, A.; Houde, O.; Moutier, S.

2012-01-01

Regret and relief are related to counterfactual thinking and rely on comparison processes between what has been and what might have been. In this article, we study the development of regret and relief from late childhood to adulthood (11.2-20.2 years), and we examine how these two emotions affect individuals' willingness to retrospectively…

Diffraction efficiency calculations of polarization diffraction gratings with surface relief

Science.gov (United States)

Nazarova, D.; Sharlandjiev, P.; Berberova, N.; Blagoeva, B.; Stoykova, E.; Nedelchev, L.

2018-03-01

In this paper, we evaluate the optical response of a stack of two diffraction gratings of equal one-dimensional periodicity. The first one is a surface-relief grating structure; the second, a volume polarization grating. This model is based on our experimental results from polarization holographic recordings in azopolymer films. We used films of commercially available azopolymer (poly[1-[4-(3-carboxy-4-hydroxyphenylazo) benzenesulfonamido]-1,2-ethanediyl, sodium salt]), shortly denoted as PAZO. During the recording process, a polarization grating in the volume of the material and a relief grating on the film surface are formed simultaneously. In order to evaluate numerically the optical response of this “hybrid” diffraction structure, we used the rigorous coupled-wave approach (RCWA). It yields stable numerical solutions of Maxwell’s vector equations using the algebraic eigenvalue method.

Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition.

Science.gov (United States)

Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian

2017-12-01

Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery

[The effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls].

Science.gov (United States)

Kim, Yi-Soon; Kim, Min-Za; Jeong, Ihn-Sook

2004-08-01

This study was aimed to identify the effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls. Study subjects was 236 women residing in the community, teachers and nurses who were older than 45 were recruited. Data was collected with self administered questionnaires from July 1st to August 31st, 2003 and analysed using SPSS/WIN 10.0 with Xtest, t-test, and stepwise multiple logistic regression at a significant level of =.05. The breast cancer screening rate was 57.2%, and repeat screening rate was 15.3%. With the multiple logistic regression analysis, factors associated with mammography screening were age and perceived barriers of action, and factors related to the repeat mammography screening were education level and other cancer screening experience. Based on the results, we recommend the development of an intervention program to decrease the perceived barrier of action, to regard mammography as an essential test in regular check-up, and to give active advertisement and education to the public to improve the rates of breast cancer screening and repeat screening.

The efficacy of mechanical vibration analgesia for relief of heel stick pain in neonates: a novel approach.

Science.gov (United States)

Baba, Lisa R; McGrath, Jacqueline M; Liu, Jiexin

2010-01-01

Hospitalized infants are often exposed to many painful procedures as a result of their illness or disease process. Untreated or poorly treated pain can have deleterious effects on normal nociceptive pain development as well as future development of pain pathways. Mechanical vibration has been found to be efficacious in adult and pediatric populations for the relief of mild-to-moderate acute and chronic pain. However, little is known about the efficacy of this intervention in the neonatal population. The purpose of this study was to test the hypothesis that mechanical vibration would be efficacious in the relief of pain associated with heel sticks in neonates. Heel sticks are one of the most common painful procedures during neonatal hospitalization. A random-sequencing crossover design was used with infants acting as their own controls. Newborn infants of 35 weeks' gestation or greater (N = 20) met the inclusion criteria for the study. Pain during heel stick was measured with the Neonatal Infant Pain Scale. The Neonatal Infant Pain Scale is a nonintrusive tool with extensive evidence of its reliability and validity in the neonatal population, when used by trained observers. Mechanical vibration produced an analgesic effect for infants who had previously experienced painful heel sticks that approached statistical significance. The apparent limitations of mechanical vibration as analgesia may be due to the concurrent use of sucrose and pacifier, the effects of order (ie, habituation), or type II error. Because vibration produced the predicted positive effect in some circumstances, further investigation in larger samples within a randomized clinical trial is warranted.

Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

Science.gov (United States)

Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

2013-01-01

Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

A Balancing Act in the Third Space: Graduate-Level Earth Science in an Urban Teacher-Residency Program

Science.gov (United States)

Zirakparvar, N. Alex

2015-01-01

This article describes a museum-based urban teacher-residency (UTR) program's approach to building subject-specific content knowledge and research experience in Earth Science teacher candidates. In the museum-based program, graduate-level science courses and research experiences are designed and implemented specifically for the UTR by active Earth…

Resident Characteristics Report

Data.gov (United States)

Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

Pain Relief in Labor: A Randomized Controlled Trial Comparing ...

African Journals Online (AJOL)

Conclusions: This study showed that 600 mg intramuscular paracetamol provides similar and modest pain relief in labor when compared to 100 mg intramuscular tramadol. It also has fewer maternal adverse effects and favorable neonatal outcome such as tramadol. It is concluded that intramuscular paracetamol is simple, ...

30 CFR 203.3 - Do I have to pay a fee to request royalty relief?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Do I have to pay a fee to request royalty... MINERALS REVENUE MANAGEMENT RELIEF OR REDUCTION IN ROYALTY RATES General Provisions § 203.3 Do I have to pay a fee to request royalty relief? When you submit an application or ask for a preview assessment...

Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans

Science.gov (United States)

2016-10-01

only one site – Cleveland Clinic Foundation. No cost extension of a 12-months of period has been submitted. Study Advertisements The online ads...other documentation. Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans REPORT DOCUMENTATION PAGE...2016 4. TITLE AND SUBTITLE Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans 5a. CONTRACT NUMBER 5b

Pressure relief experiments on a cyclindrical carbon brick tube

International Nuclear Information System (INIS)

Lang, H.; Weise, H.J.; Ennen, P.

1978-08-01

Pressure relief experiments have been carried out on a carbon brick tube. The outer diameter of the specimen was 580 mm, the inner diameter 280 mm, the length 800 mm. The experiments were made with helium at the temperature of the environment. The measurements were carried out in the pressure range from 15 upto 39 bar. The pressure loss was measured dependent on the initial pressure and on time at 5 positions uniformly distributed over the thickness of the tube wall and in the pressure vessel. The maximum pressure transients occurred amounted to approximately 60 bar/second. The maximum overpressure with respect to the environment which occurred in the carbon brick during the relief experiments was about 3.3 bar. The measurements distinctly showed the presence and the effects of inhomogeneities in the sample material. No damages or changes in the carbon brick, which could be regarded as a consequence of the experiments, were found. (orig./GSC) [de

Anthropogenic transformation of the relief of the Aegean Islands

Directory of Open Access Journals (Sweden)

Tsermegas Irena

2015-06-01

Full Text Available The purpose of this article is to present the role of human impact in the forming and transformation of the relief of the Aegean Islands. The most significant changes (with a displacement of more than 10 bln m3 of rock material are related to the creation of road infrastructure and the construction of agricultural terraces. In order to create stone buildings, 20 mln m3 of rock material was used; for the purposes of air transport a surface area of nearly 2.5 km2 was levelled; many kilometres of artificial shorelines were created and at least 4.5 mln m3 of material was displaced for the purposes of the construction of artificial reservoirs of a total capacity of more than 25 mln m3. A huge amount of material was removed as a result of mining activities. The indirect impact of economic activities on the relief of the discussed area includes mainly slope, fluvial and coastal processes.

Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis.

Science.gov (United States)

Taneja, Ashima; Kaur, Satinder; Soni, R K; Bhanupriya; Kaur, Jaspreet; Singla, Laveen

2017-07-01

Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up. There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, ppain compared to danazol.

[Burnout in nursing residents].

Science.gov (United States)

Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

2011-03-01

Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

'Birthgasm': A Literary Review of Orgasm as an Alternative Mode of Pain Relief in Childbirth.

Science.gov (United States)

Mayberry, Lorel; Daniel, Jacqueline

2016-12-01

Childbirth is a fundamental component of a woman's sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth. © The Author(s) 2015.

Reward and relief dimensions of temptation to drink: construct validity and role in predicting differential benefit from acamprosate and naltrexone.

Science.gov (United States)

Roos, Corey R; Mann, Karl; Witkiewitz, Katie

2017-11-01

Researchers have sought to distinguish between individuals whose alcohol use disorder (AUD) is maintained by drinking to relieve negative affect ('relief drinkers') and those whose AUD is maintained by the rewarding effects of alcohol ('reward drinkers'). As an opioid receptor antagonist, naltrexone may be particularly effective for reward drinkers. Acamprosate, which has been shown to down-regulate the glutamatergic system, may be particularly effective for relief drinkers. This study sought to replicate and extend prior work (PREDICT study; Glöckner-Rist et al. ) by examining dimensions of reward and relief temptation to drink and subtypes of individuals with distinct patterns of reward/relief temptation. We utilized data from two randomized clinical trials for AUD (Project MATCH, n = 1726 and COMBINE study, n = 1383). We also tested whether classes of reward/relief temptation would predict differential response to naltrexone and acamprosate in COMBINE. Results replicated prior work by identifying reward and relief temptation factors, which had excellent reliability and construct validity. Using factor mixture modeling, we identified five distinct classes of reward/relief temptation that replicated across studies. In COMBINE, we found a significant class-by-acamprosate interaction effect. Among those most likely classified in the high relief/moderate reward temptation class, individuals had better drinking outcomes if assigned to acamprosate versus placebo. We did not find a significant class-by-naltrexone interaction effect. Our study questions the orthogonal classification of drinkers into only two types (reward or relief drinkers) and adds to the body of research on moderators of acamprosate, which may inform clinical decision making in the treatment of AUD. © 2016 Society for the Study of Addiction.

Some observations on the limitations of present tort law and some thoughts on a comprehensive Nuclear Accident Act

International Nuclear Information System (INIS)

Jose, D.E.

1988-01-01

The author recalls that the existing English and American tort system has been designed to provide answers to person-specific questions, i.e. whether the acts of the defendant have caused the plaintiff's injury. When the defendant's act was exposure to radiation and the plaintiff's injury is cancer, the present scientific knowledge cannot answer that person-specific question. Only a group answer can be given. Either there are or are not excess cancers in the exposed population. But if excess cancers exist science cannot identify which person's cancer is naturally occurring and which was caused by the radiation exposure. The author discusses changing the present American system's form of analysis. Under tort law and replacing it by a comprehensive Nuclear Accident Act providing a system that could ask group questions and provide group relief (NEA) [fr

Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors.

Science.gov (United States)

Osborne, Lauren M; MacLean, Joanna V; Barzilay, Erin Murphy; Meltzer-Brody, Samantha; Miller, Laura; Yang, Sarah Nagle

2018-04-01

The reproductive life cycle has unique influences on the phenotypic expression of mental illness in women. Didactic and clinical training focused on these sex-specific influences should be a vital component of the education of future psychiatrists. The authors sought to determine the current state of and attitudes toward reproductive psychiatry in resident education. The authors administered a web-based survey to psychiatry residency training directors. They assessed the availability of both mandated and optional didactic and clinical training experiences in reproductive psychiatry. Fifty residency program directors answered the survey, for a response rate of 28%. More than half of residency program directors (59%) reported requiring some training in reproductive psychiatry. Both the breadth and depth of topics covered varied greatly among programs. Lack of time (48%) and lack of qualified faculty (26%) were the most frequently cited barriers to more training. Only 40% of residency directors surveyed agreed that all residents should be competent in reproductive psychiatry. These findings suggest that specific training in reproductive psychiatry is inconsistent in US residency programs, and that training that does exist varies considerably in clinical time and content. Given that women comprise more than 50% of all psychiatric patients and most women will menstruate, give birth, and undergo menopause, future psychiatrists would benefit from more systematic instruction in this area. The authors propose the development of a national, standardized reproductive psychiatry curriculum to address this gap and aid in producing psychiatrists competent to treat women at all stages of life.

Teaching the Healthcare Economics Milestones to Radiology Residents: Our Pilot Curriculum Experience.

Science.gov (United States)

Prober, Allen S; Mehan, William A; Bedi, Harprit S

2016-07-01

Since July 2013, the Accreditation Council for Graduate Medical Education (ACGME) has required radiology residency programs to implement a set of educational milestones to track residents' educational advancement in six core competencies, including Systems-based Practice. The healthcare economics subcompetency of Systems-based Practice has traditionally been relatively neglected, and given the new increased ACGME oversight, will specifically require greater focused attention. A multi-institutional health-care economics pilot curriculum combining didactic and practical components was implemented across five residency programs. The didactic portion included a package of online recorded presentations, reading, and testing materials developed by the American College of Radiology (ACR's) Radiology Leadership Institute. The practical component involved a series of local meetings led by program faculty with the production of a deliverable based on research of local reimbursement for a noncontrast head computed tomography. The capstone entailed the presentation of each program's deliverable during a live teleconference webcast with a Radiology Leadership Institute content expert acting as moderator and discussion leader. The pilot curriculum was well received by residents and faculty moderators, with 100% of survey respondents agreeing that the pilot met its objective of introducing how reimbursement works in American radiology in 2015 and how business terminology applies to their particular institutions. A health-care economics curriculum in the style of a Massive Open Online Course has strong potential to serve as many residency programs' method of choice in meeting the health-care economics milestones. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Remembering reliefs that have disappeared

International Nuclear Information System (INIS)

Arnaud, N.

1998-01-01

Natural radioactivity can give information about age but also about thermal evolution of rocks. The accumulation of decay products in a material can be disturbed by temperature rising. Over a certain temperature called opening temperature the decay products are migrating due to atomic diffusion. The decay reactions used usually are K 40 /Ar 40 , Sm 143 /Nd 144 , C 14 /N 14 and the successive disintegrations of uranium leading to lead. A method known as thermo-chronology studies these isotopic ratios and links them to temperatures. The application of this method to the understanding of the tectonic slab collision between India and Asia is described and some conclusions about the relief are drawn. (A.C.)

Pentazocine Pain Relief in Adult Patients With Acute Abdominal ...

African Journals Online (AJOL)

jen

on pain relief, diagnostic accuracy and treatment decisions in patients with acute ... With level of power at 80% and a 5% significance level, a ... 72 hours` duration and were judged by the attending physician to require surgical consultation. .... Clinically Important Differences Between Pre Injection, Post Injection and Final ...

Predictors of Post-Operative Pain Relief in Patients with Chronic Pancreatitis Undergoing the Frey or Whipple Procedure.

Science.gov (United States)

Sinha, Amitasha; Patel, Yuval A; Cruise, Michael; Matsukuma, Karen; Zaheer, Atif; Afghani, Elham; Yadav, Dhiraj; Makary, Martin A; Hirose, Kenzo; Andersen, Dana K; Singh, Vikesh K

2016-04-01

Post-operative pain relief in chronic pancreatitis (CP) is variable. Our objective was to determine clinical imaging or histopathologic predictor(s) of post-operative pain relief in CP patients undergoing the Whipple or Frey procedure. All patients who underwent a Whipple (n = 30) or Frey procedure (n = 30) for painful CP between January 2003 and September 2013 were evaluated. A toxic etiology was defined as a history of alcohol use and/or smoking. The pre-operative abdominal CT was evaluated for calcification(s) and main pancreatic duct (MPD) dilation (≥5 mm). The post-operative histopathology was evaluated for severe fibrosis. Clinical imaging and histopathologic features were evaluated as predictors of post-operative pain relief using univariable and multivariable regression analysis. A total of 60 patients (age 51.6 years, 53% males) were included in our study, of whom 42 (70%) reported post-operative pain relief over a mean follow-up of 1.1 years. There were 37 (62%) patients with toxic etiology, 36 (60%) each with calcification(s) and MPD dilation. A toxic etiology, calcifications, and severe fibrosis were associated with post-operative pain relief on univariable analysis (all p Whipple or Frey procedure.

How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives.

Science.gov (United States)

Bogetz, Alyssa L; Orlov, Nicola; Blankenburg, Rebecca; Bhavaraju, Vasudha; McQueen, Alisa; Rassbach, Caroline

2018-04-01

Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

The pregnant female surgical resident

Directory of Open Access Journals (Sweden)

Shifflette V

2018-05-01

Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

Use and utility of Web-based residency program information: a survey of residency applicants.

Science.gov (United States)

Embi, Peter J; Desai, Sima; Cooney, Thomas G

2003-01-01

The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty

Toward a Resident Personal Finance Curriculum: Quantifying Resident Financial Circumstances, Needs, and Interests.

Science.gov (United States)

McKillip, Ryan; Ernst, Michael; Ahn, James; Tekian, Ara; Shappell, Eric

2018-04-26

Introduction Resident financial health has been linked to wellness and resiliency, yet financial literacy among residents is highly variable. While some medical school curricula include budgeting and student loan education, content on managing finances as a resident is usually lacking. We sought to quantitatively assess residents' financial circumstances, needs, and interests to inform the design of a resident personal finance curriculum. Methods Surveys were sent to residents in eight specialties at an academic medical center. Likert-type responses allowed respondents to rate their level of comfort (1 = Very Uncomfortable, 7 = Very Comfortable) and interest (1 = Very Uninterested, 7 = Very Interested) in various personal finance topics including budgeting, loan repayment, disability insurance, life insurance, home buying, and retirement planning. Details regarding financial circumstances, including assets, liabilities, and insurance, were also collected. Results of questions that utilized a Likert-type scale are reported as median (interquartile range). Results Of 346 residents surveyed, 144 (41.6%) responded. Residents were from Internal Medicine (56, 38.9%), Pediatrics (34, 23.6%), Emergency Medicine (18, 12.5%), and other specialties (36, 25.0%). Ninety-one (63.2%) reported educational loans, with an average balance of $191,730. Credit card balances exceeding $3,000 were reported by 11 (7.6%) respondents. One-hundred-two (70.1%) reported emergency savings, but only 65 (45.1%) reported having a retirement account (average balance $27,608). Respondents rated highest comfort levels with budgeting (5[4-6]), and lowest level of comfort with disability insurance (2[2-4]) and home buying (2[2-5]). Interest in learning each topic was high (6[5-7]), with retirement planning (6[5-7]), investing (6[5-7]), and home buying (6[5-7]) the topics of highest interest. Conclusion These results highlight the deficits in personal finance literacy among residents. Future work should

Perspectives of Residents of Mashhad School of Dentistry about the Curriculum of Residency Program

Directory of Open Access Journals (Sweden)

Javad Sarabadani

2015-09-01

Full Text Available Introduction: This study was carried out to analyze the viewpoint of the residents of school of dentistry about the curriculum presented in the residency program to students of Mashhad School of Dentistry. Methods: To evaluate the perspectives of residents of dental school about the curriculum and regulations of residency program, a questionnaire was designed whose validity and reliability were confirmed by the authorities of School of Dentistry and test-retest reliability, respectively. The questionnaire was distributed among 100 residents and 80 of them completed the questionnaires. The data were analyzed by SPSS software (version 11.5. Results: A total of 43% of residents were informed of the curriculum (e.g. academic leave, transfer, removal of semester, etc.. As for the ability to write research proposal, 42.7% of residents were reported to have a favorable status, i.e. they were able to write more than 80% of their proposal. From among the residents, 30.4% had specialized English language certificate. Most of them (77% were satisfied with the professional staff, faculty members, of the faculty. Many students liked to participate in the teaching method courses of the residency program. Conclusion: Residents maintained that the curriculum in such domains as educational and research issues and special capabilities had some weak points. Thus, appropriate strategies are recommended to be applied to revise the curriculum using the residents’ views on these programs.

The Family and Medical Leave Act (FMLA): Policy Issues

Science.gov (United States)

2013-09-04

occupations (67.3%) and Management , Business , and Financial occupations (65.0%), and Production occupations (63.7%). Occupations with lower shares of...married a spouse of the same sex, regardless of the employee’s … state of residency.” (U.S. Government, Office of Personnel Management , Fact Sheet: Family ...CRS Report for Congress Prepared for Members and Committees of Congress The Family and Medical Leave Act (FMLA): Policy Issues Gerald

How did rehabilitation professionals act when faced with the Great East Japan earthquake and disaster? Descriptive epidemiology of disability and an interim report of the relief activities of the ten Rehabilitation-Related Organizations.

Science.gov (United States)

Liu, Meigen; Kohzuki, Masahiro; Hamamura, Akinori; Ishikawa, Makoto; Saitoh, Masami; Kurihara, Masaki; Handa, Kazuto; Nakamura, Haruki; Fukaura, Junichi; Kimura, Ryuji; Ito, Takao; Matsuzaka, Nobuou

2012-05-01

Inter-organizational coordination is important for rehabilitation disaster relief. The 2011 Great East Japan Earthquake and Disaster was unprecedented, being geographically widespread and multifaceted. Faced with the crisis, rehabilitation professionals established the 10 Rehabilitation-Related Organizations of Rehabilitation Support Service (10-RRO). The objectives of this paper are to provide descriptive epidemiology and assess the activities of 10-RRO. Descriptive. Epidemiological data on disability were collected, mainly from official sources. Relief activities were reviewed from daily reports, and the preparedness, initial response and functioning of 10-RRO were assessed with a questionnaire directed at 36 executives of individual organizations. The disaster was characterized by a very low ratio of injuries to death of 0.372, and an odds ratio of deaths among disabled persons of 2.32. 10-RRO provided relief activities at 3 shelters. The total number of dispatch days ranged from 107 to 146, and the cumulative number of professionals and evacuees served was 1,202 and 7,300, respectively. Support activities included prevention of immobilization, daily life support, environmental improvement and transition to temporary housing. The questionnaire survey revealed poor preparedness, satisfactory initial response and support activities, and problems of data collection and advocacy. The disaster was characterized by minimal trauma and a great need for preventing immobilization. This first collaborative endeavour was successful.

Examples, clarifications, and guidance on preparing requests for relief from pump and valve inservice testing requirements

International Nuclear Information System (INIS)

Ransom, C.B.; Hartley, R.S.

1996-02-01

In this report, the Idaho National Engineering Laboratory reviewers discuss related to requests for relief from the American Society of Mechanical Engineers code requirements for inservice testing (IST) of safety-related pumps and valves at commercial nuclear power plants. This report compiles information and examples that may be useful to licensees in developing relief requests submitted to US Nuclear Regulatory Commission (NRC) for their consideration and provides insights and recommendations on related IST issues. The report also gives specific guidance on relief requests acceptable and not acceptable to the NRC and advises licensees in the use of this information for application at their facilities

Modified dorsal root entry zone lesioning for intractable pain relief in patients with root avulsion injury.

Science.gov (United States)

Takai, Keisuke; Taniguchi, Makoto

2017-08-01

OBJECTIVE Dorsal root entry zone (DREZ) lesioning has been the most effective surgical treatment for the relief of intractable pain due to root avulsion injury, but residual pain and a decrease in pain relief in the follow-up period have been reported in 23%-70% of patients. Based on pain topography in the most recent studies on neuropathic pain, the authors modified the conventional DREZ lesioning procedure to improve clinical outcomes. The presumed rationale for this procedure is to eliminate the spontaneous discharges of neurons in the superficial spinal dorsal horn as well as wide dynamic range neurons in the deep spinal dorsal horn. METHODS Ten patients with avulsion-related pain underwent surgery between 2011 and 2015. The surgical procedure was described and postoperative pain relief was assessed as follows: excellent (residual pain never exceeded 3 on the visual analog scale [VAS] without medication), good (residual pain never exceeded 5 on the VAS with medication), and poor (residual pain was greater than 5 with medication). Specific perioperative complications were assessed. RESULTS The aim of this surgical procedure was to destroy the deeper layers of the posterior horn of spinal gray matter, which was in contrast to the procedures of Nashold and Sindou, which were to destroy the superficial layers. All patients achieved excellent (n = 7, pain relief without medication) or good (n = 3, pain relief with medication) pain relief postoperatively, and the recurrence of pain was not reported in any patients (median 29 months after surgery, range 12-64 months). Nine patients (90%) achieved complete pain relief (a score of 0 or 1 on the VAS) with or without medication. No surgical site complications such as infection or CSF leakage were noted. No motor deficit was observed in any patient. A sensory deficit was observed in 2 patients and disappeared within 1 month in 1 patient. New pain at the adjacent level of DREZ lesioning was observed in 3 patients and

Introducing a patient-controlled analgesia-based acute pain relief ...

African Journals Online (AJOL)

The 10 months after the introduction of the first acute pain relief service (APRS) in southern Africa is described. Seven hundred patients were treated with morphine by means of patient-controlled analgesia (PCA), administered to patients after major surgery or extensive burns via the intravenous (IV) or subcutaneous (SC) ...

Facebook Use between College Resident Advisors' and Their Residents: A Mixed Methods Approach.

Science.gov (United States)

Kacvinsky, Lauren E; Moreno, Megan A

2014-01-01

Facebook use is nearly ubiquitous among college students. Studies have shown links between Facebook displays of depression or problem drinking and risk of these problems. This project aimed to determine whether Facebook could be used to help Resident Advisors (RAs) identify college students at risk for depression or problem drinking. Interviews were conducted with college freshmen to investigate whether they were Facebook "friends" with their RA. Focus groups were conducted with RAs to determine their views on Facebook friending their dormitory residents and using Facebook to help identify at-risk students. 72 freshmen were interviewed and 25 RAs participated in focus groups; both agreed it is common for RAs and residents to be Facebook friends. RAs commonly noted references to depression and problem drinking on residents' Facebook pages, which often led to in-person discussions with the resident. This study provides support that RAs use Facebook to identify issues that may impact their student residents. RAs emphasized benefits of in-person interactions in order to provide support and obtain additional details about the situation. Universities could consider whether providing RA education about Facebook interactions with residents merits encouragement within their existing RA training programs.

Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

Science.gov (United States)

Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

2013-09-01

Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

Effects of perceived and exerted pain control on neural activity during pain relief in experimental heat hyperalgesia: a fMRI study.

Science.gov (United States)

Mohr, C; Leyendecker, S; Petersen, D; Helmchen, C

2012-04-01

Perceived control over pain can attenuate pain perception by mechanisms of endogenous pain control and emotional reappraisal irrespective of whether this control is exerted or only perceived. Self-initiated termination of pain elicits different expectations of subsequent pain relief as compared to perceived pain control. It is unknown whether and how this perceived vs. exerted control on pain differs and affects subsequent pain relief. Using fMRI, we studied two factors of pain control on pain relief: the (i) sense of control (perceived control but no execution) and (ii) the execution of control (exerted control). To account for the impact of factual execution of pain control on pain relief we applied bearable short and hardly bearable long contact-heat stimuli which were applied either controllable or not. Using controllability as factor, there was dissociable neural activity during pain relief: following the perceived control condition neural activity was found in the orbitofrontal and mediofrontal cortex and, following the exerted control condition, in the anterolateral and dorsolateral prefrontal cortex and posterior parietal cortex. We conclude that (i) pain controllability has an impact on pain relief and (ii) the prefrontal cortex shows dissociable neural activity during pain relief following exerted vs. perceived pain control. This might reflect the higher grade of uncertainty during pain relief following perceived pain control mediated by the orbitofrontal and medial prefrontal cortex and processes of working memory and updating expectations during pain relief following exerted control mediated by the lateral prefrontal cortex. © 2011 European Federation of International Association for the Study of Pain Chapters.

What a relief! A role for dopamine in positive (but not negative) valence.

Science.gov (United States)

Sharpe, Melissa J

2018-02-27

We have long known that dopamine encodes the predictive relationship between cues and rewards. But what about relief learning? In this issue of Neuropsychopharmacology, Meyer et al. show that the same circuits encoding rewarding events also encode relief from aversive events. And this appears to be in a manner distinct from encoding of the aversive event itself. So does dopamine only contribute to learning about positive events? And are these events encoded in the same way regardless of how that positive experience came about? Not quite. Turns out, the devil is in the details.

It Is a Man's World: Romantic Relief In The Hollywood Blockbuster

Directory of Open Access Journals (Sweden)

Esma Kartal

2014-10-01

Full Text Available The Hollywood action blockbuster has been known to benefit from conventions that assure its success at the box-office. Since these films are often identified with male genres, they feature male protagonists, causing them to mostly appeal to male audiences. Nevertheless, to attract female spectators as well, blockbusters incorporate female characters and what I like to call “romantic relief” into their narrative. Moments of romantic relief allow both the characters in the film and the audience to forget about the main action of the film briefly. These, however, fail to change the storyline in any significant way. This article largely focuses on romantic relief and its manifestation in such films as Avatar, Armageddon, Transformers and The Hobbit: The Desolation of Smaug.

Negative Self-Disclosure on the Web: The Role of Guilt Relief

Science.gov (United States)

Levontin, Liat; Yom-Tov, Elad

2017-01-01

In this paper, we suggest people use anonymous online forums as platforms for self-disclosing actions they feel guilty about—such as transgressions and unethical behaviors—with the goal of achieving guilt relief through others’ reactions. We support this proposition by analyzing field data extracted from Yahoo Answers, an online question-and-answer website. Our analysis shows the level of guilt relief an answer is expected to offer the “asker” (the self-disclosing person) is positively associated with the asker’s likelihood of selecting that answer as the “best” response to the self-disclosure. Furthermore, following receipt of a guilt-relieving answer, an asker becomes less likely to engage in prosocial behavior, which is another type of guilt-relieving action. PMID:28701982

46 CFR 53.05-2 - Relief valve requirements for hot water boilers (modifies HG-400.2).

Science.gov (United States)

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Relief valve requirements for hot water boilers (modifies HG-400.2). 53.05-2 Section 53.05-2 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... requirements for hot water boilers (modifies HG-400.2). (a) The relief valve requirements for hot water boilers...

30 CFR 204.206 - What will MMS do when it receives my request for other relief?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What will MMS do when it receives my request... THE INTERIOR MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.206 What will MMS do when it receives my request for other relief? When MMS receives your...

Leadership Training in Otolaryngology Residency.

Science.gov (United States)

Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

2017-06-01

Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching.

Science.gov (United States)

Ricciotti, Hope A; Freret, Taylor S; Aluko, Ashley; McKeon, Bri Anne; Haviland, Miriam J; Newman, Lori R

2017-10-01

To pilot a short video-based resident-as-teacher training toolkit and assess its effect on resident teaching skills in clinical settings. A video-based resident-as-teacher training toolkit was previously developed by educational experts at Beth Israel Deaconess Medical Center, Harvard Medical School. Residents were recruited from two academic hospitals, watched two videos from the toolkit ("Clinical Teaching Skills" and "Effective Clinical Supervision"), and completed an accompanying self-study guide. A novel assessment instrument for evaluating the effect of the toolkit on teaching was created through a modified Delphi process. Before and after the intervention, residents were observed leading a clinical teaching encounter and scored using the 15-item assessment instrument. The primary outcome of interest was the change in number of skills exhibited, which was assessed using the Wilcoxon signed-rank test. Twenty-eight residents from two academic hospitals were enrolled, and 20 (71%) completed all phases of the study. More than one third of residents who volunteered to participate reported no prior formal teacher training. After completing two training modules, residents demonstrated a significant increase in the median number of teaching skills exhibited in a clinical teaching encounter, from 7.5 (interquartile range 6.5-9.5) to 10.0 (interquartile range 9.0-11.5; P<.001). Of the 15 teaching skills assessed, there were significant improvements in asking for the learner's perspective (P=.01), providing feedback (P=.005), and encouraging questions (P=.046). Using a resident-as-teacher video-based toolkit was associated with improvements in teaching skills in residents from multiple specialties.

75 FR 82061 - Notice To Amend an Existing System of Records; Privacy Act of 1974; as Amended

Science.gov (United States)

2010-12-29

... or aliens lawfully admitted for permanent residence) are subject to the Privacy Act. This system... requesting notification of the existence of records on himself or herself should send or provide a signed...

Solid-Gas Coupling Model for Coal-Rock Mass Deformation and Pressure Relief Gas Flow in Protection Layer Mining

OpenAIRE

Zhu, Zhuohui; Feng, Tao; Yuan, Zhigang; Xie, Donghai; Chen, Wei

2018-01-01

The solid-gas coupling model for mining coal-rock mass deformation and pressure relief gas flow in protection layer mining is the key to determine deformation of coal-rock mass and migration law of pressure relief gas of protection layer mining in outburst coal seams. Based on the physical coupling process between coal-rock mass deformation and pressure-relief gas migration, the coupling variable of mining coal-rock mass, a part of governing equations of gas seepage field and deformation fiel...

A clinical trial comparing Lanconone® with ibuprofen for rapid relief in acute joint pain.

Science.gov (United States)

Girandola, Robert N; Srivastava, Shalini; Loullis, Costas C

2016-04-06

To study the effect of Lanconone® (1000 mg) on acute pain on exertion as compared to the standard of care, Ibuprofen (400 mg). The study recruited 72 subjects diagnosed with mild to moderate knee joint pain on exertion. Subjects with Pain Visual Analogue Scale of more than 40 mm were included. Uphill walking was provided as the stressor using Naughton's protocol on a treadmill. The subjects walked for 10 minutes continuously followed by a rest period and baseline pain score for index knee joint was recorded. Subjects were administered a single dose of Lanconone® (1000 mg)/Ibuprofen (400 mg). Thereafter the same stressor was provided at 0.5, 1, 2, 3, 4, and 6 hours, subsequently, pain scores were recorded on a visual analogue scale. Double stopwatch method was used to evaluate the onset of pain relief and time taken to meaningful pain relief. Both Lanconone® and Ibuprofen showed the first perceived pain relief at 65.31 ± 35.57 mins as compared to 60.82 ± 32.56 mins respectively. The mean time taken to experience meaningful pain relief in Lanconone® group was 196.59 ± 70.85 mins compared to 167.13 ± 71.41 mins amongst Ibuprofen group. The meaningful pain relief continued for 6 hours. The current study successfully demonstrated rapid pain-relieving potential of Lanconone® which was comparable to Ibuprofen. No adverse event related to the interventions was reported in the study. Clinical trials.gov NCT02417506 . 21 January 2015.

Geophysical research results of buried relief and distribution groundwater runoff of the Aragats massif

OpenAIRE

V.P. Vardanyan; A.H. Hovhannisyan

2017-01-01

Based on the synthesis and reinterpretation of long-term data of geophysical studies together with the hydrology - hydrological materials it has been received new data about the buried topography and spatial distribution of groundwater runoff of the Aragats massif. First of all, it requires to determine the structure of its buried relief, which is basically a regional relief aquitard. The underground water sources are considered to be precipitation on the massif (approximately 83% of the tota...

Pain relief in labour: tramadol versus pentazocine

OpenAIRE

Kavita Chandnani; H. B. Sainee

2013-01-01

Background: The present study was undertaken to compare the effect of 100 mg intramuscular tramadol to 30 mg intramuscular Pentazocine for labour analgesia. Methods: A total of 60 cases with 37-40 weeks pregnancy in labour, without any foetal or maternal complications were selected. Out of them Inj. Tramadol was given to 30 cases while rest of the 30 patients received injection Pentazocine. Results: In Tramadol group pain relief was observed in 80% cases, effect started as early as 7-8 min an...

Venting of gas deflagrations through relief pipes

OpenAIRE

Ferrara, Gabriele

2006-01-01

Vent devices for gas and dust explosions are often ducted to safety locations by means of relief pipes for the discharge of hot combustion products or blast waves (NFPA 68, 2002). The presence of the duct is likely to increase the severity of the explosion with respect to simply vented vessels posing a problem for the proper design of this venting configuration. The phenomenology of the vented explosion is complicated as the interaction of combustion in the duct with primary combustion in...

Protected Time for Research During Orthopaedic Residency Correlates with an Increased Number of Resident Publications.

Science.gov (United States)

Williams, Benjamin R; Agel, Julie A; Van Heest, Ann E

2017-07-05

The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time. In April 2016, we searched residents in postgraduate year (PGY)-3 to PGY-5 on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published during residency. Each publication's 2015 Thomson Reuters Journal Citation Reports 5-Year Journal Impact Factor and resident first authorship were noted. The number of PubMed identifiers for each program was summed and was divided by the number of residents in PGY-3 to PGY-5, giving a mean number of publications per resident. The relationship between output and program research time was compared using t tests and analysis of variance (ANOVA). A total of 1,690 residents were included, with an overall mean number (and standard deviation) of 1.2 ± 2.4 publications per resident. Eighty-seven programs reported block time, 14 programs reported longitudinal time, and 24 programs reported no time. There was a significant difference (p = 0.02) in the mean number of publications per resident when compared between programs with protected time (1.1 ± 1.2 publications) and programs with no protected time (0.6 ± 0.5 publication). One-way ANOVA demonstrated a significant mean difference across the 3 groups (p publications than block time at 1.0 ± 1.0 publication or no time at 0.6 ± 0.5 publication, a difference that persisted when adjusted to include only impact factors of >0 and exclude case reports (p = 0.0015). Both the presence of and the type of dedicated research time correlate

Psychiatry residents in a milieu participatory democracy: a resident's view.

Science.gov (United States)

Gersten, D

1978-11-01

Psychiatry residents respond with a variety of coping mechanisms to the lack of traditional structure in a milieu participatory democracy. To incorporate themselves into the system they must accept such democratic ideals as equality among staff and patients, group decision making, and free self-expression and give up some of their traditional ideas about staff and patient roles, treatment modalities, and the therapeutic environment. The author was a first-year resident in psychiatry on a university hospital inpatient therapeutic community; he discusses the conflicts between residents, who often adopt a "we-they" attitude, and the permanent staff, whose protectiveness of the ward community reflects their personal commitment to its ideals.

Long-term use of short- and long-acting nitrates in stable angina pectoris.

Science.gov (United States)

Kosmicki, Marek Antoni

2009-05-01

Long-acting nitrates are effective antianginal drugs during initial treatment. However, their therapeutic value is compromised by the rapid development of tolerance during sustained therapy, which means that their clinical efficacy is decreased during long-term use. Sublingual nitroglycerin (NTG), a short-acting nitrate, is suitable for the immediate relief of angina. In patients with stable angina treated with oral long-acting nitrates, NTG maintains its full anti-ischemic effect both after initial oral ingestion and after intermittent long-term oral administration. However, NTG attenuates this effect during continuous treatment, when tolerance to oral nitrates occurs, and this is called cross-tolerance. In stable angina long-acting nitrates are considered third-line therapy because a nitrate-free interval is required to avoid the development of tolerance. Nitrates vary in their potential to induce the development of tolerance. During long-lasting nitrate therapy, except pentaerythritol tetranitrate (PETN), one can observe the development of reactive oxygen species (ROS) inside the muscular cell of a vessel wall, and these bind with nitric oxide (NO). This leads to decreased NO activity, thus, nitrate tolerance. PETN has no tendency to form ROS, and therefore during long-term PETN therapy, there is probably no tolerance or cross-tolerance, as during treatment with other nitrates.

Blended Learning in Obstetrics and Gynecology Resident Education: Impact on Resident Clinical Performance.

Science.gov (United States)

Ghareeb, Allen; Han, Heeyoung; Delfino, Kristin; Taylor, Funminiyi

2016-01-01

Effects of residents' blended learning on their clinical performance have rarely been reported. A blended learning pilot program was instituted at Southern Illinois University School of Medicine's Obstetrics and Gynecology program. One of the modules was chronic hypertension in pregnancy. We sought to evaluate if the resident blended learning was transferred to their clinical performance six months after the module. A review of patient charts demonstrated inadequate documentation of history, evaluation, and counseling of patients with chronic hypertension at the first prenatal visit by Obstetrics and Gynecology (OB/GYN) residents. A blended learning module on chronic hypertension in pregnancy was then provided to the residents. A retrospective chart review was then performed to assess behavioral changes in the OB/GYN residents. This intervention was carried out at the Department of Obstetrics and Gynecology, Southern Illinois University. All 16 OB/GYN residents were enrolled in this module as part of their educational curriculum. A query of all prenatal patients diagnosed with chronic hypertension presenting to the OB/GYN resident clinics four months prior to the implementation of the blended learning module (March 2015-June 2015) and six months after (July 20, 2015-February 2016) was performed. Data were collected from outpatient charts utilizing the electronic medical record. Data were abstracted from resident documentation at the first prenatal visit. The residents thought that the blended learning module was applicable to performance improvement in the real-world setting. Patients evaluated before ( n = 10) and after ( n = 7) the intervention were compared. After the intervention, there was an increase in assessment of baseline liver enzymes, referral for electrocardiogram, and early assessment for diabetes in the obese patients. More patients were provided a blood pressure cuff after the module (71.4% vs. 20%). Data were provided to the residents in an

Simulation experiments for a large leak sodium-water reaction analysis. Volume 4. IHTS/relief system simulation tests

International Nuclear Information System (INIS)

Ploeger, D.W.

1978-09-01

Tests were performed in which a simplified 1/8-scale model of the intermediate heat transfer system and relief system of a LMFBR was subjected to a simulated sodium-water reaction in a steam generator. Pressures in the intermediate heat exchanger (IHX) and in the pipe were measured. The flow of water through the relief system was photographed and its velocity was measured. The forces on the relief system elbows resulting from the fluid flow were also measured. The tests were performed primarily to validate pulse propagation codes used for design and for direct use as design data

Research on Disaster Early Warning and Disaster Relief Integrated Service System Based on Block Data Theory

Science.gov (United States)

Yang, J.; Zhang, H.; Wang, C.; Tang, D.

2018-04-01

With the continuous development of social economy, the interaction between mankind and nature has become increasingly evident. Disastrous global catastrophes have occurred from time to time, causing huge losses to people's lives and property. All governments recognize the importance of the establishment of disaster early warning and release mechanisms, and it is also an urgent issue to improve the comprehensive service level of emergency response and disaster relief. However, disaster early warning and emergency relief information is usually generated by different departments, and the diverse data sources, difficult integration, and limited release speed have always been difficult issues to be solved. Block data is the aggregation of various distributed (point data) and segmentation (data) big data on a specific platform and make them happen continuous polymerization effect, block data theory is a good solution to cross-sectoral, cross-platform Disaster information data sharing and integration problems. This paper attempts to discuss the integrated service mechanism of disaster information aggregation and disaster relief based on block data theory and introduces a location-based integrated service system for disaster early warning and disaster relief.

Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS).

Science.gov (United States)

Frank, Alexander Harald Ralf; Groene, Philipp; von Ehrlich-Treuenstätt, Viktor; Heiliger, Christian; Werner, Jens; Karcz, Konrad

2017-12-01

Postoperative pain is one of the major complications in general and bariatric surgery, associated with ongoing problems such as ileus, pneumonia and prolonged mobilization. In this study, patients undergoing bariatric surgery were analyzed according to their postoperative pain relief regime. In one group patients were treated with a patient-controlled analgesia (PCA) device, while the other group was treated with oral and intravenous analgesic medication. The aim of this study was to analyze which postoperative pain relief therapy would be more appropriate. We chose the Cumulative Analgesic Consumption Score (CACS) and Numeric Rating Scale (NRS) for pain measurement. For better comparison, we performed a modification of CACS according to PCA treatment. We observed better pain relief in the PCA group. Furthermore, we observed an advantage of treatment with laxatives in patients treated with PCA. In conclusion, PCA devices are appropriate instruments for postoperative pain relief in bariatric patients. CACS is a practical tool for postoperative pain measurement, describing individual pain sensation more objectively, although holding further potential in modification.

Corruption in cyclone preparedness and relief efforts in coastal Bangladesh

DEFF Research Database (Denmark)

Mahmud, Tanvir; Prowse, Martin

2012-01-01

This article seeks to draw possible lessons for adaptation programmes in Bangladesh by examining whether cyclone preparedness and relief interventions are subject to corrupt practices. Based on a random sample survey of 278 households, three focus-group discussions and seven key-informant...

2-minute Gridded Global Relief Data (ETOPO2) v2

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Two-minute gridded global relief for both ocean and land areas are available in the ETOPO2v2 (2006) database. ETOPO2v2 replaced ETOPO2 (2001). The historic 2-minute...

Education Research: Neurology resident education

Science.gov (United States)

Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

2016-01-01

Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

[The specialty program as a training tool: an individual training plan for each resident].

Science.gov (United States)

Rodríguez González, R; Capilla Cabezuelo, E

2010-01-01

The official training program for the specialty "Diagnostic Imaging" establishes minimum learning objectives that must be fulfilled. Each accredited teaching unit is responsible for designing and carrying out a curriculum to ensure that these objectives are met, and this approach permits a degree of flexibility. Various aspects must be considered in the individual training plans for each resident: the rotation scheme according to the way the department is organized, plans for recovering missed material or reinforcing weak points, optional rotations, increasing degrees of responsibility as skills are acquired during training, and accommodating special needs of handicapped persons. Nevertheless, the individual plan must be fitted to the established curriculum and guarantee that the content of the official program is covered and that the objectives stipulated therein are met. Furthermore, the methods of teaching must be adapted to the individual characteristics of the residents, and this is the most important aspect of the individualization of training. To this end, it is fundamental for residents to take on an active role in their training, guided by their tutor and with the participation of all the radiologists in the department including the other residents, all of whom should act as teachers. Copyright © 2010 SERAM. Published by Elsevier Espana. All rights reserved.

78 FR 49242 - Relief From Joint and Several Liability

Science.gov (United States)

2013-08-13

... 66(c) allows the requesting spouse to avoid liability for tax on community income of which the... is added to Sec. 1.66-4(j)(2)(ii) for claims for equitable relief from the Federal income tax... amended as follows: PART 1--INCOME TAXES 0 Paragraph 1. The authority citation for part 1 continues to...

76 FR 76757 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

Science.gov (United States)

2011-12-08

... DEPARTMENT OF THE INTERIOR Office of Natural Resources Revenue [Docket No. ONRR-2011-0002] States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... published September 13, 2004 (69 FR 55076), provide two types of accounting and auditing relief for Federal...

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

Science.gov (United States)

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align

Pressure Relief Behaviors and Weight Shifting Activities to Prevent Pressure Ulcers in Persons with SCI

Science.gov (United States)

2016-10-01

interface pressures and increased blood flow. This level of off-loading is achieved by postural changes during sustained reaching, leaning and other...project has been designed to fill two significant gaps in the current state of knowledge: 1) accurate measurement of dedicated pressure reliefs and other...significant gaps in the current state of knowledge: 1) accurate measurement of dedicated pressure reliefs and other weight shift activities and 2) the

Preoperative pain mechanisms assessed by cuff algometry are associated with chronic postoperative pain relief after total knee replacement.

Science.gov (United States)

Petersen, Kristian Kjær; Graven-Nielsen, Thomas; Simonsen, Ole; Laursen, Mogens Berg; Arendt-Nielsen, Lars

2016-07-01

Chronic postoperative pain after total knee replacement (TKR) in knee osteoarthritis (KOA) implies clinical challenges. Widespread hyperalgesia, facilitated temporal summation of pain (TSP), and impaired conditioned pain modulation (CPM) have been found in painful KOA. This exploratory study investigated postoperative pain relief 12 months after TKR in 4 subgroups of patients preoperatively profiled by mechanistic quantitative sensory testing. In 103 patients with KOA, pressure pain detection threshold (PDT) and tolerance thresholds (PTT) were assessed at the lower leg using cuff algometry. Temporal summation of pain was measured as an increase in pain intensity scores during 10 repeated (2 seconds intervals) painful cuff stimuli. Conditioned pain modulation was calculated as the relative increase in PDT during painful conditioning stimulation. The grand averages of TSP and CPM were calculated and values below or above were used for subgrouping: facilitated TSP/impaired CPM (group A, N = 16), facilitated TSP/normal CPM (group B, N = 15), normal TSP/impaired CPM (group C, N = 44), and normal TSP/normal CPM (group D, N = 28). Clinical VAS pain intensity scores were collected before and 12 months after TKR surgery and the pain relief calculated. Less pain relief was found in group A (52.0% ± 14.0% pain relief) than in group B (81.1% ± 3.5%, P = 0.023) and group C (79.6% ± 4.4%, P = 0.007), but not group D (69.4% ± 7.9%, P = 0.087). Low preoperative PDT was associated with a less postoperative pain relief (R = -0.222, P = 0.034), whereas TSP or CPM alone showed no associations with postoperative pain relief. This explorative study indicated that patients with osteoarthritis with facilitated TSP together with impaired CPM are more vulnerable to experience less pain relief after TKR.

Administrative Relief for Grantees impacted by Hurricanes Harvey, Irma, and Maria

Science.gov (United States)

On October 26, 2017, the Office of Management and Budget issued the attached memorandum, Administrative Relief for Grantees impacted by Hurricanes, to provide Federal agencies with flexibility to assist their grant applicants and recipients.

Care home manager attitudes to balancing risk and autonomy for residents with dementia.

Science.gov (United States)

Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

2018-02-01

To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study.

Science.gov (United States)

Law, Marcus; Lam, Michelle; Wu, Diana; Veinot, Paula; Mylopoulos, Maria

2017-11-01

Residency poses challenges for residents' personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents' personal relationships and the effects changes in those relationships could have on their wellness. The authors used a constructivist grounded theory approach. In 2012-2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory. Residents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work-life imbalance imposed by their training. This poor work-life balance seemed to result in relationship issues and diminish residents' wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation. Erosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.

Diffraction from relief gratings on a biomimetic elastomer cast

International Nuclear Information System (INIS)

Guerrero, Raphael A.; Aranas, Erika B.

2010-01-01

Biomimetic optical elements combine the optimized designs of nature with the versatility of materials engineering. We employ a beetle carapace as the template for fabricating relief gratings on an elastomer substrate. Biological surface features are successfully replicated by a direct casting procedure. Far-field diffraction effects are discussed in terms of the Fraunhofer approximation in Fourier space.

Fracture toughness and stress relief response of irradiated Type 347/348 stainless steel

International Nuclear Information System (INIS)

Haggag, F.M.

1985-01-01

A test program has experimentally determined: (1) The fracture toughness of Type 347/348 stainless steel (SS) specimens with high values of irradiation fluence (2.3 to 4.8 x 10 22 n/cm 2 , E > 1.0 MeV) and experiencing different levels of irradiation creep (0.0, 0.6, 1.1, 1.8%), (2) the effect of thermal stress relief on fracture toughness recovery for the highly irradiated material, and (3) the mechanisms associated with fracture toughness recovery due to thermal stress relief. The postirradiation fracture toughness tests and tensile tests were conducted at 427 0 C

Perioperative self-reflection among surgical residents.

Science.gov (United States)

Peshkepija, Andi N; Basson, Marc D; Davis, Alan T; Ali, Muhammad; Haan, Pam S; Gupta, Rama N; Hardaway, John C; Nebeker, Cody A; McLeod, Michael K; Osmer, Robert L; Anderson, Cheryl I

2017-09-01

We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs. Phase2: September2015-September2016) were analyzed. Meaningful self-reflection was documented in 40.6% (419/1032) of entries. PGY5's meaningfully self-reflected less than PGY1-4's, 26.1% vs. 49.6% (p = 0.002). In multivariate analysis, resident narratives during Phase 2 were 4.7 times more likely to engage in meaningful self-reflection compared to Phase1 entries (p self-reflection, compared to Phase1. Surgical residents uncommonly practice meaningful self-reflection, even when prompted, and PGY5/chief residents reflect less than more junior residents. Substantial/sustained improvements in resident self-reflection can occur with both training and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

U.S. Coastal Relief Model - Florida and East Gulf of Mexico

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

Using spontaneous commentary of nursing home residents to develop resident-centered measurement tools: A case study.

Science.gov (United States)

Bangerter, Lauren R; Abbott, Katherine; Heid, Allison; Eshraghi, Karen; Van Haitsma, Kimberly

Nursing home (NH) residents routinely complete surveys that assess their health, well-being, preferences, and care needs. Such surveys reveal important information, however, are largely based on the concerns of providers as opposed to the concerns of residents. Thus, researchers must enhance efforts to ensure that these surveys are guided by the priorities, needs, and concerns of residents. We present a case study to demonstrate how spontaneous commentary of NH residents holds particular efficacy for ensuring that measurement tools are guided by the needs, concerns, and priorities of residents. Spontaneous comments from NH residents (N = 370) collected as part of a study developing the Preferences for Everyday Living Inventory for NH residents (PELI-NH) were used to refine the PELI-NH across key phases of measurement development. This work demonstrates how the spontaneous commentary of NH residents may contribute to the refinement of NH measurement tools, and allow researchers to base these tools on the needs and priorities of NH residents. Copyright © 2017 Elsevier Inc. All rights reserved.

Status of anesthesiology resident research education in the United States: structured education programs increase resident research productivity.

Science.gov (United States)

Ahmad, Shireen; De Oliveira, Gildasio S; McCarthy, Robert J

2013-01-01

The enhancement of resident research education has been proposed to increase the number of academic anesthesiologists with the skills and knowledge to conduct meaningful research. Program directors (PDs) of the U.S. anesthesiology residency programs were surveyed to evaluate the status of research education during residency training and to test the hypothesis that structured programs result in greater resident research productivity based on resident publications. Survey responses were solicited from 131 anesthesiology residency PDs. Seventy-four percent of PDs responded to the survey. Questions evaluated department demographic information, the extent of faculty research activity, research resources and research funding in the department, the characteristics of resident research education and resident research productivity, departmental support for resident research, and perceived barriers to resident research education. Thirty-two percent of programs had a structured resident research education program. Structured programs were more likely to be curriculum based, require resident participation in a research project, and provide specific training in presentation and writing skills. Productivity expectations were similar between structured and nonstructured programs. Forty percent of structured programs had > 20% of trainees with a publication in the last 2 years compared with 14% of departments with unstructured programs (difference, 26%; 99% confidence interval [CI], 8%-51%; P = 0.01). The percentage of programs that had research rotations for ≥2 months was not different between the structured and the nonstructured programs. A research rotation of >2 months did not increase the percentage of residents who had published an article within the last 2 months compared with a research rotation of 20% of residents with a publication in the last 2 years compared with 36% in programs with >20% of faculty involvement (difference, 21%; 99% CI, -4% to 46%; P = 0.03). Our

Retrospection-Simulation-Revision: Approach to the Analysis of the Composition and Characteristics of Medical Waste at a Disaster Relief Site.

Science.gov (United States)

Zhang, Li; Wu, Lihua; Tian, Feng; Wang, Zheng

2016-01-01

A large amount of medical waste is produced during disaster relief, posing a potential hazard to the habitat and the environment. A comprehensive understanding of the composition and characteristics of medical waste that requires management is one of the most basic steps in the development of a plan for medical waste management. Unfortunately, limited reliable information is available in the open literature on the characteristics of the medical waste that is generated at disaster relief sites. This paper discusses the analysis of the composition and characteristics of medical waste at a disaster relief site using the retrospection-simulation-revision method. For this study, we obtained 35 medical relief records of the Wenchuan Earthquake, Sichuan, May 2008 from a field cabin hospital. We first present a retrospective analysis of the relief medical records, and then, we simulate the medical waste generated in the affected areas. We ultimately determine the composition and characteristics of medical waste in the affected areas using untreated medical waste to revise the composition of the simulated medical waste. The results from 35 cases showed that the medical waste generated from disaster relief consists of the following: plastic (43.2%), biomass (26.3%), synthetic fiber (15.3%), rubber (6.6%), liquid (6.6%), inorganic salts (0.3%) and metals (1.7%). The bulk density of medical relief waste is 249 kg/m3, and the moisture content is 44.75%. The data should be provided to assist the collection, segregation, storage, transportation, disposal and contamination control of medical waste in affected areas. In this paper, we wish to introduce this research method of restoring the medical waste generated in disaster relief to readers and researchers. In addition, we hope more disaster relief agencies will become aware of the significance of medical case recording and storing. This may be very important for the environmental evaluation of medical waste in disaster areas, as

Survey of plants popularly used for pain relief in Rio Grande do Sul, southern Brazil

Directory of Open Access Journals (Sweden)

Eveline D. Stolz

Full Text Available Ethnobotanical data can be an important tool in the search for new drugs. The Brazilian Health Surveillance Agency accepts the registration of herbal medicines based on ethnopharmacological and ethnobotanical studies. With the purpose of increasing the knowledge of potentially useful plants for the treatment of painful conditions, we analyzed the ethnobotanical studies carried out in Rio Grande do Sul state (RS-Southern Brazil; we had access to nineteen studies.To our knowledge, this is the first compilation of ethnobotanical studies that focus on pain relief carried out in RS. The species native to RS cited in at least nine (about 50% of these studies were selected. The search retrieved 28 native species cited as used to alleviate painful conditions, which are distributed in eighteen botanical families, being Asteraceae the most mentioned. The species more frequently cited for pain relief were Achyrocline satureioides, Baccharis articulata, Baccharis crispa, Lepidium didymum, Eugenia uniflora and Maytenus ilicifolia. The only species not reported in any pre-clinical study associated with pain relief was B. articulata. Among the six species cited, no studies on clinical efficacy were found. In conclusion, the folk use of native plants with therapeutic purposes is widespread in RS State (Brazil, being pain relief an important property.

Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain

Science.gov (United States)

Zeidan, F.; Grant, J.A.; Brown, C.A.; McHaffie, J.G.; Coghill, R.C.

2013-01-01

The cognitive modulation of pain is influenced by a number of factors ranging from attention, beliefs, conditioning, expectations, mood, and the regulation of emotional responses to noxious sensory events. Recently, mindfulness meditation has been found attenuate pain through some of these mechanisms including enhanced cognitive and emotional control, as well as altering the contextual evaluation of sensory events. This review discusses the brain mechanisms involved in mindfulness meditation-related pain relief across different meditative techniques, expertise and training levels, experimental procedures, and neuroimaging methodologies. Converging lines of neuroimaging evidence reveal that mindfulness meditation-related pain relief is associated with unique appraisal cognitive processes depending on expertise level and meditation tradition. Moreover, it is postulated that mindfulness meditation-related pain relief may share a common final pathway with other cognitive techniques in the modulation of pain. PMID:22487846

Resident perceptions of the impact of duty hour restrictions on resident-attending interactions: an exploratory study.

Science.gov (United States)

Gerjevic, Kristen A; Rosenbaum, Marcy E; Suneja, Manish

2017-07-18

The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations. Focus group interviews were conducted with residents exploring their perceptions of how duty hour regulations impact their interactions with attending physicians. Qualitative analysis identified key themes in residents' experiences interacting with faculty in regard to duty hour regulations. Forty residents from five departments in two hospital systems participated. Discussion of these interactions highlighted that attending physicians demonstrate behaviors that explicitly or implicitly either lend their support and understanding of residents' need to comply with these regulations or imply a lack of support and understanding. Three major themes that contributed to the ease or difficulty in addressing duty hour regulations included attending physicians' explicit communication of expectations, implicit non-verbal and verbal cues and the program's organizational culture. Resident physicians' perception of attending physicians' explicit and implicit communication and residency programs organization culture has an impact on residents' experience with duty hour restrictions. Residency faculty and programs could benefit from explicitly addressing and supporting the challenges that residents perceive in complying with duty hour restrictions.

Analysis of topography and relief as a function of the tectonic - geomorphologic evolution of the Eastern Alps

Science.gov (United States)

Bungies, Nadin; Rosenberg, Claudio

2014-05-01

Alpine topography and relief vary regionally (Frisch et al., 1997), even on the scale of tens of kilometers. The causes of these differences are the aim of this work that is based on a geomorphological study of the eastern Alps. Earlier investigations on the topography of the Central Alps (Rosenberg & Garcia, 2013) show, by using 50 km, 75 km, and 100 km swath profiles, that the relief northward of the Insubric Line increases westward, whereas the relief southwards of the Insubric Line decreases eastward. This trend reflects collisional shortening trends recently observed in the Central Alps (Rosenberg & Kissling, 2013). In this work, we analyse the topography of the eastern Alps from the Brenner Area in the west to the Steiermark Area in the east, based on satellite images and digital terrain models, that cover an area of 36 000 km2 in the Austrian and Italian Alps. Based on these data, new GIS-aided datasets containing selected relief factors have been derived. These data are set in relationship to the eastward decrease in collisional shortening to test whether the latter trend has a geomorphic expression. In order to assess such a relationship north-south striking profiles, subparallel to the shortening direction and in addition to an E-W profile are investigated. It can be shown that the total relief of 3100 m (500-3600 m asl.) in the west of the working area is more pronounced than the total relief of 2300 m (700-3000 m asl) in the east of the working area. Furthermore slopes have higher amplitudes in the west when compared to the east. In the west approximately 65% of the slope profile show slopes larger than 50° while in the east approximately 40% of slopes are larger than 50° (based on 30 m topographic data). The evaluation of potential influencing factors will be achieved by conducting spatial and statistical data analysis and interpretation and is complemented by local studies investigating the evolution of relief for selected geologic units. Here

Psychotherapy Training: Residents' Perceptions and Experiences.

Science.gov (United States)

Kovach, Jessica G; Dubin, William R; Combs, Christopher J

2015-10-01

This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

Knowledge and Attitudes of Oman Medical Specialty Board Residents towards Evidence-Based Medicine

Directory of Open Access Journals (Sweden)

Aiman Al Wahaibi

2014-05-01

Full Text Available Objective: This study aims to evaluate the knowledge and attitudes of Oman Medical Specialty Board (OMSB residents towards Evidence-Based Medicine (EBM. Methods: This cross sectional study was conducted on all OMSB residents through a self-administered online questionnaire between October 2012 and March 2013. An electronic survey was designed to identify and determine residents' knowledge and attitudes toward the use of EBM. Results: The survey was completed by 93 (21% OMSB residents, 76 (82% of whom took part in continuing education courses and 50 (54% belonged to professional practice-oriented organizations. On average, the residents were reportedly involved in patient care for approximately 70% (Standard Deviation [SD] 17% of their time, while 14% (SD 12% participated in research activities. The results showed that 53 respondents (57% were competent users of medical search engines compared to 23 residents (25% who rated their skills as neutral. Sixteen percent of the respondents strongly agreed and 46% only agreed that the facility supports the use of current research in practice. Fourteen percent strongly agreed and fifty-three percent only agreed that the foundation of EBM is part of OMSB academic preparation. On the other hand, 17% of the respondents thought that insufficient time is always a barrier against EBM, while another 27% perceived insufficient time as a usual barrier. The lack of information resources was reported to always be a barrier in 11% of the respondents while 32% thought that it usually acts as a barrier. Conclusion: Time constraints and skills in EBM were found to be the two major obstacles. This study was, however, limited by the low response rate of the survey; thus larger studies with a previously validated questionnaire should be conducted in the future.

LOFT pressurizer safety: relief valve reliability

Energy Technology Data Exchange (ETDEWEB)

Brown, E.S.

1978-01-18

The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice.

LOFT pressurizer safety: relief valve reliability

International Nuclear Information System (INIS)

Brown, E.S.

1978-01-01

The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice

Targinact--opioid pain relief without constipation?

Science.gov (United States)

2010-12-01

Targinact (Napp Pharmaceuticals Ltd) is a modified-release combination product containing the strong opioid oxycodone plus the opioid antagonist naloxone. It is licensed for "severe pain, which can be adequately managed only with opioid analgesics".1 The summary of product characteristics (SPC) states that "naloxone is added to counteract opioid-induced constipation by blocking the action of oxycodone at opioid receptors locally in the gut". Advertising for the product claims "better pain relief", "superior GI [gastrointestinal] tolerability" and "improved quality of life" "compared to previous treatment in a clinical practice study (n=7836)". Here we consider whether Targinact offers advantages over using strong opioids plus laxatives where required.

Mean-field theory of photoinduced formation of surface reliefs in side-chain azobenzene polymers

DEFF Research Database (Denmark)

Pedersen, Thomas Garm; Johansen, Per Michael; Holme, N.C.R.

1998-01-01

A mean-field model of photoinduced surface reliefs in dye containing side-chain polymers is presented. It is demonstrated that photoinduced ordering of dye molecules subject to anisotropic intermolecular interactions leads to mass transport even when the intensity of the incident light is spatially...... uniform. Theoretical profiles are obtained using a simple variational method and excellent agreement with experimental surface reliefs recorded under various polarization configurations is found. The polarization dependence of both period and shape of the profiles is correctly reproduced by the model....

Density, Spatial Pattern and Relief Features of Sacred Sites in Northern Morocco

Directory of Open Access Journals (Sweden)

Holger Jäckle

2013-02-01

Full Text Available Sacred sites are of conservation value because of their spiritual meaning, as cultural heritage and as remnants of near-natural biotopes in landscapes strongly transformed by man. The vegetation of sacred sites in Morocco was studied recently. Information about their number, spatial pattern or relief position is fragmentary. However, these parameters are important to evaluate their role as refuge for organisms and their representativeness of potential natural vegetation. Therefore, density and spatial pattern of sacred sites on the Tangier Peninsula in NW Morocco were studied based on records on topographic maps and by ground check. Their relief position was examined calculating a logistic regression model based on site-presences and random pseudo-absences. A ground check showed that around 67% of the existing sacred sites are documented in the topographic maps. They occur in the whole study area but are agglomerated around settlements. Although sacred sites occur with preference at elevated sites they can be found in almost all relief positions, thus offering the potential of supporting different types of climax vegetation (climatic climax and pedoclimax. Because of their abundance (around 29 sacred sites / 100 km² and their distribution pattern they could serve as elements of a biotope network in degraded landscapes.

Measured Maritime Responses to Disaster Relief Scenarios in the Pacific

Science.gov (United States)

2012-12-01

command center. USS TORTUGA assisted the Japanese Ground Self Defense Force (JGSDF) by moving nearly 100 vehicles and 300 SDF personnel from Hokkaido to...northern Honshu and thus facilitated faster relief. Subsequently, TORTUGA became the flagship for Task Group 776.36, a port clearance group that

Careful: Acetaminophen in Pain Relief Medicines Can Cause Liver Damage

Science.gov (United States)

... Pain Relievers and Fever Reducers Careful: Acetaminophen in pain relief medicines can cause liver damage Share Tweet Linkedin Pin it More sharing options Linkedin Pin ... ingredient in many over-the-counter and prescription medicines that help relieve pain and reduce fever. More than 600 over-the- ...

Relief-oriented use of marijuana by teens