Cerebral activation studies by PET and fMRT, clinical relevance?; Zerebrale Aktivierungsstudien mit PET und fMRT, klinische Relevanz?

Energy Technology Data Exchange (ETDEWEB)

Brandt, T. [Neurologische Klinik und Poliklinik, Klinikum Grosshadern, Muenchen Univ. (Germany)

1997-03-01

Cerebral activation studies by PET and fMRT will gain increasing clinical relevance for functional neuroanatomy (reading, speaking), localisation of largely unknown cortical functions (vestibular cortex), imaging of subjective complaints of functional impairments (pain, smell, memory), and documentation of neurological rehabilitation at neuronal level (regeneration, compensation, substitution, learning). (orig.) [Deutsch] Zerebrale Aktivierungsstudien mit PET und fMRT erlangen zunehmend klinische Bedeutung fuer die funktionelle Neuroanatomie einzelner und komplexer Hirnleistungen (Lesen, Sprechen), die Lokalisation bislang unzureichend erforschter Hirnfunktionen (vestibulaerer Kortex), die Objektivierung subjektiver Beschwerden und Funktionsausfaelle (Schmerz, Riechen, Gedaechtnis) und die Dokumentation neurologischer Rehabilitation auf neuronaler Ebene (Regeneration, Kompensation, Substitution, Lernen). (orig.)

Image fusion of MRI and fMRI with intraoperative MRI data: methods and clinical relevance for neurosurgical interventions; Fusion von MRT-, fMRT- und intraoperativen MRT-Daten. Methode und klinische Bedeutung am Beispiel neurochirurgischer Interventionen

Energy Technology Data Exchange (ETDEWEB)

Moche, M.; Busse, H.; Dannenberg, C.; Schulz, T.; Schmidt, F.; Kahn, T. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Diagnostische Radiologie; Schmitgen, A. [GMD Forschungszentrum Informationstechnik GmbH-FIT, Sankt Augustin (Germany); Trantakis, C.; Winkler, D. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Leipzig (Germany)

2001-11-01

The aim of this work was to realize and clinically evaluate an image fusion platform for the integration of preoperative MRI and fMRI data into the intraoperative images of an interventional MRI system with a focus on neurosurgical procedures. A vertically open 0.5 T MRI scanner was equipped with a dedicated navigation system enabling the registration of additional imaging modalities (MRI, fMRI, CT) with the intraoperatively acquired data sets. These merged image data served as the basis for interventional planning and multimodal navigation. So far, the system has been used in 70 neurosurgical interventions (13 of which involved image data fusion - requiring 15 minutes extra time). The augmented navigation system is characterized by a higher frame rate and a higher image quality as compared to the system-integrated navigation based on continuously acquired (near) real time images. Patient movement and tissue shifts can be immediately detected by monitoring the morphological differences between both navigation scenes. The multimodal image fusion allowed a refined navigation planning especially for the resection of deeply seated brain lesions or pathologies close to eloquent areas. Augmented intraoperative orientation and instrument guidance improve the safety and accuracy of neurosurgical interventions. (orig.) [German] Ziel dieser Arbeit waren die Realisierung und klinische Bewertung einer Bildfusion praeoperativer MRT- und fMRT-Bilder mit intraoperativen Datensaetzen eines interventionellen MRT-Systems am Beispiel neurochirurgischer Eingriffe. Ein vertikal offenes 0,5-T-MRT-System wurde mit einem erweiterten Navigationssystem ausgestattet, welches eine Integration zusaetzlicher Bildinformationen (Hochfeld-MRT, fMRT, CT) in die intraoperativ akquirierten Datensaetze erlaubt. Diese fusionierten Bilddaten wurden zur Interventionsplanung und multimodalen Navigation verwendet. Bisher wurde das System bei insgesamt 70 neurochirurgischen Eingriffen eingesetzt, davon 13

Multiparametric and molecular imaging of breast tumors with MRI and PET/MRI; Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET-MRT

Energy Technology Data Exchange (ETDEWEB)

Pinker, K. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria); Memorial Sloan-Kettering Cancer Center, Department of Radiology, Molecular Imaging and Therapy Service, New York (United States); State University of Florida, Department of Scientific Computing in Medicine, Florida (United States); Marino, M.A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria); Policlinico Universitario G. Martino, University of Messina, Department of Biomedical Sciences and Morphologic and Functional Imaging, Messina (Italy); Meyer-Baese, A. [State University of Florida, Department of Scientific Computing in Medicine, Florida (United States); Helbich, T.H. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria)

2016-07-15

Magnetic resonance imaging (MRI) of the breast is an indispensable tool in breast imaging for many indications. Several functional parameters with MRI and positron emission tomography (PET) have been assessed for imaging of breast tumors and their combined application is defined as multiparametric imaging. Available data suggest that multiparametric imaging using different functional MRI and PET parameters can provide detailed information about the hallmarks of cancer and may provide additional specificity. Multiparametric and molecular imaging of the breast comprises established MRI parameters, such as dynamic contrast-enhanced MRI, diffusion-weighted imaging (DWI), MR proton spectroscopy ({sup 1}H-MRSI) as well as combinations of radiological and MRI techniques (e.g. PET/CT and PET/MRI) using radiotracers, such as fluorodeoxyglucose (FDG). Multiparametric and molecular imaging of the breast can be performed at different field-strengths (range 1.5-7 T). Emerging parameters comprise novel promising techniques, such as sodium imaging ({sup 23}Na MRI), phosphorus spectroscopy ({sup 31}P-MRSI), chemical exchange saturation transfer (CEST) imaging, blood oxygen level-dependent (BOLD) and hyperpolarized MRI as well as various specific radiotracers. Multiparametric and molecular imaging has multiple applications in breast imaging. Multiparametric and molecular imaging of the breast is an evolving field that will enable improved detection, characterization, staging and monitoring for personalized medicine in breast cancer. (orig.) [German] Die Magnetresonanztomographie (MRT) der Brust ist ein etabliertes nichtinvasives bildgebendes Verfahren mit vielfaeltigen Indikationen. In den letzten Jahren wurden zahlreiche funktionelle MRT- und Positronenemissionstomographie(PET)-Parameter in der Brustbildgebung evaluiert, und ihre kombinierte Anwendung ist als multiparametrische Bildgebung definiert. Bisherige Daten legen nahe, dass die multiparametrische Bildgebung mit MRT und PET

The Experiences of Female Athletic Trainers in the Role of the Head Athletic Trainer

Science.gov (United States)

Mazerolle, Stephanie M.; Burton, Laura; Cotrufo, Raymond J.

2015-01-01

Context: Very few women have leadership positions in athletic training (ie, head athletic training positions) in intercollegiate athletics. Research exists on the barriers to attaining the role; however, our understanding about the experiences of those currently engaged in the role is limited. Objective: To examine the experiences of female head athletic trainers as they worked toward and attained the position of head athletic trainer. Design: Qualitative study. Setting: National Collegiate Athletic Association Division I setting. Patients or Other Participants: Eight female athletic trainers serving in the role of head athletic trainer participated in our study. The mean age of the participants was 45 ± 12 years, with 5 ± 1.5 years of experience in the role of head athletic trainer and 21 ± 10 years of experience as athletic trainers. Data Collection and Analysis: We conducted phone interviews with the 8 participants following a semistructured format. Interviews were transcribed verbatim and analyzed following a general inductive approach as described by Thomas. To establish credibility, we used a peer reviewer, member checks, and multiple-analyst triangulation. Results: Six major themes emerged from our analysis regarding the experiences of female head athletic trainers. Opportunities to become a head athletic trainer, leadership qualities, and unique personal characteristics were discussed as factors leading to the assumption of the role of the head athletic trainer. Where women hold back, family challenges, and organizational barriers speak to the potential obstacles to assuming the role of head athletic trainer. Conclusions: Female head athletic trainers did not seek the role, but through persistence and encouragement, they find themselves assuming the role. Leadership skills were discussed as important for success in the role of head athletic trainer. Life balancing and parenting were identified as barriers to women seeking the role of head athletic

The experiences of female athletic trainers in the role of the head athletic trainer.

Science.gov (United States)

Mazerolle, Stephanie M; Burton, Laura; Cotrufo, Raymond J

2015-01-01

Very few women have leadership positions in athletic training (ie, head athletic training positions) in intercollegiate athletics. Research exists on the barriers to attaining the role; however, our understanding about the experiences of those currently engaged in the role is limited. To examine the experiences of female head athletic trainers as they worked toward and attained the position of head athletic trainer. Qualitative study. National Collegiate Athletic Association Division I setting. Eight female athletic trainers serving in the role of head athletic trainer participated in our study. The mean age of the participants was 45 ± 12 years, with 5 ± 1.5 years of experience in the role of head athletic trainer and 21 ± 10 years of experience as athletic trainers. We conducted phone interviews with the 8 participants following a semistructured format. Interviews were transcribed verbatim and analyzed following a general inductive approach as described by Thomas. To establish credibility, we used a peer reviewer, member checks, and multiple-analyst triangulation. Six major themes emerged from our analysis regarding the experiences of female head athletic trainers. Opportunities to become a head athletic trainer, leadership qualities, and unique personal characteristics were discussed as factors leading to the assumption of the role of the head athletic trainer. Where women hold back, family challenges, and organizational barriers speak to the potential obstacles to assuming the role of head athletic trainer. Female head athletic trainers did not seek the role, but through persistence and encouragement, they find themselves assuming the role. Leadership skills were discussed as important for success in the role of head athletic trainer. Life balancing and parenting were identified as barriers to women seeking the role of head athletic trainer.

Functional MRT in psychiatry and neurology. 2. rev. and upd. ed.

International Nuclear Information System (INIS)

Schneider, Frank; Fink, Gereon R.

2013-01-01

The book on functional MRT in psychiatry and neurology covers the following topics: (I) Fundamentals: functional neuro-anatomy, fundamentals of NMR imaging, basic research on the clinical use for diagnostics and therapy; basics of morphometry; real-time fMRT, planning and execution of experimental paradigms; data analysis and statistics; reliability and quality of fMRT experiments; eye movement, neuropharmacologic functional imaging, gender dependent effects, age dependent effects, resting state fMRT; meta analyses. (II) Higher brain achievements: movement and action, perception and attention, visual system and object processing, auditory system, executive functions, somatosensoric system, memory, learning and gratification system, functional neuro-anatomy of speech, number processing and calculation, connectivity, social cognition, emotions, olfactory system, functional imaging in the pain research. (III) Disease pattern: dystonia, Parkinson syndrome, Chorea Huntington, aphasia, apraxia, neglect, amnesia, function recovery following apoplexy, schizophrenia, affective disturbances, anxiety and fear, post-traumatic disturbances, hyperactivity syndrome, personality disorder. (IV) Working tools: brain atlas, tool for integrated analyses of structure, functionality and connectivity (SPM anatomy toolbox).

Superconductive MRI system, MRT-50A/SUPER

International Nuclear Information System (INIS)

Suzuki, Hirokazu; Goro, Takehiko

1992-01-01

The MRI (magnetic resonance imaging) market has been rapidly growing and more than 1,300 MRI systems are now operating in the Japanese domestic market. An upper-middle range MRI market, which is characterized by high-image quality, has newly appeared between the high-end and middle-range market niches since last year. To be competitive in this upper-middle range market, Toshiba has developed a superconductive MRI system, the MRT-50A/SUPER. The new system featured a high-performance actively shielded gradient coil called the TSGC (twin-shielded gradient coil), installed in a compact superconductive magnet. This paper introduces the MRT-50A/SUPER and describes recent developments in MRI technology. (author)

Temporomandibular Joint: MRT Diagnostics; Temporomandibulargelenk: MRT-Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Kress, B. [Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie; Universitaetsklinikum Heidelberg (Germany). Neurologische Klinik; Schmitter, M. [Universitaetsklinikum Heidelberg (Germany). Poliklinik fuer zahnaerztliche Prothetik; Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie

2005-09-01

MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary. (orig.) [German] Magnetresonanztomographie bei Kiefergelenkbeschwerden erfordert neben guter technischer Ausstattung Kenntnisse der Anatomie und Pathologie des Kiefergelenks. Diese Uebersicht stellt neben MRT-Protokollen die Anatomie und die pathologischen Befunde des Kiefergelenks bei geoeffnetem und geschlossenem Mund anhand von Abbildungen und Graphiken systematisch dar. Bildgebende Diagnostik des Kiefergelenks gruendet sich auf eine standardisierte klinische und magnetresonanztomographische Untersuchung und erfordert eine enge interdisziplinaere Kooperation zwischen Zahnmedizin und Radiologie. (orig.)

Resiliency in the Rear Detachment: Using the Rear Detachment (Provisional) as an Integral Part of Building Resiliency in Units at the Brigade and Below for Current and Future Deployments

Science.gov (United States)

2010-12-10

combat, thereby reducing combat stress reactions and symptoms .”4 Brigade Combat Team. A unit usually smaller than a division to which are...conflict and most importantly into the foreseeable future.”30 Training soldiers to be master resiliency trainers is a gigantic step in getting the concept

Alignment and position visualization methods for the biomedical imaging and therapy (BMIT) MRT lift

International Nuclear Information System (INIS)

Bree, Michael; Miller, Denise; Kerr, Graham; Belev, George; Wysokinski, Tomasz W.; Dolton, Wade

2016-01-01

The Microbeam Radiation Therapy (MRT) Lift is an eight stage positioning and scanning system at the Canadian Light Source’s BMIT Facility. Alignment of the sample with the beam using the MRT Lift is a time consuming and challenging task. The BMIT Group has developed a Python-based MRT Lift positioning and control program that uses a combination of computational and iterative methods to independently adjust the sample’s X, Y, Z, pitch and roll positions. The program offers “1-Click” alignment of the sample to the beam. Use of a wireframe visualization technique enables even minute movements to be illustrated. Proposed movements and the resulting MRT Lift position can be manually verified before being applied. Optional integration with the SolidWorks modelling platform allows high quality renderings of the MRT Lift in its current or proposed position to be displayed in real time. Human factors principles are incorporated into the program with the objective of delivering easy to use controls for this complex device.

Alignment and position visualization methods for the biomedical imaging and therapy (BMIT) MRT lift

Energy Technology Data Exchange (ETDEWEB)

Bree, Michael, E-mail: michael.bree@lightsource.ca; Miller, Denise; Kerr, Graham; Belev, George; Wysokinski, Tomasz W.; Dolton, Wade [Canadian Light Source Inc., 44 Innovation Blvd, Saskatoon, SK S7N 2V3 Canada (Canada)

2016-07-27

The Microbeam Radiation Therapy (MRT) Lift is an eight stage positioning and scanning system at the Canadian Light Source’s BMIT Facility. Alignment of the sample with the beam using the MRT Lift is a time consuming and challenging task. The BMIT Group has developed a Python-based MRT Lift positioning and control program that uses a combination of computational and iterative methods to independently adjust the sample’s X, Y, Z, pitch and roll positions. The program offers “1-Click” alignment of the sample to the beam. Use of a wireframe visualization technique enables even minute movements to be illustrated. Proposed movements and the resulting MRT Lift position can be manually verified before being applied. Optional integration with the SolidWorks modelling platform allows high quality renderings of the MRT Lift in its current or proposed position to be displayed in real time. Human factors principles are incorporated into the program with the objective of delivering easy to use controls for this complex device.

MRT of the central nervous system. 2. rev. and enl. ed.; MRT des Zentralnervensystems

Energy Technology Data Exchange (ETDEWEB)

Forsting, Michael [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Jansen, Olav (ed.) [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Radiologie und Neuroradiologie

2014-11-01

The book on MRT of the central nervous system includes the following chapters: anatomy, vascular diseases, brain tumors, craniocerebral injuries, infectious diseases, multiple sclerosis and related diseases, metabolic diseases, degenerative diseases, malformations and developmental disorders, hydrocephalus and intracranial hypertension, spinal marrow, degenerative caused spinal and foraminal stenosis, traumata, tumors and tumor-like neoplasm, vascular diseases, inflammations, infections and related diseases, diseases of the peripheral nervous system.

The diagnosis of inflammatory muscular and vascular conditions using MRT with STIR sequences. Diagnostik entzuendlicher Muskel- und Gefaesserkrankungen in der MRT mit STIR-Sequenzen

Energy Technology Data Exchange (ETDEWEB)

Beese, M.S. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Winkler, G. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany) Neurologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Nicolas, V. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Maas, R. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Kress, D. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Kunze, K. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany) Neurologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany)); Buecheler, E. (Radiologische Klinik, Universitaetskrankenhaus Eppendorf, Hamburg (Germany))

1993-06-01

The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T[sub 1] and T[sub 2] weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal myositis (3 out of 4 patients) and in one of 7 patients with untreated vasculitis. Amongst 49 patients in whom the suspected diagnosis could not be confirmed there was muscle oedema in 11 cases (9 neuropathies out of 22, two myopathies out of 10). Oedema indicated inflammatory muscular or vascular disease with a sensitivity of 97% (except in treated patients and for focal myositis). The number of false negative biopsies can be greatly reduced by the use of MRT. (orig.)

Social-pedagogical aspects of trainer's activity

Directory of Open Access Journals (Sweden)

Kramskoy S.I.

2012-11-01

Full Text Available Analysed social-pedagogical aspect of activity of trainer-teacher on preparation of sporting reserve of different level. Activity of trainer is studied on forming socially-active personalities of sportsman. The personal long-term experience is presented to trainer-teaching works of child's trainer, trainer of student command, trainer of command of major league on a handball. It is shown that multilateral activity of trainer is estimated not only the sporting results of his pupils but also has considerably more wide circle of influence on the ward. Influence of employments is represented sport on forming socially-meaningful qualities of personality. It is marked that to the basic personal qualities of trainer behave: creative activity, flexibility of mind, industriousness, honesty, disinterestedness, of principle, self-control, demand, modesty, culture.

MRI of the fetal abdomen; MRT des fetalen Abdomens

Energy Technology Data Exchange (ETDEWEB)

Hoermann, M.; Brugger, P.C.; Witzani, L.; Prayer, D. [Medizinische Universitaet Wien (Austria). Universitaetsklinik fuer Radiodiagnostik

2006-02-15

Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.) [German] Die MRT ist ein wichtiger Bestandteil zur Diagnostik des zentralen Nervensystems und thorakaler Erkrankungen in der fetalen Entwicklung. Wenngleich der Ultraschall die Methode der Wahl zur Ueberwachung des Feten in der Schwangerschaft bleibt, bekommt die fetale MRT als zusaetzliche Untersuchungstechnik zur akkuraten Diagnostik abdomineller Erkrankungen immer groessere Bedeutung. Die neueren Publikationen bestaetigen v. a. den Stellenwert der MRT in der Diagnose von Erkrankungen des fetalen Gastrointestinaltrakts und des Urogenitalsystems. Im Folgenden soll ein Ueberblick ueber die MR-Untersuchungstechnik der haeufigsten Erkrankungen des Abdomens gegeben werden. (orig.)

MRI for myocarditis; MRT bei Myokarditis

Energy Technology Data Exchange (ETDEWEB)

Gutberlet, M.; Luecke, C.; Krieghoff, C.; Hildebrand, L.; Steiner, J.; Adam, J.; Grotthoff, M.; Lehmkuhl, L. [Herzzentrum, Universitaet Leipzig, Abteilung fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Lurz, P.; Eitel, I.; Thiele, H. [Herzzentrum, Universitaet Leipzig, Abteilung Kardiologie, Leipzig (Germany)

2013-01-15

Cardiovascular magnetic resonance imaging (CMRI) has become the primary tool for the non-invasive assessment in patients with suspected myocarditis, especially after exclusion of acute coronary syndrome (ACS) for the differential diagnosis. Various MRI parameters are available which have different accuracies. Volumetric and functional ventricular assessment and the occurrence of pericardial effusion alone demonstrate only a poor sensitivity and specificity. The calculation of the T2-ratio (edema assessment), the early or global relative myocardial enhancement (gRE) and the late gadolinium enhancement (LGE), which represents irreversibly injured myocardium, are more specific parameters. All MRI parameters demonstrate the best accuracy in infarct-like acute myocarditis, whereas in chronic myocarditis sensitivity and specificity are less accurate. Therefore, a multisequential (at least two out of three parameters are positive) approach is recommended. The assessment of the value of newer, more quantitative MRI sequences, such as T1 and T2-mapping is still under investigation. (orig.) [German] Die kardiale MRT stellt die primaere nichtinvasive bildgebende Modalitaet bei Verdacht auf Myokarditis dar, insbesondere auch nach Ausschluss eines akuten Koronarsyndroms (ACS) zur Differenzialdiagnose. Verschiedene MR-Parameter mit unterschiedlicher Wertigkeit stehen zur Verfuegung. Die Beurteilung der Volumetrie und Ventrikelfunktion weisen ebenso wie der Nachweis eines Perikardergusses alleine nur eine geringe Sensitivitaet und Spezifitaet auf. Die spezifischeren MRT-Inflammationsparameter stellen die T2-Ratio (Oedemnachweis), die fruehe Kontrastmittelanreicherung bzw. das globale relative Enhancement (gRE) und die spaete Kontrastmittelanreicherung, das so genannte Late-Gadolinium-Enhancement (LGE) als Zeichen eines irreversiblen Myokardschadens dar. Alle MR-Parameter zeigen die beste diagnostische Genauigkeit bei einer ''infarktaehnlichen'' akuten

Women's Perspectives of Personal Trainers: A Qualitative Study.

Science.gov (United States)

Melton, Deana; Dail, Teresa K; Katula, Jeffrey A; Mustian, Karen M

2011-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers.

Women's Perspectives of Personal Trainers: A Qualitative Study

Science.gov (United States)

Melton, Deana; Dail, Teresa K.; Katula, Jeffrey A.; Mustian, Karen M.

2015-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers. PMID:26005398

Developing Effective Clinical Trainers

Directory of Open Access Journals (Sweden)

Kevin Khamarko

2012-05-01

Full Text Available Continuing education and training provides a means to improve performance among health care professionals (HCP. Research shows, however, that continuing professional education activities have inconsistent effects on HCP competence, performance, and patient health outcomes. Furthermore, the trainer’s role as a facilitator of knowledge translation (KT has been understudied. To understand how clinical trainers support their trainees in translating what they learned into practice, we conducted 16 in-depth interviews with expert trainers. These interviews yielded a variety of KT-enhancing strategies, including tailoring training activities to their trainees’ needs. In addition, participants recommended trainers familiarize themselves with their trainees’ work environments, be able to identify their knowledge deficits, and devote time to provide trainees with post-training support. Creating an effective training, one that leads to transfer, requires active planning, communication, and command of the training topic by skilled trainers.

Non-granulomatous prostatitis: MR appearance with an endorectal surface coil; Nichtgranulomatoese Prostatitis: Erscheinungsbild im MRT mit endorektaler Oberflaechenspule (``Endo-MRT``)

Energy Technology Data Exchange (ETDEWEB)

Szolar, D.H.M. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Ranner, G. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Preidler, K.W. [Magnetresonanztomographie-Zentrum, Univ. Graz (Austria); Lax, S. [Inst. fuer Pathologische Anatomie, Univ. Graz (Austria)

1995-01-01

Inflammatory conditions of the prostate are often idfficult to distinguish from early stages of prostate cancer with imaging techniques. The use of an endorectal surface coil in MRI of the prostate gland has been reported to provide superior resolution and better imaging of details than MRI with a body coil in the diagnosis of early prostate cancer. We report a 34-year-old patient with nonspecific non-granlomatous prostatitis in whom T{sub 2}-weighted endorectal surface coil magnetic resonance imaging (ESCMRI) showed a region of markedly decreased signal intensity in the periphery of the gland. The low signal intensity of the lesion, its sharp demarcation from the normal part of the peripheral zone of the prostate and the marked bulge of the surface contour without capsular breach of the organ were interpreted as evidence of a bioptically proven benign inflammatory condition. (orig.) [Deutsch] Die Unterscheidung entzuendlicher Prozesse von Fruehstadien maligner Neoplasien der Prostata mittels Magnetresonanztomographie bereitet immer wieder Schwierigkeiten. Die Anwendung einer Oberflaechenspule erlaubt durch hoehere Aufloesung eine exaktere Beurteilung der Prostatakapsel, was eine hoehere Treffsicherheit beim Nachweis moeglicher organueberschreitender Infiltrationen bedeutet. Wir praesentieren den Fall eines 34jaehrigen Mannes mit unspezifischer, nichtgranulomatoeser Prostatitis, bei dem das MR-Tomogramm mit endorektal plazierter Oberflaechenspule (Endo-MRT) in der Peripherzone ein Areal deutlich herabgesetzter Signalintensitaet auf T{sub 2}-gewichteten Aufnahmen zeigte. Die scharfe Begrenzung der ausgedehnten signalarmen Laesion gegenueber dem nichtbefallenen Anteil der Peripherzone beim im Endo-MRT identifizierbarer intakter Kapsel liess ein organueberschreitendes Malignom ausschliessen und bestaetigte durch histologische Aufarbeitung der Bioptate den Endo-MRT-Verdachtsbefund einer Prostatitis. (orig.)

Trainer certification

International Nuclear Information System (INIS)

Couser, S.; Moore, J.

1988-01-01

A DOE Technical Safety Appraisal in October 1986 found that training at the Portsmouth Gaseous Diffusion Plant was fragmented and lacked uniformity. Training was localized in departments and was more often handled by line supervisors, etc. - with no certification. The Trainer Certification Program has provided the means for applying standard guidelines to ensure that training is designed, applied, and evaluated in a consistent, effective, and efficient manner. The program is in a state of substantial change and a target date for compliance is set for 1989. Trainer certification will provide both current and future resources to ensure consistent and effective training. 22 figures

Muscle lesion comparing of imaging procedures (sonography and MRT) -experimental and clinical study

International Nuclear Information System (INIS)

Mellerowicz, H.; Lubasch, A.; Dulce, M.; Wagner, S.; Paul, B.

1993-01-01

Muscle injuries in sports are more common now. Diagnosis and follow up of muscle injuries is nowadays achieved by sonography and MRT. In order to assess the two imagine procedures, a direct test for comparison of sonography and MRT was performed in an experimental study: A standardised disconnection of m. triceps surae in rats was either sutured and glued or not treated. Clinical studies were performed in 26 patients suffering from muscle trauma. Sonography was proved to be a reliable procedure especially in follow up control until full weight bearing and should be used first. Negative or doubtfull findings require further investigation by MRT. Especially contrast medium (Gd-DTPA) assisted examinations enables a long term follow up and may even show small (muscle strain) and deep lying injuries. (orig.) [de

MRT Lattice Boltzmann schemes for confined suspension flows

NARCIS (Netherlands)

Sman, van der R.G.M.

2010-01-01

We introduce a novel multiple-relaxation time (modified MRT) Lattice Boltzmann scheme for simulation of confined suspension flow. Via careful tuning of the free eigenvalues of the collision operator we can substantially reduce the error in the so-called hydrodynamic radius. Its performance has been

MRT in differentiation between tumour and implant material in the postoperative sella

International Nuclear Information System (INIS)

Kaiser, W.A.; Steckelbroeck, V.; Siewert, B.; Layer, G.; Hochstetter, A.; Reiser, M.

1993-01-01

MRT criteria have been developed to distinguish between tumour and implant material following examination of 50 patients who had transsphenoidal hypophysectomies for tumours. Judgements were based on the postoperative hormonal status and the operation notes. Following contrast injection of Gd-DTPA and using T 1 weighted spin-echo sequences, implant material appeared as sandwich-like, linear or circular structures. Residual recurrent tumour produced homogenous or non-homogenous aspects without marginal enhancement in 84% of cases. Postoperative displacement of the infundibulum to the opposite side was observed in 73% of patients with tumour remnants. Sensitivity of MRT was 70%, specificity 95%. There was a positive predictive value of 94% and a negative predictive value of 72% with an accuracy of 81%. This provides assistance in differentiating between tumour remnants and implant material. MRT is recommended as a method of examination for hypophyseal tumours to evaluate the success of surgery and where there is clinical doubt concerning residual or recurrent tumour. (orig.) [de

MRI methods for pulmonary ventilation and perfusion imaging; Methoden der MRT zur Ventilations- und Perfusionsbildgebung der Lunge

Energy Technology Data Exchange (ETDEWEB)

Sommer, G. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Bauman, G. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin - Radiologische Physik, Basel (Switzerland)

2016-02-15

Detektion frueher pathologischer Veraenderungen. Standardverfahren der bildgebenden Lungendiagnostik sind die Computertomographie (CT) zur morphologischen Darstellung und die Perfusions-/Ventilationsszintigraphie bzw. ''single photon emission computed tomography'' (SPECT) zur funktionellen Diagnostik. Zur Darstellung der Lungenventilation stehen die MRT mit hyperpolarisierten Gasen, die O{sub 2}-verstaerkte MRT, die MRT mit fluorierten Gasen und die Fourier-Dekompositions-MRT (FD-MRT) zur Verfuegung. Zur Perfusionsbestimmung koennen die dynamische kontrastmittelverstaerkte MRT (DCE-MRT), das ''arterial spin labeling'' (ASL) und die FD-MRT verwendet werden. Bildgebende Verfahren erlauben einen genaueren Einblick in die Pathophysiologie der Lungenfunktion auf regionaler Ebene. Vorteile der MRT sind die fehlende Strahlenbelastung, welche die schonende Akquisition dynamischer Daten ermoeglicht sowie die Vielfalt der verfuegbaren Kontraste und damit zugaenglichen Parameter der Lungenfunktion. Ausreichende klinische Daten existieren nur fuer bestimmte Anwendungen der DCE-MRT. Fuer die uebrigen Verfahren gibt es lediglich Machbarkeitsstudien und Fallserien mit unterschiedlichem Umfang. Hyperpolarisierte Gase sind technisch bedingt nur eingeschraenkt in der Klinik anwendbar. Ein klinischer Einsatz der genannten Verfahren sollte mit Ausnahme der DCE-MRT nur innerhalb von Studien erfolgen. (orig.)

Knowledge translation to fitness trainers: A systematic review

Directory of Open Access Journals (Sweden)

Adamo Kristi B

2010-04-01

Full Text Available Abstract Background This study investigates approaches for translating evidence-based knowledge for use by fitness trainers. Specific questions were: Where do fitness trainers get their evidence-based information? What types of interventions are effective for translating evidence-based knowledge for use by fitness trainers? What are the barriers and facilitators to the use of evidence-based information by fitness trainers in their practice? Methods We describe a systematic review of studies about knowledge translation interventions targeting fitness trainers. Fitness trainers were defined as individuals who provide exercise program design and supervision services to the public. Nurses, physicians, physiotherapists, school teachers, athletic trainers, and sport team strength coaches were excluded. Results Of 634 citations, two studies were eligible for inclusion: a survey of 325 registered health fitness professionals (66% response rate and a qualitative study of 10 fitness instructors. Both studies identified that fitness trainers obtain information from textbooks, networking with colleagues, scientific journals, seminars, and mass media. Fitness trainers holding higher levels of education are reported to use evidence-based information sources such as scientific journals compared to those with lower education levels, who were reported to use mass media sources. The studies identified did not evaluate interventions to translate evidence-based knowledge for fitness trainers and did not explore factors influencing uptake of evidence in their practice. Conclusion Little is known about how fitness trainers obtain and incorporate new evidence-based knowledge into their practice. Further exploration and specific research is needed to better understand how emerging health-fitness evidence can be translated to maximize its use by fitness trainers providing services to the general public.

Health co-benefits in mortality avoidance from implementation of the mass rapid transit (MRT) system in Kuala Lumpur, Malaysia.

Science.gov (United States)

Kwan, Soo Chen; Tainio, Marko; Woodcock, James; Hashim, Jamal Hisham

2016-03-01

The mass rapid transit (MRT) is the largest transport infrastructure project under the national key economic area (NKEA) in Malaysia. As urban rail is anticipated to be the future spine of public transport network in the Greater Kuala Lumpur city, it is important to mainstream climate change mitigation and public health benefits in the local transport development. This study quantifies the health co-benefits in terms of mortality among the urbanites when the first line of the 150 km MRT system in Kuala Lumpur commences by 2017. Using comparative health risk assessment, we estimated the potential health co-benefits from the establishment of the MRT system. We estimated the reduced CO2 emissions and air pollution (PM2.5) exposure reduction among the general population from the reduced use of motorized vehicles. Mortality avoided from traffic incidents involving motorcycles and passenger cars, and from increased physical activity from walking while using the MRT system was also estimated. A total of 363,130 tonnes of CO2 emissions could be reduced annually from the modal shift from cars and motorcycles to the MRT system. Atmospheric PM2.5 concentration could be reduced 0.61 μg/m3 annually (2%). This could avoid a total of 12 deaths, mostly from cardio-respiratory diseases among the city residents. For traffic injuries, 37 deaths could be avoided annually from motorcycle and passenger cars accidents especially among the younger age categories (aged 15-30). One additional death was attributed to pedestrian walking. The additional daily physical activity to access the MRT system could avoid 21 deaths among its riders. Most of the mortality avoided comes from cardiovascular diseases. Overall, a total of 70 deaths could be avoided annually among both the general population and the MRT users in the city. The implementation of the MRT system in Greater Kuala Lumpur could bring substantial health co-benefits to both the general population and the MRT users mainly from the

Diffusion-weighted MRI of the prostate; Diffusionsgewichtete MRT der Prostata

Energy Technology Data Exchange (ETDEWEB)

Mueller-Lisse, U.G.; Scherr, M.K. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Mueller-Lisse, U.L. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Klinik und Poliklinik fuer Urologie, Muenchen (Germany); Zamecnik, P.; Schlemmer, H.P.W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung fuer Radiologische Diagnostik, Heidelberg (Germany)

2011-03-15

Diffusion-weighted magnetic resonance imaging (DWI) can complement MRI of the prostate in the detection and localization of prostate cancer, particularly after previous negative biopsy. A total of 13 original reports and 2 reviews published in 2010 demonstrate that prostate cancer can be detected by DWI due to its increased cell density and decreased diffusiveness, either qualitatively in DWI images or quantitatively by means of the apparent diffusion coefficient (ADC). In the prostate, the ADC is influenced by the strength of diffusion weighting, localization (peripheral or transitional zone), presence of prostatitis or hemorrhage and density and differentiation of prostate cancer cells. Mean differences between healthy tissue of the peripheral zone and prostate cancer appear to be smaller for ADC than for the (choline + creatine)/citrate ratio in MR spectroscopy. Test quality parameters vary greatly between different studies but appear to be slightly better for combined MRI and DWI than for MRI of the prostate alone. Clinical validation of DWI of the prostate requires both increased technical conformity and increased numbers of patients in clinical studies. (orig.) [German] Die diffusionsgewichtete MRT (''diffusion-weighted imaging'', DWI) kann die MRT der Prostata bei der Erkennung und Lokalisation von Prostatakarzinomen besonders nach vorangehender, negativer Stanzbiopsie ergaenzen. In 13 klinischen Original- und 2 Uebersichtsarbeiten des Jahres 2010 zeigt sich, dass die DWI Prostatakarzinome an Einschraenkungen der freien Teilchenbeweglichkeit bei erhoehter Zelldichte qualitativ im Bild oder quantitativ an Hand des ''apparent diffusion coefficient'' (ADC) nachweist. Den ADC in der Prostata beeinflussen Staerke der Diffusionsgewichtung, Lokalisation (periphere Zone, Transitionalzone), Vorliegen von Prostatitis oder Einblutung sowie Streudichte und Differenzierung von Prostatakarzinomzellen. Unterschiede zwischen gesundem

MRI of pulmonary embolism; MRT der akuten Lungenembolie

Energy Technology Data Exchange (ETDEWEB)

Fink, C.; Schoenberg, S.O. [Universitaetsklinikum Mannheim, Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Institut fuer Klinische Radiologie, Mannheim (Germany); Thieme, S.; Clevert, D.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Ley, S. [Deutsches Krebsforschungszentrum Heidelberg, Abteilung Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Abteilung Paediatrische Radiologie, Heidelberg (Germany); Kauczor, H.U. [Deutsches Krebsforschungszentrum Heidelberg, Abteilung Radiologie, Heidelberg (Germany)

2007-08-15

Recent technical developments have substantially improved the potential of MRI for the diagnosis of pulmonary embolism. On the MR scanner side this includes the development of short magnets and dedicated whole-body MRI systems, which allow a comprehensive evaluation of pulmonary embolism and deep venous thrombosis in a single exam. The introduction of parallel imaging has substantially improved the spatial and temporal resolution of pulmonary MR angiography. By combining time-resolved pulmonary perfusion MRI with high-resolution pulmonary MRA a sensitivity and specificity of over 90% is achievable, which is comparable to the accuracy of CTA. Thus, for certain patient groups, such as patients with contraindications to iodinated contrast media and young women with a low clinical probability for pulmonary embolism, MRI can be considered as a first-line imaging tool for the assessment of pulmonary embolism. (orig.) [German] Technische Weiterentwicklungen der MRT haben deren Moeglichkeiten fuer die Diagnostik der Lungenembolie erheblich verbessert. Hierzu zaehlen auf Geraeteseite kuerzere Magneten sowie dedizierte Ganzkoerper-MRT-Systeme, die einerseits den Patientenzugang beguenstigen und andererseits eine Abklaerung einer potenziell zugrunde liegenden Venenthrombose in einer Untersuchung ermoeglichen. Auf Seite der Sequenztechnik hat die Einfuehrung der parallelen Bildgebung die raeumliche und zeitliche Aufloesung der MR-Angiographie (MRA) der Lunge deutlich verbessert. Durch eine Kombination zeitaufgeloester Messungen der Lungenperfusion und einer raeumlich hochaufgeloesten MRA kann fuer die Diagnostik der Lungenembolie eine Sensitivitaet und Spezifitaet von ueber 90% erzielt werden, was vergleichbar der Genauigkeit der CT-Angiographie (CTA) ist. Daher kann die MRT fuer bestimmte Personen, wie z. B. Patienten mit Kontraindikationen gegen jodhaltige Roentgenkontrastmittel (z. B. Hyperthyreose) oder juengere Frauen mit einer geringen klinischen Wahrscheinlichkeit fuer

Magnetic resonance tomography and dental radiology (Dental-MRT)

International Nuclear Information System (INIS)

Gahleitner, A.; Wien Univ.; Solar, P.; Ertl, L.; Nasel, C.; Homolka, P.; Youssefzadeh, S.; Schick, S.

1999-01-01

Purpose: To demonstrate the usefulness of Dental-MRT for imaging of anatomic and pathologic conditions of the mandible and maxilla. Methods: Seven healthy volunteers, 5 patients with pulpitis, 9 patients with dentigerous cysts, 5 patients after tooth transplantation and 12 patients with atrophic mandibles were evaluated. Studies of the jaws using axial T1- and T2-weighted gradient echo and spin echo sequences in 2D and 3D technique have been to performed. The acquired images were reconstructed with a standard dental software package on a workstation as panoramic and cross sectional views of the mandible or maxilla. Results: The entire maxilla and mandibula, teeth, dental pulp and the content of the mandibular canal were well depicted. Patients with inflammatory disease of the pulp chamber demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media application marked enhancement of the dental pulp can be found. Conclusion: Dental-MRT provides a valuable tool for visualization and detection of dental diseases. (orig.) [de

Educational CPD: how UK GP trainers develop themselves as teachers.

Science.gov (United States)

Waters, Mark; Wall, David

2007-09-01

There is little in the literature giving the perspective of UK General Practice (GP) trainers on their development as teachers. What motivates GP trainers develop themselves as teachers? What obstacles to their professional development do GP trainers perceive? A questionnaire to all GP trainers in the West Midlands Deanery in 2004. 360/444 (81%) questionnaires were returned. 56.6% of GP trainers had another educational role in addition to training GP Registrars in the practice. 15.8% of trainers possessed an educational qualification. 13 had completed a Certificate in Medical Education and 28 were engaged in study towards that qualification. Trainers wanted more time to spend on their development as teachers than they presently have, and would then be interested in a wider variety of learning methods. However, 56.6% of trainers would still not choose to undertake a university-accredited course. Female GP trainers perceived more difficulty in obtaining protected time for their development as teachers (Educational CPD) (p = 0.021), were significantly less sure of their partners' support for this development (p = 0.033), and were more likely to agree with trainers undertaking a Certificate in Medical Education (p = 0.003). Having an additional educational role did not affect trainers' ability to take protected time, but significantly increased the amount of time aspired to (p = 0.005). Nothing made more difference to trainers' perception of their ability to undertake Educational CPD than did the perceived attitude of their partners. Educational CPD was very important to GP trainers, but getting protected time was difficult. Consideration of the needs and opinions of partners was a very strong barrier to trainers taking sufficient protected time. Given more available time, GP trainers would be more likely to consider gaining academic qualifications in education. However, this was not be something that all trainers wanted.

Cyborg mini-trainer.

Science.gov (United States)

Mosso, José L; Nieto, Jesus J; Carbajal, Manuel F; Marmolejo, Jorge; Ochoa, Enrique; De La Fuente, Mireya; Almazan, Andrew; Obrador, Tomas

2009-01-01

We present the smallest surgical trainer with a total weight of 400 gr, built in aluminum of 25 cm large and 24 cm wide, and 23 cm high. It's a system integrated by a small and open module, a lamp and a microcamera connected to a Head Mounted display. It holds two endoscopic instruments, and items to make knots or sutures and enhance visual-motor coordination. The vision we got is by a small microcamera displayed to a Head Mounted Display HMD. This surgical trainer is the smallest in the worldwide, easy to install, and easy to carry.

MUNICIPAL BONDS AS THE FINANCING STRATEGY FOR URBAN INFRASTRUCTURE : CASE STUDY OF JAKARTA MRT

Directory of Open Access Journals (Sweden)

Eko Nur Surachman

2016-10-01

Full Text Available The construction of Jakarta MRT Phase I has been carried out by using funds from foreign debt. Meanwhile, Jakarta MRT Phase II or other local infrastructure projects are still waiting for new funding scheme. One alternative is municipal bonds. This study investigate the possibilities of using municipal bonds to finance urban infrastructure project with the case study of Jakarta MRTPhase I. The analyzed use three perspectives including financial aspect, legal aspect, and Jakarta financial capacity aspect. financial analysis using discounted cash flow (DCF, net present value (NPV and internal rate of return (IRR.Secondly, study literature is used in the legal analysis by exploring specific regulations regarding the municipal bonds. Finally, the Jakarta Regional Budget and Jakarta Budget Audit Report is examined to get insight and depth information regarding its financial capacity. The result is municipal bonds are feasible as the source of financing Jakarta MRT Project.

MRT versus CT in the diagnosis of pneumonia. Evaluation of a T2-weighted utrafast turbo-spin-echo sequence (UTSE)

International Nuclear Information System (INIS)

Leutner, C.; Lutterbey, G.; Kuhl, C.K.; Flacke, S.; Schild, H.H.; Glasmacher, A.; Theisen, A.; Wardelmann, E.; Grohe, C.

1999-01-01

Purpose: To evaluate a T 2 -weighted URSE sequence for the assessment of pulmonary infiltrations in comparison to CT. Methods: 28 MRT scans of 22 patients with confirmed pneumonia were recorded on a 1.5 Tesla apparatus with an expiratory and diastolic triggered, T 2 -weighted ultrafast-spin-echo sequence in axial slice mode with the following parameters: TR eff /T E /Turbofactor 2000-4000/90 ms/21-23; slice thickness/separation 6/0.6 mm; FOV 360 mm; 24 slices. 24 spiral CTs (sice thickness/table advance: 1-2 mm/10 mm) were available for comparison. The separate evaluation of MRTs and CTs was performed by three radiologists in a consensus procedure with regard to pulmonary lesions (e.g., infiltration, round foci, net patterns) and image quality of the MRTs (4-step scale). Results: In 71% of the cases the CTs and MRTs agreed with the diagnosis and representation of the lesions, in 25% MRT was superior. MRT was better for the detection of pulmonary abscesses. In 93% the image quality of the MRT was very good to good. Conclusions: MRT in the technique presented here is in most cases equal to CT for the detection of pneumonia. Diagnosis of pulmonary abscesses seems to be better with MRT. (orig.) [de

Prognostic value of cardiovascular MRI in diabetics; Prognostischer Wert der kardiovaskulaeren MRT bei Diabetikern

Energy Technology Data Exchange (ETDEWEB)

Schlett, C.L.; Bertheau, R.C.; Kauczor, H.U.; Weckbach, S. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

2015-04-01

Risikostratifizierung von Noeten ist. Die klinische Untersuchung und die Bestimmung von Blutwerten dienen bei Diabetikern typischerweise zur Risikostratifizierung bzgl. kardio(zerebro)vaskulaerer Ereignisse in der Zukunft. Sowohl die Kardio- als auch die Ganzkoerper-MRT stellen standardisierte Verfahren in der klinischen Diagnostik dar. Deren Stellenwert bei der Vorhersage von Ereignissen mit entsprechender Risikostratifizierung bei Diabetikern gewinnt basierend auf aktuellen Studienergebnissen zunehmend an Bedeutung. Late Gadolinium Enhancement (LGE) im Kardio-MRT detektiert bei bis zu 30 % der Diabetiker stumme Myokardischaemien, die mit einer Hazard Ratio von 3-6 mit kardiovaskulaeren Ereignissen assoziiert sind. Ebenfalls zeigen linksventrikulaere Wandbewegungsstoerungen sowie eine erniedrigte Ejektionsfraktion einen prognostischen Wert. Im Ganzkoerper-MRT sind der Vessel-Score und Karotisstenosen zusaetzliche Praediktoren fuer kardio(zerebro)vaskulaere Ereignisse. Die MRT-basierte Vorhersage kardio(zerebro)vaskulaerer Ereignisse bietet einen signifikanten Mehrwert zur klassischen Risikostratifizierung bei Diabetikern. Jedoch erlaubt nur die umfassende Ganzkoerper-MRT-Untersuchung Patienten zu identifizieren, die ueber einen Zeitraum von 6 Jahren komplett frei von kardio(zerebro)vaskulaeren Ereignissen bleiben. Die Kardio-MRT, insbesondere die Erfassung von LGE, empfiehlt sich fuer die Vorhersage von Ereignissen. Die Ganzkoerper-MRT stellt einen prognostischen Mehrwert dar, deren klinische Relevanz in weiteren Studien geklaert werden muss. (orig.)

The technique of MRT aided abdominal drainage using an open low field magnet. Feasibility and first results

International Nuclear Information System (INIS)

Gehl, H.B.; Frahm, C.; Schimmelpenning, H.; Weiss, H.D.

1996-01-01

To test the practicality of MRT-aided drainage using an open low field magnet and to report on the early clinical results. So far seven patients have been treated (four subphrenic abscesses, two psoas abscesses and one pancreatic pseudocyst). The planning of the approach and catheter insertion were carried out under MRT control (Magnetom Open, 0.2 T). Subsequent treatment was controlled by CT and fluoroscopy. Initial puncture was carried out with a non-magnetic 18 gauge Chiba needle. The drainage catheter was introduced by Seldinger's technique in six cases and with a trocar in one patient. In all seven patients drainage could be started successfully. The design of the magnet and coils permitted adequate accessibility of the patient. There were no problems in visualising the puncture needle. Controlling the position of the catheter by MRT was, however, difficult. The first two steps in abscess drainage (planning the approach and inserting the catheter) can be carried out under MRT control. For further catheter control and observing the course of the disease we presently prefer CT or fluoroscopy. (orig.) [de

Personal trainer demographics, current practice trends and common trainee injuries

Directory of Open Access Journals (Sweden)

Gregory R. Waryasz

2016-10-01

Full Text Available Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2% and National Strength and Conditioning Association (28.9%. Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%, rotator cuff tear/tendonitis (8.9%, shin splints (8.1%, ankle sprain (7.5%, and cervical muscle strain (7.4%. There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

Science.gov (United States)

Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

2016-01-01

Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

3D Simulation of Self-Compacting Concrete Flow Based on MRT-LBM

Directory of Open Access Journals (Sweden)

Liu-Chao Qiu

2018-01-01

Full Text Available A three-dimensional multiple-relaxation-time lattice Boltzmann method (MRT-LBM with a D3Q27 discrete velocity model is applied for simulation of self-compacting concrete (SCC flows. In the present study, the SCC is assumed as a non-Newtonian fluid, and a modified Herschel–Bulkley model is used as constitutive mode. The mass tracking algorithm was used for modeling the liquid-gas interface. Two numerical examples of the slump test and enhanced L-box test were performed, and the calculated results are compared with available experiments in literatures. The numerical results demonstrate the capability of the proposed MRT-LBM in modeling of self-compacting concrete flows.

Determination of left ventricular heart volume by fast MRI in breath-hold technique: how different are quantitative ventricular angiography, quantitative MRI, and visual echocardiography?; Linksventrikulaere Herzvoluminabestimmung mittels schneller MRT in Atemanhaltetechnik: Wie unterschiedlich sind quantitativer Herzkatheter, quantitativer MRT und visuelle Echokardiographie?

Energy Technology Data Exchange (ETDEWEB)

Rominger, M.B.; Bachmann, G.F. [Giessen Univ. (Germany). Diagnostische Radiologie; Kerckhoff-Klinik GmbH, Bad Nauheim (Germany). Projektgruppe Magnetresonanztomographie; Pabst, W. [Giessen Univ. (Germany). Inst. fuer Medizinische Informatik; Ricken, W.W. [Kerckhoff-Klinik GmbH, Bad Nauheim (Germany). Projektgruppe Magnetresonanztomographie; Dinkel, H.P.; Rau, W.S. [Giessen Univ. (Germany). Diagnostische Radiologie

2000-01-01

Goal: Comparison of fast MRI, echocardiography (Echo), and ventricular angiography (Cath) in the assessment of left ventricular global function. Methods: Fast MRI in short axis plane, biplane Cath, and 2D Echo were performed in 62 patients [35 coronary artery diseases, 16 acquired valvular diseases (VD), 9 dilated cardiomyopathies (DCM), 1 congenital heart disease and 1 heart transplantation]. Enddiastolic (EDV), endsystolic (ESV), stroke volumes (SV), cardiac output (CO), and ejection fraction (EF) were compared in MRI and Cath. EF was visually estimated in 2D Echo by an experienced observer. Results: In comparison to MRI, Cath overestimated EF by 8.4%, and Echo underestimated EF by 5.6%. The limits of agreement between MRI and Cath in EF were {+-}23.8%, between MRI and Echo {+-}18%, and between Echo and Cath {+-}19.4%. Significant differences were found between Cath and MRI in EDV, SV, and CO, but not for ESV. The best agreement in EF was found in the group with DCM, the worst in the group with VD. Conclusion: Important systemic and random errors were found in the comparison of MRI, Echo, and Cath. For therapy decision and follow-up, the methods should not be exchanged unscrupulously. (orig.) [German] Ziel: Methodenvergleich von schneller Magnetresonanztomographie (MRT), Echokardiographie (Echo) und Herzkatheter (HK) in der Bestimmung linksventrikulaerer globaler Funktionsparameter. Material und Methoden: Bei 62 Patienten (35 koronare Herzerkrankungen, 16 Herzklappenvitien (KV), 9 idiopathische dilatative Kardiomyopathien (DCM), 1 kongenitale Herzerkrankung und 1 Herzktransplantation) wurde ein Methodenvergleich zwischen schneller Cine MRT im Kurzachsenschnitt, biplanarem HK und 2D Echo durchgefuehrt. Verglichen wurden in MRT und HK linksventrikulaeres enddiastolisches (EDV) und endsystolisches Volumen (ESV), Schlagvolumen (SV), Herzzeitvolumen (HZV) und Ejektionsfraktion (EF). In der Echo wurde die EF visuell durch einen erfahrenen Untersucher bestimmt

MRT of the locomotor system. 4. rev. and enl. ed.

International Nuclear Information System (INIS)

Vahlensieck, Martin; Reiser, Maximilian

2015-01-01

The book on MRT of the locomotor system covers the following topics: relevant NMT imaging techniques, spinal cord, shoulder, elbows, wrist and fingers, hip region, knee, lower leg - ankle - foot, temporomandibular joint, skeletal muscles, bone marrow, bone and soft tissue tumors, osteoporosis, sacroiliac joint, jaw and periodontium.

Applications of cerebral MRI in neonatology; MRT bei Neugeborenen mit Verdacht auf zerebrale Stoerung

Energy Technology Data Exchange (ETDEWEB)

Prayer, D. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Abt. fuer Neuroradiologie; Kuhle, S. [Universitaetsklinik fuer Kinder- und Jugendheilkunde, Wien (Austria). Abt. fuer Neonatologie, angeborene Stoerungen und Intensivmedizin; Blaicher, W. [Abt. fuer Frauenheilkunde und Praenatale Diagnostik, Wien (Germany)

2000-01-01

Magnetic resonance tomography (MRT) has become the most important method in the workup of infantile cerebral complications after primary sonography. Cerebral MR examination and image interpretation during the infantile period require extensive knowledge of morphological manifestations, their pathophysiological background, and frequency. The choice of imaging parameters and image interpretation is demonstrated in infarctions and hemorrhages of the mature and immature brain. A review of the main differential diagnoses is also given. The relevance of MR spectroscopy and fetal MRI is discussed. (orig.) [German] Zur Abklaerung zerebraler Veraenderungen bei Neugeborenen hat sich die Magnetresonanztomographie (MRT) als wichtigste weiterfuehrende Methode nach der Sonographie entwickelt. Die Durchfuehrung und Auswertung der MR-Untersuchungen erfordern jedoch eine genaue Kenntnis der morphologischen Manifestation, des pathophysiologischen Hintergrunds und der Haeufigkeit bestimmter zerebraler Komplikationen in diesem Lebensalter. Resuemee: Ausgehend von zerebrovaskulaeren Erkrankungen werden diese Fragen behandelt, wobei sowohl auf die Auswahl der adaequaten Untersuchungsparameter als auch auf die Bildinterpretation und die wichtigsten Differentialdiagnosen eingegangen wird. Die Bedeutung von MR-Spektroskopie und fetaler MRT wird diskutiert. (orig.)

Quantitatively evaluated dynamic MRT in rheumatoid arthritis of the knee joint

International Nuclear Information System (INIS)

Koenig, H.; Bolze, X.; Wolf, K.J.; Sieper, J.

1992-01-01

32 patients with chronic polyarthritis were examined by MRT. Following intra-articular application of 25 mg prednisolon, 18 patients were reexamined after two of three weeks and 7 out of 18 patients were re-examined after 8 to 16 weeks, both by MRT and clinically. After an initial double echo sequence, we carried out a dynamic series of FLASH measurements (TR 30, TE 10 ms, 70deg) following an intravenous bolus of 0.1 mmol gadolinium-DTPA. Single intensity-time curves were treated quantitatively in relation to the pannus, muscles and effusions. Two or three weeks after treatment the curve parameters showed a reduction in pannus vascularisation which remained constant for the 8 to 16 weeks of further observation. Contrast diffusion in the pannus is initially reduced but approaches the early measurements at the time of the second examination. (orig.) [de

Virtual reality adaptive stimulation of limbic networks in the mental readiness training.

Science.gov (United States)

Cosić, Kresimir; Popović, Sinisa; Kostović, Ivica; Judas, Milos

2010-01-01

A significant proportion of severe psychological problems in recent large-scale peacekeeping operations underscores the importance of effective methods for strengthening the stress resilience. Virtual reality (VR) adaptive stimulation, based on the estimation of the participant's emotional state from physiological signals, may enhance the mental readiness training (MRT). Understanding neurobiological mechanisms by which the MRT based on VR adaptive stimulation can affect the resilience to stress is important for practical application in the stress resilience management. After the delivery of a traumatic audio-visual stimulus in the VR, the cascade of events occurs in the brain, which evokes various physiological manifestations. In addition to the "limbic" emotional and visceral brain circuitry, other large-scale sensory, cognitive, and memory brain networks participate with less known impact in this physiological response. The MRT based on VR adaptive stimulation may strengthen the stress resilience through targeted brain-body interactions. Integrated interdisciplinary efforts, which would integrate the brain imaging and the proposed approach, may contribute to clarifying the neurobiological foundation of the resilience to stress.

The role of the trainer in online courses

OpenAIRE

Dias, Ana Augusta

2001-01-01

This article describes the main challenges faced by teachers and trainers when guiding or "tutoring" online courses. The focus is on their emerging role as e-tutors or e-trainers. The challenges are related with the processes of orientation, guidance and monitoring e-learners within an e-course. European Union DGXXII - Education and Training, Leoardo da VINCI Programme "Trainers Training for Virtual Learning Communities" ( ttVLC)

MOECSW trains master trainers and supervisors.

Science.gov (United States)

1995-01-01

The Ministry of Education, Culture and Social Welfare (MOECSW), as part of the Population Education Programs (formal and informal), undertook a series of training programs to upgrade the knowledge and skills of master trainers, supervisors, and resource persons. As part of the Population Education in the Formal School Sector Project (NEP/93/P01), under the Curriculum Development Centre five training courses were organized to train 220 master trainers. Under the "Three Steps Training Strategy," these 220 master trainers would teach 825 secondary school headmasters who would reach 2025 secondary school teachers. The training courses were held in Dhangadi, April 23-27, 1995; in Pokhara, April 2-7; and in Biratnagar, February 20-24. The areas covered included: 1) the pedagogical aspect of population education (content, scope, objectives, nature, teaching methodologies); 2) demography and population dynamics (composition, distribution and density, sources of population data, demographic transition, consequences and determinants of population growth); 3) family life and adolescence and human sexuality education, including acquired immunodeficiency syndrome (AIDS) education; 4) maternal and child health, and family planning; 5) environment; and 6) population policy and programs. As part of the Population Education Programme (NEP/93/P08), a Master Trainers Training Workshop was held in Makwanpur, March 26-28, 1995. These master trainers would train trainers who would train the facilitators and teachers at learning centers for adult learners under the literacy and post literacy programs. This course focused on the approaches and strategies for integrating population education in development programs, and non-formal education, adult literacy, post literacy, and out-of-school children programs. Dr. D. de Rebello and Mr. S. Hutabarat, CST Advisors on Population Education, organized the training courses and served as resource persons.

Training the Trainers - from an EU Perspective

DEFF Research Database (Denmark)

Martinsen, Bodil

of Language and Business Communication at the Aarhus School of Business.The other project participants are from Belgium, Great Britain, Italy, the Netherlands and Spain. The project, whose overall objective is to create the means to obtain competent trainers, is a follow-up to three previous projects (Grotius...... trainers have to be made available to them. The aim of this paper is to present the EU project, AGIS II, Making things happen: Training the trainers of legal interpreters and translators throughout the EU, coordinated by Kirsten W. RAsmussen and Bodil Martinsen, associate professors at the Department...... of legal interpreting. This process includes, among other things, the development of exemplary curricula, course designs, sample lesson plans and teaching materials, which will be presented and discussed/evaluated at a concluding Seminar on training the trainers, which is to be held in Aarhus, Denmark...

MRI of interstitial lung diseases. What is possible?; MRT bei interstitiellen Lungenerkrankungen. Was ist moeglich

Energy Technology Data Exchange (ETDEWEB)

Biederer, J. [Kreisklinik Gross-Gerau, Radiologie Darmstadt, Gross-Gerau (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Deutsches Zentrum fuer Lungenforschung (DZL), Translational Lung Research Center (TLRC) Heidelberg, Heidelberg (Germany); Thoraxklinik, Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Wielpuetz, M.O.; Jobst, B.J.; Dinkel, J. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Deutsches Zentrum fuer Lungenforschung (DZL), Translational Lung Research Center (TLRC) Heidelberg, Heidelberg (Germany); Thoraxklinik, Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany)

2014-12-15

Magnetic resonance imaging (MRI) of the lungs is becoming increasingly appreciated as a third diagnostic imaging modality besides chest x-ray and computed tomography (CT). Its value is well acknowledged for pediatric patients or for scientific use particularly when radiation exposure should be strictly avoided. However, the diagnosis of interstitial lung disease is the biggest challenge of all indications. The objective of this article is a summary of the current state of the art for diagnostic MRI of interstitial lung diseases. This article reflects the results of a current search of the literature and discusses them against the background of the authors own experience with lung MRI. Due to its lower spatial resolution and a higher susceptibility to artefacts MRI does not achieve the sensitivity of CT for the detection of small details for pattern recognition (e.g. fine reticulation and micronodules) but larger details (e.g. coarse fibrosis and honeycombing) can be clearly visualized. Moreover, it could be shown that MRI has the capability to add clinically valuable information on regional lung function (e.g. ventilation, perfusion and mechanical properties) and inflammation with native signal and contrast dynamics. In its present state MRI can be used for comprehensive cardiopulmonary imaging in patients with sarcoidosis or for follow-up of lung fibrosis after initial correlation with CT. Far more indications are expected when the capabilities of MRI for the assessment of regional lung function and activity of inflammation can be transferred into robust protocols for clinical use. (orig.) [German] Die MRT der Lunge entwickelt sich zu einer ernstzunehmenden dritten Saeule der Thoraxdiagnostik neben dem Thoraxroentgen und der Computertomographie (CT). Ihr Wert in der paediatrischen Lungendiagnostik oder fuer den wissenschaftlichen Einsatz, insbesondere wenn eine Strahlenexposition vermieden werden soll, ist unbestritten. Von allen Indikationen stellt die Diagnostik

Magnetic resonance tomography-guided interventional procedure for diagnosis of prostate cancer; MRT-gezielte interventionelle Verfahren zur Abklaerung des Prostatakarzinoms

Energy Technology Data Exchange (ETDEWEB)

Schernthaner, M.; Helbich, T.H.; Fueger, B.J.; Memarsadeghi, M.; Stiglbauer, A.; Linhart, H.G.; Doan, A.; Pinker, K.; Brader, P. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Division fuer Molekulare und Gender-Bildgebung, Wien (Austria); Margreiter, M. [Medizinische Universitaet Wien, Univ.-Klinik fuer Urologie, Wien (Austria)

2011-11-15

In recent years magnetic resonance imaging (MRI) has been increasingly established in the diagnosis of prostate cancer in addition to transrectal ultrasonography (TRUS). The use of T2-weighted imaging allows an exact delineation of the zonal anatomy of the prostate and its surrounding structures. Other MR imaging tools, such as dynamic contrast-enhanced T1-weighted imaging or diffusion-weighted imaging allow an inference of the biochemical characteristics (multiparametric MRI). Prostate cancer, which could only be diagnosed using MR imaging or lesions suspected as being prostate cancer, which are localized in the anterior aspect of the prostate and were missed with repetitive TRUS biopsy, need to undergo MR guided biopsy. Recent studies have shown a good correlation between MR imaging and histopathology of specimens collected by MR-guided biopsy. Improved lesion targeting is therefore possible with MR-guided biopsy. So far data suggest that MR-guided biopsy of the prostate is a promising alternative diagnostic tool to TRUS-guided biopsy. (orig.) [German] Neben dem transrektalen Ultraschall (TRUS) hat sich in den letzten Jahren die MRT als nichtinvasive Methode zur Bildgebung von Prostatatumoren etabliert. Mittels T2-gewichteter Sequenzen ist eine exakte anatomische Darstellung der Prostata und ihrer umliegenden Strukturen moeglich. Andere MRT-Techniken ermoeglichen Rueckschluesse auf das biologische Verhalten des Tumors: dynamische kontrastmittelverstaerkte T1-gewichtete Sequenzen zur Darstellung der Angiogenese, diffusionsgewichtete Aufnahmen zur Beurteilung der Zelldichte und die Spektroskopie zur Bestimmung von Gewebemetaboliten wie Cholin und Kreatin (multiparametrische Bildgebung). Prostatatumoren, die nur mittels MRT nachweisbar sind oder verdaechtige Tumoren, die hauptsaechlich anterior in der Prostata lokalisiert sind und in wiederholten TRUS-gezielten Biopsien verfehlt wurden, benoetigen eine MRT-gezielte Biopsie zur Diagnosesicherung. Die bisherigen

A Sleep Position Trainer for positional sleep apnea

DEFF Research Database (Denmark)

Laub, Rasmus R; Tønnesen, Philip; Jennum, Poul J

2017-01-01

We tested the effect of the Sleep Position Trainer, a vibrational device, for positional sleep apnea in an open, randomized controlled trial with 101 patients, where 52 patients were allocated to Sleep Position Trainer and 49 patients to a non-treatment control group for 2 months (Part 1). All...... patients were then followed as a cohort for a period of 6 months with use of the Sleep Position Trainer (Part 2). The participants were assessed with polygraphy at entry, and after 2 and 6 months. The mean apnea-hypopnea index supine was 35 per h (SD, 18) in the Sleep Position Trainer group and 38 per h...... (SD, 15) in the control group at entry. In a per protocol analysis, the mean total apnea-hypopnea index at entry and after 2 months in the Sleep Position Trainer group was 18 per h (SD, 10) and 10 per h (SD, 9; P

A mechanized gait trainer for restoration of gait.

Science.gov (United States)

Hesse, S; Uhlenbrock, D

2000-01-01

The newly developed gait trainer allows wheel-chair-bound subjects the repetitive practice of a gait-like movement without overstressing therapists. The device simulates the phases of gait, supports the subjects according to their abilities, and controls the center of mass (CoM) in the vertical and horizontal directions. The patterns of sagittal lower limb joint kinematics and of muscle activation for a normal subject were similar when using the mechanized trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists were required to support treadmill walking. Gait movements on the trainer were highly symmetrical, impact free, and less spastic. The vertical displacement of the CoM was bi-phasic instead of mono-phasic during each gait cycle on the new device. Two cases of non-ambulatory patients, who regained their walking ability after 4 weeks of daily training on the gait trainer, are reported.

Cerebral activation studies by PET and fMRT, clinical relevance?

International Nuclear Information System (INIS)

Brandt, T.

1997-01-01

Cerebral activation studies by PET and fMRT will gain increasing clinical relevance for functional neuroanatomy (reading, speaking), localisation of largely unknown cortical functions (vestibular cortex), imaging of subjective complaints of functional impairments (pain, smell, memory), and documentation of neurological rehabilitation at neuronal level (regeneration, compensation, substitution, learning). (orig.) [de

Morphing into a 21st Century Trainer.

Science.gov (United States)

Mager, R. F.

1996-01-01

Forces that will affect trainers into the next century include rapid change, information overload, globalization, downsizing, empowerment, and remote worksites. Key characteristics of a 21st-century trainer include performance orientation, technical skills, social skills, self-employability, bilingualism, and international competence. (JOW)

Discrimination against Obese Exercise Clients: An Experimental Study of Personal Trainers.

Science.gov (United States)

Fontana, Fabio; Bopes, Jonathan; Bendixen, Seth; Speed, Tyler; George, Megan; Mack, Mick

2018-01-01

The aim of the study was to compare exercise recommendations, attitudes, and behaviors of personal trainers toward clients of different weight statuses. Fifty-two personal trainers participated in the study. The data collection was organized into two phases. In phase one, trainers read a profile and watched the video displaying an interview of either an obese or an average-weight client. Profiles and video interviews were identical except for weight status. Then, trainers provided exercise recommendations and rated their attitude toward the client. In phase two, trainers personally met an obese or an average-weight mock client. Measures were duration and number of advices provided by the trainer to a question posed by the client and sitting distance between trainer and client. There were no significant differences in exercise intensity ( p = .94), duration of first session ( p = .65), and total exercise duration of first week ( p = .76) prescribed to the obese and average-weight clients. The attitude of the personal trainers toward the obese client were not significantly different from the attitude of personal trainers toward the average-weight client ( p = .58). The number of advices provided ( p = .49), the duration of the answer ( p = .55), and the distance personal trainers sat from the obese client ( p = .68) were not significantly different from the behaviors displayed toward the average-weight client. Personal trainers did not discriminate against obese clients in professional settings.

Dental magnetic resonance tomography (dental-MRT) as a method for imaging of the maxillo-mandibular bone; Dentale Magnetresonanztomographie (Dental-MRT) als Verfahren zur Darstellung des maxillomandibulaeren Zahnhalteapparates

Energy Technology Data Exchange (ETDEWEB)

Gahleitner, A.; Nasel, C.; Schick, S.; Dorffner, S.; Imhof, H.; Trattnig, S. [Wien Univ. (Austria). Abt. fuer Osteologie; Bernhart, T.; Mailath, G.; Watzek, G. [Wien Univ. (Austria). Abt. fuer Orale Chirurgie

1998-10-01

Purpose: To establish a new method for dental imaging using magnetic resonance tomography named Dental-MRT and to demonstrate its usefulness in diagnosing dentogen pathologies of the mandible and maxilla. Methods: Seven healthy volunteers, three patients with pulpitis, two patients with dentigerous cysts, two patients after tooth transplantation, and three patients with atrophic mandibles have been evaluated. Optimized axial T{sub 1}- and T{sub 2}-weighted gradient echo and spin echo sequences in 2D and 3D technique have been established to perform studies of the jaws. The acquired images were reconstructed with a standard dental software package on a workstation as panorama and cross-sectional views of the mandible or maxilla. Results: The entire maxillo-mandibular bone, teeth, dental pulp, and the content of the mandibular canal were well depicted. Patients with pulpitis demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media administration marked enhancement of the dental pulp can be demonstrated. Conclusion: Dental-MRT promises to provide a new tool for visualization and detection of dental diseases. (orig.) [Deutsch] Ziel: Das Vorstellen der Dental-MRT als neue Methode zur Darstellung des Ober- und Unterkiefers und ihre Anwendung bei der Diagnose zahnmedizinischer Erkankungen. Methoden: 7 gesunde Probanden, drei Patienten mit Pulpitis, zwei Patienten mit odontogenen Zysten, zwei Patienten nach Zahntransplantationen und drei Patienten mit atrophem Unterkiefer wurden untersucht. Optimierte axiale T{sub 1}- und T{sub 2}-gewichtete Gradienten-Echo- und Spin-Echo-Sequenzen in 2D und 3D-Technik wurden angewandt. Nach der Untersuchung wurden Panoramaschnitte und dentale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebraeuchlichen Dental-Software, angefertigt. Ergebnisse: Der gesamte Kieferbereich, Zaehne, Pulpa und der Inhalt des

The use of a cine-technique in the MRT investigation of the temporo-mandibular joint. Die Anwendung der 'Cine-Technik' in der MRT-Diagnostik des Kiefergelenkes

Energy Technology Data Exchange (ETDEWEB)

Vogl, T.J.; Assal, J. (Univ. Muenchen, Radiologische Klinik Innenstadt (Germany)); Eberhard, D.; Weigl, P.; Randzio, J. (Univ. Muenchen, Klinik und Poliklinik fuer Kieferchirurgie (Germany))

1992-03-01

A new cine-technique in a prospective study using rapid gradient echo sequences was evaluated for the MRT investigation of the temporo-mandibular joint. A newly developed hydraulic apparatus was used to produce progressive opening of the jaw and MRT appearances were recorded during predetermined points of mandibular movement. The investigation included 16 normals and 34 patients. A modified gradient echo sequence was combined with an optimised surface coil or a special double coil and this provided good spatial resolution of the articular disc and of the muscular and bony structure. Amongst the abnormal findings were luxation of the disc (15 cases), tears in the disc (5 cases), late effects of internal derangements (12 cases) and condylar hypermobility (7 cases). The new cine-technique provides specific images in any chosen position of the mandible depending on the clinical disability of the patient. (orig.).

Possibilities of whole-body MRI for investigating musculoskeletal diseases; Moeglichkeiten der Ganzkoerper-MRT zur Diagnostik muskuloskelettaler Erkrankungen

Energy Technology Data Exchange (ETDEWEB)

Lenk, S.; Claussen, C.D.; Schlemmer, H.P. [Klinikum der Eberhardt-Karls-Universitaet Tuebingen, Abteilung fuer Diagnostische Radiologie (Germany); Fischer, S. [Universitaetsklinikum Tuebingen, Abteilung fuer Strahlentherapie (Germany); Koetter, I. [Universitaetsklinikum Tuebingen, Abteilung fuer Haematoonkologie (Germany)

2004-09-01

This contribution outlines possibilities and limitations of whole-body MRI for investigating musculoskeletal diseases. Benefits and drawbacks of the novel whole-body MRI technology are discussed and a possible whole-body MRI sequence protocol for musculoskeletal examinations is proposed. Muscle, joint and bone diseases are discussed in which the application of whole-body MRI may be of advantage. Particularly, polymyositis, muscledystrophy, rheumatoid arthritis, spondylitis ancylosans, multiple trauma, skeletal metastases, multiple myeloma and malignant lymphoma are mentioned. Whole-body MRI opens new advantages for the examination of multifocal musculoskeletal diseases. The clinical benefit of this method for particular diseases has to be evaluated in further studies, however. (orig.) [German] Dieser Beitrag gibt eine Uebersicht ueber die Moeglichkeiten und Limitationen der Ganzkoerper-MRT fuer die Diagnostik von Erkrankungen des muskuloskelettalen Systems. Es werden die Vor- und Nachteile der Ganzkoerper-MRT eroertert und ein Sequenzprotokoll fuer die muskuloskelettale Diagnostik vorgeschlagen. Auf Muskel-, Gelenk- und Knochenerkrankungen, bei denen der Einsatz der Ganzkoerper-MRT indiziert erscheint, dabei insbesondere Polymyositis, Muskeldystrophie, rheumatoide Arthritis, Spondylitis ankylosans, Polytrauma, Skelettmetastasen, Plasmozytom und das maligne Lymphom wird eingegangen. Die Ganzkoerper-MRT bietet neue Moeglichkeiten, insbesondere zur Ausbreitungsdiagnostik und Verlaufskontrolle multifokaler muskuloskelettaler Erkrankungen. Der klinische Nutzen dieser Methode fuer die einzelnen Erkrankungsentitaeten muss in weiteren Studien evaluiert werden. (orig.)

Sources of practice knowledge among Australian fitness trainers.

Science.gov (United States)

Bennie, Jason A; Wiesner, Glen H; van Uffelen, Jannique G Z; Harvey, Jack T; Biddle, Stuart J H

2017-12-01

Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged ≥61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.

MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation; MRT der Skaphoidpseudarthrose mit Gd-DTPA. Stadieneinteilung und klinische Korrelation

Energy Technology Data Exchange (ETDEWEB)

Vogl, T.J. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Beutel, F. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Wilhelm, K. [LMU Muenchen (Germany). Abt. fuer Handchirurgie; Tempka, A. [Freie Univ. Berlin (Germany). Klinik fuer Unfall- und Wiederherstellungschirurgie; Schedel, H. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Haas, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Felix, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik

1994-11-01

During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T{sub 1} weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T{sub 2}-sequences and axial spin echo T{sub 2} sequences. The T{sub 1} weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T{sub 1} weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden in einem Zeitraum von 2 Jahren 134 Patienten mit einer Skaphoidpseudarthrose (SPA) vergleichend konventionell roentgenologisch und magnetresonanztomographisch untersucht. Ziel der Studie war die Erstellung einer klinisch radiologischen Stadieneinteilung mit Hilfe der kontrastverstaerkten MRT zur Verbesserung von Prognosekriterien. Alle MRT-Untersuchungen wurden an einem 1,5 Tesla-Geraet (SP63) mittels einer Oberflaechenspule unter Verwendung von T{sub 1

Organizational commitment among intercollegiate head athletic trainers: examining our work environment.

Science.gov (United States)

Winterstein, A P

1998-01-01

To 1) examine the commitment of head athletic trainers to their intercollegiate work environments, 2) develop a model that better reflects the head athletic trainer's daily work setting, and 3) use new techniques to describe the various ways head athletic trainers demonstrate commitment to their organizations. Organizational commitment (OC) surveys were sent to 461 head athletic trainers identified for the sample. A response rate of 71.5% (330/461) was obtained from the mail survey. A proportional random sample of head athletic trainers was taken from a population identified in the National Association of Collegiate Directors of Athletics (NACDA) directory of intercollegiate athletics as Division I, II, and III institutions. Returned OC surveys were analyzed using descriptive and inferential statistics for all demographic and OC variables. Exploratory cluster analysis was performed to examine naturally clustering groups. Exploratory cluster analysis revealed five naturally clustering groups that represent the head athletic trainers' patterns of commitment across the specific organizational targets. Paired t tests indicated that the continuance commitment scores were significantly lower than the affective and normative scores across the sample. Analysis of variance tests indicated significant differences for specific commitment dimensions based on gender and NCAA division demographics. Beyond that, the five-cluster solution revealed no particular demographic characteristics that predisposed individuals to specific clusters. THE FINDINGS REINFORCE A CENTRAL THEME IN INTERCOLLEGIATE ATHLETIC TRAINING: that student-athletes and student athletic trainers are the primary focus of the head athletic trainers' commitment. Positive attachment and obligation directed toward student-athletes and student athletic trainers link the five clusters. Commitment patterns in areas other than student-athletes and student athletic trainers define the cluster membership or head athletic

Health trainers making a difference to mental health and wellbeing.

Science.gov (United States)

White, Judy; Bagnall, Anne-Marie; Trigwell, Joanne

2015-05-01

This short report explores the key findings from a review(1) of information on health trainers in 2013/2014 which had a particular focus on mental health and wellbeing. After summarising the key findings of the review, it focuses on mental health, briefly exploring the links between mental and physical health before discussing what differences engagement with a health trainer made to people's sense of self-efficacy and wellbeing. Health trainers are a non-clinical workforce introduced in 2004,(2) who receive training in competencies to enable them to support people in disadvantaged communities to improve their health.(3) The population groups or settings that health trainers focus on varies from service to service, but all work one-to-one, most spending at least an hour with a client at their first appointment, supporting and enabling them to decide what they want to do. The emphasis is on the client determining their own priorities and how to achieve them. Generally, health trainers see clients for a total of six sessions, where how to achieve goals and progress towards them is discussed. The Data Collection and Reporting System (DCRS) is used by approximately 60% of Health Trainer Services to record monitoring data. Around 90% of Health Trainer Services using DCRS record ethnographic data on health trainers and clients, plus the issues clients worked on and the progress they made. There is also a wide range of other data which can be recorded, including before and after mental health and wellbeing scores. We were given access to aggregate data in order to conduct an analysis. Descriptive statistics were generated to calculate percentage change pre- to post-intervention. A total of 1,377 (= 919 full time equivalents) health trainers were recorded in the DCRS system as working with 97,248 clients in England during 2013/2014. The health trainer model embodies the principle of lay support,(4) and services aim to recruit a high proportion of their staff from similar

The reactor trainer: state-of-the-art classroom learning

International Nuclear Information System (INIS)

Stater, R.G.

1996-01-01

The Reactor Trainer is a professional, PC based, graphically enhanced, training resource specifically developed and customized for Class Room teaching of and learning about, reactor behavior. This unique, and focused, learning-target sets The Trainer apart from the panorama of the more common PC plant simulator. Its educational scope extends along a logical learning path, starting with important fundamental behavioral concepts of delayed neutrons, neutron multiplying factors, and reactor rate, moving to simple reactor transients in real time, and culminating with more complex operational evolutions. The Trainer empowers the Instructor with a dynamic Class Room demonstrator and the student with a superior hands-on learning tool. The Trainer's versatility encompasses a wide variety of educational needs, including initial operator training, requalification training, Shift Technical Advisor training, and other advanced or specialized training. In addition, The Reactor Trainer enhances prerequisite preparation of operator candidates for full-scale control room training and, in so doing, PC economics relieves full-scale simulator hours. (author)

Training of Trainers.

Science.gov (United States)

Gormley, Wilma J.; Austin, John H.

1985-01-01

Discusses specific training methods and common characteristics of participants in workshops sponsored by Agency for International Development Water and Sanitation for Health Project for extension agents, who will act as trainers in transfer of sanitation technology in developing nations. Recommendations for conducting such workshops in…

MR imaging of the prostate; MRT der Prostata

Energy Technology Data Exchange (ETDEWEB)

Asbach, P.; Haas, M.; Hamm, B. [Charite Campus Benjamin Franklin, Klinik fuer Radiologie, Berlin (Germany)

2015-12-15

Prostate cancer is the most common form of cancer in men in Germany; however, there is a distinct difference between incidence and mortality. The detection of prostate cancer is based on clinical and laboratory testing using serum prostate-specific antigen (PSA) levels and transrectal ultrasound with randomized biopsy. Multiparametric MR imaging of the prostate can provide valuable diagnostic information for detection of prostate cancer, especially after negative results of a biopsy prior to repeat biopsy. In addition the use of MR ultrasound fusion-guided biopsy has gained in diagnostic importance and has increased the prostate cancer detection rate. The prostate imaging reporting and data system (PI-RADS) classification has standardized the reporting of prostate MRI which has positively influenced the acceptance by urologists. (orig.) [German] Das Prostatakarzinom ist in Deutschland die haeufigste Krebserkrankung des Mannes, wobei ein deutlicher Unterschied zwischen Inzidenz und Mortalitaet besteht. Die Detektion des Prostatakarzinoms basiert auf klinischer und laborchemischer Untersuchung (prostataspezifisches-Antigen[PSA]-Wert) sowie der transrektalen Ultraschalluntersuchung mit randomisierter Biopsie. Die multiparametrische MR-Tomographie kann zur Detektion des Prostatakarzinoms, insbesondere bei negativer Biopsie vor einer erneuten Biopsie wertvolle diagnostische Informationen liefern. Zudem wird zunehmend die MRT-Ultraschall-Fusionsbiopsie in der Diagnostik eingesetzt, wodurch die Detektionsrate des Prostatakarzinoms deutlich gesteigert werden kann. Mit Einfuehrung der PI-RADS-Klassifikation (Prostate Imaging-Reporting and Data System) konnte zudem eine Standardisierung der Befundung erreicht werden, was die Akzeptanz der MRT der Prostata in der Urologie erhoeht hat. (orig.)

Determination of cartilage thickness in the ankle joint. MRT (1,5 T) comparative anatomical study; Bestimmung der Knorpeldicke am oberen Sprunggelenk. Eine MRT(1,5 T)-anatomische Vergleichsstudie

Energy Technology Data Exchange (ETDEWEB)

Trattnig, S. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Breitenseher, M.J. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Huber, M. [Pathologisch-Bakteriologisches Inst. Baumgartner Hoehe, Wien (Austria); Zettl, R. [Orthopaedisches Krankenhaus Gersthof, Wien (Austria); Rottmann, B. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Haller, J. [Hanuschkrankenhaus, Wien (Austria). Radiologische Abt.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria)

1997-04-01

Purpose: The aim of this study was to evaluate the accuracy of MRI in the measurement of cartilage thickness of the ankle joint in comparison to pathologic and histologic specimens. Patients and methods: The ankle joints of four fresh cadaver feet were imaged on a 1.5 T MR-unit in the coronal plane. Standard T{sub 1}-weighted spin echo (SE) and a T{sub 1}-weighted 3D-GE (FLASH-3D) sequence with fat saturation were applied. Following MR imaging, the talus was explanted and cut parallel to the MR images for macroscopic evaluation and histologic specimens were prepared. MRI measurements of the cartilage thickness of the talus were carried out in two ways: Without and with consideration of a transition zone of intermediate signal intensity between hyperintense cartilage and hypointense cortical bone. The data were compared with the anatomic specimens as the gold standard expressing the difference as a percentage value. On histologic specimens thickness of deep calcified cartilage layer was measured. Results: Measurements without the transition zone showed a mean underestimation of talus cartilage thickness of 46.8% (41.3-52.1) for T{sub 1}-SE and 47.5% (43.1-52.1) for fat saturated FLASH-3D images. Considering the transition zone the mean values were 25.0% (23.1-26.2) and 14.1% (6.7-21.5). The histologic specimens showed a three-fold increase of thickness of deep calcified cartilage layer. Conclusions: Measurements of the cartilage layer of the ankle joint on MR images are only accurate if the transition zone (calcified cartilage layer) is considered and the optimal pulse sequence (FLASH-3D-fat-sat) is applied. (orig.) [Deutsch] Ziel: Die Frage, ob die MRT die Dicke des Knorpels exakt bestimmen kann, wird kontrovers diskutiert. Ziel der Studie war die Bestimmung der Knorpeldicke am oberen Sprunggelenk mit der MRT im Vergleich zum anatomischen Praeparat. Material und Methode: Sprunggelenke von 4 Leichen wurden auf einem 1,5 Tesla MR-Geraet mittels T{sub 1}-betonter Spin

Imaging diagnostics of the wrist: MRI and Arthrography/Arthro-CT; Bildgebende Diagnostik des Handgelenkes: MRT und Arthrographie/Arthro-CT

Energy Technology Data Exchange (ETDEWEB)

Klein, H.M.; Balas, R.; Neugebauer, F. [Radiologische Gemeinschaftspraxis, Betzdorf (Germany); Vrsalovic, V. [Handchirugie, Marienhospital Siegen, Siegen (Germany)

2002-02-01

Purpose: To evaluate the use of magnetic resonance imaging (MRI) compared with arthrography and arthro-CT (AG/ACT) in patients with wrist pain. Methods: MRI and arthrography/arthro-CT (AG/ACT) of the wrist joint were retrospectively evaluated in 346 patients over a three-year period. Imaging findings were correlated to surgical results (n=78) or clinical course in an at least 6-month follow-up. Results: For tears of the triangular fibrocartilage, arthrography, arthro-CT, and MRI demonstrated a sensitivity and specificity of more than 0.96. Only the positive predictive value was superior for arthrography/arthro-CT (0.99 and 0.98, respectively) compared with MRI (0.94). Arthrography was superior for functional diagnosis of scapho-lunate ligament tears (n=25). Ulno-lunate and ulno-triquetral ligament defects were demonstrated more exactly by arthrography. Traumatic osseous defects, particularly scaphoid fractures (n=33) and avascular necrosis (n=17), were better diagnosed using MRI. Conclusion: For suspected lesions of the triangular fibrocartilage complex, AG/ACT is slightly more reliable than MRI. However, MRI was found to be highly accurate in diagnosing TFC tears, and is superior to AG/ACT in detecting traumatic and vascular lesions of the wrist. (orig.) [German] Ziel: Die Untersuchung der diagnostischen Aussagekraft von Magnetresonanz-Tomographie (MRT), Arthrographie (AG) und Arthro-CT (ACT) bei Erkrankungen des Handgelenkes. Methodik: Insgesamt 346 Untersuchungen des Handgelenkes wurden fuer einen dreijaehrigen Beobachtungszeitraum retrospektiv ausgewertet. Es wurden 211 MRT, 151 Arthrographien (AG) und 126 Arthro-CT (ACT) durchgefuehrt. Alle Diagnosen wurden operativ (n=78) oder durch den klinischen Verlauf in einer 6-monatigen Nachbeobachtung gesichert. Ergebnisse: Fuer die Diagnostik von Laesionen des diskoulnaren Komplexes lag die Sensitivitaet und Spezifitaet von AG, ACT und MRT ueber 0,96. Lediglich der positive Vorhersagewert differierte, allerdings nicht

Intraoperative appearance of the resection area in brain-tumor operations in an open 0,5 MRT; Intraoperatives Erscheinungsbild des Resektionsbereichs bei Hirntumoroperationen in einem offenen 0,5-T-MRT

Energy Technology Data Exchange (ETDEWEB)

Dietrich, J. [Universitaetsklinik fuer Diagnostische Radiologie, Leipzig (Germany). Arbeitsbereich Neuroradiologie; Schneider, J.P.; Schulz, T. [Universitaetsklinik fuer Diagnostische Radiologie, Leipzig (Germany); Seifert, V.; Trantakis, C. [Universitaetsklinik fuer Neurochirurgie, Leipzig (Germany); Kellermann, S. [Leipzig Univ. (Germany). Abt. fuer Neuropathologie

1998-11-01

During MRI-controlled resection of brain tumors using an open MRI system, operation-induced alterations may occur, especially enhancement of the resection cavity wall. This may simulate tumor areas, resulting in false assessment of the resection or resection of non-tumorous areas. Based on 42 MRI- and biopsy-controlled brain tumor resections in an 0.5 T open MRI (Signa SP, GE), the appearance and origin of operation-induced reactions are analyzed. In our opinion, there is a superposition of preformed peritumoral reactions by operation-induced microcontusions. The beginning of the cavity wall enhancement needs at least 10-15 min. MRI-controlled analysis of the intraoperative steps by the neurosurgeon and neuroradiologist allows discrimination of operation-induced reactions from tumor areas and leads to safe operation. (orig.) [Deutsch] Bei der intraoperativen Kontrolle von Hirntumorresektionen in offenen MRT-Geraeten kann es zu operativ induzierten Veraenderungen, insbesondere Rand-enhancement-Zonen, kommen. Diese koennen Tumorreste vortaeuschen, so dass die Radikalitaet des Eingriffs unterschaetzt wird oder nicht tumortragende Hirnareale entfernt werden. Ergebnisse und Diskussion: Anhand von 42 in einem offenen 0,5-T-MRT (Signa SP, GE) vorgenommenen, biopsiekontrollierten Hirntumoroperationen werden Erscheinungsbild und Entstehungsweise der Randveraenderungen analysiert. Bei den haeufig vorzufindenden Rand-enhancement-Zonen handelt es sich um eine Ueberlagerung von praeformierten Tumorrandreaktionen mit Mikrokontusionen. Die Ausbildung dieser Veraenderungen braucht eine Mindestzeit von 10-15 min. Die staendige Analyse der die Tumorresektion begleitenden MRT-Kontrollen durch den Operateur und einen mit der Problematik vertrauten Radiologen gestattet in der Regel die Differenzierung der operativ induzierten Veraenderungen und erhoeht damit die Sicherheit des Eingriffs. (orig.)

Laparoscopic virtual reality simulator and box trainer in gynecology.

Science.gov (United States)

Akdemir, Ali; Sendağ, Fatih; Oztekin, Mehmet K

2014-05-01

To investigate whether a virtual reality simulator (LapSim) and traditional box trainer are effective tools for the acquisition of basic laparoscopic skills, and whether the LapSim is superior to the box trainer in surgical education. In a study at Ege University School of Medicine, Izmir, Turkey, between September 2008 and March 2013, 40 first- and second-year residents were randomized to train via the LapSim or box trainer for 4 weeks, and 20 senior residents were allocated to a control group. All 3 groups performed laparoscopic bilateral tubal ligation. Video records of each operation were assessed via the general rating scale of the Objective Structured Assessment of Laparoscopic Salpingectomy and by operation time in seconds. Compared with the control group, the LapSim and box trainer groups performed significantly better in total score (Peducation. Training with a virtual reality simulator or box trainer should be considered before actual laparoscopic procedures are carried out. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

A virtual trainer concept for robot-assisted human motor learning in rowing

Directory of Open Access Journals (Sweden)

Baumgartner L.

2011-12-01

Full Text Available Keeping the attention level and observing multiple physiological and biomechanical variables at the same time at high precision is very challenging for human trainers. Concurrent augmented feedback, which is suggested to enhance motor learning in complex motor tasks, can also hardly be provided by a human trainer. Thus, in this paper, a concept for a virtual trainer is presented that may overcome the limits of a human trainer. The intended virtual trainer will be implemented in a CAVE providing auditory, visual and haptic cues. As a first application, the virtual trainer will be used in a realistic scenario for sweep rowing. To provide individual feedback to each rower, the virtual trainer quantifies errors and provides concurrent auditory, visual, and haptic feedback. The concurrent feedback will be adapted according to the actual performance, individual maximal rowing velocity, and the athlete’s individual perception.

Malignant degeneration of multiple cartilaginous exostosis. Diagnostic significance of MRT

International Nuclear Information System (INIS)

Bair, H.J.; Schmitt, R.; Moos, P.; Fellner, F.; Dvorak, O.; Rupprecht, H.; Lenz, M.

1997-01-01

In summary it can be said that diagnostic radiology, and particularly MRT, for evaluation of malignant degeneration of cartilaginous extoses is of high importance, also because of the difficulties posed by a biopsy for verification of malignancy. Cases of malignant cartilaginous extosis have a good prognosis at the early stages of the disease, when the extosis still is restricted to the focal region. (Orig./AJ) [de

Benign diseases of the mandible in MRI; Benigne Erkrankungen des Unterkiefers im MRT

Energy Technology Data Exchange (ETDEWEB)

Kress, B.; Sartor, K. [Universitaetsklinikum Heidelberg (Germany). Abt. Neuroradiologie; Gottschalk, A. [Bundeswehrkrankenhaus, Ulm (Germany). Abt. fuer Radiologie; Schmitter, M. [Universitaetsklinikum Heidelberg (Germany). Abt. fuer Zahnaerztliche Prothetik

2004-04-01

Diseases of the mandible affect the soft tissues aside from the osseous manifestation. This can be shown clearly and in great detail by magnetic resonance imaging (MRI). MRI is the gold standard in the diagnostic evaluation of any internal derangement of the temporomandibular joint. Dental MRI requires high resolution techniques and in some cases also intravenous administration of contrast material. These techniques allow delineation of the neurovascular bundle. In the past few years new indications were formulated, for example, the evaluation of the integrity of the inferior alveolar nerve in trauma and in radicular cysts. New quantitative methods now enable insights into the pathophysiology. The objective of this review is to communicate accepted indications for MRI of the mandible and to present innovative applications. (orig.) [German] Mandibulaere Erkrankungen beteiligen neben dem Knochen Weichteilstrukturen, die sich mit der MRT klar und detailreich darstellen lassen. In der bildgebenden Diagnostik der Binnenstoerung des Kiefergelenks (internal derangement) gilt die MRT als Goldstandard. Die MR-Tomographie des Unterkiefers erfordert hochaufloesende Techniken und bei besonderen Indikationen die intravenoese Kontrastmittelgabe. Diese Techniken erlauben es, das neurovaskulaere Buendel des Unterkiefers darzustellen. In den letzten Jahren sind neue Indikationsgebiete hinzugekommen, darunter solche, die die Unversehrtheit des N.alveolaris inferior bei Frakturen oder Raumforderungen des Unterkiefers ueberpruefen. Neue quantitative Verfahren geben mittlerweile Einblicke in Pathophysiologie. Ziel dieser Uebersichtsarbeit soll es sein, klassische Indikationen der Unterkiefer-MRT darzustellen und innovative Anwendungsmoeglichkeiten aufzuzeigen. (orig.)

New procedures. Comprehensive staging of lung cancer by MRI; Neue Verfahren. Umfassendes Staging des Lungenkarzinoms mit der MRT

Energy Technology Data Exchange (ETDEWEB)

Hintze, C. [Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Klinik fuer Diagnostische Radiologie, Kiel (Germany); Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Dinkel, J. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Biederer, J. [Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Klinik fuer Diagnostische Radiologie, Kiel (Germany); Heussel, C.P. [Thoraxklinik Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Puderbach, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie (E010), Heidelberg (Germany); Thoraxklinik Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

2010-08-15

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das Staging des Lungenkarzinoms nach dem TNM-System basiert auf der morphologischen Einschaetzung des Primarius, der Lymphknoten und Metastasen. Alle Aspekte dieser onkologisch wichtigen Beurteilung lassen sich mit der MRT erfassen. Pulmonale Rundherde sind ab der klinisch relevanten Groesse von 4-5 mm Durchmesser sicher erkennbar. Die Groesse der mediastinalen, hilaeren und supraklavikulaeren Lymphknoten kann in einem Untersuchungsgang bestimmt werden. In der koronaren Schichtfuehrung der dedizierten MRT der Lunge werden die Bereiche der bevorzugten Metastasierung in Nebennieren und weite Teile der Wirbelsaeule miterfasst. Durch eine gezielte Ganzkoerper-MRT als Suchmethode wird der letzte Teil des Stagings erfuellt. Die MRT bietet vielfaeltige Moeglichkeiten, zusaetzliche funktionelle, klinisch relevante Informationen innerhalb einer Untersuchung zu erheben. Im onkologischen Kontext sind die Perfusionsbildgebung der Lunge und die Bewegungsabschaetzung der Tumoren am bedeutendsten. Die funktionelle MRT der

Anhydrous Ammonia Training Module. Trainer's Package. Participant's Package.

Science.gov (United States)

Beaudin, Bart; And Others

This document contains a trainer's and a participant's package for teaching employees on site safe handling procedures for working with anhydrous ammonia, especially on farms. The trainer's package includes the following: a description of the module; a competency; objectives; suggested instructional aids; a training outline (or lesson plan) for…

Realism of procedural task trainers in a pediatric emergency medicine procedures course.

Science.gov (United States)

Shefrin, Allan; Khazei, Afshin; Cheng, Adam

2015-01-01

Pediatric emergency medicine (PEM) physicians have minimal experience in life saving procedures and have turned to task trainers to learn these skills. Realism of these models is an important consideration that has received little study. PEM physicians and trainees participated in a day long procedural training course that utilized commercially available and homemade task trainers to teach pericardiocentesis, chest tube insertion, cricothyroidotomy and central line insertion. Participants rated the realism of the task trainers as part of a post-course survey. The homemade task trainers received variable realism ratings, with 91% of participants rating the pork rib chest tube model as realistic, 82% rating the gelatin pericardiocentesis mold as realistic and 36% rating the ventilator tubing cricothyroidotomy model as realistic. Commercial trainers also received variable ratings, with 45% rating the chest drain and pericardiocentesis simulator as realistic, 74% rating the crichotracheotomy trainer as realistic and 80% rating the central line insertion trainer as realistic. Task training models utilized in our course received variable realism ratings. When deciding what type of task trainer to use future courses should carefully consider the desired aspect of realism, and how it aligns with the procedural skill, balanced with cost considerations.

O Personal Trainer na Perspectiva do Marketing

Directory of Open Access Journals (Sweden)

Cibele Biehl Bossle

2011-03-01

Full Text Available Esse estudo apresenta mapeamento das referências dedicadas à formação do personal trainer em bases de dados eletrônicas. Essa garimpagem revelou baixa produção científica sobre o assunto e mostrou que na literatura sobre personal trainer predominam livros com linguagem corrente no mundo dos negócios. Esses achados nos levaram a indagar sobre a força do discurso físico-empresarial, especialmente o marketing, na constituição desta ocupação profissional. Jeremy Rifkin, Zygmunt Bauman, Paula Sibilia e Denise Sant'Anna permitiram visualizar que o marketing dirigido ao personal trainer tem como tarefa reinventar, ressignificar e "repaginar" esta modalidade de serviço em nome da sobrevivência no disputado mercado da vida ativa.

Clinical application of functional MRI for chronic epilepsy; Klinischer Einsatz der funktionellen MRT bei chronischer Epilepsie

Energy Technology Data Exchange (ETDEWEB)

Woermann, F.G.; Labudda, K. [Krankenhaus Mara, Epilepsiezentrum Bethel, Abteilung fuer Magentresonanztomographie, Bielefeld (Germany)

2010-02-15

Functional magnetic resonance imaging (fMRI) is frequently used in the presurgical diagnostic procedure of epilepsy patients, in particular for lateralization of speech and memory and for localization of the primary motor cortex to delineate the epileptogenic lesion from eloquent brain areas. fMRI is one of the non-invasive procedures in the presurgical diagnostic process, together with medical history, seizure semiology, neurological examination, interictal and ictal EEG, structural MRI, video EEG monitoring and neuropsychology. This diagnostic sequence leads either to the decision for or against elective epilepsy surgery or to the decision to proceed with invasive diagnostic techniques (Wada test, intra-operative or extra-operative cortical stimulation). It is difficult to evaluate the contribution of the fMRI test in isolation to the validity of the entire diagnostic sequence. Complications such as memory loss and aphasia in temporal lobe resections or paresis after frontal lobe resections are rare and rarely of disastrous extent. This further complicates the evaluation of the clinical relevance of fMRI as a predictive tool. In this article studies which investigated the concordance between fMRI and other diagnostic gold standards will be presented as well as the association between presurgical fMRI and postsurgical morbidity. (orig.) [German] Die funktionelle Magnetresonanztomographie (fMRT) wird im Rahmen der Epilepsiediagnostik vor epilepsiechirurgischen Eingriffen insbesondere zur Lateralisation von Sprache und Gedaechtnis und zur Lokalisation der Zentralregion eingesetzt, um den eloquenten Kortex von der epilepsieverursachenden, chirurgisch zugaenglichen Laesion abzugrenzen. Dabei ist die fMRT Teil einer Sequenz nichtinvasiver klinischer Tests (Anamnese, Anfall-Semiologie, neurologischer Status, interiktales und iktales EEG, strukturelles MRT, Video-EEG-Monitoring, Neuropsychologie). Das Ergebnis dieser Sequenz ist die Entscheidung fuer oder gegen einen

Generalized Maintenance Trainer Simulator: Development of Hardware and Software. Final Report.

Science.gov (United States)

Towne, Douglas M.; Munro, Allen

A general purpose maintenance trainer, which has the potential to simulate a wide variety of electronic equipments without hardware changes or new computer programs, has been developed and field tested by the Navy. Based on a previous laboratory model, the Generalized Maintenance Trainer Simulator (GMTS) is a relatively low cost trainer that…

The Determination of Physical Activity Levels of Trainers in Kastamonu, Turkey

Directory of Open Access Journals (Sweden)

Mehmet Günay

2015-03-01

Full Text Available This study was carried out with the aim of determining the PA levels of the trainers working in Kastamonu in terms of gender and marital status variables. This study was applied to trainers from 15 different branches in the competitions organized by Kastamonu Directorate of Youth and Sports and Kastamonu Directorate of National Education. A total of 51 trainers participated in the study voluntarily; 19 of them were female; their mean age was 26.53±9.08 years, their mean height was 167.37±5.37 m and their mean weight was 60.37±7.30 kg. 32 of the trainers were male; their mean age was 35.41±8.10, their mean height was 179.69±6.25 m and their mean weight was 83.94±12.11 kg. Since the PA levels of the trainers working in the city center of Kastamonu were studied, the number of subjects was 51. In this study, in order to determine the physical activity level of the trainers, Physical Activity Evaluation Survey (PAAQ has been used. SPSS 15.0 was used to analyze the data in the dual comparisons, the nonparametric Mann-Whitney U Test has been applied. According to gender, there was no significant difference in met/week values of all indexes (p>0.05; also according to marital status, there was significant difference in met/week value of work index (p0.05, U=230,500 and sport indexes (p>0.05, U=282,000, PA levels of female trainers were found higher in home index. On the other hand, it was also determined that according to marital status, PA levels of single trainers were higher than married trainers in work index.

Combined PET/MRI in cerebral and paediatric diagnostics; Kombinierte PET/MRT-Diagnostik bei zerebralen und paediatrischen Fragestellungen

Energy Technology Data Exchange (ETDEWEB)

Pfluger, T.; Vollmar, C.; Porn, U.; Schmid, R.; Dresel, S.; Leinsinger, G.; Schmid, I.; Winkler, P.; Fischer, S.; Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Ludwig-Maximilians-Univ. Muenchen (Germany)

2002-07-01

The aim of this overview is presentation of MRI and PET as synergistic modalities for combined analysis of morphology and function. For operative planning in epilepsy surgery, definition of the epileptogenic focus based on functional PET diagnostics and morphological MRI is decisive. For staging and follow-up examinations in oncology, MRI should be complemented by PET for the assessment of tumor vitality. In paediatric oncology patients we could demonstrate a therapy relevant increase of sensitivity/specificity with combined PET/MRI in contrast to single modalities. In the brain, full spectrum of digital image registration and three-dimensional reconstruction should be used. In extracranial cases, image fusion is disturbing due to a partial loss of image information of single modalities by the fusion process. (orig.) [German] Ziel dieser Uebersicht ist die Darstellung der MRT und PET als synergistische Verfahren zur Analyse von Morphologie und Funktion. Zur Resektionsplanung im Rahmen der Epilepsiechirurgie ist die Definition des Epilepsiefokus anhand der funktionellen PET-Diagnostik und die exakte Kenntnis der zerebralen Morphologie aus der MRT ganz entscheidend. Im Rahmen des onkologischen Stagings und bei Verlaufskontrollen ist wegen der geringeren Spezifitaet der MRT die additive PET zur Beurteilung der Tumorvitalitaet erforderlich. Anhand eines paediatrisch-onkologischen Patientengutes konnten wir zeigen, dass mit der kombinierten PET/MRT-Diagnostik eine therapierelevante Steigerung der Sensitivitaet/Spezifitaet gegenueber den Einzeluntersuchungen moeglich ist. Bei zerebralen Fragestellungen sollte das gesamte Spektrum der digitalen Bildfusion mit direkter Ueberlagerung mehrerer Modalitaeten und anschliessender dreidimensionaler Rekonstruktion ausgeschoepft werden. Bei extrakraniellen Fragestellungen ist die direkte Bildueberlagerung eher hinderlich, da die Bildinformation der Einzelmodalitaeten durch die Fusion teilweise verloren geht. (orig.)

Molecular imaging of head and neck cancers. Perspectives of PET/MRI; Molekulare Bildgebung bei Kopf-ï]¿Hals-Tumoren. Perspektive der PET-MRT

Energy Technology Data Exchange (ETDEWEB)

Stumpp, P.; Kahn, T. [Universitaetsklinikum Leipzig AoeR, Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Purz, S.; Sabri, O. [Universitaetsklinikum Leipzig, Klinik und Poliklinik fuer Nuklearmedizin, Leipzig (Germany)

2016-07-15

The {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography ({sup 18}F-FDG-PET/CT) procedure is a cornerstone in the diagnostics of head and neck cancers. Several years ago PET-magnetic resonance imaging (PET/MRI) also became available as an alternative hybrid multimodal imaging method. Does PET/MRI have advantages over PET/CT in the diagnostics of head and neck cancers ?The diagnostic accuracy of the standard imaging methods CT, MRI and PET/CT is depicted according to currently available meta-analyses and studies concerning the use of PET/MRI for these indications are summarized. In all studies published up to now PET/MRI did not show superiority regarding the diagnostic accuracy in head and neck cancers; however, there is some evidence that in the future PET/MRI can contribute to tumor characterization and possibly be used to predict tumor response to therapy with the use of multiparametric imaging. Currently, {sup 18}F-FDG-PET/CT is not outperformed by PET/MRI in the diagnostics of head and neck cancers. The additive value of PET/MRI due to the use of multiparametric imaging needs to be investigated in future research. (orig.) [German] Die {sup 18}F-Fluordesoxyglukose-Positronenemissionstomographie-Computertomographie ({sup 18}F-FDG-PET-CT) hat ihren festen Stellenwert in der Diagnostik von Kopf-Hals-Tumoren. Seit einigen Jahren ist die PET-MRT als weitere hybride Bildgebungsmodalitaet verfuegbar. Bringt die PET-MRT Fortschritte bei der Diagnostik von Kopf-Hals-Tumoren ?Darstellung der diagnostischen Genauigkeit der bisherigen Bildgebungsmethoden CT, MRT und PET-CT anhand von Metaanalysen und Zusammenfassung der bisherigen Publikationen zur PET-MRT auf diesem Gebiet. Die PET-MRT zeigt in allen bisherigen Studien keine Ueberlegenheit bzgl. der diagnostischen Genauigkeit von Kopf-Hals-Tumoren. Sie kann jedoch durch die multiparametrische Diagnostik perspektivisch Beitraege zur Tumorcharakterisierung und damit moeglicherweise Voraussagen zum

Haemophilic arthropathy of the knee. Gd-DTPA enhanced MRT. Clinical and radiological correlation; Haemophile Arthropathie des Kniegelenkes. Gd-DTPA-verstaerkte MRT: klinische und roentgenologische Korrelation

Energy Technology Data Exchange (ETDEWEB)

Naegele, M. [Radiologische Universitaetsklinik, Bonn (Germany); Kunze, V. [Radiologische Universitaetsklinik, Bonn (Germany); Hamann, M. [Radiologische Universitaetsklinik, Bonn (Germany); Eickhoff, H. [Orthopaedische Klinik, Krankenhaus Troisdorf (Germany); Koch, W. [Orthopaedische Klinik, Krankenhaus Troisdorf (Germany); Oldenburg, J. [Inst. fuer Experimentelle Haematologie und Transfusionsmedizin, Bonn (Germany); Reiser, M. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Steudel, A. [Radiologische Universitaetsklinik, Bonn (Germany)

1994-02-01

17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0,1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) of FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39,6% min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.) [Deutsch] Es wurden 17 Patienten mit einer haemophilen Arthropathie der Kniegelenke mit der statischen und dynamischen MRT vor und nach i.v. Bolusgabe von Gadolinium-DTPA (0,1 mmol/kg KG) untersucht. Nach Kontrastmittelgabe konnte ein Anstieg der Signalintensitaet des Pannus von 37,4% auf SE- und von 47,7% auf FFE-Aufnahmen gemessen werden. Der Gradient des Signalintensitaetsanstieges (%/Zeit) lag fuer Pannus bei 39,6%/min. Die Kontrastmittelgabe steigerte die Abgrenzbarkeit des Pannus von Gelenkerguss und den Gelenkbinnenstrukturen. Begleitend durchgefuehrte klinische und roentgenologische Bewertungen des Schweregrades der Arthropathie korrelierten nicht mit dem Signalintensitaetsverhalten des Pannus nach Kontrastmittelgabe. (orig.)

Training the trainers: beyond providing a well-received course.

Science.gov (United States)

Blitz, Julia; Edwards, Jill; Mash, Bob; Mowle, Steve

2016-09-01

The Royal College of General Practitioners in partnership with the South African Academy of Family Physicians obtained funding to run a series of 'Training the Trainers' courses for trainers of family medicine registrars, with a view to strengthening clinical supervision of postgraduate registrars. The authors wanted to establish whether it was worthwhile for the course to be provided on an ongoing basis after the funded project was completed. Development of a pilot tool for evaluation visits after a faculty development course. The authors developed a pre-visit pack and conducted five site visits to registrar trainers who had been on the course between 12 and 24 months earlier. Before the series of visits and after each visit we debriefed and modified our approach. Optimising the use of the pre-visit pack will require greater orientation of the trainer. Administrative support for the visits will be vital. The visits were experienced very positively. However, in a context in which these visits are not the norm, the trainers need support and encouragement to participate in an activity which made them feel quite vulnerable. The tool enabled course participants to show evidence of their behaviour change, enabled their colleagues to report on the impact on their own teaching practices, and enabled registrars to voice their opinions of their trainer's supervision skills. A post-course formative evaluation visit has the potential to catalyse the impact of the training course. It will be necessary to train the family physicians who conduct these visits.

Development of a novel iPad-based laparoscopic trainer and comparison with a standard laparoscopic trainer for basic laparoscopic skills testing.

Science.gov (United States)

Yoon, Renai; Del Junco, Michael; Kaplan, Adam; Okhunov, Zhamshid; Bucur, Philip; Hofmann, Martin; Alipanah, Reza; McDougall, Elspeth M; Landman, Jaime

2015-01-01

We developed the iTrainer (iT) as a portable laparoscopic trainer, which incorporates the iPad tablet. We then compared the iT with a standard pelvic trainer (SPT) to assess surgical skills as well as its image quality, resolution, brightness, comfort, and overall performance. We designed and constructed the iT to be compatible with the Apple iPad 3 and standard laparoscopic instruments. Participants were assigned to perform the thread-the-loops task on both trainers and were prospectively randomized to start on either the iT or the SPT. Each participant was allowed a 2-minute warm-up before the 2-minute testing period. We scored participants using the product of skill quality (0-4 scale) and quantity of loops threaded (0-10 scale). Participants then rated each trainer on image quality, resolution, brightness, comfort, and overall performance on a 5-point Likert scale. A total of 45 subjects including 10 undergraduates, 10 medical students, 10 general surgery and urology residents, and 15 experts (fellows and attending surgeons) participated in this study. There was no significant difference between thread-the-loops task scores completed on the iT when compared with the SPT for all groups tested (p > 0.05) with the exception of the medical student group, who performed better on the SPT (p < 0.05). On evaluation of each trainer, participants rated the iT as having superior image quality and resolution when compared with the SPT (p < 0.05) but rated the SPT higher in overall performance (p < 0.05). Brightness and comfort were rated similarly for both trainers. We have demonstrated face validity and criterion validity for the thread-the-loops task on the iT. The iT rated superior in image quality and resolution but inferior in overall performance compared with the SPT. The iT provides trainees a unique advantage over SPT as an additional resource to laparoscopic training as it is inexpensive, portable, and can be readily available for training. Copyright © 2014

Addressing inequalities in health--what is the contribution of health trainers?

Science.gov (United States)

White, Judy; Woodward, Jenny; South, Jane

2013-07-01

The role that members of the public (non-professional lay people) can play in improving health is being increasingly recognised in research and policy. This paper explores what contribution lay people employed as health trainers are making to addressing health inequalities in England. Data from eight local evaluations of health trainer services were synthesised using a data-extraction framework to find out about client populations, any lifestyle changes made, health trainers' background and community engagement activities. These data were compared with national data to assess how findings relating to addressing inequalities compared with the national picture. Local data largely matched national data and showed that health trainers are reaching people living with disadvantage and enabling them to make lifestyle changes. The data suggest that they do this by engaging with communities and taking a person-centred approach. Being non-clinical peers is also important. However, no evidence was found that health trainers were impacting on health inequalities at a population level. Health trainers are contributing to addressing health inequalities but the services evaluated were small and had been operating for a limited time, so to expect reductions in inequalities at a population level within districts would be unrealistic. The findings of this synthesis present a challenge to primary care and public health to employ health trainers in order to engage marginalised communities as one element of plans to address health inequalities.

Evaluation of a novel high-fidelity epistaxis task trainer.

Science.gov (United States)

Scott, Grace M; Roth, Kathryn; Rotenberg, Brian; Sommer, Doron D; Sowerby, Leigh; Fung, Kevin

2016-07-01

To assess the efficacy of a novel high-fidelity epistaxis simulator in teaching epistaxis management to junior otolaryngology head and neck surgery residents. Prospective cohort study. A novel high-fidelity epistaxis task trainer was developed using a cadaver head, intravenous tubing, and a food coloring-filled saline bag to emulate blood. Learners were instructed on two techniques of nasal packing (formal nasal pack and nasal tampon) for the management of epistaxis using the task trainer. Learners were videotaped attempting to pack the nose of the task trainer pre- and postintervention (verbal instruction, and practice time with task trainer). Five board-certified otolaryngologists (blinded to pre- and postintervention status) evaluated the packing technique using standardized subjective outcome measures. There were 13 junior otolaryngology residents enrolled in the study. This cohort showed a statistically significant increase in global rating scores (P epistaxis simulator has been successful in teaching and the practical application of various skills in epistaxis management. This task trainer appears to confer an educational benefit in technical skills acquisition in novice learners. Further studies are needed to determine long-term skill retention. Simulation is a promising educational adjunct that effectively enhances epistaxis management skills acquisition while maximizing patient safety. NA. Laryngoscope, 126:1501-1503, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

The Neglected World of the Workplace Trainer

Directory of Open Access Journals (Sweden)

Marwa Elshafie

2014-04-01

Full Text Available The aim of this small-scale research is to explore the hidden world of the workplace trainer. Four trainers from a training institute in Qatar were interviewed and asked about their opinions of the employee as a learner, the trainer’s work, and the role of quality compliance in the training process. After transcribing and analysing the semi- structured interviews, several themes concerning the employee as a learner emerged such as the employees’ motivation and the effects of the workplace environment on learning. The findings also showed the trainers’ need for an adequate professional development plan and a reconsideration of their power inside the classroom. Regarding the quality compliance, there were various insights and suggestions for improvement. The results of this study are important to any workplace trainers, human development, and quality compliance employees or anyone interested in knowing more about the world of adult learning.

Educational expectations of GP trainers. A EURACT needs analysis

DEFF Research Database (Denmark)

Guldal, D.; Windak, A.; Maagaard, Roar

2012-01-01

if these needs vary between trainers who teach general practice in different settings and environments. Needs assessment: Recently EURACT, in collaboration with partners from five EU countries and Turkey, set up a project aimed at the development of a comprehensive 'training the trainers' programme. The project...

Increasing the realism of a laparoscopic box trainer: a simple, inexpensive method.

Science.gov (United States)

Hull, Louise; Kassab, Eva; Arora, Sonal; Kneebone, Roger

2010-01-01

Simulation-based training in medical education is increasing. Realism is an integral element of creating an engaging, effective training environment. Although physical trainers offer a low-cost alternative to expensive virtual reality (VR) simulators, many lack in realism. The aim of this research was to enhance the realism of a laparoscopic box trainer by using a simple, inexpensive method. Digital images of the abdominal cavity were captured from a VR simulator. The images were printed onto a laminated card that lined the bottom and sides of the box-trainer cavity. The standard black neoprene material that encloses the abdominal cavity was replaced with a skin-colored silicon model. The realism of the modified box trainer was assessed by surgeons, using quantitative and qualitative methodologies. Results suggest that the modified box trainer was more realistic than a standard box trainer alone. Incorporating this technique in the training of laparoscopic skills is an inexpensive means of emulating surgical reality that may enhance the engagement of the learner in simulation.

NMR imaging of the vertebral column and the spinal canal. 2. rev. and enl. ed.; MRT der Wirbelsaeule und des Spinalkanals

Energy Technology Data Exchange (ETDEWEB)

Forsting, Michael [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Uhlenbrock, Detlev [St.-Josefs-Hospital, Dortmund (Germany). MVZ Radiologie, Nuklearmedizin und Strahlentherapie; Wanke, Isabel [Privatklinikengruppe Hirslanden, Zurich (Switzerland); Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie

2009-07-01

The book on the MRT (magnetic resonance tomography) of the vertebral cord and spinal canal covers the following topics: physics fundamentals and application; malformation of the spinal canal; degenerative vertebral column diseases; vertebral column and spinal canal carcinomas; inflammatory diseases of the vertebral column and the spinal canal; applicability of MRT in case of acute spinal cord traumata; vascular diseases of the spinal canal.

Acquired CNS lesions in fetal MRI; Erworbene ZNS-Laesionen im fetalen MRT

Energy Technology Data Exchange (ETDEWEB)

Reith, W.; Pogledic, I. [Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2013-02-15

Acquired central nervous system (CNS) lesions are often subtle; therefore, the prenatal diagnosis of these lesions is extremely important. The fetal ultrasound examination and magnetic resonance imaging (MRI) are two important imaging methods that give an insight into these types lesions. The method of choice during pregnancy is still fetal ultrasound; however, fetal MRI is important when there are certain pathologies, e.g. periventricular leukomalacia (PVL) or malformations of the vein of Galen. In this manner clinicians can plan further therapy after childbirth in advance (e.g. cerebral angiography or embolization). (orig.) [German] Die erworbenen ZNS-Laesionen sind oft subtil, und eine praezise praenatale Diagnostik ist in diesen Faellen besonders wichtig. Die fetale Sonographie und das fetale MRT koennen hierzu einen relevanten Beitrag leisten. Die Sonographie ist immer noch die Untersuchungsmethode der Wahl waehrend der Schwangerschaft. Insbesondere bei bestimmten Pathologien wie der periventrikulaeren Leukomalazie (PVL) oder einer V. -Galeni-Malformation ist das fetale MRT sehr hilfreich, um nach der Geburt die entsprechenden weitergehenden Massnahmen, wie eine zerebrale Angiographie und Embolisation, fruehzeitig zu planen. (orig.)

Intelligent Virtual Agents as Language Trainers Facilitate Multilingualism

Directory of Open Access Journals (Sweden)

Manuela eMacedonia

2014-04-01

Full Text Available In this paper we introduce a new generation of language trainers: intelligent virtual agents (IVAs with human appearance and the capability to teach foreign language vocabulary. We report results from studies that we have conducted with Billie, an IVA employed as a vocabulary trainer, as well as research findings on the acceptance of the agent as a trainer by adults and children. The results show that Billie can train humans as well as a human teacher can and that both adults and children accept the IVA as a trainer. The advantages of IVAs are multiple. First, their teaching methods can be based on neuropsychological research findings concerning memory and learning practice. Second, virtual teachers can provide individualized training. Third, they coach users during training, are always supportive, and motivate learners to train. Fourth, agents will reside in the user’s mobile devices and thus be at the user’s disposal everywhere and anytime. Agents in apps will make foreign language training accessible to anybody at low cost. This will enable people around the world, including physically, financially and geographically disadvantaged persons, to learn a foreign language and help to facilitate multilingualism.

How Good Are Trainers' Personal Methods Compared to Two Structured Training Strategies?

Science.gov (United States)

Walls, Richard T.; And Others

Training methods naturally employed by trainers were analyzed and compared to systematic structured training procedures. Trainers were observed teaching retarded subjects how to assemble a bicycle brake, roller skate, carburetor, and lawn mower engine. Trainers first taught using their own (personal) method, which was recorded in terms of types of…

Asymptotic Analysis in MIMO MRT/MRC Systems

Directory of Open Access Journals (Sweden)

Zhou Quan

2006-01-01

Full Text Available Through the analysis of the probability density function of the squared largest singular value of a complex Gaussian matrix at the origin and tail, we obtain two asymptotic results related to the multi-input multi-output (MIMO maximum-ratio-transmission/maximum-ratio-combining (MRT/MRC systems. One is the asymptotic error performance (in terms of SNR in a single-user system, and the other is the asymptotic system capacity (in terms of the number of users in the multiuser scenario when multiuser diversity is exploited. Similar results are also obtained for two other MIMO diversity schemes, space-time block coding and selection combining. Our results reveal a simple connection with system parameters, providing good insights for the design of MIMO diversity systems.

Importance of Health Science Education for Personal Fitness Trainers.

Science.gov (United States)

Malek, Moh H.; Nalbone, David P.; Berger, Dale E.; Coburn, Jared W.

2002-01-01

Examined the relationship between commonly used indicators of knowledge and actual knowledge in five areas among fitness trainers. Data from the Fitness Instructors Knowledge Assessment indicated that a bachelor's degree in the field of exercise science and possession of one of two specific certifications strongly predicted a trainer's knowledge,…

MRI in neuromuscular disorders; MRT bei neuromuskulaeren Erkrankungen

Energy Technology Data Exchange (ETDEWEB)

Fischmann, Arne [Klinik St. Anna, Luzern (Switzerland). Inst. fuer Radiologie und Nuklearmedizin; Fischer, Dirk [Kantonsspital Bruderholz (Switzerland)

2014-03-15

Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

Magnetic resonance tomography and ultrasound in rheumatology; MRT und Sonographie in der Rheumatologie

Energy Technology Data Exchange (ETDEWEB)

Kainberger, F. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Trattnig, S. [Universitaetsklinik fuer Radiodiagnostik, Ludwig-Boltzmann-Inst. fuer Physikalische und Radiologische Tumordiagnostik, Wien (Austria); Lack, W. [Universitaetsklinik fuer Orthopaedie, Wien (Austria); Machold, K. [Universitaetsklinik fuer Innere Medizin III, Wien (Austria). Abt. fuer Rheumatologie; Graninger, W. [Universitaetsklinik fuer Innere Medizin III, Wien (Austria). Abt. fuer Rheumatologie

1996-08-01

Technical innovations and software improvements in magnetic resonance imaging (MRI) and high-resolution sonography (US) have definitely influenced the diagnostic imaging of rheumatic diseases. For MRI, improvements in surface coils, dedicated low-field systems (0.2 T), and software improvements (shorter acquisition times and refinements of fat suppressing techniques) must be mentioned. For sonography, the main innovations concern the development of higher transducer frequencies (7-15 Mhz) and power Doppler imaging. Clinical evaluations have shown that MRI and US are most useful in cases of suspected rheumatic disease with negative plain film radiographs and for documenting the course of the disease, diagnosing of early rheumatoid arthritis, making a differential diagnosis in clinically unclear rheumatic diseases, investigating vascularization, and quantifying pannus formation. In order to improve diagnostic efficacy the role of MRI and US in the management of patients with rheumatic disease should be reconsidered. (orig.) [Deutsch] Technische Innovationen in Hard- und Software von Magnetresonanztomographie (MRT) und Sonographiegeraeten haben die bildgebende Diagnostik in der Rheumatologie massgeblich beeinflusst (Verbesserungen der Oberflaechenspulen mit hohen Gradientenfeldern, dedizierte Niederfeldgeraete, Softwareverbesserungen in Form von kuerzeren Aquisitionszeiten und Verfeinerungen in der Fettunterdrueckung, hoehere Transducerfrequenzen zwischen 7 und 15 Mhz, Powerdopplerverfahren). Fuer die klinische Anwendung bedeutet dies, dass MRT und Sonographie als bildgebende Zusatzverfahren nach der Anfertigung konventioneller Roentgenaufnahmen anzuwenden sind, wenn diese unauffaellige Resultate ergeben oder spezielle Fragen zur Schwere des Krankheitsprozesses bzw. von Folgeerscheinungen zu beantworten sind. Im besonderen betrifft dies den Nachweis der Frueharthritis, die Differentialdiagnose klinisch nicht klar einzuordnender Krankheitsbilder und die Bestimmung des

Working with a personal trainer

Science.gov (United States)

... workout time Offer support, guidance, and feedback Provide motivation to continue exercising Work with your health care ... American Council on Exercise. How to Choose the Right Personal Trainer. 2014. www.acefitness.org/acefit/healthy_ ...

Training for Future Esp Trainers: Evaluating the Training of Trainers (TOT Program in Labuan Bajo, Manggarai Barat, Flores

Directory of Open Access Journals (Sweden)

Irfan Rifai

2013-04-01

Full Text Available By cooperating with Yayasan Komodo Kita and Mandiri Bank, English department of Binus University was chiefly in charge of a 15 day Training Of Trainers (TOT program for 24 participants prepared for teaching English in Labuan Bajo, Flores. The training was aimed to prepare already fluent- in – English- teachers, tour guides, and university graduates with the right tools and method in teaching English. To assess the program, a set of evaluation questionnaire was given to the participants to know their responses on the training material, the trainers, and the program by using Likert’s scale type questions. An observational record was also used as a tool to measure participants’ achievement. The questionnaire reveals that the participants respond positively to the program and the material and favor the approaches made by the trainers during the training. However, the training shows various results in participants’ performance. It is assumed that the non teaching background of the majority of participants and the level of English as two key factors influencing their performance.  

Lessons from a Train-the-Trainer Professional Development Program: The Sustainable Trainer Engagement Program (STEP)

Science.gov (United States)

Shupla, Christine; Gladney, Alicia; Dalton, Heather; LaConte, Keliann; Truxillo, Jeannette; Shipp, Stephanie

2015-11-01

The Sustainable Trainer Engagement Program (STEP) is a modified train-the-trainer professional development program being conducted by the Lunar and Planetary Institute (LPI). STEP has provided two cohorts of 6-8th grade science specialists and lead teachers in the Houston region with in-depth Earth and Space Science (ESS) content, activities, and pedagogy over 15 days each, aligned with Texas science standards. This project has two over-arching goals: to improve middle school ESS instruction, and to create and test an innovative model for Train-the-Trainer.This poster will share details regarding STEP’s activities and resources, program achievements, and its main findings to date. STEP is being evaluated by external evaluators at the Research Institute of Texas, part of the Harris County Department of Education. External evaluation shows an increase after one year in STEP participants’ knowledge (cohort 1 showed a 10% increase; cohort 2 showed a 20% increase), confidence in teaching Earth and Space Science effectively (cohort 1 demonstrated a 10% increase; cohort 2 showed a 20% increase), and confidence in preparing other teachers (cohort 1 demonstrated a 12% increase; cohort 2 showed a 20% increase). By September 2015, STEP participants led (or assisted in leading) approximately 40 workshops for about 1800 science teachers in Texas. Surveys of teachers attending professional development conducted by STEP participants show very positive responses, with averages for conference workshop evaluations ranging from 3.6 on a 4 point scale, and other evaluations averaging from 4.1 to 5.0 on a 5 point scale.Main lessons for the team on the train-the-trainer model include: a lack of confidence by leaders in K-12 science education in presenting ESS professional development, difficulties in arranging for school or district content-specific professional development, the minimal duration of most school and district professional development sessions, and uncertainties in

Clinical evaluation of female pelvic tumors. Application fields of integrated PET/MRI; Lokal- und Ganzkoerperdiagnostik weiblicher Beckentumore. Anwendungsfelder der integrierten PET-MRT

Energy Technology Data Exchange (ETDEWEB)

Grueneisen, J.; Umutlu, L. [Universitaetsklinikum Essen, Institut fuer diagnostische und interventionelle Radiologie und Neuroradiologie, Essen (Germany)

2016-07-15

Integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) scanning has recently become established in clinical imaging. Various studies have demonstrated the great potential of this new hybrid imaging procedure for applications in the field of oncology and the diagnostics of inflammatory processes. With initial studies demonstrating the feasibility and high diagnostic potential of PET/MRI comparable to PET-computed tomography (CT), the focus of future studies should be on the identification of application fields with a potential diagnostic benefit of PET/MRI over other established diagnostic tools. Both MRI and PET/CT are widely used in the diagnostic algorithms for malignancies of the female pelvis. A simultaneous acquisition of PET and MRI data within a single examination provides complementary information which can be used for a more comprehensive evaluation of the primary tumor as well as for whole body staging. Therefore, the aim of this article is to outline potential clinical applications of integrated PET/MRI for the diagnostic work-up of primary or recurrent gynecological neoplasms of the female pelvis. (orig.) [German] Integrierte Positronenemissionstomographie-Magnetresonanztomographen (PET-MRT) stehen seit wenigen Jahren fuer die klinische Diagnostik zur Verfuegung. Diverse Arbeiten konnten bereits das grosse Potenzial dieser neuen hybriden Bildgebungsmodalitaet zur Anwendung in der onkologischen und inflammatorischen Diagnostik aufzeigen. Nachdem initiale Studien die Durchfuehrbarkeit und diagnostische Vergleichbarkeit der PET-MRT zur etablierten PET-Computertomographie (PET-CT) gezeigt haben, sollte fuer eine Implementierung in der Routinediagnostik der Fokus zukuenftiger Studien darin liegen, eindeutige Indikationen zu definieren, in denen die simultane PET-MRT-Bildgebung einen definitiven Vorteil verglichen mit den etablierten diagnostischen Verfahren bietet. Sowohl die MRT als auch die PET-CT finden bereits eine

Functional MR imaging of the patellofemoral joint; Funktionelle MRT des Femoropatellargelenkes

Energy Technology Data Exchange (ETDEWEB)

Muhle, C. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)

1995-02-01

Conventional X-ray examinations of the patellofemoral joint in 30 , 60 and 90 of knee flexion demonstrate the position of the patella. On the other hand, they have been shown to be insufficient for the diagnosis of patellofemoral maltracking in the critical range between 30 of flexion and full extension. Motion-triggered and ultrafast MRI offer new possibilities for functional diagnosis of the patellofemoral joint under active knee motion. Functional MRI of the patellofemoral joint is suggested as an alternative to arthroscopy, particularly in patients with anterior knee pain or suspected patellar maltracking. (orig.) [Deutsch] Tangentialaufnahmen der Patella in 30 -, 60 - und 90 -Kniebeugung koennen zwar die Lage der Kniescheibe im Femoropatellargelenk darstellen, sie erlauben jedoch keine Aussage ueber die funktionellen Aspekte des Patellagleitens zwischen 30 -Beugung und 0 -Streckung. Dieser fuer die Kniescheibenfuehrung kritische, mittels der konventionellen Roentgentechnik (aufgrund von Femur- und Patellaueberlagerung) nicht einsehbare Bereich, kann unter aktiver Kniestreckung mit der funktionellen MRT dargestellt werden. Durch bewegungsgetriggerte Gradientenechosequenzen oder neuerdings auch durch ultraschnelle Bildsequenzen ist es moeglich, funktionelle Informationen ueber das Patellagleiten in der endgradigen Streckenbewegung zu erhalten. Die funktionelle MRT des Femorpatellargelenkes bietet daher z.B. fuer die Abklaerung von unklaren, vorderen Kniegelenksbeschwerden und bei der Frage nach Patellagleitwegsstoerungen eine Alternative zur diagnostischen Arthroskopie. (orig.)

MR imaging of the lateral collateral ligaments after ankle sprain; Aussenbandrupturen des Sprunggelenkes - Darstellung mit der MRT vor und nach funktioneller Therapie

Energy Technology Data Exchange (ETDEWEB)

Grebe, P. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Kreitner, K.F. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Roeder, W. [Abt. fuer Chirurgie, St-Hildegardis-Krankenhaus, Mainz (Germany); Kersjes, W. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Hennes, R. [Abt. fuer Allgemein- und Unfallchirurgie, St. Josefshospital, Wiesbaden (Germany); Runkel, M. [Unfallchirurgische Klinik der Unversitaetsklinik, Mainz (Germany)

1995-09-01

35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [Deutsch] 35 Patienten mit klinischem Verdacht auf Aussenbandruptur wurden mit der MRT untersucht. 13 Patienten wurden operiert, 22 konzervativ therapiert. Letztere wurden nach drei Monaten erneut mit MRT und gehaltenen Aufnahmen untersucht. Die MRT-Befunde stimmten in 12 von 13 Faellen mit den operativ erhobenen Befunden ueberein. Nach dreimonatiger konzervativer Therapie waren alle 22 Sprunggelenke stabil. Die rupturierten Baender stellten sich verdickt und durchgaengig dar. (orig./MG)

POLITENESS STRATEGIES EMPLOYED BY THE TRAINERS IN ROOM DIVISION DEPARTMENT BAPEPAR NUSA DUA

Directory of Open Access Journals (Sweden)

I Gusti Ayu Vina Widiadnya Putri

2017-05-01

Full Text Available This article tries to analyze and discuss the politeness strategies employed by the trainers in room division department when they practice on the job training in the hotel. Politeness strategy was needed when the trainers serve the guest. This research was done by observation and interview with the trainer and the guest about their conversation. The analysis of politeness strategies that employed by the trainer focused on two discussions; (1 the kinds of politeness strategies used by trainer in room division department, and (2 the implications of politeness strategies used by trainer in room division department. This research used the theory from Brown & Levinson (1987 in his book entitled Politeness: Some Universals in Language Usages. The theory is supported by other theories that are considered relevant to the topic of discussion in this research. Based on the analysis, it was found that there were two kinds of politeness stratgies that employed by the trainer in room division department Bapepar Nusa Dua, they were positive face and negative face. Beside that, there are three implications by using politness strategies such as: respect behaviour, togheterness, and cooperative interaction.

Adaptive hybrid brain-computer interaction: ask a trainer for assistance!

Science.gov (United States)

Müller-Putz, Gernot R; Steyrl, David; Faller, Josef

2014-01-01

In applying mental imagery brain-computer interfaces (BCIs) to end users, training is a key part for novice users to get control. In general learning situations, it is an established concept that a trainer assists a trainee to improve his/her aptitude in certain skills. In this work, we want to evaluate whether we can apply this concept in the context of event-related desynchronization (ERD) based, adaptive, hybrid BCIs. Hence, in a first session we merged the features of a high aptitude BCI user, a trainer, and a novice user, the trainee, in a closed-loop BCI feedback task and automatically adapted the classifier over time. In a second session the trainees operated the system unassisted. Twelve healthy participants ran through this protocol. Along with the trainer, the trainees achieved a very high overall peak accuracy of 95.3 %. In the second session, where users operated the BCI unassisted, they still achieved a high overall peak accuracy of 83.6%. Ten of twelve first time BCI users successfully achieved significantly better than chance accuracy. Concluding, we can say that this trainer-trainee approach is very promising. Future research should investigate, whether this approach is superior to conventional training approaches. This trainer-trainee concept could have potential for future application of BCIs to end users.

Neurofunctional MRI at high magnetic fields; Neurofunktionelle MRT bei hohen Feldern

Energy Technology Data Exchange (ETDEWEB)

Speck, O. [Fakultaet fuer Naturwissenschaften, Otto-von-Guericke Universitaet Magdeburg, Abteilung Biomedizinische Magnetresonanz, Institut fuer Experimentelle Physik, Magdeburg (Germany); Leibniz Institut fuer Neurobiologie, Magdeburg (Germany); Deutsches Zentrum fuer Neurodegenerative Erkrankungen (DZNE), Magdeburg (Germany); Center for Behavioral Brain Sciences (CBBS), Magdeburg (Germany); Turner, R. [MPI fuer Kognitions- und Neurowissenschaften, Abteilung Neurophysik, Leipzig (Germany)

2013-05-15

group data without the need for voxel-based congruence. (orig.) [German] fMRT-Untersuchungen sind durch den geringen aktivierungsinduzierten Signalunterschied in ihrer Sensitivitaet limitiert und innerhalb kurzer tolerierbarer Messzeiten ist die raeumliche Aufloesung limitiert. fMRT bei 1,5 und mehr noch bei 3 T ist ein zuverlaessiges Werkzeug in der Neurowissenschaft und fuer klinische Anwendungen, wie etwa die praechirurgische Funktionslokalisierung. Die fMRT-Sensitivitaet steigt stark (mehr als linear) mit hoeherer Magnetfeldstaerke. Dies war seit Jahren einer der Hauptgruende fuer die Entwicklung zu hoeheren Feldern wie etwa 7 T. Der Sensitivitaetsgewinn von 7 gegenueber 3 T ist bei hoher raeumlicher Aufloesung am groessten und die fMRT mit sehr hoher isotroper Submillimeteraufloesung wird moeglich. Bisherige Resultate zeigen, dass die Blood-oxygenation-level-dependent(BOLD)-Lokalisierung deutlich praeziser ist als bislang angenommen. Mittels Hochfeld-fMRT werden nicht nur quantitativ bessere Ergebnisse erzielt, sondern Informationen neuer Qualitaet zugaenglich wie etwa die kolumnare und schichtabhaengige Struktur des Kortex. Somit wird der Weg zu weiteren Informationen, wie etwa die Richtung kortikaler Verbindungen, eroeffnet. Diese Moeglichkeiten bergen jedoch auch neue Herausforderungen. So muessen neue Verfahren zur Prozessierung derart hochaufgeloester Daten entwickelt werden, welche z. B. ohne Glaettung auskommen, um den Informationsgehalt der Daten nicht zu reduzieren. Standardaufloesungen von 2-3 mm sind weiterhin bei 3 T ''gut aufgehoben'' und profitieren von geringeren Signalausloeschungen, weniger Verzerrungen und geringerer Lautstaerke. Zum Erreichen hoechster Aufloesung bei 7 T sind parallele Bildgebung und Verzerrungskorrektur essenziell und ermoeglichen eine gute Uebereinstimmung mit anatomischen Aufnahmen. Die Echozeit sollte bei 7 T auf ca. 20-25 ms angepasst und die Datenauswertung fuer einzelne Probanden oder Patienten ohne

Presentation Trainer Prototype 1.0

NARCIS (Netherlands)

Börner, Dirk; Specht, Marcus

2014-01-01

This software sketch comprises the first prototype of the presentation trainer. The application uses the Microsoft Kinect sensor and was built using the Processing 1.5.1 development environment. Available under the GNU LGPL licence version 3 or higher.

Simultaneous whole-body PET-MRI in pediatric oncology. More than just reducing radiation?; Simultane Ganzkoerper-PET-MRT in der paediatrischen Onkologie. Mehr als nur Strahlenersparnis

Energy Technology Data Exchange (ETDEWEB)

Gatidis, S.; Gueckel, B.; Schaefer, J.F. [Universitaet Tuebingen, Radiologische Klinik, Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Fougere, C. la [Universitaet Tuebingen, Radiologische Klinik, Nuklearmedizin, Tuebingen (Germany); Schmitt, J. [Universitaet Tuebingen, Abteilung fuer Praeklinische Bildgebung und Radiopharmazie, Werner Siemens Imaging Center, Tuebingen (Germany)

2016-07-15

Diagnostic imaging plays an essential role in pediatric oncology with regard to diagnosis, therapy-planning, and the follow-up of solid tumors. The current imaging standard in pediatric oncology includes a variety of radiological and nuclear medicine imaging modalities depending on the specific tumor entity. The introduction of combined simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) has opened up new diagnostic options in pediatric oncology. This novel modality combines the excellent anatomical accuracy of MRI with the metabolic information of PET. In initial clinical studies, the technical feasibility and possible diagnostic advantages of combined PET-MRI have been in comparison with alternative imaging techniques. It was shown that a reduction in radiation exposure of up to 70 % is achievable compared with PET-CT. Furthermore, it has been shown that the number of imaging studies necessary can be markedly reduced using combined PET-MRI. Owing to its limited availability, combined PET-MRI is currently not used as a routine procedure. However, this new modality has the potential to become the imaging reference standard in pediatric oncology in the future. This review article summarizes the central aspects of pediatric oncological PET-MRI based on existing literature. Typical pediatric oncological PET-MRI cases are also presented. (orig.) [German] Die bildgebende Diagnostik spielt in der paediatrischen Onkologie eine zentrale Rolle fuer die Diagnose, die Therapieplanung und die Nachsorge solider Tumoren. Der aktuell bildgebende Standard in der paediatrischen Onkologie sieht - abhaengig von der vorliegenden Tumorentitaet - eine Kombination mehrerer radiologischer und nuklearmedizinischer Verfahren vor. Die Einfuehrung der simultanen Positronenemissionstomographie(PET)-Magnetresonanztomographie (MRT) hat neuartige Moeglichkeiten der Diagnostik in der paediatrischen Onkologie eroeffnet. Dabei kombiniert dieses neue Verfahren die

Imaging technique and current status of valvular heart disease using cardiac MRI; Untersuchungstechniken und Stellenwert der MRT bei der Diagnostik von Herzklappenerkrankungen

Energy Technology Data Exchange (ETDEWEB)

Lotz, J.; Sohns, J.M. [Universitaetsmedizin Goettingen, Georg-August-Universitaet, Institut fuer Diagnostische und Interventionelle Radiologie, Goettingen (Germany)

2013-10-15

The main indications for cardiac magnetic resonance imaging (MRI) in the evaluation of valvular heart disease are pathologies of the aortic and pulmonary valve. For mitral and tricuspid valve pathologies MRI is not the first line modality as these are usually well visualized by echocardiography. The advantages of MRI in valvular heart disease are a high reliability in the evaluation of ventricular volumes and function as well as the assessment of the perivalvular arterial or atrial structures. This reliability and the limitless access to any imaging plane partially compensates for the lower temporal and spatial resolution in comparison to echocardiography. In patients with congenital heart disease, cardiac MRI is established as a valuable diagnostic tool in daily clinical management, especially for the evaluation of pulmonary valve defects. Nevertheless, echocardiography remains the first-line diagnostic imaging tool for the foreseeable future. (orig.) [German] Die Untersuchung der Herzklappen in der MRT umfasst derzeit v. a. die Aorten- und Pulmonalisklappe. Pathologien der atrioventrikulaeren Klappen bilden demgegenueber nur selten die zentrale Fragestellung einer kardialen MRT-Untersuchung, da diese normalerweise einer echokardiographischen Untersuchung gut zugaenglich sind. Die Staerke der MRT ist die hohe Zuverlaessigkeit, mit der neben der Klappenmorphologie und -funktion die Funktionsparameter des jeweiligen Ventrikels und die Morphologie der nachgeschalteten Arterien bestimmt werden koennen. Dadurch kann die MRT die prinzipielle Schwaeche in der Orts- und Zeitaufloesung gegenueber der Echokardiographie teilweise kompensieren. Bei Patienten mit kongenitalen Herzvitien ist die MRT-basierte Klappendiagnostik fester Bestandteil des klinischen Managements. Das gilt besonders fuer die Evaluation der Pulmonalisklappe. Die Echokardiographie bleibt absehbar die Modalitaet der ersten Wahl fuer die Klappendiagnostik am Herzen. (orig.)

A novel method for creating custom shaped ballistic gelatin trainers using plaster molds.

Science.gov (United States)

Doctor, Michael; Katz, Anne; McNamara, Shannon O; Leifer, Jessica H; Bambrick-Santoyo, Gabriela; Saul, Turandot; Rose, Keith M

2018-03-01

Simulation based procedural training is an effective and frequently used method for teaching vascular access techniques which often require commercial trainers. These can be prohibitively expensive, which allows for homemade trainers made of gelatin to be a more cost-effective and attractive option. Previously described trainers are often rectangular with a flat surface that is dissimilar to human anatomy. We describe a novel method to create a more anatomically realistic trainer using ballistic gelatin, household items, and supplies commonly found in an emergency department such as the plaster wrap typically used to make splints.

MRI in cardiac sarcoidosis and amyloidosis; MRT bei kardialer Sarkoidose und Amyloidose

Energy Technology Data Exchange (ETDEWEB)

Bauner, K.U. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Wintersperger, B. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada)

2013-01-15

Sarcoidosis and amyloidosis are both multisystem disorders, which may involve the heart; however, isolated cardiac disease is rare. Diagnosis of cardiac sarcoidosis and amyloidosis is crucial because the patient prognosis is dependent on cardiac involvement and early treatment. Echocardiography is the first line imaging modality in the diagnostic work-up of both diseases, possibly giving hints towards the correct diagnosis. Besides myocardial biopsy and radionuclide studies cardiac magnetic resonance imaging (MRI) is routinely performed in patients suspect of having infiltrative cardiomyopathy. The T1 mapping procedure is currently being evaluated as a new technique for detection and quantification of global myocardial enhancement, as seen in cardiac amyloidosis. Sensitivities and specificities for detection of cardiac sarcoidosis and amyloidosis can be significantly improved by MRI, especially with late gadolinium enhancement (LGE) imaging. In cardiac sarcoidosis the use of LGE is outcome-related while in amyloidosis analysis of T1-mapping may be of prognostic value. If cardiac involvement in sarcoidosis or amyloidosis is suspected cardiac MRI including LGE should be performed for establishing the diagnosis. (orig.) [German] Die Sarkoidose und Amyloidose sind Multisystemerkrankungen, in deren Verlauf es zu einer kardialen Beteiligung kommen kann. Bildgebend wird als primaeres Verfahren die Echokardiographie eingesetzt. Zur weiteren Diagnostik wird neben der Biopsie und nuklearmedizinischen Verfahren v. a. die MRT herangezogen. Als neuere Technik zur Darstellung globaler diffuser Kontrastmittelanreicherungen, wie sie im Rahmen der Amyloidose vorkommen, wird z. Z. das T1-Mapping evaluiert. Durch den Einsatz der MRT, insbesondere des Late-Gadolinium-Enhancements (LGE), koennen die Sensitivitaet und Spezifitaet in der Diagnostik der kardialen Sarkoidose und Amyloidose entscheidend verbessert werden. Bei der Sarkoidose stellt das Vorhandensein eines LGE einen

The influence of the Re-Link Trainer on gait symmetry in healthy adults.

Science.gov (United States)

Ward, Sarah; Wiedemann, Lukas; Stinear, Cathy; Stinear, James; McDaid, Andrew

2017-07-01

Walking function post-stroke is characterized by asymmetries in gait cycle parameters and joint kinematics. The Re-Link Trainer is designed to provide kinematic constraint to the paretic lower limb, to guide a physiologically normal and symmetrical gait pattern. The purpose of this pilot study was to assess the immediate influence of the Re-Link Trainer on measures of gait symmetry in healthy adults. Participants demonstrated a significantly lower cadence and a 62% reduction in walking speed in the Re-Link Trainer compared to normal walking. The step length ratio had a significant increase from 1.0 during normal walking to 2.5 when walking in the Re-Link Trainer. The results from this pilot study suggest in its current iteration the Re-Link Trainer imposes an asymmetrical constraint on lower limb kinematics.

77 FR 44685 - ConocoPhillips Company, Trainer Refinery, Including On-Site Leased Workers From Shrack, Young...

Science.gov (United States)

2012-07-30

..., Trainer Refinery, Including On-Site Leased Workers From Shrack, Young, and Associates, Inc., and Project Control Associates, Trainer, PA; Notice of Revised Determination on Reconsideration On April 30, 2012, the... applicable to workers and former workers of ConocoPhillips Company, Trainer Refinery, Trainer, Pennsylvania...

The use of a cine-technique in the MRT investigation of the temporo-mandibular joint

International Nuclear Information System (INIS)

Vogl, T.J.; Assal, J.; Eberhard, D.; Weigl, P.; Randzio, J.

1992-01-01

A new cine-technique in a prospective study using rapid gradient echo sequences was evaluated for the MRT investigation of the temporo-mandibular joint. A newly developed hydraulic apparatus was used to produce progressive opening of the jaw and MRT appearances were recorded during predetermined points of mandibular movement. The investigation included 16 normals and 34 patients. A modified gradient echo sequence was combined with an optimised surface coil or a special double coil and this provided good spatial resolution of the articular disc and of the muscular and bony structure. Amongst the abnormal findings were luxation of the disc (15 cases), tears in the disc (5 cases), late effects of internal derangements (12 cases) and condylar hypermobility (7 cases). The new cine-technique provides specific images in any chosen position of the mandible depending on the clinical disability of the patient. (orig.) [de

TrainerPlan : Tu plan de entrenamientos en tu móvil

OpenAIRE

López de Aberasturi Ortiz de Pinedo, Aitor

2017-01-01

TrainerPlan es una aplicación móvil desarrollada para terminales Android que permitirá la generación y consulta de planes de entrenamiento que podrán ser compartidos por diferentes usuarios. TrainerPlan és una aplicació mòbil desenvolupada per a terminals Android que permetrà la generació i consulta de plans d'entrenament que podran ser compartits per diferents usuaris. TrainerPlan is a mobile application developed for Android terminals that will allow the generation and consultation of...

MRI of pulmonary perfusion; MRT der Lungenperfusion

Energy Technology Data Exchange (ETDEWEB)

Fink, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Risse, F.; Semmler, W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Medizinische Physik in der Radiologie, Heidelberg (Germany); Schoenberg, S.O.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany)

2006-04-15

Lung perfusion is a crucial prerequisite for effective gas exchange. Quantification of pulmonary perfusion is important for diagnostic considerations and treatment planning in various diseases of the lungs. Besides disorders of pulmonary vessels such as acute pulmonary embolism and pulmonary hypertension, these also include diseases of the respiratory tract and lung tissue as well as pulmonary tumors. This contribution presents the possibilities and technical requirements of MRI for diagnostic work-up of pulmonary perfusion. (orig.) [German] Die Perfusion der Lunge ist eine entscheidende Voraussetzung fuer einen effektiven Gasaustausch. Die Bestimmung der Lungenperfusion ist bei verschiedenen Erkrankungen der Lunge fuer Diagnostik und Therapieplanung bedeutsam. Hierzu zaehlen neben Erkrankungen der Lungengefaesse wie akute Lungenembolie und pulmonale Hypertension ebenso Erkrankungen der Atemwege, des Lungengeruests und Lungentumoren. In diesem Beitrag werden die Moeglichkeiten und technischen Voraussetzungen der MRT zur Diagnostik der Lungenperfusion dargestellt. (orig.)

Modern MRI of the small bowell; Moderne MRT des Duenndarms

Energy Technology Data Exchange (ETDEWEB)

Scharitzer, M.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

2015-12-15

variety of MR sequences has enabled not only the detection but also the characterization of pathological changes of the small intestine, which are vital for further treatment of these patients. (orig.) [German] Die radiologische Diagnostik von Erkrankungen des Duenndarms wurde in den letzten beiden Jahrzehnten einem dramatischen Wandel unterzogen. Durch rasche Fortschritte mit neuen Behandlungsmethoden und einem zunehmend therapeutischen Fokus auf transmuralen Heilungsprozessen ist eine Gesamtabklaerung des Gastrointestinaltrakts in den Mittelpunkt gerueckt. Durch die Einfuehrung der Endoskopie hat die gastrointestinale Bildgebung mit der Magen-Darm-Passage bzw. dem Enteroklysma mit einer relativ hohen Strahlenbelastung nur bedingte Einsatzmoeglichkeiten gezeigt. Die Entwicklung der Schnittbildverfahren ermoeglichte eine deutlich breitere radiologische Abklaerung abdomineller Erkrankungen. Durch schnelle Untersuchungstechniken sowie einen hohen Weichteilkontrast mit dem grossen Vorteil einer fehlenden Strahlenexposition hat die MRT des Gastrointestinaltrakts zunehmende Bedeutung gewonnen. Bei suffizienter Fuellung des Darmlumens liegt ein grosser Vorteil in der gleichzeitigen Abbildung saemtlicher Darmwandschichten, der perienteralen Strukturen sowie assoziierter abdomineller Veraenderungen. Neue MR-Sequenzen wie diffusionsgewichtete Sequenzen, dynamische Kontrastmittelsequenzen oder die MR-Fluoroskopie ermoeglichen die Detektion morphologischer Veraenderungen mit zusaetzlicher Charakterisierung dieser Darmabschnitte sowie die Beurteilung funktioneller Pathologien mit dynamischer Information ueber eine gestoerte Darmmotilitaet. Aktuelle Richtlinien europaeischer radiologischer und gastroenterologischer Organisationen haben die Bedeutung der Schnittbildverfahren und insbesondere der MRT fuer die Erstdiagnose und das Follow-up bei Patienten mit Morbus Crohn bestaetigt. Durch die Moeglichkeit der Beurteilung aller Darmwandschichten sowie dem Vorhandensein extramuraler

The modern state and problems of training of fitness trainers in the USA

Directory of Open Access Journals (Sweden)

Vasilenko M.N.

2012-12-01

Full Text Available The analytical revue of system of professional fitness trainers' training in the USA is presented in the article. Analysis of 40 literature's sources is performed. The mechanisms of obtaining the profession "fitness trainers" ("personal trainers" in the USA are concretized. Investigated, that certification of competence is a necessary condition for a fitness trainers working, but the higher education (on the level of Bachelor's or Master's curriculum isn't needed. Found, that organizations and education institutes are engaged in the certification of fitness specialists. They quickly react to the emergence of new popular fitness technologies, operatively develop educational programs and offer them to the education market. There is a tendency to the emergence of specialized curriculum of Bachelor and Master in higher education. The benefits of the national American education system of future fitness trainers are singled.

Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

Directory of Open Access Journals (Sweden)

Cassie Maxwell

2017-03-01

Full Text Available Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete surveys were obtained from 289 CrossFit trainers. The mean Sport Nutrition Knowledge (SNK score was 11.1 ± 2.1, equivalent to 65.3% ± 12.4% correct. The trainers perceived nutrition to be extremely important to athletic performance (9.4 ± 0.9 on a 10 point scale. Overall, the trainers graded their SNK higher than that of their CrossFit peers. The internet and CrossFit peers were the most frequently reported sources for nutrition information; Registered Dietitians were the least reported source. The Paleo and Zone diets were the most common dietary regimens recommended by CrossFit trainers. Results indicated a positive correlation between a CrossFit trainer’s self-reported hours of nutrition education and their SNK score (r = 0.17; p < 0.01. Conclusion: Nutrition education modules for Level 1 and 2 CrossFit trainers, developed with input from Board Certified Specialists in Sports Dietetics, are recommended.

Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

Science.gov (United States)

Maxwell, Cassie; Ruth, Kyle; Friesen, Carol

2017-01-01

Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete surveys were obtained from 289 CrossFit trainers. The mean Sport Nutrition Knowledge (SNK) score was 11.1 ± 2.1, equivalent to 65.3% ± 12.4% correct. The trainers perceived nutrition to be extremely important to athletic performance (9.4 ± 0.9 on a 10 point scale). Overall, the trainers graded their SNK higher than that of their CrossFit peers. The internet and CrossFit peers were the most frequently reported sources for nutrition information; Registered Dietitians were the least reported source. The Paleo and Zone diets were the most common dietary regimens recommended by CrossFit trainers. Results indicated a positive correlation between a CrossFit trainer’s self-reported hours of nutrition education and their SNK score (r = 0.17; p CrossFit trainers, developed with input from Board Certified Specialists in Sports Dietetics, are recommended.

Injury surveillance in community sport: Can we obtain valid data from sports trainers?

Science.gov (United States)

Ekegren, C L; Gabbe, B J; Finch, C F

2015-06-01

A lack of available injury data on community sports participants has hampered the development of informed preventive strategies for the broad-base of sports participation. In community sports settings, sports trainers or first-aiders are well-placed to carry out injury surveillance, but few studies have evaluated their ability to do so. The aim of this study was to investigate the reporting rate and completeness of sports trainers' injury records and agreement between sports trainers' and players' reports of injury in community Australian football. Throughout the football season, one sports trainer from each of four clubs recorded players' injuries. To validate these data, we collected self-reported injury data from players via short message service (SMS). In total, 210 discrete injuries were recorded for 139 players, 21% by sports trainers only, 59% by players via SMS only, and 21% by both. Completeness of injury records ranged from 95% to 100%. Agreement between sports trainers and players ranged from K = 0.32 (95% confidence interval: 0.27, 0.37) for date of return to football to K = 1.00 for activity when injured. Injury data collected by sports trainers may be of adequate quality for providing an understanding of the profile of injuries. However, data are likely to underestimate injury rates and should be interpreted with caution. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Trainer variability during step training after spinal cord injury: Implications for robotic gait-training device design.

Science.gov (United States)

Galvez, Jose A; Budovitch, Amy; Harkema, Susan J; Reinkensmeyer, David J

2011-01-01

Robotic devices are being developed to automate repetitive aspects of walking retraining after neurological injuries, in part because they might improve the consistency and quality of training. However, it is unclear how inconsistent manual training actually is or whether stepping quality depends strongly on the trainers' manual skill. The objective of this study was to quantify trainer variability of manual skill during step training using body-weight support on a treadmill and assess factors of trainer skill. We attached a sensorized orthosis to one leg of each patient with spinal cord injury and measured the shank kinematics and forces exerted by different trainers during six training sessions. An expert trainer rated the trainers' skill level based on videotape recordings. Between-trainer force variability was substantial, about two times greater than within-trainer variability. Trainer skill rating correlated strongly with two gait features: better knee extension during stance and fewer episodes of toe dragging. Better knee extension correlated directly with larger knee horizontal assistance force, but better toe clearance did not correlate with larger ankle push-up force; rather, it correlated with better knee and hip extension. These results are useful to inform robotic gait-training design.

Trainer module for security control center operations

International Nuclear Information System (INIS)

Bernard, E.A.

1982-01-01

An operator trainer module has been developed to be used with the security control center equipment to be installed as part of a safeguards physical protection system. The module is designed to provide improved training and testing capabilities for control center operators through the use of simulations for perimeter equipment operations. Operators, through the trainer module, can be challenged with a variety of realistic situations which require responsive action identical to that needed in an actual system. This permits a consistent evaluation and confirmation of operator capabilities prior to assignment as an operator and allows for periodic retesting to verify that adequate performance levels are maintained

CT and MRI of the liver: when, what, why?; CT und MRT der Leber: wann, was, warum

Energy Technology Data Exchange (ETDEWEB)

Budjan, J.; Schoenberg, S.O.; Attenberger, U.I. [Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Institut fuer Klinische Radiologie und Nuklearmedizin, Universitaetsmedizin Mannheim, Mannheim (Germany)

2017-05-15

The detection and differential diagnostic clarification of liver pathologies play an important role in almost all medical disciplines. Because of its superior soft tissue contrast, the availability of liver-specific contrast agents and functional techniques, magnetic resonance imaging (MRI) is the method of choice for the diagnostics of focal and diffuse liver pathologies. In addition to its superior detection and differentiation capabilities, MRI can provide prognostic information and enable early assessment of the therapy response for malignant liver lesions using functional techniques, especially diffusion imaging. Computed tomography (CT) is the imaging method of choice for the detection of traumatic liver injury. Despite the increasing availability of functional techniques in CT, MRI remains the overall modality of choice in liver imaging. (orig.) [German] Die Detektion und die differenzialdiagnostische Abklaerung von Leberpathologien spielen in nahezu allen medizinischen Disziplinen eine bedeutende Rolle. Ihre Vorteile in Hinblick auf Weichteilkontrast, die Verfuegbarkeit leberspezifischer Kontrastmittel und funktionelle Techniken machen die MRT zum bildgebenden Verfahren der Wahl fuer die gezielte Abklaerung fokaler oder diffuser Leberpathologien. Neben hoeheren Detektionsraten und besseren Differenzierungsmoeglichkeiten stehen in der MRT funktionelle Techniken - insbesondere die Diffusionsbildgebung - zur Verfuegung, die eine Prognoseabschaetzung und die fruehe Beurteilung von Therapieansprechen bei malignen Leberlaesionen erlauben. Die CT ist bei der Detektion traumatischer Leberverletzungen Bildgebungsverfahren der Wahl; trotz der auch in der CT zunehmend verfuegbaren funktionellen Techniken bleibt die MRT in der Leberbildgebung weiterhin ueberlegen. (orig.)

Identifying context-specific competencies required by community Australian Football sports trainers.

Science.gov (United States)

Donaldson, Alex; Finch, Caroline F

2012-08-01

First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. A three-round online Delphi process. Community-AF. 16 Australian sports first-aid and community-AF experts. Rating of competencies as either 'essential', 'expected', 'ideal' or 'not required'. Results After Round 3, 47 of the 77 (61%) competencies were endorsed as 'essential' or 'expected' for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as 'ideal' or 'not required' by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF-specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the 'required' competencies, and a further six optional modules covering competencies on which consensus was not reached.

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

Science.gov (United States)

Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

2015-09-01

To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

Resilience Thinking: Integrating Resilience, Adaptability and Transformability

Directory of Open Access Journals (Sweden)

Carl Folke

2010-12-01

Full Text Available Resilience thinking addresses the dynamics and development of complex social-ecological systems (SES. Three aspects are central: resilience, adaptability and transformability. These aspects interrelate across multiple scales. Resilience in this context is the capacity of a SES to continually change and adapt yet remain within critical thresholds. Adaptability is part of resilience. It represents the capacity to adjust responses to changing external drivers and internal processes and thereby allow for development along the current trajectory (stability domain. Transformability is the capacity to cross thresholds into new development trajectories. Transformational change at smaller scales enables resilience at larger scales. The capacity to transform at smaller scales draws on resilience from multiple scales, making use of crises as windows of opportunity for novelty and innovation, and recombining sources of experience and knowledge to navigate social-ecological transitions. Society must seriously consider ways to foster resilience of smaller more manageable SESs that contribute to Earth System resilience and to explore options for deliberate transformation of SESs that threaten Earth System resilience.

MR-Guided vacuum biopsy of 206 contrast-enhancing breast lesions; MRT-gefuehrte Vakuumbiopsie bei 206 Kontrastmittel anreichernden Laesionen der Mamma

Energy Technology Data Exchange (ETDEWEB)

Perlet, C.; Schneider, P.; Sittek, H.; Reiser, M.F. [Klinikum der Universitaet Grosshadern, Muenchen (Germany). Inst. fuer Klinische Radiologie; Amaya, B.; Grosse, A.; Heywang-Koebrunner, S.H. [Martin-Luther-Universitaet, Halle (Germany). Klinik fuer Diagnostische Radiologie

2002-01-01

Purpose: To determine the accuracy and clinical use of MR-guided vacuum biopsy (VB) of enhancing breast lesions. Material and Methods: 254 lesions were referred to MR-guided vacuum-assisted breast biopsy. In 43 (16%) patients the indication was dropped because the lesions could not be identified at the time VB was scheduled. This was due to hormonal influences (n=37), to too strong compression (n=3) or to misinterpretation of the initial diagnostic MRI. In 5 cases (2%) VB was not performed due to obesity (n=2); problems of access (n=2) or a defect of the MR-unit (n=1). VB was performed on altogether 206 lesions. In 4 cases (2%) VB was unsuccessful. This was immediately realized on the post-interventional images. Thus a false negative diagnosis was avoided. Verification included excision of the cavity in cases with proven malignancy or atypical ductal hyperplasia (ADH) and (for benign lesions) retrospective correlation of VB-histology with pre- and postinterventional MRI and subsequent follow-up. Results: 51/202 successful biopsies proved malignancy. In 7 cases ADH and in 144 cases a benign lesion was diagnosed. One DCIS was underestimated as ADH. All other benign or malignant diagnoses proved to be correct. Conclusion: MR-guided VB allows reliable histological work-up of contrast-enhancing small lesions which are not visible by any other modality. (orig.) [German] Zielsetzung: Evaluation der Wertigkeit und klinischen Anwendbarkeit der MRT-gefuehrten Vakuumbiopsie (VB) bei anreichernden Mammalaesionen. Material und Methoden: Insgesamt wurden 254 Laesionen der MRT-gefuehrten VB zugewiesen. Hiervon entfiel bei 43 Patientinnen (16%) die Biopsieindikation beim Planungs-MRT, da die urspruengliche Anreicherung hormonell (n=37), durch zu starke Kompression (n=3) oder durch eine Fehlinterpretation des vorausgegangenen diagnostischen MRT (n=3) nicht mehr abgrenzbar war. Bei 5 weiteren Laesionen (2%) war die Biopsie nicht moeglich (Adipositas n=2; Zugangsprobleme n=2; MRT

Elbows higher! Performing, observing and correcting exercises by a Virtual Trainer

NARCIS (Netherlands)

Ruttkay, Z.M.; van Welbergen, H.

2008-01-01

In the framework of our Reactive Virtual Trainer (RVT) project, we are developing an Intelligent Virtual Agent (IVA) capable to act similarly to a real trainer. Besides presenting the physical exercises to be performed, she keeps an eye on the user. She provides feedback whenever appropriate, to

Trainer Burnout: The Syndrome Explored.

Science.gov (United States)

Waugh, C. Keith; Judd, Michael R.

2003-01-01

The educators' version of the Maslach Burnout Inventory was completed by 40 of 156 in-house trainers. More than one-third experience emotional exhaustion weekly, and almost half feel a lack of personal accomplishment. Subscales of emotional exhaustion, depersonalization, and personal accomplishment correlated with perceptions of organizations'…

Variations in area-level disadvantage of Australian registered fitness trainers usual training locations

OpenAIRE

Bennie, Jason A.; Thornton, Lukar E.; van Uffelen, Jannique G. Z.; Banting, Lauren K.; Biddle, Stuart J. H.

2016-01-01

Background Leisure-time physical activity and strength training participation levels are low and socioeconomically distributed. Fitness trainers (e.g. gym/group instructors) may have a role in increasing these participation levels. However, it is not known whether the training location and characteristics of Australian fitness trainers vary between areas that differ in socioeconomic status. Methods In 2014, a sample of 1,189 Australian trainers completed an online survey with questions about ...

Can Resilience Thinking Inform Resilience Investments? Learning from Resilience Principles for Disaster Risk Reduction

Directory of Open Access Journals (Sweden)

Margot Hill Clarvis

2015-07-01

Full Text Available As the human and financial costs of natural disasters rise and state finances continue to deplete, increasing attention is being placed on the role of the private sector to support disaster and climate resilience. However, not only is there a recognised lack of private finance to fill this gap, but international institutional and financing bodies tend to prioritise specific reactive response over preparedness and general resilience building. This paper utilises the central tenets of resilience thinking that have emerged from scholarship on social-ecological system resilience as a lens through which to assess investing in disaster risk reduction (DRR for resilience. It draws on an established framework of resilience principles and examples of resilience investments to explore how resilience principles can actually inform decisions around DRR and resilience investing. It proposes some key lessons for diversifying sources of finance in order to, in turn, enhance “financial resilience”. In doing so, it suggests a series of questions to align investments with resilience building, and to better balance the achievement of the resilience principles with financial requirements such as financial diversification and replicability. It argues for a critical look to be taken at how resilience principles, which focus on longer-term systems perspectives, could complement the focus in DRR on critical and immediate stresses.

Intelligent virtual agents as language trainers facilitate multilingualism.

Science.gov (United States)

Macedonia, Manuela; Groher, Iris; Roithmayr, Friedrich

2014-01-01

intelligent virtual agents (IVAs) with human appearance and the capability to teach foreign language vocabulary. We report results from studies that we have conducted with Billie, an IVA employed as a vocabulary trainer, as well as research findings on the acceptance of the agent as a trainer by adults and children. The results show that Billie can train humans as well as a human teacher can and that both adults and children accept the IVA as a trainer. The advantages of IVAs are multiple. First, their teaching methods can be based on neuropsychological research findings concerning memory and learning practice. Second, virtual teachers can provide individualized training. Third, they coach users during training, are always supportive, and motivate learners to train. Fourth, agents will reside in the user's mobile devices and thus be at the user's disposal everywhere and anytime. Agents in apps will make foreign language training accessible to anybody at low cost. This will enable people around the world, including physically, financially, and geographically disadvantaged persons, to learn a foreign language and help to facilitate multilingualism.

General Practitioner trainers prescribe fewer antibiotics in primary care: Evidence from France.

Science.gov (United States)

Devillers, Louise; Sicsic, Jonathan; Delbarre, Angelique; Le Bel, Josselin; Ferrat, Emilie; Saint Lary, Olivier

2018-01-01

Antibiotic prescription is a central public health issue. Overall, 90% of antibiotic prescriptions are delivered to patients in ambulatory care, and a substantial proportion of these prescriptions could be avoided. General Practitioner (GP) trainers are similar to other GPs in terms of sociodemographic and medical activities, but they may have different prescription patterns. Our aim was to compare the antibiotic prescribing rates between GP trainers and non-trainers. This observational cross-sectional study was conducted on administrative data claims from the French National Health Insurance. The antibiotic prescribing rate was calculated. The main independent variable was the training status of the GPs. Prescribing rates were adjusted for the various GPs' characteristics (gender, age, location of the practice, number of visits per GP and the case-mix) in a multiple linear regression analysis. Between June 2014 and July 2015 the prescribing patterns of 860 GPs were analysed, among which 102 were GP trainers (12%). Over the year 363,580 patients were prescribed an antibiotic out of 3,499,248 visits for 1,299,308 patients seen over the year thus representing around 27.5% of patients. In the multivariate analyses, being a trainer resulted in a significant difference of 6.62 percentage points (IC 95%: [-8.55; -4.69]; prole of GP trainers in antibiotic prescriptions. By prescribing fewer antibiotics and influencing the next generations of GPs, the human and economic burden of antibiotics could be reduced.

Validation of open-surgery VR trainer

NARCIS (Netherlands)

Sanders, A.J.B.; Luursema, J.M.; Warntjes, P.; Mastboom, W.J.B.; Geelkerken, R.H.; Klaase, J.M.; Rödel, S.G.J.; ten Cate Hoedemaker, H.O.; Kommers, P.A.M.; Verwey, W.B.; Kunst, E.E.; Westwood, James D.

2006-01-01

VREST (Virtual Reality Educational Surgical Tools) is developing a universal and autonomous simulation platform which can be used for training and assessment of medical students and for continuing education of physicians. With the VREST - Virtual Lichtenstein Trainer, simulating the open surgery

Resilience versus "Resilient Individual": What Exactly Do We Study?

Directory of Open Access Journals (Sweden)

Jan Sebastian Novotný

2014-07-01

Full Text Available The nature and definition of resilience, despite the extensive 40 years of research, is still unclear. Currently is resilience seen as a personality trait, sum of the traits/factors, result of adaptation, or as a process. The concept of resilience as personality traits is usually tied to uni-dimensional or "simplex" theories of resistance as Hardiness, Sense of Control, Ego-Resiliency, Self-efficacy, Sense of Coherence, or specific personality traits. Multidimensional concepts see resilience as a complex of personality and social (environmental factors that work in interaction, complement or replace each other, and, in aggregate, create a comprehensive picture of resilience. The concept of resilience as the result of adaptation examines resilience in terms of the presence/absence of adverse/pathological manifestations, consequences and outcomes in relation to the earlier effect of stressful, risky or otherwise unfavorable situations. Finally, the concept of resilience as the process examines individual's response to risk factors or wounds that are present in the environment. Resilience is thus a process consisting of interactions between individual characteristics and the environment. Most experts and a large part of resilience research is based on the first three concepts that however explore how "resilient" the individual is rather than resilience itself, since they are based on "diagnosing" or at best dimensional, at worse dichotomous rating of the individual's resilience (within personality trait approach, or on the evaluation of the presence/absence of factors/source of resilience, thereby they are still holding the "diagnostic" approach (within multidimensional approach. Only the examination of processes, such as the ongoing interaction between these risk factors, resilience factors, outcomes (expressions of personality, behavior, presence of problems, etc. and other variables allows us to understand resilience (the true nature of how

ASTP crewmen in Apollo Command Module Trainer during training session at JSC

Science.gov (United States)

1975-01-01

The three members of the American ASTP prime crew are photographed inside the Apollo Command Module (CM) trainer in a water tank in bldg 260 during water egress training at JSC. They are, left to right, Astronauts Thomas P. Stafford, commander; Vance D. Brand, command module pilot; and Donald K. Slayton, docking module pilot (23430); Slayton attaches his life preserver as he egresses an Apollo Command Module trainer in a water tank in bldg 260 during water egresss training at JSC. Astronauts Brand (on left) and Stafford have already egressed the trainer and are seated in a three-man life raft.

Design of Human-Machine Interface and altering of pelvic obliquity with RGR Trainer.

Science.gov (United States)

Pietrusinski, Maciej; Unluhisarcikli, Ozer; Mavroidis, Constantinos; Cajigas, Iahn; Bonato, Paolo

2011-01-01

The Robotic Gait Rehabilitation (RGR) Trainer targets secondary gait deviations in stroke survivors undergoing rehabilitation. Using an impedance control strategy and a linear electromagnetic actuator, the device generates a force field to control pelvic obliquity through a Human-Machine Interface (i.e. a lower body exoskeleton). Herein we describe the design of the RGR Trainer Human-Machine Interface (HMI) and we demonstrate the system's ability to alter the pattern of movement of the pelvis during gait in a healthy subject. Results are shown for experiments during which we induced hip-hiking - in healthy subjects. Our findings indicate that the RGR Trainer has the ability of affecting pelvic obliquity during gait. Furthermore, we provide preliminary evidence of short-term retention of the modified pelvic obliquity pattern induced by the RGR Trainer. © 2011 IEEE

Cardiodiagnostic imaging. MRT, CT, echocardiography and other methods

International Nuclear Information System (INIS)

Erbel, R.; Kreitner, K.F.; Barkhausen, J.; Thelen, M.

2007-01-01

The book presents a differentiated approach to cardiac imaging. The focus is n cardio-MR/-CT and echocardiography. These are highly complex methods involving new equipment, new protocols and indications. The techniques are new and difficult to learn for everybody concerned. MR, CT and echocardiography must always be viewed in the context of other diagnostic methods. The interdisciplinary approach of the book addresses both radiologists and cardiologists and relies on the vast experience of the authors. The book offers more than 500 large high-quality reference images reflecting the latest state of the art. It has amethodological section in which the current methods are described (X-ray, echocardiography, nuclear medicine, angiography, CT, MRT etc.) along with their advantages and shortcomings, and a clinical section in which the main indications are described in the common standardized way (anatomy, clinical picture, interpretation, differential diagnosis). (orig.)

Signal effects of various radiographic contrast media and their interaction with gadolinium DTPA during MRT

International Nuclear Information System (INIS)

Kopka, L.; Funke, M.; Fischer, U.; Vosshenrich, R.; Schroeder, M.; Grabbe, E.

1994-01-01

T 1 and T 2 weighted signals dereived from various radiological contrast media were studied during MRT spin-echo sequences. In addition, the interaction between radiological contrast media and Gadolinium-DTPA concerning T 1 signals was evaluated. Ionic (ioxitalaminic acid) and non-ionic radiological contrast media (Iopromid, Iotrolan) were used in diagnostic concentrations. Measurements were carried out with a superconductive magnet of 1.5 Tesla. Radiological contrast media produced significantly higher signals than a physiological sodium chloride solution in T 1 -weighted spin-echo sequences. Evn small amounts (15% of total volume) of radiological contrast media during T 1 -weighted spin-echo sequences led to a significant reduction (about 25%) of the signal intensity of a 2 mM Gadolinium-DTPA solution. This may lead to diagnostic problems, as was shown in a series of 25 MR arthrograms of the shoulder. It is recommended than an interval of at least 6 hours should elapse between the use of a radiological contrst medium and an MRT examination. (orig.) [de

Identifying resilient and non-resilient middle-adolescents in a ...

African Journals Online (AJOL)

The aim in this study was to develop a way of identifying resilient and non- resilient middle adolescents in a formerly black-only urban residential (township) school, in order to ultimately support the development of learners' resilience under stressful circumstances. A Resilience Scale was developed to screen for resilient ...

Safe and competent opioid prescribing education: Increasing dissemination with a train-the-trainer program.

Science.gov (United States)

Zisblatt, Lara; Hayes, Sean M; Lazure, Patrice; Hardesty, Ilana; White, Julie L; Alford, Daniel P

2017-01-01

Due to the high prevalence of prescription opioid misuse, the US Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended-release/long-acting (ER/LA) opioids to fund continuing education based on an FDA curricular Blueprint. This paper describes the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) train-the-trainer program and its impact on (1) disseminating the SCOPE of Pain curriculum and (2) knowledge, confidence, attitudes, and performance of the participants of trainer-led compared with expert-led meetings. SCOPE of Pain is a 3-hour ER/LA opioid REMS education. In addition to expert-led live statewide meetings, a 2-hour train-the-trainer (TTT) workshop was developed to increase dissemination nationally. The trainers were expected to conduct SCOPE of Pain meetings at their institutions. Participants of both the trainer-led and expert-led SCOPE of Pain programs were surveyed immediately post and 2 months post meetings to assess improvements in knowledge, confidence, attitudes, and self-reported safe opioid prescribing practices. During 9 months (May 2013 to February 2014), 89 trainers were trained during 9 TTT workshops in 9 states. Over 24 months (May 2013 to April 2015), 33% of the trainers conducted at least 1 SCOPE of Pain training, with a total of 79 meetings that educated 1419 participants. The average number of meetings of those who conducted at least 1 meeting was 2.8 (range: 1-19). The participants of the trainer-led programs were significantly more likely to be practicing in rural settings than those who participated in the expert-led meetings (39% vs. 26%, P strategy to increase guideline-based safe opioid prescribing knowledge, confidence, attitudes, and self-reported practices.

MRI for therapy control in patients with aortic isthmus stenosis; MRT zur Therapiekontrolle bei Patienten mit Aortenisthmusstenose

Energy Technology Data Exchange (ETDEWEB)

Wintersperger, B.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Toronto General Hospital, University of Toronto, Department of Medical Imaging, University Health Network, Toronto M5G 2N2 (Canada); Theisen, D.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

2011-01-15

Aortic isthmus stenosis is the most common congenital aortic anomaly and is often a problem for therapy surveillance. In addition to possible comorbidities (e.g. bicuspid aortic valve) it is accompanied by various middle and long-term complications depending on the primary choice of the therapeutic procedure. Magnetic resonance imaging (MRI) plays an important role for the mostly young patients in the control of the aortic isthmus stenosis and therapy because it is non-invasive and there is no X-ray exposure. Radiologists should be well-informed on the principles of the therapeutic procedure in order to be competent in the interpretation of MRI findings. Due to the continuous development of MRI technology, techniques for functional evaluation (e.g. dynamic MRA, 4D PC flow measurement) are increasingly becoming available in addition to high-resolution MR angiography (MRA), which could predict the risk of possible complications, such as aneurysms. However, in this aspect further studies are necessary. Interventional therapy with stents and stent grafts is often employed for the therapy of possible complications following an operation (aneurysms, restenosis) but because of massive metal artefacts the use of MRI is often sometimes severely limited. (orig.) [German] Die Aortenisthmusstenose als haeufigste angeborene Aortenanomalie stellt ein haeufiges Problem der Therapieueberwachung dar und ist neben moeglichen begleitenden Anomalien (z. B. bikuspidale Aortenklappe) in Abhaengigkeit vom primaer gewaehlten Therapieverfahren mit verschiedenen Komplikationen im mittel- bis laengerfristigem Verlauf vergesellschaftet. Bei der Kontrolle der Aortenisthmusstenose bzw. deren Therapie spielt die Magnetresonanztomographie (MRT) aufgrund der Nichtinvasivitaet und fehlenden Strahlenexposition bei den meist juengeren Patienten eine wichtige Rolle. Der Radiologe sollte ueber die Grundzuege der Therapieverfahren informiert sein, um die MRT-Befunde kompetent zu befunden. Durch stetige

Weanling piglet cerebellum: a surrogate for tolerance to MRT (microbeam radiation therapy) in pediatric neuro-oncology

Science.gov (United States)

Laissue, Jean A.; Blattmann, Hans; Di Michiel, Marco; Slatkin, Daniel N.; Lyubimova, Nadia; Guzman, Raphael; Zimmermann, Werner; Birrer, Stephan; Bley, Tim; Kircher, Patrick; Stettler, Regina; Fatzer, Rosmarie; Jaggy, Andre; Smilowitz, Henry; Brauer, Elke; Bravin, Alberto; Le Duc, Geraldine; Nemoz, Christian; Renier, Michel; Thomlinson, William C.; Stepanek, Jiri; Wagner, Hans-Peter

2001-12-01

The cerebellum of the weanling piglet (Yorkshire) was used as a surrogate for the radiosensitive human infant cerebellum in a Swiss-led program of experimental microbeam radiation therapy (MRT) at the ESRF. Five weanlings in a 47 day old litter of seven, and eight weanlings in a 40 day old litter of eleven were irradiated in November, 1999 and June, 2000, respectively. A 1.5 cm-wide x 1.5 xm-high array of equally space approximately equals 20-30 micrometers wide, upright microbeams spaced at 210 micrometers intervals was propagated horizontally, left to right, through the cerebella of the prone, anesthetized piglets. Skin-entrance intra-microbeam peak adsorbed doses were uniform, either 150, 300, 425, or 600 gray (Gy). Peak and inter-microbeam (valley) absorbed doses in the cerebellum were computed with the PSI version of the Monte Carlo code GEANT and benchmarked using Gafchromic and radiochromic film microdosimetry. For approximately equals 66 weeks [first litter; until euthanasia], or approximately equals 57 weeks [second litter; until July 30, 2001] after irradiation, the littermates were developmentally, behaviorally, neurologically and radiologically normal as observed and tested by experienced farmers and veterinary scientists unaware of which piglets were irradiated or sham-irradiated. Morever, MRT implemented at the ESRF with a similar array of microbeams and a uniform skin-entrance peak dose of 625 Gy, followed by immunoprophylaxis, was shown to be palliative or curative in young adult rats bearing intracerebral gliosarcomas. These observations give further credence to MRT's potential as an adjunct therapy for brain tumors in infancy, when seamless therapeutic irradiation of the brain is hazardous.

Supporting teachers and trainers for successful reforms and quality of VET

DEFF Research Database (Denmark)

Kruse, Katrine; Gottlieb, Susanne; Andersen, Ole Dibbern

This article presents how teachers and trainers in the Danish vocational education and training (VET) system are prepared for their work as professionals in an educational system undergoing rapid changes.......This article presents how teachers and trainers in the Danish vocational education and training (VET) system are prepared for their work as professionals in an educational system undergoing rapid changes....

Clinical anxiety among final year dental students: The trainers and students perspectives

Directory of Open Access Journals (Sweden)

A Obarisiagbon

2013-01-01

Full Text Available Background: The dental clinical setting, which is a significant learning environment for undergraduate dental students, may induce anxiety, which may adversely affect the clinical performance. The purpose of this cross-sectional study was to determine the factors provoking clinical anxiety in dental students from the trainers and students perspectives. Materials and Methods: This cross-sectional study was conducted among 6 th (final year dental students of University of Benin and their clinical trainers between January and March 2012 using the 38-item modified Moss and McManus clinical anxiety questionnaire. Results: Of the 67 participants, 32 (47.8% were 6 th year dental students while 35 (52.2% were clinical trainers. According to the students, the top clinical anxiety provoking situations were inability to meet requirements before exams, inability to pass the final exams, dealing with psychiatric patients, coping with uncooperative children, getting infected by patients, fracturing a tooth during extraction, extracting the wrong tooth, discovering calculus by the supervisor after scaling, accidental pulp exposure, inadvertently hurting patients and using the high speed hand piece. There existed concordance on the top two clinical anxiety provoking situations reported by the students and their clinical trainers. However, measuring blood pressure, taking pulse, presenting in the clinic, handling a syncopal attack, and accidental pulp exposure were statistically significant contrasting clinical anxiety provoking situations from dental students and trainers perspectives. Conclusion: Data from this study revealed that clinical trainers share largely the same perspectives with the dental students on the clinical anxiety provoking situations with slight variations. Fostering a supportive learning environment conducive to dental student learning by strengthen efforts to minimize clinical anxiety is a necessity.

Resilience Thinking: Integrating Resilience, Adaptability and Transformability

NARCIS (Netherlands)

Folke, C.; Carpenter, S.R.; Walker, B.; Scheffer, M.; Chapin, T.; Rockstrom, J.

2010-01-01

Resilience thinking addresses the dynamics and development of complex social-ecological systems (SES). Three aspects are central: resilience, adaptability and transformability. These aspects interrelate across multiple scales. Resilience in this context is the capacity of a SES to continually change

Assessment of manual restorative treatment (MRT) with amalgam in high-caries Filipino children: results after 2 years.

Science.gov (United States)

Monse-Schneider, B; Heinrich-Weltzien, R; Schug, D; Sheiham, A; Borutta, A

2003-04-01

The atraumatic restorative treatment (ART), using only hand instruments and glass-ionomer cement as adhesive material is recommended for restorative dental treatment in disadvantaged communities lacking electricity and sophisticated dental equipment. Research is required on more durable restorative materials appropriate for populations with high-caries experience. The aim of the study was to evaluate, under field conditions, the applicability and effectiveness of an encapsulated amalgam as restorative material in ART prepared cavities in permanent teeth of children with high-caries rates. As the definition of ART restricts the manual treatment to adhesive materials the approach used is called the manual restorative treatment (MRT). Two dentists and two trained healthcare workers, using hand instruments and an encapsulated amalgam that was mixed with a manually driven triturator, placed a total of 934 restorations in the permanent dentition in 466 children. Due to irregular school attendance of Filipino children only 611 restorations could be evaluated by one independent dentist. The average age at reassessment of restorations was 27 +/- 4.5 months. 93.3% of the restorations were acceptable. The failure rate of occlusal surface restorations was 5.6% compared with 13.6% of buccal surface fillings. The survival rate of large occlusal restorations was 95.1% compared with 93.7% for small restorations. The survival of MRT restorations was not influenced by the experience and professional level of the operator. Amalgam is a suitable MRT material, especially for extensive occlusal lesions in high-caries populations. Studies of longer duration are needed to confirm this finding.

Radiology trainer. Musculoskeletal system

International Nuclear Information System (INIS)

Staebler, A.; Erlt-Wagner, B.

2006-01-01

This book enables students to simulate examinations. The Radiology Trainer series comprises the whole knowledge of radiology in the form of case studies for self-testing. It is based on the best-sorted German-language collection of radiological examinations of all organ regions. Step by step, radiological knowledge is trained in order to make diagnoses more efficient. The book series ensures optimal preparation for the final medical examinations and is also a valuable tool for practical training. (orig.)

[Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting].

Science.gov (United States)

Gachoud, D; Félix, S; Monti, M

2015-11-04

Communication between trainer and trainee plays a central role in teaching and learning in the clinical environment. There are various strategies to frame the dialogue between trainee and trainer. These strategies allow trainers to be more effective in their supervision, which is important in our busy clinical environment. Communication strategies are well adapted to both in- and out-patient settings, to both under- and postgraduate contexts. This article presents three strategies that we think are particularly useful. They are meant to give feedback, to ask questions and to present a case.

Athletic Trainers' Attitudes and Perceptions of Environmental Sustainability.

Science.gov (United States)

Potteiger, Kelly; Pitney, William A; Cappaert, Thomas A; Wolfe, Angela

2017-12-01

  Environmental sustainability efforts are becoming a critical concern in health care. However, little is known regarding how athletic trainers feel about the environment or what can be done to reduce the environmental impact of the practice of athletic training.   To examine athletic trainers' attitudes toward and perceptions of factors related to environmental sustainability.   Sequential, mixed methods using a survey, focus groups, and personal interviews.   Field study.   Four hundred forty-two individuals completed the survey. Sixteen participated in the qualitative portion.   Quantitative results from the Athletic Training Environmental Impact Survey included data from a 5-point Likert scale (1 = lowest rating and 5 = highest rating). Descriptive statistics and 1-way analyses of variance were used to describe perceptions and determine differences in mean opinion, National Athletic Trainers' Association district, and use of green techniques. Qualitative data were transcribed verbatim and analyzed inductively.   The mean score for opinion of the environment was 3.30 ± 0.52. A difference was found between opinion and National Athletic Trainers' Association district ( F 9, 429 = 2.43, P = .01). A Bonferroni post hoc analysis identified this difference ( P = .03) between members of District 2 (Delaware, New Jersey, New York, Pennsylvania) and District 9 (Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, Tennessee). An inductive analysis resulted in 3 emergent themes: (1) barriers to using green techniques, (2) motivators for using green techniques, and (3) solutions to overcoming the barriers. The information gleaned from participants in the qualitative portion of the study can be useful for clinicians wishing to implement basic conservation efforts in their practice settings and may guide future sustainability projects.   Overall, participants reported a positive opinion of environmental sustainability topics related to athletic

Creutzfeldt-Jakob disease: the value of MRI; Creutzfeldt-Jakob-Krankheit: Stellenwert der MRT

Energy Technology Data Exchange (ETDEWEB)

Urbach, H.; Tschampa, H.J.; Keller, E.; Schild, H.H. [Radiologische Klinik, Neuroradiologie, Rheinische Friedrich-Wilhelms-Univ. Bonn (Germany); Paus, S. [Neurologische Klinik, Rheinische Friedrich-Wilhelms-Univ. Bonn (Germany)

2001-06-01

To define the role of MRI in the diagnosis of Creutzfeldt-Jakob disease (CJD). Methods: 14 patients with suspected CJD were studied within 3 years. MRI findings were correlated with WHO established diagnostic criteria (clinical findings, EEG, CSF with 14-3-3 protein assay). Results: 12 patients had CJD. One patient each suffered from Hashimoto's encephalitis and ALS dementia complex, respectively. Nine of 12 CJD patients had increased signal intensity of the striatum (n = 8), pulvinar thalami (n = 5) and/or cerebellar and cerebral cortex (n = 3), respectively. Signal intensity was most pronounced on FLAIR sequences; six patients were studied with diffusion-weighted MRI and showed impaired diffusion in these areas. Both patients without CJD did not show the abovementioned signal changes (sensitivity 75%, specificity and positive predictive value 100%, respectively). Conclusion: If patients with suspected CJD are studied with FLAIR and diffusion-weighted sequences, this disorder can reliably be proven or ruled out. Typical MRI findings narrow down the differential diagnosis and should be included in the WHO diagnostic criteria. (orig.) [German] Bestimmung des Stellenwerts der MRT in der Diagnostik der Creutzfeldt-Jakob-Krankheit (CJK). Methoden: Analyse der MRTs von 14 innerhalb von drei Jahren mit Verdacht auf CJK zugewiesenen Patienten. Korrelation der MRTs mit den entsprechend den WHO-Diagnosekriterien etablierten Untersuchungsverfahren (Klinik, EEG, Liquor mit 14-3-3 Protein-Nachweis). Ergebnisse: 12 Patienten hatten eine CJK, jeweils ein Patient hatte eine Hashimoto-Enzephalitis bzw. einen ALS-Demenz-Komplex. Bei 9 der 12 CJK-Patienten fanden sich beidseits Signalerhoehungen des Striatum (n = 8), des Pulvinar thalami (n = 5) und/oder des Kleinhirn- bzw. Grosshirnkortex (n = 3). Die Signalerhoehungen waren am deutlichsten auf FLAIR-Aufnahmen erkennbar; 6 mit diffusionsgewichteter MRT untersuchte Patienten wiesen eine eingeschraenkte Diffusion dieser Areale

An electromechanical gait trainer for restoration of gait in hemiparetic stroke patients: preliminary results.

Science.gov (United States)

Hesse, S; Werner, C; Uhlenbrock, D; von Frankenberg, S; Bardeleben, A; Brandl-Hesse, B

2001-01-01

Modern concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. This preliminary study investigated whether an additional 4-week daily therapy on the gait trainer could improve gait ability in 14 chronic wheelchair-bound hemiparetic subjects. The 4 weeks of physiotherapy and gait-trainer therapy resulted in a relevant improvement of gait ability in all subjects. Velocity, cadence, and stride length improved significantly (p gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke; further studies are needed.

Blended learning in CME: the perception of GP trainers.

Science.gov (United States)

Te Pas, E; Meinema, J G; Visser, M R M; van Dijk, N

2016-05-01

Blended learning (the combination of electronic methods with traditional teaching methods) has the potential to combine the best of traditional education with the best of computer-mediated training. We chose to develop such an intervention for GP trainers who were undertaking a Continuing Medical Education (CME) course in evidence-based medicine (EBM). This study reports on our experience and investigated the factors influencing the perception on usefulness and logistics of blended learning for learners in CME. In total, 170 GP trainers participated in the intervention. We used questionnaires, observations during the four face-to-face meetings and evaluations in the e-course over one year. Additionally we organised focus groups to gain insight in some of the outcomes of the questionnaires and interpretations of the observations. The GP trainers found the design and the educational method (e-course in combination with meetings) attractive, instructive and complementary. Factors influencing their learning were (1) educational design, (2) educational method, (3) topic of the intervention, (4) time (planning), (5) time (intervention), (6) learning style, (7) technical issues, (8) preconditions and (9) level of difficulty. A close link between daily practice and the educational intervention was considered an important precondition for the success of the intervention in this group of learners. GP trainers were positive about blended learning: they found e-learning a useful way to gain knowledge and the meetings a pleasant way of transferring the knowledge into practice. Although some preconditions should be taken into consideration during its development and implementation, they would participate in similarly designed learning in the future.

Cross-cultural communication capabilities of U.S. military trainers: host nation perspective.

Science.gov (United States)

Mahmood, Maysaa; Alameri, Ali; Jawad, Shakir; Alani, Yasir; Zuerlein, Scott; Nakano, Gregg; Anderson, Warner; Beadling, Charles

2013-06-01

A survey was conducted to assess trainee perception of the cross-cultural communication competency of U.S. military trainers and their satisfaction with the training they received. Findings from the survey show that U.S. military trainers rely significantly on local interpreters. This indicates variability in the ability of the trainers to communicate effectively with host nation partners, the variability being dependent on the capabilities of the individual interpreter. The findings illustrate the importance of providing military health personnel with training on how to work effectively with interpreters. The use of supplementary resources such as electronic translation devises when the interpreter is not capable of conveying health-related training information with the desired level of accuracy is recommended. Expanding the availability of general cultural training, which provides baseline information on local values, traditions, and customs in addition to health-specific cultural orientation, is also recommended to help military health trainers customize their training content and methods to fit the local environment. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Resilience thinking: integrating resilience, adaptability and transformability

Science.gov (United States)

Carl Folke; Stephen R. Carpenter; Brian Walker; Marten Scheffer; Terry Chapin; Johan. Rockstrom

2010-01-01

Resilience thinking addresses the dynamics and development of complex social-ecological systems (SES). Three aspects are central: resilience, adaptability and transformability. These aspects interrelate across multiple scales. Resilience in this context is the capacity of a SES to continually change and adapt yet remain within critical thresholds. Adaptability is part...

Epiphyseal injuries of the distal tibia. Does MRI provide useful additional information?; Epiphysenfugenverletzungen der distalen Tibia. Sinnvolle Mehrinformation durch die MRT?

Energy Technology Data Exchange (ETDEWEB)

Iwinska-Zelder, J.; Schmidt, S.; Ishaque, N.; Klose, K.J.; Hoppe, M. [Marburg Univ. (Germany). Abt. fuer Strahlendiagnostik; Schmitt, J.; Gotzen, L. [Marburg Univ. (Germany). Medizinisches Zentrum fuer Operative Medizin

1999-01-01

Plain film radiography often underestimates the extent of injury in children with epiphyseal fracture. Especially Salter-Harris V fractures (crush fracture of the epiphyseal plate) are often primarily not detected. MRI of the ankle was performed in 10 children aged 9-17 (mean 14) years with suspected epiphyseal injury using 1.0-T Magnetom Expert. The fractures were classified according to the Salter-Harris-Rang-Odgen classification and compared with the results of plain radiography. In one case MRI could exclude epiphyseal injury; in four cases the MRI findings changed the therapeutic management. The visualisation of the fracture in three orthogonal planes and the possibility of detection of cartilage and ligamentous injury in MR imaging makes this method superior to conventional radiography and CT. With respect to radiation exposure MRI instead of CT should be used for the diagnosis of epiphyseal injuries in children. (orig.) [Deutsch] Die konventionelle Roentgendiagnostik unterschaetzt haeufig das Ausmass der kindlichen Extremitaetenfrakturen mit Epiphysenbeteiligung (Typ Salter-Harris). Insbesondere werden die Kompressionsfrakturen der Wachstumsfuge (Salter-Harris V) primaer haeufig nicht erkannt. Prospektiv wurden 10 Kinder im Alter von 9-17 Jahren (Durchschnittsalter = 14 J.) mit Verdacht auf eine epiphysaere Fraktur der distalen Tibia magnetresonanztomographisch (1.0-Tesla Magnetom Expert), untersucht. Die MRT-Ergebnisse wurden auf der Basis der Klassifikation nach Salter-Harris-Rang-Odgen mit den konventionellen Roentgenbildern verglichen. In einem Fall, bei einem 15jaehrigen Patienten, gelang durch die MRT der Ausschluss einer epiphysaeren Verletzung. In 7 Faellen fuehrte der MRT-Einsatz zu einer Aenderung der Klassifikation nach Salter-Harris. Hieraus resultierte bei 4 Patienten ein Therapiewechsel. Da Frakturen, die sie begleitenden Knorpellaesionen und ligamentaere Verletzungen multiplanar dargestellt werden koennen, weist die MRT deutliche Vorteile

Design of Human – Machine Interface and Altering of Pelvic Obliquity with RGR Trainer

Science.gov (United States)

Pietrusinski, Maciej; Unluhisarcikli, Ozer; Mavroidis, Constantinos; Cajigas, Iahn; Bonato, Paolo

2012-01-01

The Robotic Gait Rehabilitation (RGR) Trainer targets secondary gait deviations in stroke survivors undergoing rehabilitation. Using an impedance control strategy and a linear electromagnetic actuator, the device generates a force field to control pelvic obliquity through a Human-Machine Interface (i.e. a lower body exoskeleton). Herein we describe the design of the RGR Trainer Human-Machine Interface (HMI) and we demonstrate the system’s ability to alter the pattern of movement of the pelvis during gait in a healthy subject. Results are shown for experiments during which we induced hip-hiking – in healthy subjects. Our findings indicate that the RGR Trainer has the ability of affecting pelvic obliquity during gait. Furthermore, we provide preliminary evidence of short-term retention of the modified pelvic obliquity pattern induced by the RGR Trainer. PMID:22275693

From resilience thinking to Resilience Planning: Lessons from practice.

Science.gov (United States)

Sellberg, M M; Ryan, P; Borgström, S T; Norström, A V; Peterson, G D

2018-07-01

Resilience thinking has frequently been proposed as an alternative to conventional natural resource management, but there are few studies of its applications in real-world settings. To address this gap, we synthesized experiences from practitioners that have applied a resilience thinking approach to strategic planning, called Resilience Planning, in regional natural resource management organizations in Australia. This case represents one of the most extensive and long-term applications of resilience thinking in the world today. We conducted semi-structured interviews with Resilience Planning practitioners from nine organizations and reviewed strategic planning documents to investigate: 1) the key contributions of the approach to their existing strategic planning, and 2) what enabled and hindered the practitioners in applying and embedding the new approach in their organizations. Our results reveal that Resilience Planning contributed to developing a social-ecological systems perspective, more adaptive and collaborative approaches to planning, and that it clarified management goals of desirable resource conditions. Applying Resilience Planning required translating resilience thinking to practice in each unique circumstance, while simultaneously creating support among staff, and engaging external actors. Embedding Resilience Planning within organizations implied starting and maintaining longer-term change processes that required sustained multi-level organizational support. We conclude by identifying four lessons for successfully applying and embedding resilience practice in an organization: 1) to connect internal "entrepreneurs" to "interpreters" and "networkers" who work across organizations, 2) to assess the opportunity context for resilience practice, 3) to ensure that resilience practice is a learning process that engages internal and external actors, and 4) to develop reflective strategies for managing complexity and uncertainty. Copyright © 2018 The Authors

Early diagnosis of skeletal disorders in childhood and adolescence by MRI; Fruehdiagnose orthopaedischer Erkrankungen des Kindes- und Jugendalters mit der MRT

Energy Technology Data Exchange (ETDEWEB)

Meurer, A.; Schwitalle, M.; Engelhardt, O.; Heine, J. [Johannes Gutenberg-Univ. Mainz (Germany). Orthopaedische Klinik und Poliklinik; Kreitner, K.F. [Johannes Gutenberg-Univ. Mainz (Germany). Inst. fuer Klinische Strahlenkunde

1998-09-18

The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)

Acquisition of fundamental laparoscopic skills: is a box really as good as a virtual reality trainer?

Science.gov (United States)

Vitish-Sharma, P; Knowles, J; Patel, B

2011-01-01

Laparoscopic surgery requires working in a three-dimensional environment with a two-dimensional view. Skills such as depth perception, hand to eye co-ordination and bimanual manipulation are crucial to its efficacy. To compare the efficiency of training in laparoscopic skills on a VR simulator with a traditional box trainer. Twenty medical students were recruited. An initial training session on the relevant anatomy and steps of a laparoscopic cholecystectomy was given. Baseline skills were recorded using a pre-training laparoscopic cholecystectomy on the VR trainer. Parameters measured were: (1) total time taken (mins); (2) number of movements right and left instrument; (3) path length (cms) of right and left instrument was recorded. Ten students trained on a VR simulator, and ten on a box trainer, for three hours each. The box trainer group exercises were based on the Royal College of Surgeons core laparoscopic skills course, and the VR trainer exercises were based on the Simbionix LapMentor basic skills tasks. Following this both groups were reassessed by a laparoscopic cholecystectomy on the VR trainer. Both groups showed improvement in all measured parameters. A student T-test at 95% confidence interval showed no statistically significant difference between the two groups pre and post training. Both the VR and box trainer are effective in the acquisition of laparoscopic skills. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Magnetic resonance imaging of pulmonary perfusion. Technical requirements and diagnostic impact; MRT der Lungenperfusion. Technische Voraussetzungen und diagnostischer Stellenwert

Energy Technology Data Exchange (ETDEWEB)

Attenberger, U.I.; Buesing, K.; Schoenberg, S.O.; Fink, C. [Klinikum Mannheim der Universitaet Heidelberg, Institut fuer Klinische Radiologie und Nuklearmedizin, Universitaetsmedizin Mannheim, Mannheim (Germany); Ingrisch, M.; Reiser, M. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Campus Grosshadern, Muenchen (Germany)

2009-08-15

With technical improvements in gradient hardware and the implementation of innovative k-space sampling techniques, such as parallel imaging, the feasibility of pulmonary perfusion MRI could be demonstrated in several studies. Dynamic contrast-enhanced 3D gradient echo sequences as used for time-resolved MR angiography have been established as the preferred pulse sequences for lung perfusion MRI. With these techniques perfusion of the entire lung can be visualized with a sufficiently high temporal and spatial resolution. In several trials in patients with acute pulmonary embolism, pulmonary hypertension and airway diseases, the clinical benefit and good correlation with perfusion scintigraphy have been demonstrated. The following review article describes the technical prerequisites, current post-processing techniques and the clinical indications for MR pulmonary perfusion imaging using MRI. (orig.) [German] Mit der Verfuegbarkeit leistungsfaehiger Gradientensysteme und schneller k-Raum-Akquisitionstechniken wie der parallelen Bildgebung konnten verschiedene Studien die Machbarkeit der Lungenperfusionsbildgebung in der MRT zeigen. In der Praxis haben sich dynamische kontrastverstaerkte 3D-Gradientenechosequenzen, wie sie fuer zeitaufgeloeste MR-Angiographien verwendet werden, fuer die Bildgebung der Lungenperfusion etabliert. Hiermit ist es moeglich, die Perfusion der gesamten Lunge mit ausreichend hoher zeitlicher und raeumlicher Aufloesung zu visualisieren. In mehren klinischen Studien konnte bei Patienten mit Lungenembolie, pulmonaler Hypertonie sowie Erkrankungen der Atemwege und des Lungenparenchyms der klinische Nutzen der Lungenperfusions-MRT und die gute Uebereinstimmung mit der Lungenperfusionsszintigraphie nachgewiesen werden. Der folgende Uebersichtsartikel beschreibt die technische Durchfuehrung, Bildnachverarbeitung und die klinischen Anwendungsgebiete der MRT zur Untersuchung der Lungenperfusion. (orig.)

Understanding Resilience

Directory of Open Access Journals (Sweden)

Gang eWu

2013-02-01

Full Text Available Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of PTSD, depression and other psychiatric disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, and are thus thought to be resilient. Resilience as successful adaptation relies on effective responses to environmental challenges and ultimate resistance to the deleterious effects of stress, therefore a greater understanding of the factors that promote such effects is of great relevance. This review focuses on recent findings regarding genetic, epigenetic, developmental, psychosocial and neurochemical factors that are considered essential contributors to the development of resilience. Neural circuits and pathways involved in mediating resilience are also discussed. The growing understanding of resilience factors will hopefully lead to the development of new pharmacological and psychological interventions for enhancing resilience and mitigating the untoward consequences.

Grading sacroiliitis with emphasis on MRI imaging; Grading der Sakroiliitis mit Betonung der MRT-Bildgebung

Energy Technology Data Exchange (ETDEWEB)

Jurik, A.G.; Egund, N. [The Department of Radiology R, Aarhus Kommunehospital (Denmark)

2004-03-01

Cross-sectional imaging techniques play a decisive role in identification, localization, and characterization of alterations in the sacroiliac joint during the early stage of seronegative spondylarthropathy (SpA). Although several studies showed that the diagnostic capabilities of MRI and CT are superior to those of conventional radiography, they have not yet become established and accepted as methods for evaluating the grade of ankylosing spondylitis (AS) in contrast to conventional radiography. The lack of acceptance for MRI and/or CT methods for evaluating and grading changes in the sacroiliac joint makes it difficult to include the results of these procedures in classifying the grade of SpA. Moreover, grading the changes in the sacroiliac joint in SpA with a method more sensitive than conventional radiography will be of prime importance in assessing treatment, e.g., the efficacy of new biological therapeutic agents directed against the tumor necrosis factor-alpha (TNF-{alpha}). An overview of the available grading methods is provided and MRI and CT techniques are presented. (orig.) [German] Schnittbildverfahren spielen bei der Identifizierung, Lokalisation und Charakterisierung von Veraenderungen des Sakroiliakalgelenks (SIG) im Fruehstadium der seronegativen Spondylarthropathie (SpA) eine entscheidende Rolle. Obwohl mehrere Studien zeigten, dass der diagnostische Wert der MRT und CT jenem der konventionellen Radiographie ueberlegen ist, hat sich das Schnittbildverfahren als Mittel zur Evaluierung des Grades der ankylosierenden Spondylitis (AS) im Gegensatz zur konventionellen Radiographie noch nicht etabliert und durchgesetzt. Dieses Fehlen eines akzeptierten MRT- und/oder CT-Verfahrens zur Evaluierung und zum Grading der Veraenderungen am SIG macht es schwierig, die Ergebnisse dieser Verfahren bei der Einstufung des Grades der AS-Veraenderungen und Erarbeitung von Diagnosekriterien fuer andere Formen der SpA einzubeziehen. Ausserdem wird das Grading der SIG

Training aids: the motor operator valve trainer

International Nuclear Information System (INIS)

McCulloch, B.

1987-01-01

The spectrum of training aids used in the nuclear industry runs the gamut from the very basic (i.e., valve training aids - gate, globe, check) to the highly complex (i.e., nuclear full scope simulator). Designing and purchasing the best training aids take much time, detailed investigation, and good understanding of plant operations. The training aid that has given the New York Power Authority the best results has been the motor operator valve (MOV) trainer. Some of the items that make the MOV trainer a good choice are: (1) large number of MOVs in the plant, (2) importance of MOVs to safe plant operation, (3) detailed MOV procedures used by the plant, (4) history of MOV problems, and (5) ability to demonstrate important concepts and operation - hammer blow effect, torque and limit switch adjustment and functions, and actual sequence of operation of the limitorque valve operator

Optimized detection and characterization of liver metastases. The role of current MRI contrast agents; Optimierte Detektion und Charakterisierung von Lebermetastasen. Leistungsvermoegen aktueller MRT-Kontrastmittel

Energy Technology Data Exchange (ETDEWEB)

Weinrich, J.M.; Well, L.; Bannas, P. [Universitaetsklinikum Hamburg-Eppendorf, Zentrum fuer Radiologie und Endoskopie, Klinik und Poliklinik fuer diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg (Germany)

2017-05-15

Metastases are the most common malignant lesions of the liver. The presence of liver metastases is an important prognostic factor and is decisive for the further management, especially in patients with colorectal cancer. Detection and characterization of liver metastases as well as differentiation from benign lesions are of high importance and a daily challenge in clinical radiology. Contrast-enhanced magnetic resonance imaging (MRI) has the highest sensitivity in detecting liver metastases. The sensitivity of MRI has been further increased due to the development of liver-specific contrast agents. This article describes the role of extracellular and hepatobiliary contrast agents for the detection and characterization of liver metastases. Moreover, the current knowledge on safety, sequence optimization, transient severe dyspnea and the combination of hepatobiliary with intravascular contrast agents for liver imaging is discussed. (orig.) [German] Metastasen sind die haeufigsten malignen Leberlaesionen. Das Vorhandensein von Lebermetastasen ist entscheidend fuer die Prognose und weitere Therapieplanung von Tumorpatienten, insbesondere von Patienten mit kolorektalen Karzinomen. Die Detektion von Lebermetastasen sowie deren Unterscheidung von anderen Leberlaesionen sind daher von hoechster Bedeutung und stellen eine alltaegliche Herausforderung fuer den Radiologen dar. Die Bildgebung mit der hoechsten Sensitivitaet fuer die Detektion von Lebermetastasen stellt die dynamische kontrastmittelgestuetzte Magnetresonanztomographie (MRT) dar. Die bereits hohe Sensitivitaet der MRT wird durch den Einsatz leberspezifischer Kontrastmittel noch weiter gesteigert. Dieser Artikel beleuchtet die Rolle der aktuellen unspezifischen und leberspezifischen MRT-Kontrastmittel fuer die Detektion und Charakterisierung von Lebermetastasen. Weiterhin werden Erkenntnisse zur Sicherheit, Sequenzoptimierung, zu transienten Atemartefakten und zur Kombination von MRT-Kontrastmitteln fuer die

MR imaging in congenital complicated anterior body wall defects; MRT von komplizierten angeborenen Bauchwanddefekten

Energy Technology Data Exchange (ETDEWEB)

Hoermann, M.; Scharitzer, M. [Universitaetsklinik fuer Radiodiagnostik, AKH-Wien (Austria); Pumberger, W. [Universitaetsklinik fuer Kinderchirurgie, AKH-Wien (Austria); Patzak, B. [Pathologisch-anatomisches Museum im Narrenturm, AKH-Wien (Austria)

2003-04-01

Introduction: Aim of this study was to estimate the value of postmortem MR imaging in evaluation of specimen with congenital anterior body wall defects of the museum of pathologic-anatomy. Material and Methods: We examined 19 specimen with a 1.5 Tesla unit by using T{sub 1}- and T{sub 2}-weighted sagittal and coronal sequences. In some specimen additional axial T{sub 2}-weighted images were obtained. We evaluated the site of the bowel, the liver, the heart and presence of associated disorders. Results: The bowels were completely intraabdominal, in two specimen, completely extraabdominal in 12 specimen and in 5 specimen intra- and extraabdominal. The liver was in two specimen completely extraabdominal/in 12 completely intracorporal, and in 5 specimen intra- and extraabdominal. In 5 cases the heart was located extraanatomically. In 12 specimen we found disorders of the spine and the extremities. Congenital disorders of the kidneys were found in 6 specimen. Conclusion: MR imaging is of great value in the assessment of congenital anterior body wall defects. In the light of ultrafast sequences the role of fetal MR imaging in the evaluation of congenital body wall defects may be mandatory in the future. (orig.) [German] Einleitung: Wir nutzten die Sammlung des pathologisch-anatomischen Museums in Wien, um die Wertigkeit der MRT zur Beschreibung von angeborenen vorderen Bauchwanddefekten und deren assoziierten Erkrankungen zu bestimmen. Material und Methode: Wir untersuchten 19 Exponate mit einem 1,5-Tesla-Geraet unter Verwendung von sagittalen und koronalen T{sub 1}- und T{sub 2}-gewichteten Sequenzen. Ausgewertet wurden die Lage des Darmes, der Leber, des Herzens und assoziierte Missbildungen. Ergebnisse: Der Darm lag in zwei Faellen intraabdominal, zur Gaenze extraabdominal in 12 Faellen, intra- und extraabdominal in 5 Faellen. Die Leber war in zwei Exponaten zur Gaenze extraabdominal, in 5 intra- und extraabdominal und in 12 Exponaten intraabdominal. Assoziiert waren

Intraoperative use of an open midfield MR scanner in the surgical treatment of cerebral gliomas; Intraoperative Nutzung eines offenen Mittelfeld-MRT waehrend der chirurgischen Therapie zerebraler Gliome

Energy Technology Data Exchange (ETDEWEB)

Schneider, J.P.; Schulz, T.; Dietrich, J.; Kahn, T. [Klinik und Poliklinik fuer Diagnostische Radiologie, Univ. Leipzig (Germany); Trantakis, C. [Klinik und Poliklinik fuer Neurochirurgie, Univ. Leipzig (Germany)

2003-07-01

The aim of the present study was to evaluate the effectiveness of intraoperative MRI guidance in achieving more gross-total resection in case of primary brain tumors. We studied 12 patients with low-grade glioma and 19 patients with high-grade glioma who underwent surgery within a vertically open 0.5T MR system. After initial imaging, the resection was stopped at the point in which the neurosurgeon considered the resection complete by viewing the operation field. At this time, intraoperative MRI was repeated (''first control'') to identify any residual tumor. Areas of tumor-suspected tissue were localized and resected, with the exception of tissue adjacent to eloquent areas. Final imaging was carried out before closing the craniotomy. Comparison of ''first control'' and final imaging revealed a decrease of residual tumor volume from 32% to 4.3% in low-grade gliomas, and from 29% to 10% in high-grade gliomas. Intraoperative MRI allows a clear optimization of microsurgical resection of both low-grade and high-grade gliomas. (orig.) [German] Ziel der Untersuchung war es, die Effektivitaet des Einsatzes der intraoperativen MRT bei der Resektion gliogener Hirntumoren zu pruefen. 12 Patienten mit niedriggradigem Gliom und 19 Patienten mit Glioblastom wurden in einem vertikal offenen 0,5-T-MRT operiert. Nach der initialen Bildgebung erfolgte die Resektion bis zu dem Zeitpunkt, an dem der Neurochirurg kein Tumorgewebe mehr im OP-Situs abgrenzen konnte. Zu diesem Zeitpunkt erfolgte eine erneute MRT (''= erste Kontrolle'') zur Visualisierung nur MR-tomographisch darstellbaren Resttumors. Solche Areale wurden im OP-Situs lokalisiert und mit Ausnahme von Strukturen in der Naehe eloquenter Hirnareale reseziert. Vor Verschluss des Schaedels erfolgte eine abschliessende MR-Kontrolle. Durch Einsatz der intraoperativen MRT konnte eine Absenkung des relativen Resttumorvolumens von 32% auf 4,3% bei niediggradigen Gliomen und

Knowledge about sports-related concussion: is the message getting through to coaches and trainers?

Science.gov (United States)

White, Peta E; Newton, Joshua D; Makdissi, Michael; Sullivan, S John; Davis, Gavin; McCrory, Paul; Donaldson, Alex; Ewing, Michael T; Finch, Caroline F

2014-01-01

The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. An online knowledge survey was widely promoted across Australia in May-August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.

Communicating Leave No Trace ethics and practices: Efficacy of two-day trainer courses

Science.gov (United States)

Daniels, M.L.; Marion, J.L.

2005-01-01

Heavy recreational visitation within protected natural areas has resulted in many ecological impacts. Many of these impacts may be avoided or minimized through adoption of low-impact hiking and camping practices. Although ?No Trace? messages have been promoted in public lands since the 1970s, few studies have documented the reception and effectiveness of these messages. The U.S. Leave No Trace Center for Outdoor Ethics develops and promotes two-day Trainer courses that teach Leave No Trace (LNT) skills and ethics to outdoor professionals, groups, and interested individuals. This study examined the change in knowledge, ethics, and behavior of LNT Trainer course participants. The respondents were a convenience sample of participants in Trainer courses offered from April through August 2003. Trainer course instructors administered pre-course and post-course questionnaires to their participants, and we contacted participants individually with a followup questionnaire 4 months after completion of their course. Scores for each of the sections increased immediately following the course, and decreased slightly over the 4 months following the course. Overall, more than half of the knowledge and behavior items, and half of the ethics items, showed significant improvement from pre-course measures to the follow-up. Age, reported LNT experience, and backpacking experience affected the participants? pre-course knowledge and behavior scores. Younger, less experienced respondents also showed a greater improvement in behavior following the course. Trainer course participants also shared their LNT skills and ethics with others both formally and informally. In summary, the LNT Trainer course was successful in increasing participants? knowledge, ethics, and behavior, which they then shared with others. Since many low impact skills taught in the LNT curriculum are supported by scientific research, LNT educational programs have the potential to effectively minimize the environmental

Attitudes toward the health of men that regularly occupy in a trainer hall.

Directory of Open Access Journals (Sweden)

Adamchhuk Ja.

2012-02-01

Full Text Available It is accepted to consider that by motivation for people that practice in a trainer hall is an improvement of health and original appearance. The aim of this research was to determine whether there is training by part of forming of positive attitude toward the health of men-sportsmen-amateurs that occupy in a trainer hall. In research took part 100 men that engage in the power training in one of three trainer halls of Warsaw. Investigational divided by two groups: 50 persons that occupy in a trainer hall more than one year, but no more than 3 years (group A and 50 persons that practice more than 3 (group B. It is well-proven that training positively influences on the emotional state of men. It was discovered at the same time, that than greater experience of sportsman-amateur, the considerably more often he used additions (including by a stimulant. There was no medical control in both groups. Positive influence of the power training shows that they can be the important element of prophylaxis and physiotherapy.

Caregiver Resiliency.

Science.gov (United States)

Siebert, Al

2002-01-01

This article argues that school counselors cannot teach and preach resilient behavior if they are not models of resiliency themselves. Examines why some people come through challenging times more emotionally intact than others and suggests some tips for increasing one's resilience potential. (GCP)

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Science.gov (United States)

Broglio, Steven P.; Cantu, Robert C.; Gioia, Gerard A.; Guskiewicz, Kevin M.; Kutcher, Jeffrey; Palm, Michael; McLeod, Tamara C. Valovich

2014-01-01

Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations. PMID:24601910

Dental magnetic resonance tomography (dental-MRT) as a method for imaging of the maxillo-mandibular bone

International Nuclear Information System (INIS)

Gahleitner, A.; Nasel, C.; Schick, S.; Dorffner, S.; Imhof, H.; Trattnig, S.; Bernhart, T.; Mailath, G.; Watzek, G.

1998-01-01

Purpose: To establish a new method for dental imaging using magnetic resonance tomography named Dental-MRT and to demonstrate its usefulness in diagnosing dentogen pathologies of the mandible and maxilla. Methods: Seven healthy volunteers, three patients with pulpitis, two patients with dentigerous cysts, two patients after tooth transplantation, and three patients with atrophic mandibles have been evaluated. Optimized axial T 1 - and T 2 -weighted gradient echo and spin echo sequences in 2D and 3D technique have been established to perform studies of the jaws. The acquired images were reconstructed with a standard dental software package on a workstation as panorama and cross-sectional views of the mandible or maxilla. Results: The entire maxillo-mandibular bone, teeth, dental pulp, and the content of the mandibular canal were well depicted. Patients with pulpitis demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media administration marked enhancement of the dental pulp can be demonstrated. Conclusion: Dental-MRT promises to provide a new tool for visualization and detection of dental diseases. (orig.) [de

Magnetic resonance imaging of dilated cardiomyopathy; MRT bei dilatativen Kardiomyopathien

Energy Technology Data Exchange (ETDEWEB)

D' Anastasi, M. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Greif, M. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik und Poliklinik I, Muenchen (Germany); Reiser, M.F.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Deutsches Zentrum fuer Herzkreislaufforschung (DZHK), Muenchen (Germany)

2013-01-15

Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy with a prevalence of 1 out of 2,500 in adults. Due to mild clinical symptoms in the early phase of the disease, the true prevalence is probably even much higher. Patients present with variable clinical symptoms ranging from mild systolic impairment of left ventricular function to congestive heart failure. Even sudden cardiac death may be the first clinical symptom of DCM. The severity of the disease is defined by the degree of impairment of global left ventricular function. Arrhythmias, such as ventricular or supraventricular tachycardia, atrioventricular (AV) block, ventricular extrasystole and atrial fibrillation are common cardiac manifestations of DCM. Magnetic resonance imaging (MRI) plays an important role in the exact quantification of functional impairment of both ventricles and in the evaluation of regional wall motion abnormalities. With its excellent ability for the assessment of myocardial structure, it is becoming increasingly more important for risk stratification and therapy guidance. (orig.) [German] Die dilatative Kardiomyopathie (DCM) ist die haeufigste Form der Kardiomyopathie mit einer Praevalenz von 1/2500 Erwachsenen. Aufgrund der zunaechst milden klinischen Symptomatik ist jedoch von einer relativ hohen Dunkelziffer auszugehen. Die klinische Praesentation ist variabel, die Schwere der Erkrankung wird vom Ausmass der systolischen Funktionseinschraenkung bestimmt. Herzrhythmusstoerungen, wie ventrikulaere oder supraventrikulaere Tachykardien, AV-Blockierungen, ventrikulaere Extrasystolen und Vorhofflimmern sind moegliche klinische Manifestationen. Bei manchen Patienten ist der ploetzliche Herztod die erste klinische Manifestation der Erkrankung. Die kardiale MRT spielt eine bedeutende Rolle fuer die Beurteilung des Ausmasses der ventrikulaeren Dilatation, Dysfunktion und fuer die Beurteilung regionaler Wandbewegungsstoerungen. Darueber hinaus kann sie zur Anwendung kommen

Magnetic resonance imaging (MRI) of the TMJ: Influence on therapy and inter-observer agreement of two radiologists; Magnetresonanztomographie (MRT) des Kiefergelenkes: Einfluss auf Therapieentscheidung und Uebereinstimmung zweier Auswerter

Energy Technology Data Exchange (ETDEWEB)

Vahlensieck, M.; Okweschokwu, S. [Radiologie Haydnhaus, Bonn (Germany); Greven, M. [Medeco Zahnklinik, Bonn (Germany)

2002-11-01

Aim: To evaluate the influence of MRI of the temporomandibular joint on the therapeutic strategy in patients with craniomandibular disorders (internal derangement) and, furthermore, to analyze interobserver agreement for defined MRI criteria. Materials and Methods: Fifty-one unilateral and bilateral MRI examinations of 32 patients were enrolled. Therapeutic strategies before and after performance of the MRI were compared. Retrospectively, two radiologists independently analyzed the MR images for position of the disk, position of the condyle, signal intensity of the disk and bilaminar zone, osseous changes and several additional findings, using a check list. Agreement was tested by kappa statistics. Results: In 56% of the cases, changes of the therapeutic regimen were registered after MRI. Statistically significant agreement of the two observers was found for anterior position of the disk (kappa=0.44), transverse position of the disk (kappa=0.46) and position of the condyle (kappa=0.45). No significant agreement was found for signal intensity of the disk (kappa=0.14) or bilaminar zone (kappa=0.24), osseous changes (kappa=0.13) and the additional findings (kappa=0.29). Discussion: MRI has a measurable impact on the therapeutic approach to the internal derangement of the TMJ. The position of the disk and condyle can be reproducibly judged, while the signal intensity of the disk and bilaminar zone and the osseous changes are subject to wide observer variations. (orig.) [German] Zielsetzung: Es sollte der Einfluss der MRT des Kiefergelenkes auf die Therapieentscheidung untersucht werden. Des Weiteren sollten Uebereinstimmungen zweier unabhaengiger Radiologen in der Beurteilung von Kiefergelenk MRT anhand definierter Kriterien bestimmt werden. Material und Methoden: 51 MR-Untersuchungen des Kiefergelenkes wurden ausgewertet. Bei diesen Patienten wurde das urspruengliche mit dem Behandlungskonzept nach MRT verglichen. Alle MRT wurden von zwei Radiologen ausgewertet. Die

Comparison of PET and fMRI activation patterns during declarative memory processes; Vergleich von PET und fMRT-Aktivierungsmustern waehrend deklarativer Gedaechtnisvorgaenge

Energy Technology Data Exchange (ETDEWEB)

Mottaghy, F.M.; Krause, B.J.; Schmidt, D.; Hautzel, H.; Mueller-Gaertner, H.-W. [Heinrich-Heine-Univ. Duesseldorf (Germany). Klinik fuer Nuklearmedizin; Forschungszentrum Juelich (DE). Klinik fuer Nuklearmedizin (KME); Herzog, H.; Shah, N.J. [Forschungszentrum Juelich (DE). Inst. fuer Medizin (IME); Halsband, U. [Albert-Ludwigs-Univ. Freiburg (Germany). Psychologisches Inst., Neuropsychologie

2000-11-01

Aim: In this study neuronal correlates of encoding and retrieval in paired association learning were compared using two different neuroimaging methods: Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Methods: 6 right-handed normal male volunteers took part in the study. Each subject underwent six 0-15-butanol PET scans and an fMRI study comprising four single epochs on a different day. The subjects had to learn and retrieve 12 word pairs which were visually presented (highly imaginable words, not semantically related). Results: Mean recall accuracy was 93% in the PET as well as in the fMRI experiment. During encoding and retrieval we found anterior cingulate cortex activation, and bilateral prefrontal cortex activation in both imaging modalities. Furthermore, we demonstrate the importance of the precuneus in episodic memory. With PET the results demonstrate frontopolar activations whereas fMRI fails to show activations in this area probably due to susceptibility artifacts. In fMRI we found additionally parahippocampal activation and due to the whole-brain coverage cerebellar activation during encoding. The distance between the center-of-mass activations in both modalities was 7.2{+-}6.5 mm. Conclusion: There is a preponderance of commonalities in the activation patterns yielded with fMRI and PET. However, there are also important differences. The decision to choose one or the other neuroimaging modality should among other aspects depend on the study design (single subject vs. group study) and the task of interest. (orig.) [German] Ziel: Vergleich der beiden Bildgebungsmethoden Positronen-Emissions-Tomographie (PET) und funktionelle Magnetresonanztomographie (fMRT) bei einer deklarativen Gedaechtnisaufgabe. Methoden: 6 Probanden wurden sowohl mit einer GE 4096+PET-Kamera als auch mit einem Siemens Vision MR-Tomographen waehrend einer deklarativen Gedaechtnisaufgabe untersucht. Die Gedaechtnisaufgabe bestand darin, 12 Wortpaare

Resilience - A Concept

Science.gov (United States)

2016-04-05

the assessment of the health of a network or system. The hypothesis is: resiliency is meaningful in the context of holistic assessments of... health , holistic , Resiliency Tier, Resiliency Tier Matrix, State of Resiliency 295Defense ARJ, July 2015, Vol. 22 No. 3 : 294–324 296 Defense ARJ, July...upon who is speaking. Taking this one step further, consider resiliency as a concept that provides a holistic view of a system or capability, just

Effectiveness of box trainers in laparoscopic training

Directory of Open Access Journals (Sweden)

Dhariwal Anender

2007-01-01

Full Text Available Rationale and Objectives: Various devices are used to aid in the education of laparoscopic skills ranging from simple box trainers to sophisticated virtual reality trainers. Virtual reality system is an advanced and effective training method, however it is yet to be adopted in India due to its cost and the advanced technology required for it. Therefore, box trainers are being used to train laparoscopic skills. Hence this study was undertaken to assess the overall effectiveness of the box-training course. Study Procedure: The study was conducted during six-day laparoscopic skills training workshops held during 2006. Twenty five surgeons; age range of 26 to 45 years, of either sex, who had not performed laparoscopic surgery before; attending the workshop were evaluated. Each participant was given a list of tasks to perform before beginning the box-training course on day one and was evaluated quantitatively by rating the successful completion of each test. Evaluation began when the subject placed the first tool into the cannula and ended with task completion. Two evaluation methods used to score the subject, including a global rating scale and a task-specific checklist. After the subject completed all sessions of the workshop, they were asked to perform the same tasks and were evaluated in the same manner. For each task completed by the subjects, the difference in the scores between the second and first runs were calculated and interpreted as an improvement as a percentage of the initial score. Statistical Analysis: Wilcoxon matched-paired signed-ranks test was applied to find out the statistical significance of the results obtained. Results: The mean percentage improvement in scores for both the tasks, using global rating scale, was 44.5% + 6.930 (Mean + SD. For task 1, using the global rating scale mean percentage improvement was 49.4% + 7.948 (Mean + SD. For task 2, mean percentage improvement using global rating scale was 39.6% + 10.4 (Mean

Tic Tac Toe Math. Train the Trainer.

Science.gov (United States)

Center for Alternative Learning, Bryn Mawr, PA.

This report describes a project that developed a "Train the Trainer" program that would enable individuals to learn and teach the alternative instructional technique, Tic Tac Toe Math, developed by Richard Cooper for adult basic education students. The pilot workshop conducted as part of the project identified problems that traditional…

Systemic resilience model

International Nuclear Information System (INIS)

Lundberg, Jonas; Johansson, Björn JE

2015-01-01

It has been realized that resilience as a concept involves several contradictory definitions, both for instance resilience as agile adjustment and as robust resistance to situations. Our analysis of resilience concepts and models suggest that beyond simplistic definitions, it is possible to draw up a systemic resilience model (SyRes) that maintains these opposing characteristics without contradiction. We outline six functions in a systemic model, drawing primarily on resilience engineering, and disaster response: anticipation, monitoring, response, recovery, learning, and self-monitoring. The model consists of four areas: Event-based constraints, Functional Dependencies, Adaptive Capacity and Strategy. The paper describes dependencies between constraints, functions and strategies. We argue that models such as SyRes should be useful both for envisioning new resilience methods and metrics, as well as for engineering and evaluating resilient systems. - Highlights: • The SyRes model resolves contradictions between previous resilience definitions. • SyRes is a core model for envisioning and evaluating resilience metrics and models. • SyRes describes six functions in a systemic model. • They are anticipation, monitoring, response, recovery, learning, self-monitoring. • The model describes dependencies between constraints, functions and strategies

Cleared Hot: A Forward Air Control (Airborne) Concepts Trainer

National Research Council Canada - National Science Library

King, Gregory; Lakey, Charles

2006-01-01

With the aim of creating a skill trainer of conceptual knowledge, what is the development process for ensuring the correct set of objectives are determined, matched to appropriate technology, and implemented...

The Current State of Personal Training: an Industry Perspective of Personal Trainers in a Small Southeast Community

Science.gov (United States)

Melton, Deana I.; Katula, Jeffrey A.; Mustian, Karen M.

2014-01-01

Although research has identified a number of qualities and competencies necessary to be an effective exercise leader, the fitness industry itself is largely unregulated and lacks a unified governing body. As such, a plethora of personal trainer certifications exists with varying degrees of validity that fail to ensure qualified trainers and, therefore, protect the consumer. It is argued that the potential consequences of this lack of regulation are poor societal exercise adherence, potential injury to the client, and poor public perception of personal trainers. Additionally, it is not known whether personal trainers are meeting the needs of their clients or what criteria are used in the hiring of personal trainers. Thus, the purpose of this investigation was to examine the current state of personal training in a midsized Southeast city by using focus group methodology. Local personal trainers were recruited for the focus groups (n = 11), and the results from which were transcribed, coded, and analyzed for themes using inductive reasoning by the authors. Qualities and characteristics that identified by participants clustered around 4 main themes. Client selection rationale consisted of qualities that influenced a client’s decision to hire a particular trainer (e.g., physique, gender, race). Client loyalty referred to the particular qualities involved in maintaining clients (e.g., motivation skills, empathy, social skills). Credentials referred to formal training (e.g., college education, certifications). Negative characteristics referred to qualities considered unethical or unprofessional (e.g., sexual comments, misuse of power) as well as the consequences of those behaviors (e.g., loss of clients, potential for litigation). These results are discussed regarding the implications concerning college programs, certification organizations, increasing public awareness of expectations of qualified trainers, and a move towards state licensure. PMID:18438226

Can we continue to ignore gender differences in performance on simulation trainers?

Science.gov (United States)

Thorson, Chad M; Kelly, Jason P; Forse, R Armour; Turaga, Kiran K

2011-05-01

There are differences between the genders in their innate performances on simulation trainers, which may impair accurate assessment of psychomotor skills. The performance of fourth-year students with no exposure to the Minimally Invasive Surgical Trainer compared based on gender, and other psychomotor skills. Our study included 16 male and 16 female students. After adjusting for choice of medical specialty (Pvideo game use (P=.6), and experience in the operating room (P=.4), female sex was an independent factor for worse performance (P=.04) in multivariate models. Women took more time than men (P<.01) and made more errors (29 versus 25 on 3 reps, P<.01). Among medical students with no previous exposure to laparoscopic trainers, female students perform worse than male students after adjusting for confounding factors. This difference must be recognized by training programs while using simulators for training and evaluation.

Craniocerebral trauma. Magnetic resonance imaging of diffuse axonal injury; Schaedel-Hirn-Trauma. MRT bei diffuser axonaler Verletzung

Energy Technology Data Exchange (ETDEWEB)

Mallouhi, A. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Abteilung fuer Neuro- und Muskuloskelettale Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

2014-09-15

fuer Behinderung oder Tod. Es fuehrt haeufig zu einer axonalen Scherverletzung. Die daraus resultierende Pathologie wird als diffuse axonale Verletzung (''diffuse axonal injury'', DAI) bezeichnet. Die DAI-assoziierten Laesionen treten bilateral und verteilt auf und werden in der oberflaechlichen und in der tiefen weissen Substanz beobachtet. Sie finden sich sowohl in der Naehe als auch weit entfernt von der Aufprallstelle. Bei klinischem Verdacht auf eine diffuse axonale Verletzung ist die Magnetresonanztomographie (MRT) zur weiteren Abklaerung die Methode der Wahl, dies insbesondere bei Patienten mit einer unauffaelligen Computertomographie des Schaedels. Zur Abklaerung des Gehirns nach einem Schaedel-Hirn-Trauma (SHT) wird ein multimodales MR-Verfahren angewendet, das in 2 Kategorien unterteilt werden kann: strukturelle und funktionelle MR-Bildgebung. Fuer die strukturelle MRT kommen hauptsaechlich die Fluid-attenuated-inversion-recovery(FLAIR)-Gewichtung und die suszeptibilitaetsgewichtete Bildgebung (SWI) zum Einsatz. Die SWI ist ausserordentlich auf Blutabbauprodukte empfindlich, welche als kleine Signalausloeschungen an 3 typischen Lokalisationen (an der Rinden-Mark-Grenzzone, im Corpus callosum und im Hirnstamm) zur Darstellung kommen. Die funktionelle MRT umfasst eine Gruppe staendig in Entwicklung befindlicher Techniken, welche ein grosses Potenzial zur optimalen Evaluierung der weissen Substanz bei Patienten nach einem SHT haben. Diese modernen bildgebenden Verfahren ermoeglichen die Visualisierung der mit Scherverletzungen assoziierten Veraenderungen, wie die Funktionsbeeintraechtigung der Axone, die verminderte Durchblutung und abnormale metabolische Aktivitaet der betroffenen Gehirnanteile. Die multimodale MR-Abklaerung bei Patienten mit DAI fuehrt zu einer detaillierteren und differenzierteren Darstellung der zugrunde liegenden pathophysiologischen Veraenderungen der verletzten Nervenbahnen und traegt zur Verbesserung der

Psychological Trait Resilience Within Ecological Systems Theory: The Resilient Systems Scales.

Science.gov (United States)

Maltby, John; Day, Liz; Flowe, Heather D; Vostanis, Panos; Chivers, Sally

2017-07-14

This project describes the development of the Resilient Systems Scales, created to address conceptual and methodological ambiguities in assessing the ecological systems model of resilience. Across a number of samples (total N = 986), our findings suggest that the Resilient Systems Scales show equivalence to a previously reported assessment (Maltby, Day, & Hall, 2015 ) in demonstrating the same factor structure, adequate intercorrelation between the 2 measures of resilience, and equivalent associations with personality and well-being. The findings also suggest that the Resilient Systems Scales demonstrate adequate test-retest reliability, compare well with other extant measures of resilience in predicting well-being, and map, to varying degrees, onto positive expression of several cognitive, social, and emotional traits. The findings suggest that the new measure can be used alongside existing measures of resilience, or singly, to assess positive life outcomes within psychology research.

[Development of a gait trainer with regulated servo-drive for rehabilitation of locomotor disabled patients].

Science.gov (United States)

Uhlenbrock, D; Sarkodie-Gyan, T; Reiter, F; Konrad, M; Hesse, S

1997-01-01

The aim of the present study was to develop a new gait trainer for the rehabilitation of non-ambulatory patients. For the simulation of the gait phase, we used a commercially available fitness trainer (Fast Track) with two foot plates moving in an alternating fashion and connected to a servo-controlled propulsion system providing the necessary support for the movement depending on the patient's impairment level. To compensate deficient equilibrium reflexes, the patient was suspended in a harness capable of supporting some of his/her weight. Video analysis of gait and the kinesiological EMG were used to assess the pattern of movement and the corresponding muscle activity, which were then evaluated in healthy subjects, spinal cord injured and stroke patients and compared with walking on the flat or on a treadmill. Walking on the gait trainer was characterised by a symmetrical, sinusoidal movement of lower amplitude than in normal gait. The EMG showed a low activity of the tibialis anterior muscle, while the antigravity muscles were clearly activated by the gait trainer during the stance phase. In summary, the new gait trainer generates a symmetrical gait-like movement, promoting weight acceptance in the stance phase, which is important for the restoration of walking ability.

Resilient leadership and the organizational culture of resilience: construct validation.

Science.gov (United States)

Everly, George S; Smith, Kenneth J; Lobo, Rachel

2013-01-01

Political, economic, and social unrest and uncertainty seem replete throughout the world. Within the United States, political vitriol and economic volatility have led to severe economic restrictions. Both government and private sector organizations are being asked to do more with less. The specter of dramatic changes in healthcare creates a condition of uncertainty affecting budget allocations and hiring practices. If ever there was a time when a "resilient culture" was needed, it is now. In this paper we shall discuss the application of "tipping point" theory (Gladwell, 2000) operationalized through a special form of leadership: "resilient leadership" (Everly, Strouse, Everly, 2010). Resilient leadership is consistent with Gladwells "Law of the Few" and strives to create an organizational culture of resilience by implementing an initial change within no more than 20% of an organization's workforce. It is expected that such a minority, if chosen correctly, will "tip" the rest of the organization toward enhanced resilience, ideally creating a self-sustaining culture of resilience. This paper reports on the empirical foundations and construct validation of "resilient leadership".

Resilience

Science.gov (United States)

Resilience is an important framework for understanding and managing complex systems of people and nature that are subject to abrupt and nonlinear change. The idea of ecological resilience was slow to gain acceptance in the scientific community, taking thirty years to become widel...

Developing the resilience typology

DEFF Research Database (Denmark)

Simonsen, Daniel Morten

2013-01-01

There is a growing interest in resilience in internal crisis management and crisis communication. How an organization can build up resilience as a response to organisational crisis, at a time when the amount of crises seem only to increase, is more relevant than ever before. Nevertheless resilience...... is often perceived in the literature as something certain organisations have by definition, without further reflection on what it is that creates this resiliency. This article explores what it is that creates organisational resilience, and in view of the different understandings of the resilience...... phenomenon, develops a typology of resilience. Furthermore the resilience phenomenon is discussed against the definition of a crisis as a cosmological episode, and implications for future research is discussed and summarized....

A mechanized gait trainer for restoring gait in nonambulatory subjects.

Science.gov (United States)

Hesse, S; Uhlenbrock, D; Werner, C; Bardeleben, A

2000-09-01

To construct an advanced mechanized gait trainer to enable patients the repetitive practice of a gaitlike movement without overstraining therapists. DEVICE: Prototype gait trainer that simulates the phases of gait (by generating a ratio of 40% to 60% between swing and stance phases), supports the subjects according to their ability (lifts the foot during swing phase), and controls the center of mass in the vertical and horizontal directions. Two nonambulatory, hemiparetic patients who regained their walking ability after 4 weeks of daily training on the gait trainer, a 55-year-old woman and a 62-year-old man, both of whom had a first-time ischemic stroke. Four weeks of training, five times a week, each session 20 minutes long. Functional ambulation category (FAC, levels 0-5) to assess gait ability and ground level walking velocity. Rivermead motor assessment score (RMAS, 0-13) to assess gross motor function. Patient 1: At the end of treatment, she was able to walk independently on level ground with use of a walking stick. Her walking velocity had improved from .29m/sec to .59m/sec. Her RMAS score increased from 4 to 10, meaning she could walk at least 40 meters outside, pick up objects from floor, and climb stairs independently. Patient 2: At end of 4-week training, he could walk independently on even surfaces (FAC level 4), using an ankle-foot orthosis and a walking stick. His walking velocity improved from .14m/sec to .63m/sec. His RMAS increased from 3 to 10. The gait trainer enabled severely affected patients the repetitive practice of a gaitlike movement. Future studies may elucidate its value in gait rehabilitation of nonambulatory subjects.

The Organizational Climate in Collegiate Athletics: An Athletic Trainer's Perspective.

Science.gov (United States)

Mazerolle, Stephanie M; Eason, Christianne M

2018-01-01

  An organizational climate is largely based on an employee's perceptions of the working conditions in which he or she engages regularly. A multifaceted concept, the organizational climate is often formed by perceptions of employee welfare, rewards, and support. Achieving work-life balance is also a part of the climate.   To learn collegiate athletic trainers' perceptions of organizational climate and specifically how it may pertain to their work-life balance.   Phenomenologic study.   Collegiate practice setting.   Thirty athletic trainers working in the collegiate athletics setting took part in 1-on-1 phone interviews. The participants were 30.5 (interquartile range [IQR] = 7.75) years old and had been certified for 7 (IQR = 5) years and at their current position for 4 (IQR = 3) years.   Participants completed a phone interview that followed a semistructured framework. All transcribed interviews were analyzed using a phenomenologic approach. Researcher triangulation, expert review, and data saturation were used to establish credibility.   Athletic trainers working in the collegiate athletics setting who had positive perceptions of their work-life balance described their organizational climate as family friendly. Our participants' supervisors allowed for autonomy related to work scheduling, which provided opportunities for work-life balance. These athletic trainers believed that they worked in a climate that was collegial, which was helpful for work-life balance. In addition, the importance of placing family first was part of the climate.   The perceptions of our participants revealed a climate of family friendliness, supervisor support, and collegiality among staff members, which facilitated the positive climate for work-life balance. The mindset embraced the importance of family and recognized that work did not always have to supersede personal priorities.

[Tools for laparoscopic skill development - available trainers and simulators].

Science.gov (United States)

Jaksa, László; Haidegger, Tamás; Galambos, Péter; Kiss, Rita

2017-10-01

The laparoscopic minimally invasive surgical technique is widely employed on a global scale. However, the efficient and ethical teaching of this technique requires equipment for surgical simulation. These educational devices are present on the market in the form of box trainers and virtual reality simulators, or some combination of those. In this article, we present a systematic overview of commercially available surgical simulators describing the most important features of each product. Our overview elaborates on box trainers and virtual reality simulators, and also touches on surgical robotics simulators, together with operating room workflow simulators, for the sake of completeness. Apart from presenting educational tools, we evaluated the literature of laparoscopic surgical education and simulation, to provide a complete picture of the unfolding trends in this field. Orv Hetil. 2017; 158(40): 1570-1576.

Examining the Experiences of Athletic Trainers as they transition into their First Full-Time Position

Directory of Open Access Journals (Sweden)

Stephanie M. Mazerolle

2017-04-01

Full Text Available Transition to clinical practice is an important topic in athletic training, as it can be a period of time that presents challenges for the athletic trainer. Most of the research pertaining to transition to practice focuses on the skills and knowledge necessary for clinical practice, yet we know that stress can manifest from not only being an independent practitioner but also from learning how to balance one’s roles. We wanted to understand the perspective of today’s novice athletic trainers and how they feel in their first full-time position, specifically relating to their professional development and establishment or maintenance of work-life balance (WLB. Using a qualitative paradigm, we phone interviewed athletic trainers who were categorized as career starters by the National Athletic Trainers’ Association. Using a purposive recruitment strategy we were able to recruit 20 (12 female, 8 male athletic trainers meeting this classification. General inductive analyses were used to code the data from our interviews, and we satisfied credibility though saturation of the data, peer review, and researcher triangulations during the coding process. Our findings suggest that while confidence in clinical skills is apparent, some of the more administrative aspects of clinical practice present challenges. We found that various employment settings offered various expectations or challenges that had the potential to impact WLB. A blend of professional and organizational processes helped transition the athletic trainer, and although both were helpful each also could be bolstered to improve transitioning for the newly credentialed athletic trainer. Employers of early career starters should be aware of the stress related to transition to practice, and the time it can take to acclimate.

Imaging of Nuclear Weapon Trainers

Energy Technology Data Exchange (ETDEWEB)

Schwellenbach, David [National Security Technologies, LLC. (NSTec), Mercury, NV (United States)

2017-12-06

The Configurable Muon Tracker (CMT) is an adaptation of the existing drift tube detector commercially available from Decision Sciences International Corporation (DSIC). NSTec engineered the CMT around commercially available drift tube assemblies to make a detector that is more versatile than previous drift tube assemblies. The CMT became operational in February 2013. Traditionally, cosmic-ray muon trackers rely on near-vertical trajectory muons for imaging. Since there are scenarios where imaging using vertical trajectory muons is not practical, NSTec designed the CMT specifically for quick configurability to track muons from any trajectory. The CMT was originally designed to be changed from vertical imaging mode to horizontal imaging mode in a few hours with access to a crane or other lifting equipment. In FY14, locations for imaging weapon trainers and SNM were identified and it was determined that lifting equipment would not typically be available in experimental areas. The CMT was further modified and a portable lifting system was developed to allow reconfiguration of the CMT without access to lifting equipment at the facility. This system was first deployed at Los Alamos National Laboratory’s W-division, where several trainers were imaged in both horizontal and vertical modes. Real-time images have been compared in both modes showing that imaging can be done in both modes with the expected longer integration time for horizontal mode. Further imaging and post processing of the data is expected to continue into early FY15.

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas; CT und MRT des erworbenen Cholesteatoms: Prae- und postoperative Bildgebung

Energy Technology Data Exchange (ETDEWEB)

Krestan, C.; Czerny, C. [Abteilung fuer Osteologie, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Gstoettner, W. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Frankfurt (Germany); Franz, P. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Wien (Austria)

2003-03-01

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [German] In dieser Arbeit wird die Rolle der hochaufloesenden Computertomographie (HRCT) und der Magnetresonanztomographie (MRT) zur Abklaerung prae- und postoperativ bedingter Komplikationen erworbener Cholesteatome beschrieben. Die Bildgebung wurde sowohl mit der HRCT als auch mit der MRT durchgefuehrt. Die HRCT und die MRT wurden in axialer und koronaler Ebene (auch

'Resilience thinking' in transport planning

OpenAIRE

Wang, JYT

2015-01-01

Resilience has been discussed in ecology for over forty years. While some aspects of resilience have received attention in transport planning, there is no unified definition of resilience in transportation. To define resilience in transportation, I trace back to the origin of resilience in ecology with a view of revealing the essence of resilience thinking and its relevance to transport planning. Based on the fundamental concepts of engineering resilience and ecological resilience, I define "...

Em companhia do personal trainer: significados atribuídos pelos alunos ao atendimento personalizado

Directory of Open Access Journals (Sweden)

Maurício Leite da Silva

2016-11-01

Este estudo objetivou compreender os significados do atendimento do personal trainer para o respectivo aluno deste profissional. É uma pesquisa de cunho qualitativo que se sustenta na literatura especializada sobre as temáticas personal trainer e treinamento personalizado. O estudo se valeu da análise de conteúdo como método e da entrevista semiestruturada como ferramenta metodológica. Foram entrevistados sete alunos de treinadores personalizados de uma academia de ginástica da cidade de Cachoeirinha/RS, Brasil. Após a análise das entrevistas, foi possível compreender que o atendimento do personal trainer para os alunos entrevistados significa resultados rápidos, confiança e motivação.

Four concepts for resilience and the implications for the future of resilience engineering

International Nuclear Information System (INIS)

Woods, David D.

2015-01-01

The concept of system resilience is important and popular—in fact, hyper-popular over the last few years. Clarifying the technical meanings and foundations of the concept of resilience would appear to be necessary. Proposals for defining resilience are flourishing as well. This paper organizes the different technical approaches to the question of what is resilience and how to engineer it in complex adaptive systems. This paper groups the different uses of the label ‘resilience’ around four basic concepts: (1) resilience as rebound from trauma and return to equilibrium; (2) resilience as a synonym for robustness; (3) resilience as the opposite of brittleness, i.e., as graceful extensibility when surprise challenges boundaries; (4) resilience as network architectures that can sustain the ability to adapt to future surprises as conditions evolve. - Highlights: • There continues to be a wide diversity of definitions of the label resilience. • Research progress points to 4 basic concepts underneath diverse uses of. • Each of the four core concepts defines different research agendas. • The 4 concepts provide guides on how to engineer resilience for safety

Clinical value of MRI concerning dissection of the supraaortic vessels; Wertigkeit der MRT bei posttraumatischer Dissektion supraaortaler Gefaesse

Energy Technology Data Exchange (ETDEWEB)

Pauls, S.; Goerich, J.; Kraemer, S. [Abt. fuer Diagnostische Radiologie, Univ. Ulm (Germany); Hartwig, E. [Unfall- und Wiederherstellungschirurgie, Univ. Ulm (Germany)

2002-03-01

Purpose: Evaluation of the potential of MRI concerning dissection of the supra-aortic vessels after cervical trauma. Patients and methods: During the time period from August 1998 to February 2001, 148 patients with trauma were examined by means of MRI scan of the neck / cervical spine or skull concerning morphology of the cervical spine as well as the brain tissue. MRI sequences were weighted T{sub 1} and T{sub 2} before and after contrast medium in transverse and sagittal slices. Additional time of flight (TOF) sequences and contrast-enhanced angiography were acquired. The MRI images were examined by two experienced radiologists when tied consensus was reached. Results: 7 patients (4,7%) with a total of 9 dissections of the vertebral and/or internal carotid artery were found; diagnosis was done on TOF images, contrast enhances MR-angiography, transversal T{sub 1}- and T{sub 2}-weighted sequences as well as T{sub 1}-weighted images post-contrast medium. Therapy was changed accordingly in 4 cases and anticoagulation initiated. Conclusion: All patients with cervical injuries should be screened by MRI including MR-angiography, T{sub 1}-weighted images pre- and post-contrast agent to achieve a sure diagnosis concerning the precise size of the dissection. MRI has proven to be an excellent diagnostic tool for our patient group. (orig.) [German] Ziel: Beurteilung der Bedeutung der MRT bezueglich der Dissektionen supraaortaler Gefaesse im Rahmen cervicaler Traumata. Patienten und Methode: Im Zeitraum von August 1998 bis Februar 2001 wurden an unserer Klinik 148 Patienten mit Traumata zugewiesen, welche zur Abklaerung einer Gefuegestoerung der HWS bzw. Ausschluss einer Myelonaffektion eine MRT-Untersuchung des Halses / der HWS oder Schaedels erhielten. Es wurden jeweils T{sub 1}- und T{sub 2}-gewichtete Sequenzen in transversaler und sagittaler Schnittfuehrung vor und nach Kontrastmittelgabe angefertigt. Zusaetzlich wurden TOF-Sequenzen sowie kontrastunterstuetzte

Conceptualizing Resilience

Directory of Open Access Journals (Sweden)

Thomas A. Birkland

2016-12-01

Full Text Available This commentary provides an overview of the idea of resilience, and acknowledges the challenges of defining and applying the idea in practice. The article summarizes a way of looking at resilience called a “resilience delta”, that takes into account both the shock done to a community by a disaster and the capacity of that community to rebound from that shock to return to its prior functionality. I show how different features of the community can create resilience, and consider how the developed and developing world addresses resilience. I also consider the role of focusing events in gaining attention to events and promoting change. I note that, while focusing events are considered by many in the disaster studies field to be major drivers of policy change in the United States disaster policy, most disasters have little effect on the overall doctrine of shared responsibilities between the national and subnational governments.

The law on sport in the light of the opinion of the fitness instructors and personal trainers

OpenAIRE

Patrycja, Proskura; Kazimierz, Witkowski

2017-01-01

The popularity of the work as a fitness instructor and personal trainer in our country continues to grow. Right about this flu in Poland is not regulated, which creates a lot of concerns about the quality of their qualifications.The existing law on sport of 25 June 2010 requirements for trainers and instructors, excluded the requirement of graduate and cut off the procedure of applying for consent to the competent Minister of physical culture to carry out specialized trainer courses and ins...

The law on sport in the light of the opinion of the fitness instructors and personal trainers

OpenAIRE

Patrycja, Proskura; Kazimierz, Witkowski

2017-01-01

The popularity of the work as a fitness instructor and personal trainer in our country continues to grow. Right about this flu in Poland is not regulated, which creates a lot of concerns about the quality of their qualifications. The existing law on sport of 25 June 2010 requirements for trainers and instructors, excluded the requirement of graduate and cut off the procedure of applying for consent to the competent Minister of physical culture to carry out specialized trainer courses and in...

Pengembangan alat tempo trainer untuk membantu efisiensi gerakan lengan gaya bebas cabang olahraga renang

Directory of Open Access Journals (Sweden)

Bahtiyar Heru Susanto

2017-09-01

This research aimed to develop the tools of Tempo Trainer to help efficiency of arm freestyle movement on the branch of swimming. Small-scale trials were conducted on four coaches and 10 athletes in the swimming association Tirta Alvita and Yuso. Large-scale trial was conducted on 10 coaches and 25 athletes in the swimming association Tirta Alvita, Yuso, Dolphin, Caesar, and Arowana. The instrument used to collect data was a questionnaire based on the analysis PIECES (Performance, Information, Economic, Control, Efficiency, Services. The assessment result of experts, coaches, and athletes toward Tempo Trainer tool shows that the assessment categoryis good, valid and reliable. Based of the resultsthat Tempo Trainer tool developed can count the number of cycles of freestyle movement, a sound that can be heard by coaches and athletes, can be used for more than one athlete, as well as it is more affordable. The coaches assessment shows valid results with every indicator PIECES obtain value rxy > r table = 0.632, with reliable results rxy = 0.908. The assessment of Tempo Trainer draft tool by athletes is good and valid with the result of the rxy > r table = 0.750.

Assessment of the Clinical Trainer as a Role Model: A Role Model Apperception Tool (RoMAT)

NARCIS (Netherlands)

Jochemsen-van der Leeuw, H. G. A. Ria; van Dijk, Nynke; Wieringa-de Waard, Margreet

2014-01-01

Purpose Positive role modeling by clinical trainers is important for helping trainees learn professional and competent behavior. The authors developed and validated an instrument to assess clinical trainers as role models: the Role Model Apperception Tool (RoMAT). Method On the basis of a 2011

Integrated Approach to a Resilient City: Associating Social, Environmental and Infrastructure Resilience in its Whole

Directory of Open Access Journals (Sweden)

Birutė PITRĖNAITĖ-ŽILĖNIENĖ

2014-12-01

Full Text Available Rising complexity, numbers and severity of natural and manmade disasters enhance the importance of reducing vulnerability, or on contrary – increasing resilience, of different kind of systems, including those of social, engineering (infrastructure, and environmental (ecological nature. The goal of this research is to explore urban resilience as an integral system of social, environmental, and engineering resilience. This report analyses the concepts of each kind of resilience and identifies key factors influencing social, ecological, and infrastructure resilience discussing how these factors relate within urban systems. The achievement of resilience of urban and regional systems happens through the interaction of the different elements (social, psychological, physical, structural, and environmental, etc.; therefore, resilient city could be determined by synergy of resilient society, resilient infrastructure and resilient environment of the given area. Based on literature analysis, the current research provides some insights on conceptual framework for assessment of complex urban systems in terms of resilience. To be able to evaluate resilience and define effective measures for prevention and risk mitigation, and thereby strengthen resilience, we propose to develop an e-platform, joining risk parameters’ Monitoring Systems, which feed with data Resiliency Index calculation domain. Both these elements result in Multirisk Platform, which could serve for awareness and shared decision making for resilient people in resilient city.

Quantifying resilience for resilience engineering of socio technical systems

OpenAIRE

Häring, Ivo; Ebenhöch, Stefan; Stolz, Alexander

2016-01-01

Resilience engineering can be defined to comprise originally technical, engineering and natural science approaches to improve the resilience and sustainability of socio technical cyber-physical systems of various complexities with respect to disruptive events. It is argued how this emerging interdisciplinary technical and societal science approach may contribute to civil and societal security research. In this context, the article lists expected benefits of quantifying resilience. Along the r...

Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

OpenAIRE

Cassie Maxwell; Kyle Ruth; Carol Friesen

2017-01-01

Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete sur...

Resilience: Theory and Application.

Energy Technology Data Exchange (ETDEWEB)

Carlson, J.L.; Haffenden, R.A.; Bassett, G.W.; Buehring, W.A.; Collins, M.J., III; Folga, S.M.; Petit, F.D.; Phillips, J.A.; Verner, D.R.; Whitfield, R.G. (Decision and Information Sciences)

2012-02-03

There is strong agreement among policymakers, practitioners, and academic researchers that the concept of resilience must play a major role in assessing the extent to which various entities - critical infrastructure owners and operators, communities, regions, and the Nation - are prepared to respond to and recover from the full range of threats they face. Despite this agreement, consensus regarding important issues, such as how resilience should be defined, assessed, and measured, is lacking. The analysis presented here is part of a broader research effort to develop and implement assessments of resilience at the asset/facility and community/regional levels. The literature contains various definitions of resilience. Some studies have defined resilience as the ability of an entity to recover, or 'bounce back,' from the adverse effects of a natural or manmade threat. Such a definition assumes that actions taken prior to the occurrence of an adverse event - actions typically associated with resistance and anticipation - are not properly included as determinants of resilience. Other analyses, in contrast, include one or more of these actions in their definitions. To accommodate these different definitions, we recognize a subset of resistance- and anticipation-related actions that are taken based on the assumption that an adverse event is going to occur. Such actions are in the domain of resilience because they reduce both the immediate and longer-term adverse consequences that result from an adverse event. Recognizing resistance- and anticipation-related actions that take the adverse event as a given accommodates the set of resilience-related actions in a clear-cut manner. With these considerations in mind, resilience can be defined as: 'the ability of an entity - e.g., asset, organization, community, region - to anticipate, resist, absorb, respond to, adapt to, and recover from a disturbance.' Because critical infrastructure resilience is important

Multiparametric MRI of the prostate. Important radiological findings for urologists; Multiparametrische MRT der Prostata. Wichtige radiologische Befunde fuer den Urologen

Energy Technology Data Exchange (ETDEWEB)

Schlemmer, Heinz-Peter [Deutsches Krebsforschungszentrum (DKFZ), Heidelberg (Germany)

2017-08-15

High prevalence of prostate cancer with multifocality and biological heterogeneity. Insufficient conventional urological diagnostics. Discrimination between significant and insignificant cancer needed. Digital rectal examination, prostate-specific antigen (PSA) serum level, systematic transrectal ultrasound (TRUS)-guided prostate biopsy. Multiparametric magnetic resonance imaging (mpMRI) including T2-weighted (T2w), diffusion-weighted and dynamic contrast-enhanced MRI according to the prostate imaging reporting and data system (PIRADS), MR-targeted biopsy, most frequently MR/TRUS image fusion biopsy. Prostate cancer is characterized by low signal intensity on T2w MRI, restricted water diffusion and pronounced and early uptake of contrast enhancement. Sensitivity and specificity according to the current literature are ca. 80% and 90%, respectively. In cases of suspected prostate cancer, most accurate are mpMRI according to PIRADS and in cases of positive findings, MRI-targeted biopsy, most frequently as MRI/TRUS image fusion biopsy. (orig.) [German] Hohe Praevalenz des Prostatakarzinoms mit Multifokalitaet und biologischer Heterogenitaet. Unzureichende konventionelle urologische Diagnostik. Unterscheidung klinisch signifikanter von klinisch nicht signifikanten Karzinomen erforderlich. Digitale rektale Untersuchung, Serum-PSA (prostataspezifisches Antigen), transrektale Sonographie (TRUS), systematische transrektale TRUS-Biopsie. Multiparametrische Magnetresonanztomographie (mpMRT) mit T2w- und diffusionsgewichteten sowie dynamischen kontrastmittelverstaerkten T1w-Sequenzen, dem Standard nach dem Prostate Imaging Reporting and Data System (PIRADS) entsprechend. MR-unterstuetzte Biopsie, meist MR-/TRUS-Fusionsbiopsie. Prostatakarzinome sind typischerweise T2-hypointens mit eingeschraenkter Diffusion und zeigen eine rasche Kontrastmittelanflutung. Nach der Literatur betragen Sensitivitaet und Spezifitaet der mpMRT ca. 80 bzw. 90 %. Fuer die Abklaerung bei Verdacht auf

Variations in area-level disadvantage of Australian registered fitness trainers usual training locations

Directory of Open Access Journals (Sweden)

Jason A. Bennie

2016-07-01

Full Text Available Abstract Background Leisure-time physical activity and strength training participation levels are low and socioeconomically distributed. Fitness trainers (e.g. gym/group instructors may have a role in increasing these participation levels. However, it is not known whether the training location and characteristics of Australian fitness trainers vary between areas that differ in socioeconomic status. Methods In 2014, a sample of 1,189 Australian trainers completed an online survey with questions about personal and fitness industry-related characteristics (e.g. qualifications, setting, and experience and postcode of their usual training location. The Australian Bureau of Statistics ‘Index of Relative Socioeconomic Disadvantage’ (IRSD was matched to training location and used to assess where fitness professionals trained and whether their experience, qualification level and delivery methods differed by area-level disadvantage. Linear regression analysis was used to examine the relationship between IRSD score and selected characteristics adjusting for covariates (e.g. sex, age. Results Overall, 47 % of respondents worked in areas within the three least-disadvantaged deciles. In contrast, only 14.8 % worked in the three most-disadvantaged deciles. In adjusted regression models, fitness industry qualification was positively associated with a higher IRSD score (i.e. working in the least-disadvantaged areas (Cert III: ref; Cert IV β:13.44 [95 % CI 3.86-23.02]; Diploma β:15.77 [95 % CI: 2.17-29.37]; Undergraduate β:23.14 [95 % CI: 9.41-36.86]. Conclusions Fewer Australian fitness trainers work in areas with high levels of socioeconomic disadvantaged areas than in areas with low levels of disadvantage. A higher level of fitness industry qualifications was associated with working in areas with lower levels of disadvantage. Future research should explore the effectiveness of providing incentives that encourage more fitness trainers and those with

Variations in area-level disadvantage of Australian registered fitness trainers usual training locations.

Science.gov (United States)

Bennie, Jason A; Thornton, Lukar E; van Uffelen, Jannique G Z; Banting, Lauren K; Biddle, Stuart J H

2016-07-11

Leisure-time physical activity and strength training participation levels are low and socioeconomically distributed. Fitness trainers (e.g. gym/group instructors) may have a role in increasing these participation levels. However, it is not known whether the training location and characteristics of Australian fitness trainers vary between areas that differ in socioeconomic status. In 2014, a sample of 1,189 Australian trainers completed an online survey with questions about personal and fitness industry-related characteristics (e.g. qualifications, setting, and experience) and postcode of their usual training location. The Australian Bureau of Statistics 'Index of Relative Socioeconomic Disadvantage' (IRSD) was matched to training location and used to assess where fitness professionals trained and whether their experience, qualification level and delivery methods differed by area-level disadvantage. Linear regression analysis was used to examine the relationship between IRSD score and selected characteristics adjusting for covariates (e.g. sex, age). Overall, 47 % of respondents worked in areas within the three least-disadvantaged deciles. In contrast, only 14.8 % worked in the three most-disadvantaged deciles. In adjusted regression models, fitness industry qualification was positively associated with a higher IRSD score (i.e. working in the least-disadvantaged areas) (Cert III: ref; Cert IV β:13.44 [95 % CI 3.86-23.02]; Diploma β:15.77 [95 % CI: 2.17-29.37]; Undergraduate β:23.14 [95 % CI: 9.41-36.86]). Fewer Australian fitness trainers work in areas with high levels of socioeconomic disadvantaged areas than in areas with low levels of disadvantage. A higher level of fitness industry qualifications was associated with working in areas with lower levels of disadvantage. Future research should explore the effectiveness of providing incentives that encourage more fitness trainers and those with higher qualifications to work in more socioeconomically

Design and implementation of robust controllers for a gait trainer.

Science.gov (United States)

Wang, F C; Yu, C H; Chou, T Y

2009-08-01

This paper applies robust algorithms to control an active gait trainer for children with walking disabilities. Compared with traditional rehabilitation procedures, in which two or three trainers are required to assist the patient, a motor-driven mechanism was constructed to improve the efficiency of the procedures. First, a six-bar mechanism was designed and constructed to mimic the trajectory of children's ankles in walking. Second, system identification techniques were applied to obtain system transfer functions at different operating points by experiments. Third, robust control algorithms were used to design Hinfinity robust controllers for the system. Finally, the designed controllers were implemented to verify experimentally the system performance. From the results, the proposed robust control strategies are shown to be effective.

A train-the-trainer education and promotion program: chronic fatigue syndrome – a diagnostic and management challenge

Directory of Open Access Journals (Sweden)

Hynes Kevin

2008-10-01

Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complicated illness for providers and patients. Fewer than 20% of persons with CFS have been diagnosed and treated. For providers, compounding the issue are the challenges in making a diagnosis due to the lack of a biomedical marker. Methods The objective of the CFS diagnosis and management curriculum was to instruct core trainers as to the evaluation, diagnosis, and management of CFS. Over a two year period, 79 primary care physicians, physician assistants, and nurse practitioners from diverse regions in the U.S. participated as core trainers in a two day Train-the-Trainer (TTT workshop. As core trainers, the workshop participants were expected to show increases in knowledge, self-efficacy, and management skills with the primary goal of conducting secondary presentations. Results The optimal goal for each core trainer to present secondary training to 50 persons in the health care field was not reached. However, the combined core trainer group successfully reached 2064 primary care providers. Eighty-two percent of core trainers responded "Very good" or "Excellent" in a post-tessurvey of self-efficacy expectation and CFS diagnosis. Data from the Chicago workshops showed significant improvement on the Primary Care Opinion Survey (p Conclusion Data show the workshop was successful in meeting the objectives of increasing CFS knowledge and raising perceived self-efficacy towards making a diagnosis. The CFS TTT program informed an educational provider project by shifting the format for physicians to grand rounds and continuing medical education design while retaining TTT aspects for nurse practitioners and physicians assistants. Evaluations also indicate that secondary trainings may be more readily employed and accepted if administrative barriers are addressed early in the planning phases.

Ethical Issues of ICT Use by Teacher Trainers: Use of E-Books in Academic Settings

Science.gov (United States)

Kilickaya, Ferit; Krajka, Jaroslaw

2015-01-01

In an attempt to address the issue of ethics in ICT use by university teacher trainers, the current study aimed to investigate academics' downloading and sharing e-books as well as the reasons that led them to be involved in this piracy. The participants included 140 teacher trainers working at faculties of education in Turkey, and a questionnaire…

Framing resilience: social uncertainty in designing urban climate resilience

OpenAIRE

Wardekker, J.A.

2016-01-01

Building urban resilience to climate change and other challenges will be essential for maintaining thriving cities into the future. Resilience has become very popular in both research on and practice of climate adaptation. However, people have different interpretations of what it means: what resilience-building contributes to, what the problems, causes and solutions are, and what trade-offs, side-effects and other normative choices are acceptable. These different ways of ‘framing’ climate res...

Value of breast MRI as supplement to mammography and sonography for high risk breast cancer patients; Wertigkeit der Mamma-MRT als Ergaenzung zu Mammographie und Sonographie bei Patientinnen mit erhoehtem Mammakarzinomrisiko

Energy Technology Data Exchange (ETDEWEB)

Schlossbauer, T.; Hellerhoff, K.; Reiser, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

2008-04-15

The aim of this study is to give an overview on early detection of breast cancer in patients with an increased risk of breast cancer. Sensitivities and diagnostic accuracies of breast MRI, mammography and ultrasound were compared. A systematic literature search of the past 3 years was performed. Studies which compared breast imaging modalities and used image-guided biopsy results as standard of reference were included. Patients included had to have had an increased lifetime risk for breast cancer (>15%). Regarding sensitivity and diagnostic accuracy, breast MRI performed best in comparison to the other modalities within this collective of patients. Sensitivities ranged from 71-100%, 0-78%, and 13-65%, for MRI, mammography, and ultrasound, respectively Breast MRI is a well established tool for screening in patients at high risk for developing breast cancer and is a valuable supplement to mammography and ultrasound within this selected cohort of patients. (orig.) [German] Ziele der Arbeit sind die inhaltliche Einfuehrung in das Thema Frueherkennung des Mammakarzinoms bei Patientinnen mit erhoehtem Risiko und eine systematische Analyse der Wertigkeit von MRT und anderen bildgebenden Verfahren in diesem Zusammenhang. Es wurde eine systematische Literaturrecherche ueber die letzten 3 Jahre durchgefuehrt. Dabei wurden Vergleichsstudien der verschiedenen bildgebenden Verfahren in der Mammadiagnostik beruecksichtigt, bei denen die bildgesteuerte Biopsie als Goldstandard angegeben wurde. Von allen bildgebenden Verfahren zeigt die Mamma-MRT bei Patientinnen mit familiaerem Risiko die hoechste Sensitivitaet und diagnostische Genauigkeit bei der Detektion des Mammakarzinoms. Fuer MRT, Mammographie und Sonographie werden Sensitivitaeten zwischen 71 und 100%, 0 und 78% sowie 13 und 65% angegeben. Die Mamma-MRT ist ein etabliertes Verfahren zum Screening von Risikopatientinnen. Uebereinstimmend wird der diagnostische Nutzen der Mamma-MRT als ergaenzendes Verfahren zu Mammographie

Trainer-to-student ratios for teaching psychomotor skills in health care fields, as applied to osteopathic manipulative medicine.

Science.gov (United States)

Snider, Karen T; Seffinger, Michael A; Ferrill, Heather P; Gish, Eric E

2012-04-01

The hallmark of osteopathic medical education is the inclusion of hands-on instruction in osteopathic manipulative medicine (OMM), which includes palpatory diagnosis and osteopathic manipulative treatment (OMT). This OMM training typically involves a primary instructor presenting theory and techniques with step-by-step demonstrations to a large group of first- and second-year osteopathic medical students. Additional instructors, referred to as table trainers, assist the primary instructor by supervising the students as they practice the presented techniques. To the authors' knowledge, there is no currently accepted standard for a table trainer-to-student ratio in OMM skills laboratories within osteopathic medical schools in the United States. However, through a Google Web search and PubMed literature review, the authors identified published trainer-to-student ratios used in other health care skills training curricula. Psychomotor skills training courses in health care fields typically have a table trainer-to-student ratio of 1 trainer to 8 or fewer students. On the basis of these findings and psychomotor skills learning theory, the authors conclude that this ratio is likely sufficient for OMM skills training.

Magnetic resonance imaging in the evaluation of pneumonia; Nachweis von pneumonischen Infiltraten mit der MRT

Energy Technology Data Exchange (ETDEWEB)

Eibel, R.; Herzog, P.; Dietrich, O.; Reiser, M.; Schoenberg, S.O. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Rieger, C.; Ostermann, H. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Abteilung fuer Haematologie/Onkologie, Klinikum Grosshadern

2006-04-15

Magnetic resonance imaging (MRI) of the lung is challenging because of substantial drawbacks. However, lung pathologies that are associated with increased attenuation values in CT enhance visualization in MRI: proton density is increased and tissue-air interfaces, resulting in susceptibility artifacts, are reduced in pneumonia, pneumonitis, edema, and carcinoma. On the other hand, many lung diseases result in shortness of breath, so that patients cannot hold their breath for long periods. Therefore, fast imaging techniques are required which should also allow for high spatial resolution so that small lesions can be detected. Calcifications and air pockets within lesions are not readily recognized with MRI. Thin section CT is standard for the diagnosis of pneumonia. With parallel imaging techniques, MRI examination of the lungs can be performed with short periods of breath holding, which allow for sub-centimeter resolution in the z-axis. Especially for follow-up examinations in immunocompromised patients and, in some instances, for the staging of malignant diseases (malignant pleural mesothelioma, lung cancer, respectively), MRI is very promising and may contribute to a decrease in the radiation exposure of the patients. (orig.) [German] Die MRT des Lungenparenchyms ist wegen des extrem niedrigen Protonengehalts des Lungengewebes und den starken Grenzflaechen zwischen Luft und Parenchym prinzipiell sehr problematisch. Allerdings liegt bei pathologischen Lungengewebeveraenderungen eine andere Situation vor, da infolge von Oedem, Entzuendung bzw. Tumorwachstum der Protonengehalt erhoeht und die Grenzflaechen reduziert sind. Viele Erkrankungen der Lunge fuehren dazu, dass der Patient den Atem nicht lange anzuhalten vermag. Daher sind MRT-Pulssequenzen erforderlich, die eine Datenakquisition in wenigen Sekunden gestatten. Aus technischer Sicht werden die vom CT bekannten Submillimeterschichten vielleicht nie realisierbar sein, sodass sicher auch in Zukunft kleine

Practice until you can preach anything: The Presentation Trainer

NARCIS (Netherlands)

Schneider, Jan

2015-01-01

Public speaking skills are relevant for many professions, developing these skills requires practice and feedback. In order to get this feedback we developed the Presentation Trainer, a tool that automatically tracks your voice, posture and movements to give you feedback about your nonverbal

Development Aspects of a Robotised Gait Trainer for Neurological Rehabilitation

National Research Council Canada - National Science Library

Schmidt, H

2001-01-01

.... Conventional training methods, e.g. treadmill training, require great physical effort from the therapists to assist the patient After the successful development and application of a mechanised gait trainer, a new research project...

Java programming 24-hour trainer

CERN Document Server

Fain, Yakov

2015-01-01

Quick and painless Java programming with expert multimedia instruction Java Programming 24-Hour Trainer, 2nd Edition is your complete beginner's guide to the Java programming language, with easy-to-follow lessons and supplemental exercises that help you get up and running quickly. Step-by-step instruction walks you through the basics of object-oriented programming, syntax, interfaces, and more, before building upon your skills to develop games, web apps, networks, and automations. This second edition has been updated to align with Java SE 8 and Java EE 7, and includes new information on GUI b

WordPress 24-hour trainer

CERN Document Server

Plumley, George

2015-01-01

Create and expand feature-rich sites with no programming experience Ready to build, maintain, and expand your web site with WordPress but have no prior programming experience? WordPress 24-Hour Trainer, 3rd Edition is your book-and-video learning solution that walks you step-by-step through all the important features you will need to know. Lessons range from focused, practical everyday tasks to more advanced, creative features. Learn from an industry professional how to enter content, create pages, manage menus, utilize plug-ins, connect to social media, create membership and e-commerce site

Excel VBA 24-hour trainer

CERN Document Server

Urtis, Tom

2015-01-01

Master VBA automation quickly and easily to get more out of Excel Excel VBA 24-Hour Trainer, 2nd Edition is the quick-start guide to getting more out of Excel, using Visual Basic for Applications. This unique book/video package has been updated with fifteen new advanced video lessons, providing a total of eleven hours of video training and 45 total lessons to teach you the basics and beyond. This self-paced tutorial explains Excel VBA from the ground up, demonstrating with each advancing lesson how you can increase your productivity. Clear, concise, step-by-step instructions are combined wit

Development of a framework for resilience measurement: Suggestion of fuzzy Resilience Grade (RG) and fuzzy Resilience Early Warning Grade (REWG).

Science.gov (United States)

Omidvar, Mohsen; Mazloumi, Adel; Mohammad Fam, Iraj; Nirumand, Fereshteh

2017-01-01

Resilience engineering (RE) can be an alternative technique to the traditional risk assessment and management techniques, to predict and manage safety conditions of modern socio-technical organizations. While traditional risk management approaches are retrospective and highlight error calculation and computation of malfunction possibilities, resilience engineering seeks ways to improve capacity at all levels of organizations in order to build strong yet flexible processes. Considering the resilience potential measurement as a concern in complex working systems, the aim of this study was to quantify the resilience by the help of fuzzy sets and Multi-Criteria Decision-Making (MCDM) techniques. In this paper, we adopted the fuzzy analytic hierarchy process (FAHP) method to measure resilience in a gas refinery plant. A resilience assessment framework containing six indicators, each with its own sub-indicators, was constructed. Then, the fuzzy weights of the indicators and the sub-indicators were derived from pair-wise comparisons conducted by experts. The fuzzy evaluating vectors of the indicators and the sub-indicators computed according to the initial assessment data. Finally, the Comprehensive Resilience Index (CoRI), Resilience Grade (RG), and Resilience Early Warning Grade (REWG) were established. To demonstrate the applicability of the proposed method, an illustrative example in a gas refinery complex (an instance of socio-technical systems) was provided. CoRI of the refinery ranked as "III". In addition, for the six main indicators, RG and REWG ranked as "III" and "NEWZ", respectively, except for C3, in which RG ranked as "II", and REWG ranked as "OEWZ". The results revealed the engineering practicability and usefulness of the proposed method in resilience evaluation of socio-technical systems.

Flood Resilient Systems and their Application for Flood Resilient Planning

Science.gov (United States)

Manojlovic, N.; Gabalda, V.; Antanaskovic, D.; Gershovich, I.; Pasche, E.

2012-04-01

Following the paradigm shift in flood management from traditional to more integrated approaches, and considering the uncertainties of future development due to drivers such as climate change, one of the main emerging tasks of flood managers becomes the development of (flood) resilient cities. It can be achieved by application of non-structural - flood resilience measures, summarised in the 4As: assistance, alleviation, awareness and avoidance (FIAC, 2007). As a part of this strategy, the key aspect of development of resilient cities - resilient built environment can be reached by efficient application of Flood Resilience Technology (FReT) and its meaningful combination into flood resilient systems (FRS). FRS are given as [an interconnecting network of FReT which facilitates resilience (including both restorative and adaptive capacity) to flooding, addressing physical and social systems and considering different flood typologies] (SMARTeST, http://www.floodresilience.eu/). Applying the system approach (e.g. Zevenbergen, 2008), FRS can be developed at different scales from the building to the city level. Still, a matter of research is a method to define and systematise different FRS crossing those scales. Further, the decision on which resilient system is to be applied for the given conditions and given scale is a complex task, calling for utilisation of decision support tools. This process of decision-making should follow the steps of flood risk assessment (1) and development of a flood resilience plan (2) (Manojlovic et al, 2009). The key problem in (2) is how to match the input parameters that describe physical&social system and flood typology to the appropriate flood resilient system. Additionally, an open issue is how to integrate the advances in FReT and findings on its efficiency into decision support tools. This paper presents a way to define, systematise and make decisions on FRS at different scales of an urban system developed within the 7th FP Project

Training the Trainers of Tomorrow Today - driving excellence in medical education

Science.gov (United States)

Fellow-Smith, Elizabeth; Beveridge, Ed; Hogben, Katy; Wilson, Graeme; Lowe, John; Abraham, Rachel; Ingle, Digby; Bennett, Danielle; Hernandez, Carol

2013-01-01

Training the Trainers of Tomorrow Today (T4) is a new way to deliver “Training for Trainers”. Responding to local dissatisfaction with existing arrangements, T4 builds on 3 essential requirements for a future shape of training: 1. Clinical Leadership and a Collaborative Approach 2. Cross-Specialty Design and Participation 3. Local Delivery and Governance Networks Design principles also included: 3 levels of training to reflect differing needs of clinical supervisors, educational supervisors and medical education leader, mapping to GMC requirements and the London Deanery's Professional Development Framework; alignment of service, educational theory and research; recognition of challenges in delivering and ensuring attendance in busy acute and mental health settings, and the development of a faculty network. The delivery plan took into account census of professional development uptake and GMC Trainee Surveys. Strong engagement and uptake from the 11 Trusts in NW London has been achieved, with powerful penetration into all specialties. Attendance has exceeded expectations. Against an initial 12 month target of 350 attendances, 693 were achieved in the first 8 months. Evaluation of content demonstrates modules are pitched appropriately to attendees needs, with positive feedback from trainers new to the role. Delivery style has attracted high ratings of satisfaction: 87% attendees rating delivery as “good\\excellent”. External evaluation of impact demonstrated improved training experiences through changes in supervision, the learning environment and understanding of learning styles. We have addressed sustainability of the programme by advertising and recruiting Local Faculty Development Trainers. Volunteer consultants and higher trainees are trained to deliver the programme on a cascade model, supported by the Specialty Tutors, individual coaching and educational bursaries. The Trainers are local champions for excellence in training, provide a communication

Developing Objective Criteria for Evaluating Student Athletic Trainers.

Science.gov (United States)

Treadway, Linda

In devising a form for the evaluation of students preparing to become athletic trainers, it is helpful to have a checklist in which objectives and behavioral responses are organized into categories, such as prevention of injury, first aid, emergency care, treatment, rehabilitation, and taping and wrapping. It is also important to have records and…

Resilience Indicator Summaries and Resilience Scores CNMI JPEG Maps

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Maps of relative classifications (low to high) for six resilience indicators and two anthropogenic stressors and a map of final relative resilience scores for 78...

Resilience Indicator Summaries and Resilience Scores CNMI Excel database

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Maps of relative classifications (low to high) for six resilience indicators and two anthropogenic stressors and a map of final relative resilience scores for 78...

Design of Human – Machine Interface and Altering of Pelvic Obliquity with RGR Trainer

OpenAIRE

Pietrusinski, Maciej; Unluhisarcikli, Ozer; Mavroidis, Constantinos; Cajigas, Iahn; Bonato, Paolo

2011-01-01

The Robotic Gait Rehabilitation (RGR) Trainer targets secondary gait deviations in stroke survivors undergoing rehabilitation. Using an impedance control strategy and a linear electromagnetic actuator, the device generates a force field to control pelvic obliquity through a Human-Machine Interface (i.e. a lower body exoskeleton). Herein we describe the design of the RGR Trainer Human-Machine Interface (HMI) and we demonstrate the system’s ability to alter the pattern of movement of the pelvis...

Concussion Assessment in California Community College Football: Athletic Trainers' Strides toward a Safer Return to Play

Science.gov (United States)

Chinn, Nancy Resendes

2010-01-01

The purpose of this mixed method study was to compare current practices of athletic trainers in the management of concussion in football at California Community Colleges (CCC) with the concussion management guidelines set forth by the National Athletic Trainers Association (NATA). The study also set out to gain understanding of why some athletic…

Blended learning in CME: the perception of GP trainers

NARCIS (Netherlands)

te Pas, E.; Meinema, J. G.; Visser, M. R. M.; van Dijk, N.

2016-01-01

Blended learning (the combination of electronic methods with traditional teaching methods) has the potential to combine the best of traditional education with the best of computer-mediated training. We chose to develop such an intervention for GP trainers who were undertaking a Continuing Medical

A Measure of Team Resilience: Developing the Resilience at Work Team Scale.

Science.gov (United States)

McEwen, Kathryn; Boyd, Carolyn M

2018-03-01

This study develops, and initial evaluates, a new measure of team-based resilience for use in research and practice. We conducted preliminary analyses, based on a cross-sectional sample of 344 employees nested within 31 teams. Seven dimensions were identified through exploratory and confirmatory factor analyses. The measure had high reliability and significant discrimination to indicate the presence of a unique team-based aspect of resilience that contributed to higher work engagement and higher self-rated team performance, over and above the effects of individual resilience. Multilevel analyses showed that team, but not individual, resilience predicted self-rated team performance. Practice implications include a need to focus on collective as well as individual behaviors in resilience-building. The measure provides a diagnostic instrument for teams and a scale to evaluate organizational interventions and research the relationship of resilience to other constructs.

The utilization of performance evaluation instruments by technical trainers to evaluate maintenance personnel in the nuclear power industry in the United States

International Nuclear Information System (INIS)

Hornberger, C.K.

1993-01-01

The purpose of this study was to document the utilization of performance evaluation instruments by technical trainers in the evaluation of maintenance personnel in US nuclear power plants. Performance evaluation of maintenance personnel has been identified by nuclear utilities and the Nuclear Regulatory Commission as the only acceptable method of determining worker competence. The NRC requires performance evaluation to be conducted to performance standards, but it does not specify the standards or the method to be utilized. Each plant is free to establish its own standards and methods of evaluation. This was a descriptive study utilizing descriptive statistics for the analysis of the data. The subjects included 655 maintenance trainers in 72 US nuclear plants. Conclusions of the study include: (1) Technical trainers are in compliance with NRC regulations. (2) Evaluation materials developed by the Institute of Nuclear Power Operations are used by technical trainers in every one of the 62 plants that responded. (3) In-plant or self-developed Performance Evaluation Instruments are utilized by 419 or 95.2% of the technical trainers. (4) Technical trainers incorporate nine common components into their Performance Evaluation Instruments. (5) Technical trainers evaluate maintenance processes and the product produced by workers when following procedures and specifications are critical and when safety hazards are involved. (6) Technical trainers believe that utilizing Performance Evaluation Instruments makes their job easier by providing documentation about the quality and standards of maintenance skills. (7) Technical trainers believe that maintenance workers benefit when their skills are assessed through the use of Performance Evaluation Instruments

Physical disease and resilient outcomes: a systematic review of resilience definitions and study methods.

Science.gov (United States)

Johnston, Marjorie C; Porteous, Terry; Crilly, Michael A; Burton, Christopher D; Elliott, Alison; Iversen, Lisa; McArdle, Karen; Murray, Alison; Phillips, Louise H; Black, Corri

2015-01-01

Findings from physical disease resilience research may be used to develop approaches to reduce the burden of disease. However, there is no consensus on the definition and measurement of resilience in the context of physical disease. The aim was to summarize the range of definitions of physical disease resilience and the approaches taken to study it in studies examining physical disease and its relationship to resilient outcomes. Electronic databases were searched from inception to March 2013 for studies in which physical disease was assessed for its association with resilient outcomes. Article screening, data extraction, and quality assessment were carried out independently by 2 reviewers, with disagreements being resolved by a third reviewer. The results were combined using a narrative technique. Of 2280 articles, 12 met the inclusion criteria. Of these studies, 1 was of high quality, 9 were of moderate quality, and 2 were low quality. The common findings were that resilience involves maintaining healthy levels of functioning following adversity and that it is a dynamic process not a personality trait. Studies either assessed resilience based on observed outcomes or via resilience measurement scales. They either considered physical disease as an adversity leading to resilience or as a variable modifying the relationship between adversity and resilience. This work begins building consensus as to the approach to take when defining and measuring physical disease resilience. Resilience should be considered as a dynamic process that varies across the life-course and across different domains, therefore the choice of a resilience measure should reflect this. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Mapping Resilience

DEFF Research Database (Denmark)

Carruth, Susan

2015-01-01

by planners when aiming to construct resilient energy plans. It concludes that a graphical language has the potential to be a significant tool, flexibly facilitating cross-disciplinary communication and decision-making, while emphasising that its role is to support imaginative, resilient planning rather than...... the relationship between resilience and energy planning, suggesting that planning in, and with, time is a core necessity in this domain. It then reviews four examples of graphically mapping with time, highlighting some of the key challenges, before tentatively proposing a graphical language to be employed...

Recruitment and Rotation of the Trainers in the Lifelong Learning Context

Science.gov (United States)

Mamaqi, Xhevrie; Rubio, Pilar Olave; Alvarez, Jesús Miguel

The workplace of today is characterized by rapid changes in work processes, in competition, in customer demands, and in work practices. To keep abreast of these rapid changes employers and employees must be committed to lifelong learning in order to keep ahead. One of the most important actors in the lifelong learning development process are the trainers, whose professional characteristics needs meeting new skills and adapting an varied and specific contents of the current labour market. Affected by the discontinuity and a high rate of job rotation, the recognition of it labour status and basic competence and skills, forms part of the Bologna Process recognized as Vocational Education Training (VET). Sixty in-depth interviews realized to managers of the centres of formation, are used as tools to obtain information about following topics: recruitment strategies, conventional and not conventional routes of the recruitment, rate rotation, qualification and training of the Spanish trainers. The transcription of the interviews achieve that not always exist a previous plan of recruitment, except that it is a question as big centers of formation. Also, the obtained information indicates a high rate of rotation that affects the trainers ones as professionals since there exists the discontinuity of the formative offer on the labour market.

Intention to use sport concussion guidelines among community-level coaches and sports trainers.

Science.gov (United States)

Newton, Joshua D; White, Peta E; Ewing, Michael T; Makdissi, Michael; Davis, Gavin A; Donaldson, Alex; Sullivan, S John; Seward, Hugh; Finch, Caroline F

2014-09-01

Sporting bodies have developed guidelines for managing community-level players with suspected concussion in response to international consensus statements on concussion in sport. The purpose of this study was to examine the factors that influence the intended use of concussion guidelines among community-level coaches and sports trainers from two popular football codes in Australia: Australian football and rugby league. Cross-sectional survey. The survey, based on an extended theory of planned behaviour model, was completed by 183 Australian football coaches, 121 Australian football sports trainers, 171 rugby league coaches, and 142 rugby league sports trainers. Personal norms and self-efficacy were significant predictors of intention to use concussion guidelines, although the relationship between self-efficacy and intention was stronger among Australian football coaches than rugby league coaches. Analysis of the salient beliefs that underpin self-efficacy found that coaches, irrespective of football code, felt less familiar (χ(2)=25.70, psports trainers in using the concussion guidelines. At the same time, Australian football personnel, irrespective of their team role, felt that they had insufficient time (χ(2)=8.04, psport concussion guidelines should focus on enhancing self-efficacy and leveraging personal norms. Increasing coaches' familiarity and experience in using the concussion guidelines would also be warranted, as would finding ways to overcome the perceived time and resource constraints identified among Australian football personnel. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Teaching Resilience: A Narrative Inquiry into the Importance of Teacher Resilience

Science.gov (United States)

Vance, Angela; Pendergast, Donna; Garvis, Susanne

2015-01-01

This study set out to explore how high school teachers perceive their resilience as they teach a scripted social and emotional learning program to students with the goal of promoting the resilience skills of the students in their pastoral care classes. In this emerging field of research on teacher resilience, there is a paucity of research…

Rights for resilience: food sovereignty, power, and resilience in development practice

Directory of Open Access Journals (Sweden)

Marygold Walsh-Dilley

2016-03-01

Full Text Available Even as resilience thinking becomes evermore popular as part of strategic programming among development and humanitarian organizations, uncertainty about how to define, operationalize, measure, and evaluate resilience for development goals prevails. As a result, many organizations and institutions have undertaken individual, collective, and simultaneous efforts toward clarification and definition. This has opened up a unique opportunity for a rethinking of development practices. The emergent consensus about what resilience means within development practice will have important consequences both for development practitioners and the communities in which they work. Incorporating resilience thinking into development practice has the potential to radically transform this arena in favor of social and environmental justice, but it could also flounder as a way to dress old ideas in new clothes or, at worst, to further exploit, disempower, and marginalize the world's most vulnerable populations. We seek to make an intervention into the definitional debates surrounding resilience that supports the former and helps prevent the latter. We argue that resilience thinking as it has been developed in social-ecological systems and allied literatures has a lot in common with the concept of food sovereignty and that paying attention to some of the lessons and claims of food sovereignty movements could contribute toward building a consensus around resilience that supports social and environmental justice. In particular, the food sovereignty movement relies on a strategy that elevates rights. We suggest that a rights-based approach to resilience-oriented development practice could contribute to its application in just and equitable ways.

Haemophilic arthropathy of the knee. Gd-DTPA enhanced MRT. Clinical and radiological correlation

International Nuclear Information System (INIS)

Naegele, M.; Kunze, V.; Hamann, M.; Eickhoff, H.; Koch, W.; Oldenburg, J.; Reiser, M.

1994-01-01

17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0,1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) of FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39,6% min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.) [de

Resilience in disaster research

DEFF Research Database (Denmark)

Dahlberg, Rasmus; Johannessen-Henry, Christine Tind; Raju, Emmanuel

2015-01-01

This paper explores the concept of resilience in disaster management settings in modern society. The diversity and relatedness of ‘resilience’ as a concept and as a process are reflected in its presentation through three ‘versions’: (i) pastoral care and the role of the church for victims...... of disaster trauma, (ii) federal policy and the US Critical Infrastructure Plan, and (iii) the building of resilient communities for disaster risk reduction practices. The three versions aim to offer characteristic expressions of resilience, as increasingly evident in current disaster literature....... In presenting resilience through the lens of these three versions, the article highlights the complexity in using resilience as an all-encompassing word. The article also suggests the need for understanding the nexuses between risk, vulnerability, and policy for the future of resilience discourse....

An overdue alignment of risk and resilience? A conceptual contribution to community resilience.

Science.gov (United States)

Mochizuki, Junko; Keating, Adriana; Liu, Wei; Hochrainer-Stigler, Stefan; Mechler, Reinhard

2018-04-01

A systematic review of literature on community resilience measurement published between 2005 and 2014 revealed that the profound lack of clarity on risk and resilience is one of the main reasons why confusion about terms such as adaptive capacity, resilience, and vulnerability persists, despite the effort spared to operationalise these concepts. Resilience is measured in isolation in some cases, where a shock is perceived to arise external to the system of interest. Problematically, this contradicts the way in which the climate change and disaster communities perceive risk as manifesting itself endogenously as a function of exposure, hazard, and vulnerability. The common conceptualisation of resilience as predominantly positive is problematic as well when, in reality, many undesirable properties of a system are resilient. Consequently, this paper presents an integrative framework that highlights the interactions between risk drivers and coping, adaptive, and transformative capacities, providing an improved conceptual basis for resilience measurement. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Characterization of wood polymer composite and design of root trainer

Science.gov (United States)

Chitra, K. N.; Abhilash, R. M.; Chauhan, Shakti Singh; Venkatesh, G. S.; Shivkumar, N. D.

2018-04-01

Biopolymers have received much attention of researchers due to concerns over disposal of plastics, greenhouse gas emission and environmental problems associated with it. Polylactic Acid (PLA) is one of the thermoplastic biopolymer made from lactic acid by using agricultural resources. PLA has received significant interest due to its competitive properties when compared to commodity plastics such as Polyethylene, Polypropylene and Polystyrene. PLA has interesting properties such as high stiffness, UV stability, clear and glossy finish. However, application of PLA is restricted due to its brittle nature. Engineering and thermal properties of PLA can be improved by reinforcing fibres and fillers. Lignocelluloses or natural fibres such as Jute, Hemp, Bamboo, Sisal and Wood fibres can be used as reinforcement. By using natural fibres, a very bio-compostable composite can be produced. In the present study, short fibres from Melia Dubia wood were extracted and used as reinforcement to PLA Bio-Polymer matrix. Characterization of developed composite was obtained using tensile and flexural tests. Tensile test simulation of composite was performed using Altair Hypermesh, a Finite Element (FE) preprocessor and LS-Dyna an explicit FE solver. MAT_01, an elastic material model in LS-Dyna was used to model the behaviour. Further, the design of Root Trainer using developed composite has been explored. A Root Trainer is an aid to the cultivation of seedlings in nurseries. Root Trainer made by using developed composite has advantage of biodegradability and eco-friendly nature.

Face, content and concurrent validity of the Mimic® dV-Trainer for robot-assisted endoscopic surgery: a prospective study.

Science.gov (United States)

Egi, H; Hattori, M; Tokunaga, M; Suzuki, T; Kawaguchi, K; Sawada, H; Ohdan, H

2013-01-01

The aim of this study was to determine whether any correlation exists between the performance of the Mimic® dV-Trainer (Mimic Technologies, Seattle, Wash., USA) and the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, Calif., USA). Twelve participants were recruited, ranging from residents to consultants. We used four training tasks, consisting of 'Pick and Place', 'Peg Board', 'Thread the Rings' and 'Suture Sponge', from the software program of the Mimic dV-Trainer. The performance of the participants was recorded and measured. Additionally, we prepared the same tasks for the da Vinci Surgical System. All participants completed the tasks using the da Vinci Surgical System and were assessed according to time, the Objective Structured Assessment of Technical Skill checklist and the global rating score for endoscopic suturing assessed by two independent blinded observers. After performing these tasks, the participants completed a questionnaire that evaluated the Mimic dV-Trainer's face and content validity. The final results for each participant for the Mimic dV-Trainer and the da Vinci Surgical System were compared. All participants ranked the Mimic dV-Trainer as a realistic training platform that is useful for residency training. There was a significant relationship between the Mimic dV-Trainer and the da Vinci Surgical System in all four tasks. We verified the reliability of the assessment of the checklist and the global rating scores for endoscopic suturing assessed by the two blinded observers using Cronbach's alpha test (r = 0.803, 0.891). We evaluated the concurrent validity of the Mimic dV-Trainer and the da Vinci Surgical System. Our results suggest the possibility that training using the Mimic dV-Trainer may therefore be able to improve the operator's performance during live robot-assisted surgery. © 2013 S. Karger AG, Basel.

Data replicating the factor structure and reliability of commonly used measures of resilience: The Connor–Davidson Resilience Scale, Resilience Scale, and Scale of Protective Factors

Directory of Open Access Journals (Sweden)

A.N. Madewell

2016-09-01

Full Text Available The data presented in this article are related to the article entitled “Assessing Resilience in Emerging Adulthood: The Resilience Scale (RS, Connor Davidson Resilience Scale (CD-RISC, and Scale of Protective Factors (SPF” (Madewell and Ponce-Garcia, 2016 [1]. The data were collected from a sample of 451 college students from three universities located in the Southwestern region of the United States: 374 from a large public university and 67 from two smaller regional universities. The data from the three universities did not significantly differ in terms of demographics. The data represent participant responses on six measurements to include the Resilience Scale-25 (RS-25, Resilience Scale-14 (RS-14, Connor Davidson Resilience Scale-25 (CD-RISC-25, Connor Davidson Resilience Scale-10 (CD-RISC-10, Scale of Protective Factors-24 (SPF-24, and the Life Stressor Checklist Revised (LSC-R. Keywords: Scale of Protective Factors, Resilience Scale, Connor–Davidson Resilience Scale, Emerging adulthood, Confirmatory factor analysis

Multifractal resilience and viability

Science.gov (United States)

Tchiguirinskaia, I.; Schertzer, D. J. M.

2017-12-01

The term resilience has become extremely fashionable and there had been many attempts to provide operational definition and in fact metrics going beyond a set of more or less ad-hoc indicators. The viability theory (Aubin and Saint-Pierre, 2011) have been used to give a rather precise mathematical definition of resilience (Deffuant and Gilbert, 2011). However, it does not grasp the multiscale nature of resilience that is rather fundamental as particularly stressed by Folke et al (2010). In this communication, we first recall a preliminary attempt (Tchiguirinskaia et al., 2014) to define multifractal resilience with the help of the maximal probable singularity. Then we extend this multifractal approach to the capture basin of the viability, therefore the resilient basin. Aubin, J P, A. Bayen, and P Saint-Pierre (2011). Viability Theory. New Directions. Springer, Berlin,. Deffuant, G. and Gilbert, N. (eds) (2011) Viability and Resilience of Complex Systems. Springer Berlin.Folke, C., S R Carpenter, B Walker, M Sheffer, T Chapin, and J Rockstroem (2010). Resilience thinking: integrating re- silience, adaptability and transformability. Ecology and So- ciety, 14(4):20, Tchiguirinskaia,I., D. Schertzer, , A. Giangola-Murzyn and T. C. Hoang (2014). Multiscale resilience metrics to assess flood. Proceedings of ICCSA 2014, Normandie University, Le Havre, France -.

Vision Trainer Teaches Focusing Techniques at Home

Science.gov (United States)

2015-01-01

Based on work Stanford Research Institute did for Ames Research Center, Joseph Trachtman developed a vision trainer to treat visual focusing problems in the 1980s. In 2014, Trachtman, operating out of Seattle, released a home version of the device called the Zone-Trac. The inventor has found the biofeedback process used by the technology induces an alpha-wave brain state, causing increased hand-eye coordination and reaction times, among other effects

Framing resilience: social uncertainty in designing urban climate resilience

NARCIS (Netherlands)

Wardekker, J.A.

2016-01-01

Building urban resilience to climate change and other challenges will be essential for maintaining thriving cities into the future. Resilience has become very popular in both research on and practice of climate adaptation. However, people have different interpretations of what it means: what

Accuracy of renal volume assessment in children by three-dimensional sonography; Nierenvolumetrie im Kindesalter: Genauigkeit der dreidimensionalen Sonographie im Vergleich zur konventionellen Sonographie und CT/MRT

Energy Technology Data Exchange (ETDEWEB)

Fritz, G.A.; Riccabona, M.; Bohdal, G. [Klinik fuer Radiologie, Universitaetsklinikum Graz (Austria); Quehenberger, F. [Inst. fuer medizinische Informatik, Statistik und Dokumentation, Universitaetsklinikum Graz (Austria)

2003-04-01

Purpose: Prospective evaluation of the accuracy of three-dimensional ultrasound (3DUS) to assess the renal parenchymal volume. Materials and Methods: CT, MRI, 2DUS and 3DUS were used to measure the renal volume in 40 patients (range: neonate to 17 years; mean age: 8.95 years). The 3DUS was determined with a Voluson 730 (Kretztechnik, GE) or an external 3D-system (EchoTech, GE) using electromagnetic positioning sensors attached to conventional 2DUS-equipment. The 2DUS volume was calculated with the ellipsoid equation and the 3DUS volume computed with the system integrated software. For CT and MRI, planimetric analysis was used to determine the renal parenchymal volume, whereby the dilated collecting system of a hydronephrosis was subtracted to obtain the real renal parenchymal volume. The results of 2DUS and 3DUS were compared to the results of CT and MRI, and inter- and intraobserver variabilities were calculated. Results: In 74 of 77 kidneys, the 3DUS study was of diagnostic quality. The accuracy of the 3DUS volumes compared well to the CT and MRI volumes with a mean difference of -1.8 {+-} 4.6% versus a mean difference of -2.4 {+-} 15.4% for 2DUS. In normal kidneys, the accuracy was -2.6 {+-} 4.4% for 3DUS and -3.8 {+-} 14.7% for 2DUS. In hydronephrosis, the accuracy was +4.0 {+-} 5.9% and +9.6 {+-} 21.3%, respectively, indicating that 3DUS is more accurate than 2DUS, particularly in kidneys with a dilated collecting system. Inter- and intraobserver variabilities were {+-} 7.3% and {+-} 5.3%. Conclusion: For assessing the renal parenchymal volume in children, 3DUS is feasible and comparable to CT and MRI. (orig.) [German] Studienziel: Prospektive Evaluation der Genauigkeit des drei-dimensionalen Ultraschalls (3DUS) bei der Volumetrie der kindlichen Niere im Vergleich zur CT/MRT. Methode: Bei 40 Patienten (Alter: 0 - 17 Jahre) mit einer klinisch indizierten CT/MRT des Abdomens oder des Harntrakts wurde zusaetzlich ein 2D- und 3DUS inklusive Volumetrie des

MIST VR. A laparoscopic surgery procedures trainer and evaluator.

Science.gov (United States)

Sutton, C; McCloy, R; Middlebrook, A; Chater, P; Wilson, M; Stone, R

1997-01-01

The key bimanual instrument tasks involved in laparoscopic surgery have been abstracted for use in a virtual reality surgical skills evaluator and trainer. The trainer uses two laparoscopic instruments mounted on a frame with position sensors which provide instrument movement data that is translated into interactive real time graphics on a PC (P133, 16 Mb RAM, graphics acceleration card). An accurately scaled operating volume of 10 cm3 is represented by a 3D cube on the computer screen. "Camera" position and size of target objects can be varied for different skill levels. Targets appear randomly within the operating volume according to the skill task and can be grasped and manipulated with the instruments. Accuracy and errors during the tasks and time to completion are logged. Mist VR has tutorial, training, examination, analysis and configuration modes. Six tasks have been selected and include combinations of instrument approach, target acquisition, target manipulation and placement, transfer between instruments, target contact with optional diathermy, and controlled instrument withdrawal/replacement. Tasks can be configured for varying degrees of difficulty and the configurations saved to a library for reuse. Specific task configurations can be assigned to individual students. In the examination mode the supervisor can select the tasks, repetitions and order and save to a specific file for that trainee. Progress can be assessed and there is the option for playback of the training session or examination. Data analyses permit overall, including task, and right or left hand performances to be quantified. Mist VR represents a significant advance over the subjective assessment of training performances with existing "plastic box" basic trainers.

Two-Way Communication between Scientists and the Public: A View from Science Communication Trainers in North America

Science.gov (United States)

Yuan, Shupei; Oshita, Tsuyoshi; AbiGhannam, Niveen; Dudo, Anthony; Besley, John C.; Koh, Hyeseung E.

2017-01-01

The current study explores the degree to which two-way communication is applied in science communication contexts in North America, based on the experiences of science communication trainers. Interviews with 24 science communication trainers suggest that scientists rarely focus on applying two-way communication tactics, such as listening to their…

Einfluss der Lage des aktiven Kontaktes innerhalb des Nucleus subthalamicus auf den Effekt der tiefen Hirnstimulation bei Parkinson Patienten- Eine MRT-basierte Untersuchung

OpenAIRE

Wodarg, Fritz

2013-01-01

Anhand Prä- und postoperativer MRT-Bilder wird die Lage der Elektroden zur Hochfrequenzstimulation innerhalb des N. subthalamicus bestimmt und mit dem klinischen Ergebnis der Stimulation bei 30 Parkinson Patienten korreliert. Eine Stimulation in lateralen Anteilen des STN bringt signifikant bessere klinische Ergebnisse.

Refining Trait Resilience: Identifying Engineering, Ecological, and Adaptive Facets from Extant Measures of Resilience

Science.gov (United States)

Maltby, John; Day, Liz; Hall, Sophie

2015-01-01

The current paper presents a new measure of trait resilience derived from three common mechanisms identified in ecological theory: Engineering, Ecological and Adaptive (EEA) resilience. Exploratory and confirmatory factor analyses of five existing resilience scales suggest that the three trait resilience facets emerge, and can be reduced to a 12-item scale. The conceptualization and value of EEA resilience within the wider trait and well-being psychology is illustrated in terms of differing relationships with adaptive expressions of the traits of the five-factor personality model and the contribution to well-being after controlling for personality and coping, or over time. The current findings suggest that EEA resilience is a useful and parsimonious model and measure of trait resilience that can readily be placed within wider trait psychology and that is found to contribute to individual well-being. PMID:26132197

A Whole Community Approach toward Child and Youth Resilience Promotion: A Review of Resilience Literature.

Science.gov (United States)

Khanlou, Nazilla; Wray, Ron

2014-01-01

A literature review of child and youth resilience with a focus on: definitions and factors of resilience; relationships between resilience, mental health and social outcomes; evidence for resilience promoting interventions; and implications for reducing health inequities. To conduct the review, the first two following steps were conducted iteratively and informed the third step: 1) Review of published peer-review literature since 2000; and 2) Review of grey literature; and 3) Quasi-realist synthesis of evidence. Evidence from three perspectives were examined: i) whether interventions can improve 'resilience' for vulnerable children and youth; ii) whether there is a differential effect among different populations; and, iii) whether there is evidence that resilience interventions 'close the gap' on health and social outcome measures. Definitions of resilience vary as do perspectives on it. We argue for a hybrid approach that recognizes the value of combining multiple theoretical perspectives, epistemologies (positivistic and constructivist/interpretive/critical) in studying resilience. Resilience is: a) a process (rather than a single event), b) a continuum (rather than a binary outcome), and c) likely a global concept with specific dimensions. Individual, family and social environmental factors influence resilience. A social determinants perspective on resilience and mental health is emphasized. Programs and interventions to promoting resilience should be complimentary to public health measures addressing the social determinants of health. A whole community approach to resilience is suggested as a step toward closing the public health policy gap. Local initiatives that stimulate a local transformation process are needed. Recognition of each child's or youth's intersections of gender, lifestage, family resources within the context of their identity markers fits with a localized approach to resilience promotion and, at the same time, requires recognition of the

Virtual Close Quarter Battle (CQB) Graphical Decision Trainer

Science.gov (United States)

2002-09-01

leave a gap in what would traditionally be thought of as an ideal locomotion device. Research has shown that the introduction of vestibular cues in...NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS VIRTUAL CLOSE QUARTER BATTLE (CQB) GRAPHICAL DECISION TRAINER by Jordan Reece...including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson

Assessing Resilience in Stressed Watersheds

Directory of Open Access Journals (Sweden)

Kristine T. Nemec

2014-03-01

Full Text Available Although several frameworks for assessing the resilience of social-ecological systems (SESs have been developed, some practitioners may not have sufficient time and information to conduct extensive resilience assessments. We have presented a simplified approach to resilience assessment that reviews the scientific, historical, and social literature to rate the resilience of an SES with respect to nine resilience properties: ecological variability, diversity, modularity, acknowledgement of slow variables, tight feedbacks, social capital, innovation, overlap in governance, and ecosystem services. We evaluated the effects of two large-scale projects, the construction of a major dam and the implementation of an ecosystem recovery program, on the resilience of the central Platte River SES (Nebraska, United States. We used this case study to identify the strengths and weaknesses of applying a simplified approach to resilience assessment. Although social resilience has increased steadily since the predam period for the central Platte River SES, ecological resilience was greatly reduced in the postdam period as compared to the predam and ecosystem recovery program time periods.

Family Resilience in the Military

Science.gov (United States)

Meadows, Sarah O.; Beckett, Megan K.; Bowling, Kirby; Golinelli, Daniela; Fisher, Michael P.; Martin, Laurie T.; Meredith, Lisa S.; Osilla, Karen Chan

2016-01-01

Abstract Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. A standard definition is a necessary for DoD to more effectively assess its efforts to sustain and improve family resilience. RAND authors reviewed the literature on family resilience and, in this study, recommend a definition that could be used DoD-wide. The authors also reviewed DoD policies related to family resilience, reviewed models that describe family resilience and identified key family resilience factors, and developed several recommendations for how family-resilience programs and policies could be managed across DoD. PMID:28083409

Resilience of the IMS system

DEFF Research Database (Denmark)

Kamyod, Chayapol; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

2014-01-01

The paper focuses on end-to-end resilience analysis of the IMS based network through the principal resilience parameters by using OPNET. The resilience behaviours of communication across multiple IMS domains are investigated at different communication scenarios and compared with previous state......-of-the-art. Moreover, the resilience effects when adding a redundancy of the S-CSCF unit are examined. The results disclose interesting resilience behaviours for long distance communications....

Radiology trainer. Surgical ambulance. Revision 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Ackermann, Ole; Barkhausen, Joerg

2013-01-01

The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin; Magnetresonanztomographie (MRT) der Leber und des Gehirns bei haematologisch-onkologischen Patienten mit Fieber unbekannter Ursache

Energy Technology Data Exchange (ETDEWEB)

Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Heussel, G. [Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik

1998-08-01

To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamic) and 16 brain MRI (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [Deutsch] Untersuchung des Nutzens der MRT der Leber und des Gehirns bei klinisch auffaelligen haematologischen Patienten mit Fieber unbekannter Ursache. Material und Methoden: Es wurden 20 MRT der Leber (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamisch) und 16 MRT des Gehirns (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) zur Fokussuche bei Infektionsverdacht und Organhinweisen durchgefuehrt. Es erfolgte der Abgleich mit dem weiteren klinischen Verlauf. Ergebnisse: 11/20 MRT-Untersuchungen der Leber zeigten einen Herdbefund: Candidiasis (n=3), Mykobakteriose (n=2

Inaccuracy of a physical strain trainer for the monitoring of partial weight bearing.

Science.gov (United States)

Pauser, Johannes; Jendrissek, Andreas; Swoboda, Bernd; Gelse, Kolja; Carl, Hans-Dieter

2011-11-01

To investigate the use of a physical strain trainer for the monitoring of partial weight bearing. Case series with healthy volunteers. Orthopedic clinic. Healthy volunteers (N=10) with no history of foot complaints. Volunteers were taught to limit weight bearing to 10% body weight (BW) and 50% BW, monitored by a physical strain trainer. The parameters peak pressure, maximum force, force-time integral, and pressure-time integral were assessed by dynamic pedobarography when volunteers walked with full BW (condition 1), 50% BW (condition 2), and 10% BW (condition 3). With 10% BW (condition 3), forces with normative gait (condition 1) were statistically significantly reduced under the hindfoot where the physical strain trainer is placed. All pedobarographic parameters were, however, exceeded when the total foot was measured. A limitation to 10% BW with the physical strain trainer (condition 3) was equal to a bisection of peak pressure and maximum force for the total foot with normative gait (condition 1). Halved BW (condition 2) left a remaining mean 82% of peak pressure and mean 59% of maximum force from full BW (condition 1). The concept of controlling partial weight bearing with the hindfoot-addressing device does not represent complete foot loading. Such devices may be preferably applied in cases when the hindfoot in particular must be off-loaded. Other training devices (eg, biofeedback soles) that monitor forces of the total foot have to be used to control partial weight bearing of the lower limb accurately. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Resilience: Building immunity in psychiatry

Science.gov (United States)

Shastri, Priyvadan Chandrakant

2013-01-01

The challenges in our personal, professional, financial, and emotional world are on rise, more so in developing countries and people will be longing for mental wellness for achieving complete health in their life. Resilience stands for one's capacity to recover from extremes of trauma and stress. Resilience in a person reflects a dynamic union of factors that encourages positive adaptation despite exposure to adverse life experiences. One needs to have a three-dimensional construct for understanding resilience as a state (what is it and how does one identify it?), a condition (what can be done about it?), and a practice (how does one get there?). Evaluating the level of resilience requires the measurement of internal (personal) and external (environmental) factors, taking into account that family and social environment variables of resilience play very important roles in an individual's resilience. Protection factors seem to be more important in the development of resilience than risk factors. Resilience is a process that lasts a lifetime, with periods of acquisition and maintenance, and reduction and loss for assessment. Overall, currently available data on resilience suggest the presence of a neurobiological substrate, based largely on genetics, which correlates with personality traits, some of which are configured via social learning. The major questions about resilience revolve around properly defining the concept, identifying the factors involved in its development and recognizing whether it is actually possible to immunize mental health against adversities. In the clinical field, it may be possible to identify predisposing factors or risk factors for psychopathologies and to develop new intervention strategies, both preventive and therapeutic, based on the concept of resilience. The preferred environments for application of resilience are health, education, and social policy and the right approach in integrating; it can be developed only with more research

Resilience in nurses: an integrative review.

Science.gov (United States)

Hart, Patricia L; Brannan, Jane D; De Chesnay, Mary

2014-09-01

To describe nursing research that has been conducted to understand the phenomenon of resilience in nurses. Resilience is the ability to bounce back or cope successfully despite adverse circumstances. Nurses deal with modern-day problems that affect their abilities to remain resilient. Nursing administrators/managers need to look for solutions not only to recruit nurses, but to become knowledgeable about how to support and retain nurses. A comprehensive search was undertaken for nursing research conducted between 1990 and 2011. Key search terms were nurse, resilience, resiliency and resilient. Whittemore and Knafl's integrative approach was used to conduct the methodological review. Challenging workplaces, psychological emptiness, diminishing inner balance and a sense of dissonance are contributing factors for resilience. Examples of intrapersonal characteristics include hope, self-efficacy and coping. Cognitive reframing, toughening up, grounding connections, work-life balance and reconciliation are resilience building strategies. This review provides information about the concept of resilience. Becoming aware of contributing factors to the need for resilience and successful strategies to build resilience can help in recruiting and retaining nurses. Understanding the concept of resilience can assist in providing support and developing programmes to help nurses become and stay resilient. © 2012 John Wiley & Sons Ltd.

Radiology trainer. Torso, internal organs and vessels

International Nuclear Information System (INIS)

Staebler, A.; Ertl-Wagner, B.

2006-01-01

This book enables students to simulate examinations. The Radiology Trainer series comprises the whole knowledge of radiology in the form of case studies for self-testing. It is based on the best-sorted German-language collection of radiological examinations of all organ regions. Step by step, radiological knowledge is trained in order to make diagnoses more efficient. The book series ensures optimal preparation for the final medical examinations and is also a valuable tool for practical training. (orig.)

Towards resilient cities. Comparing approaches/strategies

Directory of Open Access Journals (Sweden)

Angela Colucci

2012-07-01

Full Text Available The term “resilience” is used in many disciplines with different meanings. We will adopt the ecological concept of resilience, which epitomises the capacity of a system to adapt itself in response to the action of a force, achieving a state of equilibrium different from the original (White, 2011. Since the end of the last century, with a significant increase over the last few years, resilience has featured as key concept in many technical, political papers and documents, and appears in many researches. Of all this recent and varied range of literature, our focus is on those texts that combine resilience with strategies, processes and models for resilient cities, communities and regions. Starting from the resilience strategies developed as response for risks mitigation, the paper thus explores other approaches and experiences on cities resilience that have been conducted: the aim is to compare and identify innovation in the planning process towards risks mitigation. In this paper we present a summary of the initial survey stage of our research, with three main aims: understanding the approaches to resilience developed so far and identifying which aspects these approaches share (or not;understanding which strategies are being proposed for resilient regions, cities or social-ecological systems;understanding whether proposed resilience strategies involve innovations in urban and regional development disciplines. The aim is to understand whether the proposed concept of resilience, or rather strategies, constitute progress and contribute to innovation in the areas of urban planning and design in relation to risk mitigation. Three main families of literature have been identified from the recent literature promoting resilience as a key strategy. The first aim of the research is to understand which particular concept and which aspects of resilience are used, which resilience strategies are proposed, how the term ‘city’ is defined and interpreted

[Improving the collective self-efficacy of the teams of nurse trainers at IFSI through professional didactics].

Science.gov (United States)

Nagels, Marc

2011-03-01

The purpose of the study is to show that the analysis of the activity is a factor of construction of the collective self-efficacy of the trainers of five training institutes in nursing care (IFSI). As a collective system of beliefs on the capacity of the group to attain its goals, self-efficacy finds its foundations in the sociocognitive theory which articulates, within a mutual triadic causality, the personal, behavioral and environmental factors of the human agentivity. The personal determiners (self-efficacy, cognitive organization of the activity) are put in connection with the behavioral (production of the performance) and environmental (attribution of skill, professional tasks and standards) factors. The intervention consisted in introducing one hundred and nine nurse trainers to work analysis in a context of hospital reforms. The collective self-efficacy of the trainers appears as a key variable of the success of these reforms. The collective self-efficacy was the object of a pre-test and a qualitative post-test on the basis of motivational indicators, of the effectiveness of the educational realizations to the students and the estimation of the performance of the group to conduct the reform. The level of collective self-efficacy increases and the first realizations maintain the belief of the trainers in their capacity to succeed collectively in the implementation of the training plan. This is the first research in France which shows that the analysis of the activity comes along with an increase of the collective self-efficacy in work. These results question the practices of the trainers beyond the paramedical sector alone.

Focusing the Meaning(s of Resilience: Resilience as a Descriptive Concept and a Boundary Object

Directory of Open Access Journals (Sweden)

Fridolin Simon. Brand

2007-06-01

Full Text Available This article reviews the variety of definitions proposed for "resilience" within sustainability science and suggests a typology according to the specific degree of normativity. There is a tension between the original descriptive concept of resilience first defined in ecological science and a more recent, vague, and malleable notion of resilience used as an approach or boundary object by different scientific disciplines. Even though increased conceptual vagueness can be valuable to foster communication across disciplines and between science and practice, both conceptual clarity and practical relevance of the concept of resilience are critically in danger. The fundamental question is what conceptual structure we want resilience to have. This article argues that a clearly specified, descriptive concept of resilience is critical in providing a counterbalance to the use of resilience as a vague boundary object. A clear descriptive concept provides the basis for operationalization and application of resilience within ecological science.

Understanding individual resilience in the workplace: the international collaboration of workforce resilience model.

Science.gov (United States)

Rees, Clare S; Breen, Lauren J; Cusack, Lynette; Hegney, Desley

2015-01-01

When not managed effectively, high levels of workplace stress can lead to several negative personal and performance outcomes. Some professional groups work in highly stressful settings and are therefore particularly at risk of conditions such as anxiety, depression, secondary traumatic stress, and burnout. However, some individuals are less affected by workplace stress and the associated negative outcomes. Such individuals have been described as "resilient." A number of studies have found relationships between levels of individual resilience and specific negative outcomes such as burnout and compassion fatigue. However, because psychological resilience is a multi-dimensional construct it is necessary to more clearly delineate it from other related and overlapping constructs. The creation of a testable theoretical model of individual workforce resilience, which includes both stable traits (e.g., neuroticism) as well as more malleable intrapersonal factors (e.g., coping style), enables information to be derived that can eventually inform interventions aimed at enhancing individual resilience in the workplace. The purpose of this paper is to introduce a new theoretical model of individual workforce resilience that includes several intrapersonal constructs known to be central in the appraisal of and response to stressors and that also overlap with the construct of psychological resilience. We propose a model in which psychological resilience is hypothesized to mediate the relationship between neuroticism, mindfulness, self-efficacy, coping, and psychological adjustment.

Resilience and (in)security

DEFF Research Database (Denmark)

dunn cavelty, myriam; Kaufmann, Mareile; Kristensen, Kristian Søby

2015-01-01

, and redefine relations of security and insecurity. We show the increased attention – scholarly as well as political – given to resilience in recent times and provide a review of the state of critical security studies literature on resilience. We argue that to advance this discussion, resilience needs...

Resilience Management System And Development Of Resilience Capability On Site Workers

OpenAIRE

Komatsubara, Akinori

2013-01-01

When we consider the safety of socio-technical or safety critical systems, discussions from three layers are required; safety strategy, safety management and safety activity. In this study, development of resilience safety from the three layers is discussed. For the safety management layer, this study proposes resilience management system (RMS) as the style of safety management system (SMS) for resilience safety approach. Two cases at Japanese companies to enhance attitude and non-technical s...

Effects of intensive therapy using gait trainer or floor walking exercises early after stroke.

Science.gov (United States)

Peurala, Sinikka H; Airaksinen, Olavi; Huuskonen, Pirjo; Jäkälä, Pekka; Juhakoski, Mika; Sandell, Kaisa; Tarkka, Ina M; Sivenius, Juhani

2009-02-01

To analyse the effects of gait therapy for patients after acute stroke in a randomized controlled trial. Fifty-six patients with a mean of 8 days post-stroke participated in: (i) gait trainer exercise; (ii) walking training over ground; or (iii) conventional treatment. Patients in the gait trainer exercise and walking groups practiced gait for 15 sessions over 3 weeks and received additional physiotherapy. Functional Ambulatory Category and several secondary outcome measures assessing gait and mobility were administered before and after rehabilitation and at 6-month follow-up. Patients also evaluated their own effort. Walking ability improved more with intensive walk training compared with conventional treatment; median Functional Ambulatory Category was zero in all patients at the start of the study, but it was 3 in both walk-training groups and 0.5 in the conventional treatment group at the end of the therapy. Median Functional Ambulatory Category was 4 in both walk-training groups and 2.5 in conventional treatment group at 6-month follow-up. Mean accomplished walking distance was not different between the gait trainer exercise and over ground walking groups. Borg scale indicated more effort in over ground walking. Secondary outcomes also indicated improvements. Exercise therapy with walking training improved gait function irrespective of the method used, but the time and effort required to achieve the results favour the gait trainer exercise. Early intensive gait training resulted in better walking ability than did conventional treatment.

FlexiTrainer: A Visual Authoring Framework for Case-Based Intelligent Tutoring Systems

National Research Council Canada - National Science Library

Ramachandran, Sowmya; Remolina, Emilio; Fu, Daniel

2006-01-01

.... This paper describes FlexiTrainer, an authoring framework that enables the rapid creation of pedagogically rich and performance-oriented learning environments with custom content and tutoring strategies...

Degrees of Resilience: Profiling Psychological Resilience and Prospective Academic Achievement in University Inductees

Science.gov (United States)

Allan, John F.; McKenna, Jim; Dominey, Susan

2014-01-01

University inductees may be increasingly vulnerable to stressors during transition into higher education (HE), requiring psychological resilience to achieve academic success. This study aimed to profile inductees' resilience and to investigate links to prospective end of year academic outcomes. Scores for resilience were based on a validated…

Foundations of resilience thinking.

Science.gov (United States)

Curtin, Charles G; Parker, Jessica P

2014-08-01

Through 3 broad and interconnected streams of thought, resilience thinking has influenced the science of ecology and natural resource management by generating new multidisciplinary approaches to environmental problem solving. Resilience science, adaptive management (AM), and ecological policy design (EPD) contributed to an internationally unified paradigm built around the realization that change is inevitable and that science and management must approach the world with this assumption, rather than one of stability. Resilience thinking treats actions as experiments to be learned from, rather than intellectual propositions to be defended or mistakes to be ignored. It asks what is novel and innovative and strives to capture the overall behavior of a system, rather than seeking static, precise outcomes from discrete action steps. Understanding the foundations of resilience thinking is an important building block for developing more holistic and adaptive approaches to conservation. We conducted a comprehensive review of the history of resilience thinking because resilience thinking provides a working context upon which more effective, synergistic, and systems-based conservation action can be taken in light of rapid and unpredictable change. Together, resilience science, AM, and EPD bridge the gaps between systems analysis, ecology, and resource management to provide an interdisciplinary approach to solving wicked problems. © 2014 Society for Conservation Biology.

Midwives׳ experiences of workplace resilience.

Science.gov (United States)

Hunter, Billie; Warren, Lucie

2014-08-01

many UK midwives experience workplace adversity resulting from a national shortage of midwives, rise in birth rate and increased numbers of women entering pregnancy with complex care needs. Research evidence suggests that workplace pressures, and the emotional demands of the job, may increase midwives׳ experience of stress and contribute to low morale, sickness and attrition. Much less is known about midwives who demonstrate resilience in the face of adversity. Resilience has been investigated in studies of other health and social care workers, but there is a gap in knowledge regarding midwives׳ experiences. to explore clinical midwives׳ understanding and experience of professional resilience and to identify the personal, professional and contextual factors considered to contribute to or act as barriers to resilience. an exploratory qualitative descriptive study. In Stage One, a closed online professional discussion group was conducted over a one month period. Midwives discussed workplace adversity and their resilient responses to this. In Stage Two, the data were discussed with an Expert Panel with representatives from midwifery workforce and resilience research, in order to enhance data interpretation and refine the concept modelling. the online discussion group was hosted by the Royal College of Midwives, UK online professional networking hub: 'Communities'. 11 practising midwives with 15 or more years of 'hands on clinical experience', and who self-identified as being resilient, took part in the online discussion group. thematic analysis of the data identified four themes: challenges to resilience, managing and coping, self-awareness and building resilience. The participants identified 'critical moments' in their careers when midwives were especially vulnerable to workplace adversity. Resilience was seen as a learned process which was facilitated by a range of coping strategies, including accessing support and developing self-awareness and protection of self

Resilience among Military Youth

Science.gov (United States)

Easterbrooks, M. Ann; Ginsburg, Kenneth; Lerner, Richard M.

2013-01-01

In this article, the authors present their approach to understanding resilience among military connected young people, and they discuss some of the gaps in their knowledge. They begin by defining resilience, and then present a theoretical model of how young people demonstrate resilient functioning. Next they consider some of the research on…

Errors during MRT measurements of the left ventricular volume using a multi-slice technique

International Nuclear Information System (INIS)

Pitton, M.B.; Just, M.; Grebe, P.; Kreitner, K.F.; Erbel, R.; Thelen, M.

1992-01-01

A multi-slice technique for MRT measurements of the left ventricular volume is much faster than the use of single-slice methods and is therefore better tolerated, leaving time for additional measurements. The end-diastolic left ventricular volume can be reliably measured by this method (123.3±13.5 ml vs. 124.1±ml). The end-systolic volume is consistently overestimated by 23.7±18,3% compared with the reference value obtained by single slice measurements (47.9±8.9 ml vs 39.1±7.9 ml). Correspondingly, stroke volume and ejection fraction is underestimated on average by 10.6±9.7% and 10.6±7.6% respectively). (orig.) [de

Laparoscopic simulation for all: two affordable, upgradable, and easy-to-build laparoscopic trainers.

Science.gov (United States)

Smith, Matthew D; Norris, Joseph M; Kishikova, Lyudmila; Smith, David P

2013-01-01

Laparoscopic surgery has established itself as the approach of choice for a multitude of operations in general, urological, and gynecological surgery. A number of factors make performing laparoscopic surgery technically demanding, and as such it is crucial that surgical trainees hone their skills safely on trainers before operating on patients. These can be highly expensive. Here, we describe a novel and upgradable approach to constructing an affordable laparoscopic trainer. A pattern was produced to build an upgradable laparoscopic trainer for less than $100. The basic model was constructed from an opaque plastic crate with plywood base, 2 trocars, and 2 pairs of disposable laparoscopic instruments. A laptop, a light emitting diode (LED), and a fixed webcam were utilized to visualize the box interior. An enhanced version was also created, as an optional upgrade to the basic model, featuring a neoprene-trocar interface and a simulated mobile laparoscope. The described setup allowed trainees to gain familiarity with laparoscopic techniques, beginning with simple manipulation and then progressing through to more relevant procedures. Novices began by moving easy-to-grasp objects between containers and then attempting more challenging manipulations such as stacking sugar cubes, excising simulated lesions, threading circular mints onto cotton, and ligating fastened drinking straws. These techniques have introduced the necessity of careful instrument placement and have increased trainees' dexterity with laparoscopy. Here, we have outlined an upgradable and affordable alternative laparoscopic trainer that has given many trainees crucial experience with laparoscopic techniques, allowing them to safely improve their manual skill and confidence. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Gait pattern of severely disabled hemiparetic subjects on a new controlled gait trainer as compared to assisted treadmill walking with partial body weight support.

Science.gov (United States)

Hesse, S; Uhlenbrock, D; Sarkodie-Gyan, T

1999-10-01

To investigate to what extent and with how much therapeutic effort nonambulatory stroke patients could train a gait-like movement on a newly developed, machine-supported gait trainer. Open study comparing the movement on the gait trainer with assisted walking on the treadmill. Motion analysis laboratory of a rehabilitation centre. Fourteen chronic, nonambulatory hemiparetic patients. Complex gait analysis while training on the gait trainer and while walking on the treadmill. Gait kinematics, kinesiological EMG of several lower limb muscles and the required assistance. Patients could train a gait-like movement on the gait trainer, characterized kinematically by a perfect symmetry, larger hip extension during stance, less knee flexion and less ankle plantar flexion during swing as compared to treadmill walking (p gait trainer (p gait trainer offered severely disabled hemiparetic subjects the possibility of training a gait-like, highly symmetrical movement with a favourable facilitation of relevant anti-gravity muscles. At the same time, the effort required of the therapists was reduced.

Examining the Experiences of Athletic Trainers as they transition into their First Full-Time Position

OpenAIRE

Stephanie M. Mazerolle; McLain Whitney; Christy Eason

2017-01-01

Transition to clinical practice is an important topic in athletic training, as it can be a period of time that presents challenges for the athletic trainer. Most of the research pertaining to transition to practice focuses on the skills and knowledge necessary for clinical practice, yet we know that stress can manifest from not only being an independent practitioner but also from learning how to balance one’s roles. We wanted to understand the perspective of today’s novice athletic trainers a...

National athletic trainers' association position statement: management of the athlete with type 1 diabetes mellitus.

Science.gov (United States)

Jimenez, Carolyn C; Corcoran, Matthew H; Crawley, James T; Guyton Hornsby, W; Peer, Kimberly S; Philbin, Rick D; Riddell, Michael C

2007-01-01

To present recommendations for the certified athletic trainer in the management of type 1 diabetes in the athlete. In managing diabetes, the most important goal is to keep blood glucose levels at or as close to normal levels as possible without causing hypoglycemia. This goal requires the maintenance of a delicate balance among hypoglycemia, euglycemia, and hyperglycemia, which is often more challenging in the athlete due to the demands of physical activity and competition. However, effectively managing blood glucose, lipid, and blood pressure levels is necessary to ensuring the long-term health and well-being of the athlete with diabetes. These recommendations are intended to provide the certified athletic trainer participating in the management of an athlete with type 1 diabetes mellitus with the specific knowledge and problem-solving skills needed. Athletic trainers have more contact with the athlete with diabetes than most members of the diabetes management team do and so must be prepared to assist the athlete as required.

Initial training for trainers the spiral process or ''getting trained while training''

International Nuclear Information System (INIS)

Croes, R.

1996-01-01

The initial training program for trainers is part of an overall gradual development towards full professionalism. Based on the two key words, responsibility and autonomy, the global aim is to provide assistance to new instructors so that they become full actors in their own training process and to prepare them to deal with all the different situations they may meet. The SPIRAL process lasts one full year and could be characterized in four words: alternation, support, individualization and project. From the first weeks in the process, the new trainers already deliver training instructions. The SPIRAL year terminates with the presentation to the project before an evaluation board. The evaluation takes into account the project and the on going assessment of acquisition of knowledge and skills

The Resilient Schools Consortium (RiSC): Linking Climate Literacy, Resilience Thinking and Service Learning

Science.gov (United States)

Branco, B. F.; Fano, E.; Adams, J.; Shon, L.; Zimmermann, A.; Sioux, H.; Gillis, A.

2017-12-01

Public schools and youth voices are largely absent from climate resilience planning and projects in New York City. Additionally, research shows that U.S. science teachers' understanding of climate science is lacking, hence there is not only an urgent need to train and support teachers on both the science and pedagogy of climate change, but to link climate literacy, resilience thinking and service learning in K-12 education. However, research on participation of students and teachers in authentic, civic-oriented experiences points to increased engagement and learning outcomes in science. The Resilient Schools Consortium (RiSC) Project will address all these needs through an afterschool program in six coastal Brooklyn schools that engages teachers and urban youth (grades 6-12), in school and community climate resilience assessment and project design. The RiSC climate curriculum, co-designed by New York City school teachers with Brooklyn College, the National Wildlife Federation, New York Sea Grant and the Science and Resilience Institute at Jamaica Bay, will begin by helping students to understand the difference between climate and weather. The curriculum makes extensive use of existing resources such as NOAA's Digital Coast and the Coastal Resilience Mapping Portal. Through a series of four modules over two school years, the six RiSC teams will; 1. explore and understand the human-induced drivers of climate change and, particularly, the significant climate and extreme weather related risks to their schools and surrounding communities; 2. complete a climate vulnerability assessment within the school and the community that is aligned to OneNYC - the city's resilience planning document; 3. design and execute a school-based resilience project; and 4. propose resilience guidelines for NYC Department of Education schools. At the end of each school year, the six RiSC teams will convene a RiSC summit with city officials and resilience practitioners to share ideas and

Trainer variability during step training after spinal cord injury: Implications for robotic gait-training device design

OpenAIRE

Jose A. Galvez, PhD; Amy Budovitch, PT; Susan J. Harkema, PhD; David J. Reinkensmeyer, PhD

2011-01-01

Robotic devices are being developed to automate repetitive aspects of walking retraining after neurological injuries, in part because they might improve the consistency and quality of training. However, it is unclear how inconsistent manual training actually is or whether stepping quality depends strongly on the trainers' manual skill. The objective of this study was to quantify trainer variability of manual skill during step training using body-weight support on a treadmill and assess factor...

Assessing resilience in adolescence: the Spanish adaptation of the Adolescent Resilience Questionnaire.

Science.gov (United States)

Guilera, Georgina; Pereda, Noemí; Paños, Ana; Abad, Judit

2015-07-11

The concept and assessment of resilience have attracted considerable attention in recent years, but none of the instruments developed to measure resilience in adolescents have been adapted to the Spanish context. The Adolescent Resilience Questionnaire (ARQ) provides a comprehensive and multidimensional assessment of the resources associated with resilience in adolescents. This study analyzes the psychometric properties of the ARQ. Participants included a community sample of 1101 Spanish adolescents (53.5 % boys) aged 12-17 years (M = 14.51; SD = 1.755). Results confirm the factor structure based on 12 scales. Internal consistency was generally adequate (between .60 and .84), although the unacceptable coefficient for the Empathy/Tolerance scale (α = .38) means that this scale needs to be revised for the Spanish context. Relationships between ARQ scales and psychopathology were in the expected direction and magnitude. Some gender differences were observed, with higher scores for boys on Confidence and Negative cognition. The Spanish version of the ARQ can help to identify personal characteristics associated with resilience and signs of positive engagement with family, peers, school, and the community. It can identify those adolescents most likely to show resilience in response to adversity, as well as those who may be vulnerable under situations of stress.

Influence of running shoes and cross-trainers on Achilles tendon forces during running compared with military boots.

Science.gov (United States)

Sinclair, Jonathan; Taylor, P J; Atkins, S

2015-06-01

Military recruits are known to be susceptible to Achilles tendon pathology. The British Army have introduced footwear models, the PT-03 (cross-trainer) and PT1000 (running shoes), in an attempt to reduce the incidence of injuries. The aim of the current investigation was to examine the Achilles tendon forces of the cross-trainer and running shoe in relation to conventional army boots. Ten male participants ran at 4.0 m/s in each footwear condition. Achilles tendon forces were obtained throughout the stance phase of running and compared using repeated-measures ANOVAs. The results showed that the time to peak Achilles tendon force was significantly shorter when running in conventional army boots (0.12 s) in comparison with the cross-trainer (0.13 s) and running shoe (0.13 s). Achilles tendon loading rate was shown to be significantly greater in conventional army boots (38.73 BW/s) in comparison with the cross-trainer (35.14 BW/s) and running shoe (33.57 BW/s). The results of this study suggest that the running shoes and cross-trainer footwear are associated with reductions in Achilles tendon parameters that have been linked to the aetiology of injury, and thus it can be hypothesised that these footwear could be beneficial for military recruits undertaking running exercises. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Resilience Design Patterns: A Structured Approach to Resilience at Extreme Scale

International Nuclear Information System (INIS)

Engelmann, Christian; Hukerikar, Saurabh

2017-01-01

Reliability is a serious concern for future extreme-scale high-performance computing (HPC) systems. Projections based on the current generation of HPC systems and technology roadmaps suggest the prevalence of very high fault rates in future systems. While the HPC community has developed various resilience solutions, application-level techniques as well as system-based solutions, the solution space remains fragmented. There are no formal methods and metrics to integrate the various HPC resilience techniques into composite solutions, nor are there methods to holistically evaluate the adequacy and efficacy of such solutions in terms of their protection coverage, and their performance \\& power efficiency characteristics. Additionally, few of the current approaches are portable to newer architectures and software environments that will be deployed on future systems. In this paper, we develop a structured approach to the design, evaluation and optimization of HPC resilience using the concept of design patterns. A design pattern is a general repeatable solution to a commonly occurring problem. We identify the problems caused by various types of faults, errors and failures in HPC systems and the techniques used to deal with these events. Each well-known solution that addresses a specific HPC resilience challenge is described in the form of a pattern. We develop a complete catalog of such resilience design patterns, which may be used by system architects, system software and tools developers, application programmers, as well as users and operators as essential building blocks when designing and deploying resilience solutions. We also develop a design framework that enhances a designer's understanding the opportunities for integrating multiple patterns across layers of the system stack and the important constraints during implementation of the individual patterns. It is also useful for defining mechanisms and interfaces to coordinate flexible fault management across

Astronaut Anna Fisher practices control of the RMS in a trainer

Science.gov (United States)

1984-01-01

Astronaut Anna Lee Fisher, mission specialist for 51-A, practices control of the remote manipulator system (RMS) at a special trainer at JSC. Dr. Fisher is pictured in the manipulator development facility (MDF) of JSC's Shuttle mockup and integration laboratory.

Zoogeomorphology and resilience theory

Science.gov (United States)

Butler, David R.; Anzah, Faisal; Goff, Paepin D.; Villa, Jennifer

2018-03-01

Zoogeomorphology, the study of animals as geomorphic agents, has been largely overlooked in the context of resilience theory and biogeomorphic systems. In this paper, examples are provided of the interactions between external landscape disturbances and zoogeomorphological agents. We describe cases in which naturally occurring zoogeomorphological agents occupy a landscape, and examine whether those zoogeomorphic agents provide resilience to a landscape or instead serve as a landscape stress capable of inducing a phase-state shift. Several cases are described whereby the presence of exotic (introduced) zoogeomorphic agents overwhelms a landscape and induce collapse. The impact of climate change on species with zoogeomorphological importance is discussed in the context of resilience of a landscape. We conclude with a summary diagram illustrating the relationships existing between zoogeomorphic impacts and landscape resilience in the context of our case studies, and speculate about the future of the study of zoogeomorphology in the framework of resilience theory.

Tiered Approach to Resilience Assessment.

Science.gov (United States)

Linkov, Igor; Fox-Lent, Cate; Read, Laura; Allen, Craig R; Arnott, James C; Bellini, Emanuele; Coaffee, Jon; Florin, Marie-Valentine; Hatfield, Kirk; Hyde, Iain; Hynes, William; Jovanovic, Aleksandar; Kasperson, Roger; Katzenberger, John; Keys, Patrick W; Lambert, James H; Moss, Richard; Murdoch, Peter S; Palma-Oliveira, Jose; Pulwarty, Roger S; Sands, Dale; Thomas, Edward A; Tye, Mari R; Woods, David

2018-04-25

Regulatory agencies have long adopted a three-tier framework for risk assessment. We build on this structure to propose a tiered approach for resilience assessment that can be integrated into the existing regulatory processes. Comprehensive approaches to assessing resilience at appropriate and operational scales, reconciling analytical complexity as needed with stakeholder needs and resources available, and ultimately creating actionable recommendations to enhance resilience are still lacking. Our proposed framework consists of tiers by which analysts can select resilience assessment and decision support tools to inform associated management actions relative to the scope and urgency of the risk and the capacity of resource managers to improve system resilience. The resilience management framework proposed is not intended to supplant either risk management or the many existing efforts of resilience quantification method development, but instead provide a guide to selecting tools that are appropriate for the given analytic need. The goal of this tiered approach is to intentionally parallel the tiered approach used in regulatory contexts so that resilience assessment might be more easily and quickly integrated into existing structures and with existing policies. Published 2018. This article is a U.S. government work and is in the public domain in the USA.

Measuring resilience in integrated planning

DEFF Research Database (Denmark)

Apneseth, K.; Wahl, A. M.; Hollnagel, E.

2013-01-01

This chapter demonstrates how a Resilience Analysis Grid (RAG) can be used to profile the performance of a company in terms of the four abilities that characterize a resilient organization. It describes the development of a new, RAG-based tool founded on Resilience Engineering principles that can...... be used to assess an organization's resilience. The tool was tested in a case study involving a company in the offshore oil and gas industry. The company had decided to adopt an Integrated Operations (IO) approach to operations and maintenance planning and the tool was used to evaluate the impact...... of the Integrated Planning (IPL) process on its resilience....

An analysis of equine round pen training videos posted online: Differences between amateur and professional trainers.

Directory of Open Access Journals (Sweden)

Erin Kydd

Full Text Available Natural Horsemanship is popular among many amateur and professional trainers and as such, has been the subject of recent scientific enquiry. One method commonly adopted by Natural Horsemanship (NH trainers is that of round pen training (RPT. RPT sessions are usually split into a series of bouts; each including two phases: chasing/flight and chasing offset/flight offset. However, NH training styles are heterogeneous. This study investigated online videos of RPT to explore the characteristics of RPT sessions and test for differences in techniques and outcomes between amateurs and professionals (the latter being defined as those with accompanying online materials that promote clinics, merchandise or a service to the public. From more than 300 candidate videos, we selected sample files for individual amateur (n = 24 and professional (n = 21 trainers. Inclusion criteria were: training at liberty in a Round Pen; more than one bout and good quality video. Sessions or portions of sessions were excluded if the trainer attached equipment, such as a lunge line, directly to the horse or the horse was saddled, mounted or ridden. The number of bouts and duration of each chasing and non-chasing phase were recorded, and the duration of each RPT session was calculated. General weighted regression analysis revealed that, when compared with amateurs, professionals showed fewer arm movements per bout (p<0.05. Poisson regression analysis showed that professionals spent more time looking up at their horses, when transitioning between gaits, than amateurs did (p<0.05. The probability of horses following the trainer was not significantly associated with amount of chasing, regardless of category. Given that, according to some practitioners, the following response is a goal of RPT, this result may prompt caution in those inclined to give chase. The horses handled by professionals showed fewer conflict behaviours (e.g. kicking, biting, stomping, head-tossing, defecating

An investigation into the competence of workplace trainers to meet ...

African Journals Online (AJOL)

An investigation into the competence of workplace trainers to meet the special learning needs of under-prepared learners. ... This goal is shared by the business sector who is aware that only a competent employee can make a meaningful contribution to organisational growth. The writer investigated the capacity of South ...

Reframing Resilience: Pilot Evaluation of a Program to Promote Resilience in Marginalized Older Adults

Science.gov (United States)

Fullen, Matthew C.; Gorby, Sean R.

2016-01-01

Resilience has been described as a paradigm for aging that is more inclusive than models that focus on physiological and functional abilities. We evaluated a novel program, Resilient Aging, designed to influence marginalized older adults' perceptions of their resilience, self-efficacy, and wellness. The multiweek group program incorporated an…

Robotics On-Board Trainer (ROBoT)

Science.gov (United States)

Johnson, Genevieve; Alexander, Greg

2013-01-01

ROBoT is an on-orbit version of the ground-based Dynamics Skills Trainer (DST) that astronauts use for training on a frequent basis. This software consists of two primary software groups. The first series of components is responsible for displaying the graphical scenes. The remaining components are responsible for simulating the Mobile Servicing System (MSS), the Japanese Experiment Module Remote Manipulator System (JEMRMS), and the H-II Transfer Vehicle (HTV) Free Flyer Robotics Operations. The MSS simulation software includes: Robotic Workstation (RWS) simulation, a simulation of the Space Station Remote Manipulator System (SSRMS), a simulation of the ISS Command and Control System (CCS), and a portion of the Portable Computer System (PCS) software necessary for MSS operations. These components all run under the CentOS4.5 Linux operating system. The JEMRMS simulation software includes real-time, HIL, dynamics, manipulator multi-body dynamics, and a moving object contact model with Tricks discrete time scheduling. The JEMRMS DST will be used as a functional proficiency and skills trainer for flight crews. The HTV Free Flyer Robotics Operations simulation software adds a functional simulation of HTV vehicle controllers, sensors, and data to the MSS simulation software. These components are intended to support HTV ISS visiting vehicle analysis and training. The scene generation software will use DOUG (Dynamic On-orbit Ubiquitous Graphics) to render the graphical scenes. DOUG runs on a laptop running the CentOS4.5 Linux operating system. DOUG is an Open GL-based 3D computer graphics rendering package. It uses pre-built three-dimensional models of on-orbit ISS and space shuttle systems elements, and provides realtime views of various station and shuttle configurations.

Characterizations of a quality certified athletic trainer.

Science.gov (United States)

Raab, Scot; Wolfe, Brent D; Gould, Trenton E; Piland, Scott G

2011-01-01

Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Delphi study. Interviews in conference rooms or business offices and by telephone. Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers? Association (2, 3, 4, 9). Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.

Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer.

Science.gov (United States)

Dias, D; Laíns, J; Pereira, A; Nunes, R; Caldas, J; Amaral, C; Pires, S; Costa, A; Alves, P; Moreira, M; Garrido, N; Loureiro, L

2007-12-01

Partial body weight support (PBWS) is an accepted treatment for hemiplegic patients. The aim of this study is to compare the efficiency of gait trainer with conventional treatment on the gait management after stroke. Forty chronic post-stroke hemiplegics were part of a prospective research. Inclusion criteria were: first ever stroke in a chronic stage with stabilised motor deficits; age >18 and gait trainer, for the same period of time and frequency. Assessment tools: Motricity Index (MI); Toulouse Motor Scale (TMS); modified Ashworth Spasticity Scale (mASS); Berg Balance Scale (BBS); Rivermead Mobility Index (RMI); Fugl-Meyer Stroke Scale (F-MSS); Functional Ambulation Category (FAC); Barthel Index (BI); 10 meters, time up and go (TUG), 6 minutes, and step tests. EG and CG did the assessments before treatment (T(0)), right after treatment (T(1)), and on follow-up, 3 months later (T(2)). CG and EG were homogenous in all the variables at T(0). CG and EG showed improvement in almost all the assessment scales after treatment, although only some with relevant differences. EG showed statistically relevant improvement on T(1) and on T(2) in several of the assessment tools, whereas CG only showed statistically significant improvement after T(1) and only in some of the assessment tools. Both groups of chronic hemiplegic patients improved after either PBWS with gait trainer or Bobath treatment. Only subjects undergoing PBWS with gait trainer maintained functional gain after 3 months.

Foot loading with an ankle-foot orthosis: the accuracy of an integrated physical strain trainer.

Science.gov (United States)

Pauser, Johannes; Jendrissek, Andreas; Brem, Matthias; Gelse, Kolja; Swoboda, Bernd; Carl, Hans-Dieter

2012-07-01

To investigate the value of a built-in physical strain trainer for the monitoring of partial weight bearing with an ankle-foot orthosis. 12 healthy volunteers were asked to perform three trials. Plantar peak pressure values from normal gait (trial one) were defined as 100% (baseline). The following trials were performed with the Vacoped® dynamic vacuum ankle orthosis worn in a neutral position with full weight bearing (trial two) and a restriction to 10% body weight (BW) (trial three), as monitored with an integrated physical strain trainer. Peak plantar pressure values were obtained using the pedar® X system. Peak pressure values were statistically significantly reduced wearing the Vacoped® shoe with full weight bearing for the hindfoot to 68% of the baseline (normal gait) and for the midfoot and forefoot to 83% and 60%, respectively. Limited weight bearing with 10% BW as controlled by physical strain trainer further reduced plantar peak pressure values for the hindfoot to 19%, for the midfoot to 43% of the baseline and the forefoot to 22% of the baseline. The Vacoped® vacuum ankle orthosis significantly reduces plantar peak pressure. The integrated physical strain trainer seems unsuitable to monitor a limitation to 10% BW adequately for the total foot. The concept of controlling partial weight bearing with the hindfoot-addressing device within the orthosis seems debatable but may be useful when the hindfoot in particular must be off-loaded.

The essence of training trainers in the context of distance education

Directory of Open Access Journals (Sweden)

Yudy Alexandra Molina-Hurtado

2016-12-01

mobilization of knowledge in concrete situations and different scenarios. The objective of the article focuses on the importance of the training of trainers in the context of distance education so characterized, on the one hand, the trainer as a person who refines and contemplates his practice from a surrounding reality that impels the formation of values ethical, human, political, economic, social and immersed cultic in the role of teachers in the twenty-first century, and on the other hand, teachers in training as critical beings, advocates and peacemakers to think as teachers for life. Under this, a reflection between teacher training and professional development to the challenges that teachers face in training regarding their teaching practices supported from teaching and affirmed in the classroom through the teaching process is presented under the staging of competitions and performances from processes that generate autonomy to face the complex world in which we live.

A PC based multi-CPU severe accident simulation trainer

International Nuclear Information System (INIS)

Jankowski, M.W.; Bienarz, P.P.; Sartmadjiev, A.D.

2004-01-01

MELSIM Severe Accident Simulation Trainer is a personal computer based system being developed by the International Atomic Energy Agency and Risk Management Associates, Inc. for the purpose of training the operators of nuclear power stations. It also serves for evaluating accident management strategies as well as assessing complex interfaces between emergency operating procedures and accident management guidelines. The system is being developed for the Soviet designed WWER-440/Model 213 reactor and it is plant specific. The Bohunice V2 power station in the Slovak Republic has been selected for trial operation of the system. The trainer utilizes several CPUs working simultaneously on different areas of simulation. Detailed plant operation displays are provided on colour monitor mimic screens which show changing plant conditions in approximate real-time. Up to 28 000 curves can be plotted on a separate monitor as the MELSIM program proceeds. These plots proceed concurrently with the program, and time specific segments can be recalled for review. A benchmarking (limited in scope) against well validated thermal-hydraulic codes and selected plant accident data (WWER-440/213 Rovno NPP, Ukraine) has been initiated. Preliminary results are presented and discussed. (author)

Children's resilience and trauma-specific cognitive behavioral therapy: Comparing resilience as an outcome, a trait, and a process.

Science.gov (United States)

Happer, Kaitlin; Brown, Elissa J; Sharma-Patel, Komal

2017-11-01

Resilience, which is associated with relatively positive outcomes following negative life experiences, is an important research target in the field of child maltreatment (Luthar et al., 2000). The extant literature contains multiple conceptualizations of resilience, which hinders development in research and clinical utility. Three models emerge from the literature: resilience as an immediate outcome (i.e., behavioral or symptom response), resilience as a trait, and resilience as a dynamic process. The current study compared these models in youth undergoing trauma-specific cognitive behavioral therapy. Results provide the most support for resilience as a process, in which increase in resilience preceded associated decrease in posttraumatic stress and depressive symptoms. There was partial support for resilience conceptualized as an outcome, and minimal support for resilience as a trait. Results of the models are compared and discussed in the context of existing literature and in light of potential clinical implications for maltreated youth seeking treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Resiliência e maus-tratos à criança Resilience and child abuse

Directory of Open Access Journals (Sweden)

Maria de Fátima Pinheiro da Silva Junqueira

2003-02-01

Full Text Available O artigo propõe discutir o conceito de resiliência a partir de uma revisão crítica. Foram priorizados textos produzidos por órgãos que têm um papel direcionador no campo da saúde da criança e do adolescente (OPAS - Organização Pan-Americana da Saúde; ASBRA - Associação Brasileira de Adolescência. Discute-se as principais definições de resiliência. São debatidas as contribuições e limitações das leituras vigentes. Debate-se ainda, as possibilidades conceituais e operativas da resiliência frente às situações de maus-tratos contra criança e adolescente, tomando o exemplo do abuso sexual intrafamiliar. Conclui-se que o conceito de resiliência apresenta polarizações em torno de certos eixos: "adaptação/superação", "inato/adquirido", "permanente/circunstancial". Contudo, ele aponta para um ponto comum: a singularidade e a delicadeza das relações microssociais de promoção em saúde.The article discusses the resilience concept from a critical review. It prioritizes texts produced by organizations with leading roles in the field of child and adolescent health (PAHO, Pan-American Health Organization; ASBRA, the Brazilian Association for Adolescence. The main definitions of resilience are discussed, along with a debate on the contributions and limitations of the current literature. Furthermore, the conceptual and operative possibilities of resilience when confronted with child abuse are discussed, specifically using intra-familial sexual abuse as an example. The authors conclude that the concept of resilience presents polarization around certain axes: "adaptation/overcoming process", "innate/acquired", "permanent/circumstantial". However, they all point to a common ground: the singularity and delicacy of micro-social health-promoting relationships.

The Resilient Brain

Science.gov (United States)

Brendtro, Larry K.; Longhurst, James E.

2005-01-01

Brain research opens new frontiers in working with children and youth experiencing conflict in school and community. Blending this knowledge with resilience science offers a roadmap for reclaiming those identified as "at risk." This article applies findings from resilience research and recent brain research to identify strategies for reaching…

Warrior Resilience Training in Operation Iraqi Freedom: combining rational emotive behavior therapy, resiliency, and positive psychology.

Science.gov (United States)

Jarrett, Thomas

2008-01-01

Warrior Resilience Training (WRT) is an educational class designed to enhance Warrior resilience, thriving, and posttraumatic growth for Soldiers deployed in Operation Iraqi Freedom. Warrior Resilience Training uses rational emotive behavior therapy (REBT), Army leadership principles, and positive psychology as a vehicle for students to apply resilient philosophies derived from Army Warrior Ethos, Stoic philosophy, and the survivor and resiliency literature. Students in WRT are trained to focus upon virtue, character, and emotional self-regulation by constructing and maintaining a personal resiliency philosophy that emphasizes critical thinking, rationality, virtue, and Warrior Ethos. The author, an Army licensed clinical social worker, executive coach, REBT doctoral fellow, and former Special Forces noncommissioned officer, describes his initial experience teaching WRT during Operation Iraqi Freedom to combat medics and Soldiers from 2005 to 2006, and his experience as a leader of a combat stress control prevention team currently in Iraq offering mobile WRT classes in-theater. Warrior Resilience Training rationale, curriculum, variants (like Warrior Family Resilience Training), and feedback are included, with suggestions as to how behavioral health providers and combat stress control teams might better integrate their services with leaders, chaplains, and commands to better market combat stress resiliency, reduce barriers to care, and promote force preservation. Informal analysis of class feedback from 1168 respondents regarding WRT reception and utilization is examined.

Implementation of the RS232 communication trainer using computers and the ATMEGA microcontroller for interface engineering Courses

Science.gov (United States)

Amelia, Afritha; Julham; Viyata Sundawa, Bakti; Pardede, Morlan; Sutrisno, Wiwinta; Rusdi, Muhammad

2017-09-01

RS232 of serial communication is the communication system in the computer and microcontroller. This communication was studied in Department of Electrical Engineering and Department of Computer Engineering and Informatics Department at Politeknik Negeri Medan. Recently, an application of simulation was installed on the computer which used for teaching and learning process. The drawback of this system is not useful for communication method between learner and trainer. Therefore, this study was created method of 10 stage to which divided into 7 stages and 3 major phases. It can be namely the analysis of potential problems and data collection, trainer design, and empirical testing and revision. After that, the trainer and module were tested in order to get feedback from the learner. The result showed that 70.10% of feedback which wide reasonable from the learner of questionnaire.

Access and Resilience: Analyzing the Construction of Social Resilience to the Threat of Water Scarcity

Directory of Open Access Journals (Sweden)

Ruth Langridge

2006-12-01

Full Text Available Resilience is a vital attribute that characterizes a system's capacity to cope with stress. Researchers have examined the measurement of resilience in ecosystems and in social-ecological systems, and the comparative vulnerability of social groups. Our paper refocuses attention on the processes and relations that create social resilience. Our central proposition is that the creation of social resilience is linked to a community's ability to access critical resources. We explore this proposition through an analysis of how community resilience to the stress of water scarcity is influenced by historically contingent mechanisms to gain, control, and maintain access to water. Access is defined broadly as the ability of a community to actually benefit from a resource, and includes a wider range of relations than those derived from property rights alone. We provide a framework for assessing the construction of social resilience and use it to examine, first, the different processes and relations that enabled four communities in northern California to acquire access to water, and second, how access contributed to their differential levels of resilience to potential water scarcity. Legal water rights are extremely difficult to alter, and given the variety of mechanisms that can generate access, our study suggests that strengthening and diversifying a range of structural and relational mechanisms to access water can enhance a community's resilience to water scarcity.

Fetal MRI and ultrasound of congenital CNS anomalies; Fetales MRT und Ultraschall der angeborenen ZNS-Fehlbildungen

Energy Technology Data Exchange (ETDEWEB)

Pogledic, I.; Reith, W. [Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Meyberg-Solomayer, G. [Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Frauenheilkunde, Geburtsheilkunde und Reproduktionsmedizin, Homburg/Saar (Germany)

2013-02-15

In the last decade the newest technologies, fetal magnetic resonance imaging (MRI) and 3D ultrasound, have given an insight into the minute structures of the fetal brain. However, without knowledge of the basic developmental processes the imaging is futile. Knowledge of fetal neuroanatomy corresponding to the gestational week is necessary in order to recognize pathological structures. Furthermore, a modern neuroradiologist should be acquainted with the three steps in the formation of the cerebral cortex: proliferation, migration and differentiation of neurons in order to be in a position to suspect that there is a pathology and start recognizing and discovering the abnormalities. The fetal MRI has become an important complementary method to ultrasound especially in cortical malformations when confirmation of the prenatal diagnosis is needed and additional pathologies need to be diagnosed. In this manner these two methods help in parental counseling and treatment planning. (orig.) [German] Dank neuer Technologien (z. B. fetale MRT, 3-D-Sonographie) ist es moeglich, kleinste Hirnstrukturen darzustellen. Ohne Kenntnisse der grundlegenden Entwicklungsprozesse des Gehirns waere die Bildgebung jedoch sinnlos. Um pathologische Veraenderungen zu erkennen, ist es notwendig, den Stand der fetalen Neuroanatomie in der entsprechenden Schwangerschaftswoche zu kennen. Heutzutage sollte sich ein Neuroradiologe mit den 3 Schritten der kortikalen Entwicklung - Proliferation, Migration und Differenzierung der Neuronen - vertraut machen. Nur dann wird er in der Lage sein, pathologische Veraenderungen in Betracht zu ziehen, bzw. diese zu erkennen. Die fetale MRT ist besonders wichtig, ergaenzend zur zerebralen Sonographie, zur Diagnosebestaetigung bei kortikalen Veraenderungen und Nachweis weiterer Pathologien. In dieser Kombination ermoeglichen diese Methoden eine adaequate Beratung der Eltern und Planung der Behandlung. (orig.)

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

Science.gov (United States)

Kaminski, Thomas W.; Hertel, Jay; Amendola, Ned; Docherty, Carrie L.; Dolan, Michael G.; Hopkins, J. Ty; Nussbaum, Eric; Poppy, Wendy; Richie, Doug

2013-01-01

Objective: To present recommendations for athletic trainers and other allied health care professionals in the conservative management and prevention of ankle sprains in athletes. Background: Because ankle sprains are a common and often disabling injury in athletes, athletic trainers and other sports health care professionals must be able to implement the most current and evidence-supported treatment strategies to ensure safe and rapid return to play. Equally important is initiating preventive measures to mitigate both first-time sprains and the chance of reinjury. Therefore, considerations for appropriate preventive measures (including taping and bracing), initial assessment, both short- and long-term management strategies, return-to-play guidelines, and recommendations for syndesmotic ankle sprains and chronic ankle instability are presented. Recommendations: The recommendations included in this position statement are intended to provide athletic trainers and other sports health care professionals with guidelines and criteria to deliver the best health care possible for the prevention and management of ankle sprains. An endorsement as to best practice is made whenever evidence supporting the recommendation is available. PMID:23855363

Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer.

Science.gov (United States)

Teishima, Jun; Hattori, Minoru; Inoue, Shogo; Ikeda, Kenichiro; Hieda, Keisuke; Ohara, Shinya; Egi, Hiroyuki; Ohdan, Hideki; Matsubara, Akio

2014-07-01

We assess the retention of robot-assisted surgical skills among urologic surgeons. The robot-assisted surgery skills of 20 urologic surgeons were assessed using a Mimic dV-Trainer program (Mimic Technologies, Inc., Seattle, WA) consisting of 6 tasks. These 20 surgeons had no previous experience either using the Mimic dV-Trainer or acting as the main surgeon in robot-assisted surgery. The surgeons completed the program 4 times in a row; after 1 year, they completed it again for a fifth time. Performance scores were recorded using the Mimic dV-Trainer's built-in algorithm. For all 6 tasks, there were significant improvements to the scores in the fourth trials compared with those in the first trials. The scores in the fifth trials did not significantly decline compared with those in the fourth trials. There was no significant difference between the fifth trial scores of surgeons with laparoscopic surgery skills/experience and those without. Our results indicate that fundamental robot-assisted surgical skills can be retained in the long-term after they are acquired.

The value of magnetic resonance imaging (MRI) in the treatment planning of vertebral metastasis considering economic aspects. A cost benefit-analysis; Die Wertigkeit der Magnetresonanztomographie (MRT) unter oekonomischen Aspekten bei der Bestrahlungsplanung von Wirbelkoerpermetastasen. Eine Kosten-Nutzen-Analyse

Energy Technology Data Exchange (ETDEWEB)

Prott, F.J.; Schlehuber, E.; Scharding, B.J.; Rinast, E. [Strahlentherapie Wiesbaden, St.-Josefs-Hospital (Germany); Micke, O. [Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie, Universitaetsklinikum Muenster (Germany)

2002-05-01

Is magnetic resonance imaging (MRI) based target volume definition for treatment planning of vertebral metastasis effective under economic considerations.From 1994 to 1999, a total of 137 patients with bone metastases affecting the vertebral column underwent MRI of the cercival, thoracic, or lumbar spine for the treatment planning of palliative radiation therapy. The following radiation treatment consisted in a irradiation of the affected vertebral region up to a total dose of 30-40 Gy.The cost calculation for radiotherapy and magnetic resonance tomography was done using the common tariff model (EBM) of the German Health Insurances.In 73% of patients (101 patients), magnetic resonance imaging resulted in marked corrections of the irradiation fields which would have resulted in the necessity of treatment for recurrence in the case of treatment planning without MRI.Consequently, the higher cost of MRI of 345.00 DEM (176,40 EUR) lead to a saving of 497.00 DEM (254,11 EUR) compared to a recurrence treatment of 10 fractions and of 1,428.00 DEM (730,12 EUR) compared to 20 fractions. The transport expenses for the second treatment could be saved as well.Even under economic considerations MRI is effective. (orig.) [German] Ist eine MRT-gestuetzte Zielvolumendefinition bei der Strahlentherapie von Knochenmetastasen ein sinnvolles Vorgehen unter oekonomischen Gesichtspunkten?1994-1999 wurde bei 137 Patienten mit einem ossaer metastasierenden Tumor und Befall der Wirbelsaeule eine Magnetresonanztomographie (MRT) zur Planung einer palliativen Radiatio durchgefuehrt. Die nachfolgende Strahlentherapie bestand aus einer Radiatio des betroffenen Wirbelkoerperabschnitts bis zu einer Gesamtherddosis von 30-40 Gy. Fuer die Berechnung der Kosten wurde der einheitliche Bewertungsmassstab der Deutschen Krankenkassen zugrunde gelegt.Aufgrund der MRT-Untersuchungen wurde bei 73% der Patienten eine Veraenderung des Bestrahlungsfeldes vorgenommen, die im Falle einer nicht MRT

How Resilience Works.

Science.gov (United States)

Coutu, Diane L.

2002-01-01

Looks at coping skills that carry people through life and why some have them and others do not. Suggests that resilience is a reflex, a way of facing and understanding the world, and that resilient people and companies face reality with staunchness, make meaning out of hardship, and improvise. (JOW)

Formal aspects of resilience

Directory of Open Access Journals (Sweden)

Diana-Maria Drigă

2015-12-01

Full Text Available The concept of resilience has represented during the recent years a leading concern both in Romania, within the European Union and worldwide. Specialists in economics, management, finance, legal sciences, political sciences, sociology, psychology, grant a particular interest to this concept. Multidisciplinary research of resilience has materialized throughout the time in multiple conceptualizations and theorizing, but without being a consensus between specialists in terms of content, specificity and scope. Through this paper it is intended to clarify the concept of resilience, achieving an exploration of the evolution of this concept in ecological, social and economic environment. At the same time, the paper presents aspects of feedback mechanisms and proposes a formalization of resilience using the logic and mathematical analysis.

Understanding Individual Resilience in the Workplace: The International Collaboration of Workforce Resilience (ICWR Model

Directory of Open Access Journals (Sweden)

Clare Samantha Rees

2015-02-01

Full Text Available When not managed effectively, high levels of workplace stress can lead to several negative personal and performance outcomes. Some professional groups work in highly stressful settings and are therefore particularly at risk of conditions such as anxiety, depression, secondary traumatic stress and burnout. However, some individuals are less affected by workplace stress and the associated negative outcomes. Such individuals have been described as ‘resilient’. A number of studies have found relationships between levels of individual resilience and specific negative outcomes such as burnout and compassion fatigue. However, because psychological resilience is a multi-dimensional construct it is necessary to more clearly delineate it from other related and overlapping constructs. The creation of a testable theoretical model of individual workforce resilience, which includes both stable traits (e.g. neuroticism as well as more malleable intrapersonal factors (e.g. coping style, enables information to be derived that can eventually inform interventions aimed at enhancing individual resilience in the workplace. The purpose of this paper is to introduce a new theoretical model of individual workforce resilience that includes several intrapersonal constructs known to be central in the appraisal of and response to stressors and that also overlap with the construct of psychological resilience. We propose a model in which psychological resilience is hypothesised to mediate the relationship between neuroticism, mindfulness, self-efficacy, coping and psychological adjustment.

Introduction 'Governance for Drought Resilience'

NARCIS (Netherlands)

Bressers, Nanny; Bressers, Johannes T.A.; Larrue, Corinne; Bressers, Hans; Bressers, Nanny; Larrue, Corinne

2016-01-01

This book is about governance for drought resilience. But that simple sentence alone might rouse several questions. Because what do we mean with drought, and how does that relate to water scarcity? And what do we mean with resilience, and why is resilience needed for tackling drought? And how does

Resiliency against stress among athletes

Directory of Open Access Journals (Sweden)

Kamila Litwic-Kaminska

2015-10-01

Full Text Available Background The aim of this paper is to describe the results of a study concerning the relationship between resiliency and appraisal of a stressful situation, anxiety reactions and undertaken methods of coping among sportsmen. Participants and procedure The research concerned 192 competitors who actively train in one of the Olympic disciplines – individual or team. We used the following instruments: Resiliency Assessment Scale (SPP-25; Stress Appraisal Questionnaire A/B; Reactions to Competition Questionnaire; Coping Inventory for Stressful Situations (CISS; Sport Stress Coping Strategies Questionnaire (SR3S, self-constructed. Results Athletes most frequently apply positive types of stress appraisal, and they cope with stress through a task-oriented style during competitions. There is a relationship between the level of resiliency and the analysed aspects of the process of stress. The higher the resiliency, the more positive is the appraisal of a stressful situation and the more task-oriented are the strategies applied. Similarly, in everyday situations resilient sportspeople positively appraise difficult situations and undertake mostly task-oriented strategies. Resiliency is connected with less frequently experiencing reactions in the form of anxiety. Conclusions The obtained results, similarly to previous research, suggest that resiliency is connected with experiencing positive emotions. It causes more frequent appraisal of stressful situations as a challenge. More resilient people also choose more effective and situation-appropriate coping strategies. Therefore they are more resistant to stress.

Developing a workplace resilience instrument.

Science.gov (United States)

Mallak, Larry A; Yildiz, Mustafa

2016-05-27

Resilience benefits from the use of protective factors, as opposed to risk factors, which are associated with vulnerability. Considerable research and instrument development has been conducted in clinical settings for patients. The need existed for an instrument to be developed in a workplace setting to measure resilience of employees. This study developed and tested a resilience instrument for employees in the workplace. The research instrument was distributed to executives and nurses working in the United States in hospital settings. Five-hundred-forty completed and usable responses were obtained. The instrument contained an inventory of workplace resilience, a job stress questionnaire, and relevant demographics. The resilience items were written based on previous work by the lead author and inspired by Weick's [1] sense-making theory. A four-factor model yielded an instrument having psychometric properties showing good model fit. Twenty items were retained for the resulting Workplace Resilience Instrument (WRI). Parallel analysis was conducted with successive iterations of exploratory and confirmatory factor analyses. Respondents were classified based on their employment with either a rural or an urban hospital. Executives had significantly higher WRI scores than nurses, controlling for gender. WRI scores were positively and significantly correlated with years of experience and the Brief Job Stress Questionnaire. An instrument to measure individual resilience in the workplace (WRI) was developed. The WRI's four factors identify dimensions of workplace resilience for use in subsequent investigations: Active Problem-Solving, Team Efficacy, Confident Sense-Making, and Bricolage.

Formative Evaluation of the Tactical Patrol Craft Trainer: A Computer-Based Training Evaluation

National Research Council Canada - National Science Library

Jacobs, Dean

1997-01-01

...) during the implementation stage. The TPCT is an interactive multi-media computer based trainer designed to deliver a full fidelity and analog video training scenario to Prospective Commanding Officers (PCOs...

Presentation Trainer: a toolkit for learning non-verbal public speaking skills

NARCIS (Netherlands)

Schneider, Jan; Börner, Dirk; Van Rosmalen, Peter; Specht, Marcus

2014-01-01

The paper presents and outlines the demonstration of Presentation Trainer, a prototype that works as a public speaking instructor. It tracks and analyses the body posture, movements and voice of the user in order to give in- structional feedback on non-verbal communication skills. Besides exploring

Communal resilience: the Lebanese case

Directory of Open Access Journals (Sweden)

Eric BOUTIN

2015-07-01

Full Text Available In a turbulent and aggressive environment, organizations are subject to external events. They are sometimes destabilized and can disappear. This context explains the multiplication of works studying resilience of human organizations. Resilience is then defined as the ability of the organization studied to face an external shock.This paper proposes a state of the art of resilience concept and considers the interests of the transposition of the concept to the field of a territorial community. A case study will lead us to apply the concept of resilience to the Lebanese nation.

Practical Leakage-Resilient Symmetric Cryptography

DEFF Research Database (Denmark)

Faust, Sebastian; Pietrzak, Krzysztof; Schipper, Joachim

2012-01-01

Leakage resilient cryptography attempts to incorporate side-channel leakage into the black-box security model and designs cryptographic schemes that are provably secure within it. Informally, a scheme is leakage-resilient if it remains secure even if an adversary learns a bounded amount of arbitr......Leakage resilient cryptography attempts to incorporate side-channel leakage into the black-box security model and designs cryptographic schemes that are provably secure within it. Informally, a scheme is leakage-resilient if it remains secure even if an adversary learns a bounded amount...

Community Resilience to Militant Islamism: Who and What?: An Explorative Study of Resilience in Three Danish Communities

DEFF Research Database (Denmark)

Dalgaard-Nielsen, Anja; Schack, Patrick

2016-01-01

of resilience to militant Islamism in three Danish communities. It shows how families and trust-based networks, including local government, are the major sources of resilience, but also how punitive national policies and discourses work at cross purposes with resilience-building by reducing local actors......Building community resilience to violent extremism increasingly figures as a goal in national security strategies and debates. The exact meaning of resilience remains unclear, complicating an informed discussion of whom and what to support. This article presents findings from an explorative study...

Airman and Family Resilience: Lessons from the Scientific Literature

Science.gov (United States)

2015-01-01

www.rand.org/paf v Table of Contents Preface...initially for children and adolescents, the Army has modified its content for integration into MRT as part of the Comprehensive Soldier Fitness...positively and significantly associated with the PTGI-C. Self- reporting of rumination was not significantly associated with PTG. Social support may be

MRI, CT, and sonography in the preoperative evaluation of primary tumor extension in malignant pleural mesothelioma; MRT, CT und Sonographie in der praeoperativen Beurteilung der Primaertumorausdehnung beim malignen Pleuramesotheliom

Energy Technology Data Exchange (ETDEWEB)

Layer, G.; Steudel, A.; Schild, H.H. [Radiologische Universitaetsklinik Bonn (Germany); Schmitteckert, H.; Tuengerthal, S.; Schirren, J. [Thoraxklinik Heidelberg-Rohrbach (Germany); Kaick, G. van [Deutsches Krebsforschungszentrum Heidelberg (Germany). Schwerpunkt fuer Onkologische Diagnostik und Therapie

1999-04-01

Purpose: Evaluation of the diagnostic value of the imaging modalities computed tomography (CT), magnetic resonance imaging (MRI), and thoracic sonography in the preoperative staging of malignant pleural mesothelioma. Results: The accuracy rates for CT were 85%, 98%, 83%, 73%, 71%, and 83%. MRI had an accuracy of 71%, 92%, 71%, 83%, 71%, and 96%, the thoracic ultrasound examinations of 76%, 63%, 51%, 60%, 71% and 89%. Conclusions: According to these results CT remains the method of choice in the preoperative assessment of T-stage of malignant pleural mesothelioma. MRI is of nearly the same value, but is not a must. Sonography may be supplementary method for operation planning. (orig./AJ) [Deutsch] Ziel: Evaluation der diagnostischen Wertigkeit der Schnittbildverfahren MRT, CT und Sonographie in der praeoperativen Diagnostik des Pleuramesothelioms. Ergebisse: Die Treffsicherheiten betrugen fuer die genannten anatomischen Regionen im CT 85%, 98%, 83%, 73%, 71%, und 83%, im MRT 71%, 92%, 71%, 83%, 71% bzw. 96%, waehrend sich fuer die thorakale Ultraschalluntersuchung Treffsicherheiten von 76%, 63%, 51%, 60%, 71% und 89% errechneten. Schlussfolgerungen: Die CT bleibt damit das Verfahren erster Wahl in der praeoperativen Diagnostik des malignen Pleuramesothelioms. Eine unbedingte Forderung nach praeoperativer Durchfuehrung einer MRT-Untersuchung ergibt sich nach der vorliegenden Studie nicht. Die Sonographie des Thorax und oberen Abdomens liefert einen wichtigen ergaenzenden Beitrag bei der Planung der Operation des malignen Pleuramesothelioms. (orig./AJ)

Aligning Organizational Pathologies and Organizational Resilience Indicators

Directory of Open Access Journals (Sweden)

Manuel Morales Allende

2017-07-01

Full Text Available Developing resilient individuals, organizations and communities is a hot topic in the research agenda in Management, Ecology, Psychology or Engineering. Despite the number of works that focus on resilience is increasing, there is not completely agreed definition of resilience, neither an entirely formal and accepted framework. The cause may be the spread of research among different fields. In this paper, we focus on the study of organizational resilience with the aim of improving the level of resilience in organizations. We review the relation between viable and resilient organizations and their common properties. Based on these common properties, we defend the application of the Viable System Model (VSM to design resilient organizations. We also identify the organizational pathologies defined applying the VSM through resilience indicators. We conclude that an organization with any organizational pathology is not likely to be resilient because it does not fulfill the requirements of viable organizations.

Development of a multi-dimensional measure of resilience in adolescents: the Adolescent Resilience Questionnaire

Directory of Open Access Journals (Sweden)

Buzwell Simone

2011-10-01

Full Text Available Abstract Background The concept of resilience has captured the imagination of researchers and policy makers over the past two decades. However, despite the ever growing body of resilience research, there is a paucity of relevant, comprehensive measurement tools. In this article, the development of a theoretically based, comprehensive multi-dimensional measure of resilience in adolescents is described. Methods Extensive literature review and focus groups with young people living with chronic illness informed the conceptual development of scales and items. Two sequential rounds of factor and scale analyses were undertaken to revise the conceptually developed scales using data collected from young people living with a chronic illness and a general population sample. Results The revised Adolescent Resilience Questionnaire comprises 93 items and 12 scales measuring resilience factors in the domains of self, family, peer, school and community. All scales have acceptable alpha coefficients. Revised scales closely reflect conceptually developed scales. Conclusions It is proposed that, with further psychometric testing, this new measure of resilience will provide researchers and clinicians with a comprehensive and developmentally appropriate instrument to measure a young person's capacity to achieve positive outcomes despite life stressors.

The Communities Advancing Resilience Toolkit (CART): an intervention to build community resilience to disasters.

Science.gov (United States)

Pfefferbaum, Rose L; Pfefferbaum, Betty; Van Horn, Richard L; Klomp, Richard W; Norris, Fran H; Reissman, Dori B

2013-01-01

Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.

Evaluation of the effectiveness of a novel gait trainer in increasing the functionality of individuals with motor impairment: A case series.

Science.gov (United States)

Raveh, Eitan; Schwartz, Isabella; Karniel, Naama; Portnoy, Sigal

2017-10-16

Regaining the ability to independently ambulate following a physical disability can increase functional ability and participation of patients in daily life. Gait trainers are assistive devices that enable body support and provide safety during gait. However, most conventional gait trainers are pre-configured to a constant position, therefore not suitable for practicing sit-to-stand function, and require assistance from a caregiver in order to mount the device from a sitting position. We therefore evaluated the effectiveness of a dynamically-adjusting gait trainer, designed to provide independence and safety during gait and various activities, in both lab setting and at home in four subjects (one female, three males, ages 32-79 years) with limited ambulation. Spatiotemporal parameters and gait symmetry were recorded, as well as activity levels, actual use of device, and satisfaction. Although gait parameters and physical activity levels were not notably improved, and in one case were worsened, three subjects reported positive experience with the gait trainer. The new gait trainer may have advantages in supporting users with limited mobility during walking and various functions and decrease the risk for falls. A longer practice time and individual fitting process are recommended for better accommodation to the new possibilities.

Resilience Design Patterns - A Structured Approach to Resilience at Extreme Scale (version 1.1)

Energy Technology Data Exchange (ETDEWEB)

Hukerikar, Saurabh [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Engelmann, Christian [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2016-12-01

Reliability is a serious concern for future extreme-scale high-performance computing (HPC) systems. Projections based on the current generation of HPC systems and technology roadmaps suggest the prevalence of very high fault rates in future systems. The errors resulting from these faults will propagate and generate various kinds of failures, which may result in outcomes ranging from result corruptions to catastrophic application crashes. Therefore the resilience challenge for extreme-scale HPC systems requires management of various hardware and software technologies that are capable of handling a broad set of fault models at accelerated fault rates. Also, due to practical limits on power consumption in HPC systems future systems are likely to embrace innovative architectures, increasing the levels of hardware and software complexities. As a result the techniques that seek to improve resilience must navigate the complex trade-off space between resilience and the overheads to power consumption and performance. While the HPC community has developed various resilience solutions, application-level techniques as well as system-based solutions, the solution space of HPC resilience techniques remains fragmented. There are no formal methods and metrics to investigate and evaluate resilience holistically in HPC systems that consider impact scope, handling coverage, and performance & power efficiency across the system stack. Additionally, few of the current approaches are portable to newer architectures and software environments that will be deployed on future systems. In this document, we develop a structured approach to the management of HPC resilience using the concept of resilience-based design patterns. A design pattern is a general repeatable solution to a commonly occurring problem. We identify the commonly occurring problems and solutions used to deal with faults, errors and failures in HPC systems. Each established solution is described in the form of a pattern that

Building Inner Resilience

Science.gov (United States)

Lantieri, Linda

2008-01-01

The capacity to be in control of one's thoughts, emotions, and physiology can form an internal safety net preparing children to face the challenges and opportunities of life. This is the goal of the Inner Resilience Program in the New York City Schools. Teachers in the Inner Resilience Program's intervention are exposed to calming and focusing…

Resilience in patients with psychotic disorder.

Science.gov (United States)

Bozikas, V; Parlapani, E

2016-01-01

The recovery movement differentiated clinical, which is related to disorder's symptoms, from personal recovery, which is outlined by a subjectively defined wellness state, characterised by hope and self-management. Schizophrenia research has long focused on risk factors and symptoms. The recovery movement triggered a focus shift from psychopathology towards better adjustment and growth despite living with schizophrenia. The recovery movement flourished parallel with positive psychology, the scientific study of ordinary human strengths and virtues investigating human motives and potentials. Understanding of human strengths could contribute to prevention or lessening of psychiatric disorders' devastating consequences, since optimism, sense of personal control and many other positive processes promote psychological health. Lately, the concepts of positive psychology have been implemented in schizophrenia research. Positive self-appraisals moderated suicidal ideation, even when patients experienced high levels of hopelessness.1 Additionally, among other factors, better self-images, internal locus of control (i.e. the perception that events in one's life relate to one's actions) and emphasis on personal efforts predicted a more favourable outcome in functioning of unmedicated patients.2 The concept of "resilience" is closely related to positive psychology. The American Psychological Association defines resilience as ''the process of adapting well in the face of adversity, trauma, threats or significant sources of stress''. The concept of resilience includes rebound from adversity.3 Determinants of resilience include biological, psychological, social and cultural factors that interact in a complex manner. The major manifestations of personal resilience are social competence, problem solving, autonomy and sense of purpose.5 Personality strengths that relate to resilience include high self-esteem, extroversion and optimism. Internal assets and personal competencies

Animal experimental studies on the influence of fatty infiltration of the liver on tissue relaxation times and signal changes in MRT

International Nuclear Information System (INIS)

Kreft, B.; Stark, D.; Schild, H.

1995-01-01

Using a spectrometer (n=60) in vitro and MRT imaging (n=8) in vivo, we studied the influence of fatty changes of liver cells on the relaxation times of the liver (two animal models of fatty liver disease/orotic acid, L-ethionine). Induction of fatty degeneration of the liver by means of an orotic acid diet resulted in pure deposition of fat in the liver without any histological or serological proof of inflammatory changes. Although accumulation of triglyceride in the liver reduced the T 1 relaxation time only relatively slightly (-15%), there was good correlation (r=0.88) between fat content and T 1 . There was also good correlation (r=0.92) between T 2 and histological fat content. Inflammatory changes besides fatty deposition were seen both serologically and histologically in the L-ethionine model, so that the fatty content did not correlate with T 1 . In-vivo MRT imaging showed that spin-echo sequences are inappropriate for diagnosing fatty infiltration of the liver despite the relaxation time changes produced by the fatty deposition. On the other hand, chemical-shift imaging sequences are very sensitive to identify fatty deposits, and are also independent of any additionally existing inflammatory changes. (orig.) [de

The Australian Natural Disaster Resilience Index

Science.gov (United States)

Thoms, Martin

2016-04-01

The Australian Natural Disaster Resilience Index Martin Thoms, Melissa Parsons, Phil Morley Bushfire and Natural Hazards Cooperative Research Centre, Geography and Planning, University of New England, Armidale NSW 2351, Australia. Natural hazard management policy directions in Australia - and indeed internationally - are increasingly being aligned to ideas of resilience. Resilience to natural hazards is the ability of individuals and communities to cope with disturbance and adversity and to maintain adaptive behaviour. Operationalizing the measurement and assessment of disaster resilience is often undertaken using a composite index, but this exercise is yet to be undertaken in Australia. The Australian Natural Disaster Resilience Index is a top-down, national scale assessment of the resilience of communities to natural hazards. Resilience is assessed based on two sets of capacities: coping and adaptive capacities. Coping capacity relates to the factors influencing the ability of a community to prepare for, absorb and recover from a natural hazard event. Adaptive capacity relates to the arrangements and processes that enable adjustment through learning, adaptation and transformation. Indicators are derived under themes of social character, economic capital, infrastructure and planning, emergency services, community capital, information and engagement and governance/leadership/policy, using existing data sets (e.g. census data) or evaluation of policy and procedure (e.g. disaster management planning). A composite index of disaster resilience is then computed for each spatial division, giving national scale coverage. The results of the Australian Natural Disaster Resilience Index will be reported in a State of Disaster Resilience report, due in 2018. The index is co-designed with emergency service agencies, and will support policy development, planning, community engagement and emergency management.

Realism of procedural task trainers in a pediatric emergency medicine procedures course

Directory of Open Access Journals (Sweden)

Allan Shefrin

2015-04-01

Conclusions: Task training models utilized in our course received variable realism ratings. When deciding what type of task trainer to use future courses should carefully consider the desired aspect of realism, and how it aligns with the procedural skill, balanced with cost considerations.

[Perspectives on resilience : trait or aptitude ?

Science.gov (United States)

Rolin, H; Fossion, P; Kotsou, I; Leys, C

2018-01-01

In this paper, we discuss various issues related to the concept of resilience, which is conventionally defined as a dynamic process allowing for a positive adaptation in a context of significant adversity. First, we try to draw the reader's attention to the importance of the concept of resilience in terms of public health. Second, we address the difficulty of measuring resilience in a relevant and operational manner. Third, we then address the question of whether resilience can be conceived only in the context of a confrontation with trauma, or whether its application can be relevant to the everyday nontraumatic adversity. In this regard, we introduce and define another coping strategy which is the Sense of Coherence (SOC). Fourth, we discuss the nature of resilience, that is to say, whether it should be considered as a personality trait or as an aptitude. We try to show that this problem arises from the difficulty to specify the emotional processes involved in resilience. Finally, we propose future research perspectives that should allow us to better understand the concept of resilience.

Differentiation of testicular diseases via dynamic MRT

International Nuclear Information System (INIS)

Kaiser, W.A.; Reinges, T.; Miersch, W.D.; Vogel, J.

1994-01-01

The present study aimed at resolving whether dynamic MRT can improve diagnostic relevance in diseases of the testes compared with conventional spin echo images. The testes of 20 healthy volunteers and of 16 patients of the Department of Urology of the University of Bonn were examined by means of MR tomography. Within 12 hours after MR tomography the patients were surgically explored, biopsied and if necessary orchiectomised. Results obtained with the volunteers were uniform and well reproducible, independent of external influences. On comparing the maximal enhancement curves of the examined various testicular tumors with the standard values established by examining the healthy volunteers, the curves obtained with the malignant testicular tumors were always clearly above the chosen confidence range of 3 standard deviations so that malignancy diagnosis was easy. However, the degree of maximal enhancement did not enable us to arrive at a conclusion in respect of the tumor type or the degree of malignancy. The greatest enhancement occurred with the tumor of Sertoli's cell which could thus be clearly differentiated against the other malignant testicular tumors. Due to masking of the gadolinium effect by haemosiderin deposits, haemorrhagica in the tumor tissue should be excluded by means of T 2 -weighted spin echo sequences before following up a suspicion of malignant testicular tomor. Benign intratesticular changes could be safely separated from malignant findings by means of the maximal enhancement curve lying in the normal range or below the curve of the volunteers. As with other organs, dynamic MR tomography yields definitely more and better information than conventional MR tomography also in the diagnosis of testicular tumours. However, these ''pros'' do not offset the ''cons'' of high costs of such examinations. (orig.) [de

Resilience in women with autoimmune rheumatic diseases.

Science.gov (United States)

Rojas, Manuel; Rodriguez, Yhojan; Pacheco, Yovana; Zapata, Elizabeth; Monsalve, Diana M; Mantilla, Rubén D; Rodríguez-Jimenez, Monica; Ramírez-Santana, Carolina; Molano-González, Nicolás; Anaya, Juan-Manuel

2017-12-28

To evaluate the relationship between resilience and clinical outcomes in patients with autoimmune rheumatic diseases. Focus groups, individual interviews, and chart reviews were done to collect data on 188 women with autoimmune rheumatic diseases, namely rheumatoid arthritis (n=51), systemic lupus erythematosus (n=70), systemic sclerosis (n=35), and Sjögren's syndrome (n=32). Demographic, clinical, and laboratory variables were assessed including disease activity by patient reported outcomes. Resilience was evaluated by using the Brief Resilience Scale. Bivariate, multiple linear regression, and classification and regression trees were used to analyse data. Resilience was influenced by age, duration of disease, and socioeconomic status. Lower resilience scores were observed in younger patients (50years) had higher resilience scores regardless of socioeconomic status. There was no influence of disease activity on resilience. A particular behaviour was observed in systemic sclerosis in which patients with high socioeconomic status and regular physical activity had higher resilience scores. Resilience in patients with autoimmune rheumatic diseases is a continuum process influenced by age and socioeconomic status. The ways in which these variables along with exercise influence resilience deserve further investigation. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Resilience in Utility Technologies

Science.gov (United States)

Seaton, Roger

The following sections are included: * Scope of paper * Preamble * Background to the case-study projects * Source projects * Resilience * Case study 1: Electricity generation * Context * Model * Case study 2: Water recycling * Context * Model * Case study 3: Ecotechnology and water treatment * Context * The problem of classification: Finding a classificatory solution * Application of the new taxonomy to water treatment * Concluding comments and questions * Conclusions * Questions and issues * Purposive or Purposeful? * Resilience: Flexibility and adaptivity? * Resilience: With respect of what? * Risk, uncertainty, surprise, emergence - What sort of shock, and who says so? * Co-evolutionary friction * References

Kwalifikacje i kompetencje trenerów personalnych a oczekiwania rynku pracy = Personal trainers professional qualifications - demands of the labour market

Directory of Open Access Journals (Sweden)

Aleksandra Leśniewska

2016-09-01

Abstract Fitness has been a growth industry over the past years and seems not to be saturated on the polish ground. Fitness clubs offer a wide range of services to their clients from group classes to individual trainings such as personal training. However, personal trainers in Poland have conducive and effortless way to access to their profession, they still struggle with the lack of professional standards and incoherent educationa; system. The main purpose of this article was to define what are the demands of the labour market in terms of required qualifications and competences for personal trainers who are taking part in recruitment process.   Keywords: personal trainer, fitness services, qualifications and competencies, labour market

Continued formation to higher education teacher of university of vale do Itajai: the look of trainers of Gepes/Univali

Directory of Open Access Journals (Sweden)

Kátia Naomi Kuroshima

2016-09-01

Full Text Available This experience report presents the five trainer look belonging Study and Research Group in Higher Education -GEPES/UNIVALI, for Continued Formation Program to Higher Education by University of Vale do Itajaí – CF-UNIVALI. The main objective aims to highlight relevant experiences of trainer teachers with their peers in that program. Specific objectives are: reflect to its meaning, identify the positive aspects, describe conflicts, tensions and difficulties and provide essential aspects in the training. The main reasons for the preparation of the article are: be a trainer in CF-UNIVALI is challenging, mainly because it is a work with their peers: the need to socialize experience, about the training performance, given the few publications. Its methodology showed changes in its operational formats since its implementation in 2000, whose teaching participation was voluntary. Workshops, lectures, conferences, round table, experience reports, video conference, distance education activities, and others, include institutional and specific themes, during the months of February and July, in three shifts, in all campus. Based on content developed in this article, we have as final consideration, that, to be a trainer is to exercise and transit in the field of attitudes, skills and competences of teaching, be reflective and researcher teacher, talking and overcoming the challenges and pedagogical confrontation, in support of human and social development and quality of higher education, established at institutional education policy. It is hope that this article contributes other reflections, studies and research on the role of the trainer in this type of training.

Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies.

Science.gov (United States)

Chmitorz, A; Kunzler, A; Helmreich, I; Tüscher, O; Kalisch, R; Kubiak, T; Wessa, M; Lieb, K

2018-02-01

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Resilience definitions, theory, and challenges: interdisciplinary perspectives.

Science.gov (United States)

Southwick, Steven M; Bonanno, George A; Masten, Ann S; Panter-Brick, Catherine; Yehuda, Rachel

2014-01-01

In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).

Resilience definitions, theory, and challenges: interdisciplinary perspectives

Science.gov (United States)

Southwick, Steven M.; Bonanno, George A.; Masten, Ann S.; Panter-Brick, Catherine; Yehuda, Rachel

2014-01-01

In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture). PMID:25317257

Transdisciplinary application of the cross-scale resilience model

Science.gov (United States)

Sundstrom, Shana M.; Angeler, David G.; Garmestani, Ahjond S.; Garcia, Jorge H.; Allen, Craig R.

2014-01-01

The cross-scale resilience model was developed in ecology to explain the emergence of resilience from the distribution of ecological functions within and across scales, and as a tool to assess resilience. We propose that the model and the underlying discontinuity hypothesis are relevant to other complex adaptive systems, and can be used to identify and track changes in system parameters related to resilience. We explain the theory behind the cross-scale resilience model, review the cases where it has been applied to non-ecological systems, and discuss some examples of social-ecological, archaeological/ anthropological, and economic systems where a cross-scale resilience analysis could add a quantitative dimension to our current understanding of system dynamics and resilience. We argue that the scaling and diversity parameters suitable for a resilience analysis of ecological systems are appropriate for a broad suite of systems where non-normative quantitative assessments of resilience are desired. Our planet is currently characterized by fast environmental and social change, and the cross-scale resilience model has the potential to quantify resilience across many types of complex adaptive systems.

Injured Athletes' Perceived Loss of Identity: Educational Implications for Athletic Trainers

Science.gov (United States)

Lockhart, Barbara D.

2010-01-01

Context: As educators, athletic trainers should familiarize athletes with the concepts of self acceptance self-esteem and identity to assuage psychological trauma accompanying injury because the more a person identifies with being an athlete, the more difficult it is to deal with athletic injury. Objective: The objective of this article is to…

The Measurement and Role of Ecological Resilience Systems Theory Across Domain-Specific Outcomes: The Domain-Specific Resilient Systems Scales.

Science.gov (United States)

Maltby, John; Day, Liz; Hall, Sophie S; Chivers, Sally

2017-10-01

Research suggests that trait resilience may be best understood within an ecological resilient systems theory, comprising engineering, ecological, and adaptive capacity resilience. However, there is no evidence as to how this theory translates to specific life domains. Data from two samples (the United States, n = 1,278; the United Kingdom, n = 211) facilitated five studies that introduce the Domain-Specific Resilient Systems Scales for assessing ecological resilient systems theory within work, health, marriage, friendships, and education. The Domain-Specific Resilient Systems Scales are found to predict unique variance in job satisfaction, lower job burnout, quality-of-life following illness, marriage commitment, and educational engagement, while controlling for factors including sex, age, personality, cognitive ability, and trait resilience. The findings also suggest a distinction between the three resilience dimensions in terms of the types of systems to which they contribute. Engineering resilience may contribute most to life domains where an established system needs to be maintained, for example, one's health. Ecological resilience may contribute most to life domains where the system needs sustainability in terms of present and future goal orientation, for example, one's work. Adaptive Capacity may contribute most to life domains where the system needs to be retained, preventing it from reaching a crisis state, for example, work burnout.

Resilience in Aging Mice.

Science.gov (United States)

Kirkland, James L; Stout, Michael B; Sierra, Felipe

2016-11-01

Recently discovered interventions that target fundamental aging mechanisms have been shown to increase life span in mice and other species, and in some cases, these same manipulations have been shown to enhance health span and alleviate multiple age-related diseases and conditions. Aging is generally associated with decreases in resilience, the capacity to respond to or recover from clinically relevant stresses such as surgery, infections, or vascular events. We hypothesize that the age-related increase in susceptibility to those diseases and conditions is driven by or associated with the decrease in resilience. Thus, a test for resilience at middle age or even earlier could represent a surrogate approach to test the hypothesis that an intervention delays the process of aging itself. For this, animal models to test resilience accurately and predictably are needed. In addition, interventions that increase resilience might lead to treatments aimed at enhancing recovery following acute illnesses, or preventing poor outcomes from medical interventions in older, prefrail subjects. At a meeting of basic researchers and clinicians engaged in research on mechanisms of aging and care of the elderly, the merits and drawbacks of investigating effects of interventions on resilience in mice were considered. Available and potential stressors for assessing physiological resilience as well as the notion of developing a limited battery of such stressors and how to rank them were discussed. Relevant ranking parameters included value in assessing general health (as opposed to focusing on a single physiological system), ease of use, cost, reproducibility, clinical relevance, and feasibility of being repeated in the same animal longitudinally. During the discussions it became clear that, while this is an important area, very little is known or established. Much more research is needed in the near future to develop appropriate tests of resilience in animal models within an aging context

Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

Energy Technology Data Exchange (ETDEWEB)

East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

2008-09-22

This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.

Development of an advanced mechanised gait trainer, controlling movement of the centre of mass, for restoring gait in non-ambulant subjects.

Science.gov (United States)

Hesse, S; Sarkodie-Gyan, T; Uhlenbrock, D

1999-01-01

The study aimed at further development of a mechanised gait trainer which would allow non-ambulant people to practice a gait-like motion repeatedly. To simulate normal gait, discrete stance and swing phases, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. A complex gear system provided the gait-like movement of two foot plates with a ratio of 60% to 40% between the stance and swing phases. A controlled propulsion system adjusted its output according to patient's efforts. Two eccenters on the central gear controlled phase-adjusted the vertical and horizontal position of the centre of mass. The patterns of sagittal lower limb joint kinematics and of muscle activation of a normal subject were similar when using the mechanised trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists supported treadmill walking. Gait movements on the trainer were highly symmetrical, impact-free, and less spastic. The weight-bearing muscles were activated in a similar fashion during both conditions. The vertical displacement of the centre of mass was bi-instead of mono-phasic during each gait cycle on the new device. In conclusion, the gait trainer allowed wheelchair-bound subjects the repetitive practice of a gait-like movement without overstraining therapists.

The Resiliency Scale for Young Adults

Science.gov (United States)

Prince-Embury, Sandra; Saklofske, Donald H.; Nordstokke, David W.

2017-01-01

The Resiliency Scale for Young Adults (RSYA) is presented as an upward extension of the Resiliency Scales for Children and Adolescents (RSCA). The RSYA is based on the "three-factor model of personal resiliency" including "mastery," "relatedness," and "emotional reactivity." Several stages of scale…

Metrics for energy resilience

International Nuclear Information System (INIS)

Roege, Paul E.; Collier, Zachary A.; Mancillas, James; McDonagh, John A.; Linkov, Igor

2014-01-01

Energy lies at the backbone of any advanced society and constitutes an essential prerequisite for economic growth, social order and national defense. However there is an Achilles heel to today's energy and technology relationship; namely a precarious intimacy between energy and the fiscal, social, and technical systems it supports. Recently, widespread and persistent disruptions in energy systems have highlighted the extent of this dependence and the vulnerability of increasingly optimized systems to changing conditions. Resilience is an emerging concept that offers to reconcile considerations of performance under dynamic environments and across multiple time frames by supplementing traditionally static system performance measures to consider behaviors under changing conditions and complex interactions among physical, information and human domains. This paper identifies metrics useful to implement guidance for energy-related planning, design, investment, and operation. Recommendations are presented using a matrix format to provide a structured and comprehensive framework of metrics relevant to a system's energy resilience. The study synthesizes previously proposed metrics and emergent resilience literature to provide a multi-dimensional model intended for use by leaders and practitioners as they transform our energy posture from one of stasis and reaction to one that is proactive and which fosters sustainable growth. - Highlights: • Resilience is the ability of a system to recover from adversity. • There is a need for methods to quantify and measure system resilience. • We developed a matrix-based approach to generate energy resilience metrics. • These metrics can be used in energy planning, system design, and operations

What do you mean, 'resilient geomorphic systems'?

Science.gov (United States)

Thoms, M. C.; Piégay, H.; Parsons, M.

2018-03-01

Resilience thinking has many parallels in the study of geomorphology. Similarities and intersections exist between the scientific discipline of geomorphology and the scientific concept of resilience. Many of the core themes fundamental to geomorphology are closely related to the key themes of resilience. Applications of resilience thinking in the study of natural and human systems have expanded, based on the fundamental premise that ecosystems, economies, and societies must be managed as linked social-ecological systems. Despite geomorphology and resilience sharing core themes, appreciation is limited of the history and development of geomorphology as a field of scientific endeavor by many in the field of resilience, as well as a limited awareness of the foundations of the former in the more recent emergence of resilience. This potentially limits applications of resilience concepts to the study of geomorphology. In this manuscript we provide a collective examination of geomorphology and resilience as a means to conceptually advance both areas of study, as well as to further cement the relevance and importance of not only understanding the complexities of geomorphic systems in an emerging world of interdisciplinary challenges but also the importance of viewing humans as an intrinsic component of geomorphic systems rather than just an external driver. The application of the concepts of hierarchy and scale, fundamental tenets of the study of geomorphic systems, provide a means to overcome contemporary scale-limited approaches within resilience studies. Resilience offers a framework for geomorphology to expand its application into the broader social-ecological domain.

Regional employment growth, shocks and regional industrial resilience

DEFF Research Database (Denmark)

Holm, Jacob Rubæk; Østergaard, Christian Richter

2013-01-01

The resilience of regional industries to economic shocks has gained a lot of attention in evolutionary economic geography recently. This paper uses a novel quantitative approach to investigate the regional industrial resilience of the Danish ICT sector to the shock following the burst of the dot......-com bubble. It is shown that regions characterised by small and young ICT service companies were more adaptable and grew more than others, while diversity and urbanisation increased the sensitivity to the business cycle after the shock. Different types of resilient regions are found: adaptively resilient......, rigidly resilient, entrepreneurially resilient and non-resilient regions....

Resilience | Science Inventory | US EPA

Science.gov (United States)

Resilience is an important framework for understanding and managing complex systems of people and nature that are subject to abrupt and nonlinear change. The idea of ecological resilience was slow to gain acceptance in the scientific community, taking thirty years to become widely accepted (Gunderson 2000, cited under Original Definition). Currently, the concept is commonplace in academics, management, and policy. Although the idea has quantitative roots in the ecological sciences and was proposed as a measurable quality of ecosystems, the broad use of resilience led to an expansion of definitions and applications. Holling’s original definition, presented in 1973 (Holling 1973, cited under Original Definition), was simply the amount of disturbance that a system can withstand before it shifts into an alternative stability domain. Ecological resilience, therefore, emphasizes that the dynamics of complex systems are nonlinear, meaning that these systems can transition, often abruptly, between dynamic states with substantially different structures, functions, and processes. The transition of ecological systems from one state to another frequently has important repercussions for humans. Recent definitions are more normative and qualitative, especially in the social sciences, and a competing definition, that of engineering resilience, is still often used. Resilience is an emergent phenomenon of complex systems, which means it cannot be deduced from the behavior of t

Measuring county resilience after the 2008 Wenchuan earthquake

Science.gov (United States)

Li, X.; Lam, N.; Qiang, Y.; Li, K.; Yin, L.; Liu, S.; Zheng, W.

2015-01-01

The catastrophic earthquake in 2008 has caused serious damage to Wenchuan County and the surrounding area in China. In recent years, great attention has been paid to the resilience of the affected area. This study applied a new framework, the Resilience Inference Measurement (RIM) model, to quantify and validate the community resilience of 105 counties in the affected area. The RIM model uses cluster analysis to classify counties into four resilience levels according to the exposure, damage, and recovery conditions, and then applies discriminant analysis to quantify the influence of socioeconomic characteristics on the county resilience. The analysis results show that counties located right at the epicenter had the lowest resilience, but counties immediately adjacent to the epicenter had the highest resilience capacities. Counties that were farther away from the epicenter returned to normal resiliency. The socioeconomic variables, including sex ratio, per capita GDP, percent of ethnic minority, and medical facilities, were identified as the most influential socio-economic characteristics on resilience. This study provides useful information to improve county resilience to earthquakes and support decision-making for sustainable development.

Interrogating resilience in health systems development.

Science.gov (United States)

van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

2017-11-01

The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Healthy ageing, resilience and wellbeing.

Science.gov (United States)

Cosco, T D; Howse, K; Brayne, C

2017-12-01

The extension of life does not appear to be slowing, representing a great achievement for mankind as well as a challenge for ageing populations. As we move towards an increasingly older population we will need to find novel ways for individuals to make the best of the challenges they face, as the likelihood of encountering some form of adversity increases with age. Resilience theories share a common idea that individuals who manage to navigate adversity and maintain high levels of functioning demonstrate resilience. Traditional models of healthy ageing suggest that having a high level of functioning across a number of domains is a requirement. The addition of adversity to the healthy ageing model via resilience makes this concept much more accessible and more amenable to the ageing population. Through asset-based approaches, such as the invoking of individual, social and environmental resources, it is hoped that greater resilience can be fostered at a population level. Interventions aimed at fostering greater resilience may take many forms; however, there is great potential to increase social and environmental resources through public policy interventions. The wellbeing of the individual must be the focus of these efforts; quality of life is an integral component to the enjoyment of additional years and should not be overlooked. Therefore, it will become increasingly important to use resilience as a public health concept and to intervene through policy to foster greater resilience by increasing resources available to older people. Fostering wellbeing in the face of increasing adversity has significant implications for ageing individuals and society as a whole.

An examination of stress and burnout in certified athletic trainers at division I-a universities.

Science.gov (United States)

Hendrix, A E; Acevedo, E O; Hebert, E

2000-04-01

A growing body of knowledge indicates that too much stress can negatively influence psychological and physical health. A model proposed by Smith to explore personal and situational variables, stress appraisal, and burnout has led to significant understanding of burnout of individuals working in service professions. We examined the relationship of hardiness, social support, and work-related issues relevant to athletic trainers to perceived stress and the relationship of perceived stress to burnout. Correlational analyses were performed to examine the relationships predicted by Smith's model. In addition, we conducted stepwise multiple regression analyses to assess the relative contributions of the personal and situational variables to perceived stress and to examine the relative impact of perceived stress on 3 burnout factors (emotional exhaustion, personal accomplishment, and depersonalization). One hundred eighteen certified athletic trainers working in National Collegiate Athletic Association Division I-A intercollegiate settings that maintain a football program. We assessed personal and situational variables using the Hardiness Test, the Social Support Questionnaire, and the Athletic Training Issues Survey, adapted for this study. The Perceived Stress Scale was used to assess stress appraisal, and the Maslach Burnout Inventory was used to assess 3 dimensions of burnout. Our results were in support of Smith's theoretical model of stress and burnout. Athletic trainers who scored lower on hardiness and social support and higher on athletic training issues tended to have higher levels of perceived stress. Furthermore, higher perceived stress scores were related to higher emotional exhaustion and depersonalization and lower levels of personal accomplishment. Our findings examining burnout in Division I athletic trainers were similar to those of other studies investigating coaches and coach-teachers and in support of Smith's theoretical model of stress and burnout.

Regional Employment Growth, Shocks and Regional Industrial Resilience

DEFF Research Database (Denmark)

Holm, J.R.; Østergaard, Christian Richter

2015-01-01

The resilience of regional industries to economic shocks has gained a lot of attention in evolutionary economic geography recently. This paper uses a novel quantitative approach to investigate the regional industrial resilience of the Danish information and communication technology (ICT) sector...... to the shock following the burst of the dot.com bubble. It is shown that regions characterized by small and young ICT service companies were more adaptable and grew more than others, while diversity and urbanization increased the sensitivity to the business cycle after the shock. Different types of resilient...... regions are found: adaptively resilient, rigidly resilient, entrepreneurially resilient and non-resilient regions....

Temporal Changes in Community Resilience to Drought Hazard

Science.gov (United States)

Mihunov, V.

2017-12-01

The threat of droughts and their associated impacts on the landscape and human communities have long been recognized. While considerable research on the climatological aspect of droughts has been conducted, studies on the resilience of human communities to the effects of drought remain limited. Understanding how different communities respond to and recover from the drought hazard, i.e. their community resilience, should inform the development of better strategies to cope with the hazard. This research assesses community resilience to drought hazard in South-Central U.S. and captures the temporal changes of community resilience in the region facing the climate change. First, the study applies the Resilience Inference Measurement (RIM) framework using the existing drought incidence, crop damage, socio-economic and food-water-energy nexus variables, which allows to assign county-level resilience scores in the study region and derive variables contributing to the resilience. Second, it captures the temporal changes in community resilience by using the model extracted from the RIM study and socio-economic data from several consecutive time periods. The resilience measurement study should help understand the complex process underlying communities' response to the drought impacts. The results identify gaps in resilience planning and help the improvement of the community resilience to the droughts of increasing frequency and intensity.

Degrees of reality: airway anatomy of high-fidelity human patient simulators and airway trainers.

Science.gov (United States)

Schebesta, Karl; Hüpfl, Michael; Rössler, Bernhard; Ringl, Helmut; Müller, Michael P; Kimberger, Oliver

2012-06-01

Human patient simulators and airway training manikins are widely used to train airway management skills to medical professionals. Furthermore, these patient simulators are employed as standardized "patients" to evaluate airway devices. However, little is known about how realistic these patient simulators and airway-training manikins really are. This trial aimed to evaluate the upper airway anatomy of four high-fidelity patient simulators and two airway trainers in comparison with actual patients by means of radiographic measurements. The volume of the pharyngeal airspace was the primary outcome parameter. Computed tomography scans of 20 adult trauma patients without head or neck injuries were compared with computed tomography scans of four high-fidelity patient simulators and two airway trainers. By using 14 predefined distances, two cross-sectional areas and three volume parameters of the upper airway, the manikins' similarity to a human patient was assessed. The pharyngeal airspace of all manikins differed significantly from the patients' pharyngeal airspace. The HPS Human Patient Simulator (METI®, Sarasota, FL) was the most realistic high-fidelity patient simulator (6/19 [32%] of all parameters were within the 95% CI of human airway measurements). The airway anatomy of four high-fidelity patient simulators and two airway trainers does not reflect the upper airway anatomy of actual patients. This finding may impact airway training and confound comparative airway device studies.

MRI for therapy planning in patients with atrial septum defects; MRT zur Therapieplanung bei Patienten mit Vorhofseptumdefekt

Energy Technology Data Exchange (ETDEWEB)

Huber, A.; Rummeny, E. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institut fuer Radiologie, Muenchen (Germany); Prompona, M.; Reiser, M.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Kozlik-Feldmann, R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Kinderkardiologie, Muenchen (Germany); Muehling, O. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik I, Muenchen (Germany)

2011-01-15

The aim of this study was to determine the value of a combined magnetic resonance imaging (MRI) protocol including steady-state free precession (SSFP) imaging, phase-contrast measurements and contrast-enhanced MR angiography (CE-MRA) for presurgical or preinterventional diagnostic imaging in patients with suspected atrial septum defects. Out of 65 MRI studies of patients with suspected atrial septum defects, 56 patients were included in the study. The atrial septum defects were identified on cine images. Velocity encoded flow measurements were used to determine shunt volumes, which were compared with invasive oxymetry in 24 patients. Contrast-enhanced MRI was used to assess the thoracic vessels in order to detect vascular anomalies. The findings were compared with the intraoperative results. A total of 24 patients with high shunt volumes were treated either surgically (16 patients) or interventionally (8 patients) and 32 patients with low shunt volumes did not require surgical or interventional treatment. The vascular anomaly, which in all cases was anomalous pulmonary venous return, was confirmed by the intraoperative findings. The type and location of atrial septal defects which required treatment, were confirmed intraoperatively or during the intervention. The results of shunt quantification by MRI showed a good correlation with the results of invasive oximetry (r=0.91, p <0.0001). A combined MRI protocol including cine SSFP images, velocity-encoded flow measurements and CE-MRA is an accurate method for preoperative and preinterventional evaluation of atrial septum defects. (orig.) [German] Ziel war es, die Wertigkeit eines kombinierten MRT-Protokolls aus Funktionsuntersuchung, Flussmessung und MR-Angiographie zur praeoperativen oder -interventionellen Abklaerung bei Patienten mit Vorhofseptumdefekt zu evaluieren. Ingesamt wurden 56 Patienten mit Vorhofseptumdefekt aus einem Kollektiv von 65 Patienten mit Verdacht auf Vorhofseptumdefekt, die im MRT untersucht

Consultant medical trainers, modernising medical careers (MMC and the European time directive (EWTD: tensions and challenges in a changing medical education context

Directory of Open Access Journals (Sweden)

Payne Heather

2008-05-01

Full Text Available Abstract Background We analysed the learning and professional development narratives of Hospital Consultants training junior staff ('Consultant Trainers' in order to identify impediments to successful postgraduate medical training in the UK, in the context of Modernising Medical Careers (MMC and the European Working Time Directive (EWTD. Methods Qualitative study. Learning and continuing professional development (CPD, were discussed in the context of Consultant Trainers' personal biographies, organisational culture and medical education practices. We conducted life story interviews with 20 Hospital Consultants in six NHS Trusts in Wales in 2005. Results Consultant Trainers felt that new working patterns resulting from the EWTD and MMC have changed the nature of medical education. Loss of continuity of care, reduced clinical exposure of medical trainees and loss of the popular apprenticeship model were seen as detrimental for the quality of medical training and patient care. Consultant Trainers' perceptions of medical education were embedded in a traditional medical education culture, which expected long hours' availability, personal sacrifices and learning without formal educational support and supervision. Over-reliance on apprenticeship in combination with lack of organisational support for Consultant Trainers' new responsibilities, resulting from the introduction of MMC, and lack of interest in pursuing training in teaching, supervision and assessment represent potentially significant barriers to progress. Conclusion This study identifies issues with significant implications for the implementation of MMC within the context of EWTD. Postgraduate Deaneries, NHS Trusts and the new body; NHS: Medical Education England should deal with the deficiencies of MMC and challenges of ETWD and aspire to excellence. Further research is needed to investigate the views and educational practices of Consultant Medical Trainers and medical trainees.

Practicals, skills and emotional requirements. A look of entrepreneurship trainers in Villa Maria (Córdoba

Directory of Open Access Journals (Sweden)

Diego Quattrini

2017-04-01

Full Text Available In the last years to respond to social marginalization processes compensation social policies were launched, some of them with the idea to support the construction of the employability of working people. As part of these policies, in the different levels of government, were promoted training in entrepreneurship. In this sense, this paper seeks to address the educational proposals aimed at formation in work emotions for trainers in micro-entrepreneurship Villa Maria (Cordoba. The proposal is to analyze the discourse of based management skills of trainers in relation to their possible impact on the construction of “enterprising sensibilities” for the job. To examine part this type of the training will be used methodology of q

A new multidimensional measure of personal resilience and its use: Chinese nurse resilience, organizational socialization and career success.

Science.gov (United States)

Wei, Wei; Taormina, Robert J

2014-12-01

This study refined the concept of resilience and developed four valid and reliable subscales to measure resilience, namely, Determination, Endurance, Adaptability and Recuperability. The study also assessed their hypothesized relationships with six antecedent variables (worry, physiological needs satisfaction, organizational socialization, conscientiousness, future orientation and Chinese values) and with one outcome variable (nurses' career success). The four new 10-item subscale measures of personal resilience were constructed based on their operational definitions and tested for their validity and reliability. All items were included in a questionnaire completed by 244 full-time nurses at two hospitals in China. All four measures demonstrated concurrent validity and had high reliabilities (from 0.74 to 0.78). The hypothesized correlations with the personality and organizational variables were statistically significant and in the predicted directions. Regression analyses confirmed these relationships, which explained 25-32% of the variance for the four resilience facets and 27% of the variance for the nurses' career success. The results provided strong evidence that organizational socialization facilitates resilience, that resilience engenders career success and that identifying the four resilience facets permits a more complete understanding of personal resilience, which could benefit nurses, help nurse administrators with their work and also help in treating patients. © 2014 John Wiley & Sons Ltd.

Resilience through adaptation.

Directory of Open Access Journals (Sweden)

Guus A Ten Broeke

Full Text Available Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS. Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations with agent-based models (ABMs provide a helpful tool. However, the value of ABMs for studying adaptation depends on the availability of methodologies for sensitivity analysis that can quantify resilience and adaptation in ABMs. In this paper we propose a sensitivity analysis methodology that is based on comparing time-dependent probability density functions of output of ABMs with and without agent adaptation. The differences between the probability density functions are quantified by the so-called earth-mover's distance. We use this sensitivity analysis methodology to quantify the probability of occurrence of critical transitions and other long-term effects of agent adaptation. To test the potential of this new approach, it is used to analyse the resilience of an ABM of adaptive agents competing for a common-pool resource. Adaptation is shown to contribute positively to the resilience of this ABM. If adaptation proceeds sufficiently fast, it may delay or avert the collapse of this system.

Resilience through adaptation.

Science.gov (United States)

Ten Broeke, Guus A; van Voorn, George A K; Ligtenberg, Arend; Molenaar, Jaap

2017-01-01

Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS). Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations with agent-based models (ABMs) provide a helpful tool. However, the value of ABMs for studying adaptation depends on the availability of methodologies for sensitivity analysis that can quantify resilience and adaptation in ABMs. In this paper we propose a sensitivity analysis methodology that is based on comparing time-dependent probability density functions of output of ABMs with and without agent adaptation. The differences between the probability density functions are quantified by the so-called earth-mover's distance. We use this sensitivity analysis methodology to quantify the probability of occurrence of critical transitions and other long-term effects of agent adaptation. To test the potential of this new approach, it is used to analyse the resilience of an ABM of adaptive agents competing for a common-pool resource. Adaptation is shown to contribute positively to the resilience of this ABM. If adaptation proceeds sufficiently fast, it may delay or avert the collapse of this system.

Sociotechnical Resilience: A Preliminary Concept.

Science.gov (United States)

Amir, Sulfikar; Kant, Vivek

2018-01-01

This article presents the concept of sociotechnical resilience by employing an interdisciplinary perspective derived from the fields of science and technology studies, human factors, safety science, organizational studies, and systems engineering. Highlighting the hybrid nature of sociotechnical systems, we identify three main constituents that characterize sociotechnical resilience: informational relations, sociomaterial structures, and anticipatory practices. Further, we frame sociotechnical resilience as undergirded by the notion of transformability with an emphasis on intentional activities, focusing on the ability of sociotechnical systems to shift from one form to another in the aftermath of shock and disturbance. We propose that the triad of relations, structures, and practices are fundamental aspects required to comprehend the resilience of sociotechnical systems during times of crisis. © 2017 Society for Risk Analysis.

Resilience and Coping After Hospital Mergers.

Science.gov (United States)

Russo, Cynthia; Calo, Oriana; Harrison, Georgia; Mahoney, Kathleen; Zavotsky, Kathleen Evanovich

The aim of this study was to explore the relationship between resilience and coping in frontline nurses working in a healthcare system that has recently undergone a merger. Hospital mergers are common in the current healthcare environment. Mergers can provide hospital nurses the opportunity to use and develop positive coping strategies to help remain resilient during times of change. An anonymous-survey, quantitative, exploratory, descriptive study design was used. Data were obtained from an electronic survey that was made available to all nurses working in a 3-hospital system located in the northeast. Overall, the results showed that, when nurses reported using positive coping strategies, they report higher levels of resilience. The levels of resilience also varied from campus to campus. The campus that has been through 2 recent mergers reported the highest levels of resilience. This study suggests that, during times of change in the workplace, if nurses are encouraged to use positive coping strategies, they may have higher levels of resilience. This changing environment provides the clinical nurse specialists/clinical nurse educators the opportunity to foster and support frontline nurses in the use of healthy coping strategies and to help improve and maintain a high level of resilience, which is critical in today's healthcare environment.

Resilience in IMS

DEFF Research Database (Denmark)

Kamyod, Chayapol; Nielsen, Rasmus Hjorth; Prasad, Neeli R.

2012-01-01

) and supporting always on services. Therefore, not only Quality of Service (QoS) but also resilience is required. In this paper, we attempt to evaluate and analyze end-to-end reliability of the IMS system using a model proposed as a combination of Reliability Block Diagram (RBD) and Markov Reward Models (MRMs......Reliability evaluation of systems has been widely researched for improving system resilience especially in designing processes of a complex system. The convergence of different access networks is possible via IP Multimedia Subsystem (IMS) for development toward Next Generation Networks (NGNs......). The resilience of the IMS architecture is studied by applying 1:1 redundancy at different communication scenarios between end users within and across communication domains. The model analysis provides useful reliability characteristics of the system and can be further applied for system design processes....

Multidimensional approach to complex system resilience analysis

International Nuclear Information System (INIS)

Gama Dessavre, Dante; Ramirez-Marquez, Jose E.; Barker, Kash

2016-01-01

Recent works have attempted to formally define a general metric for quantifying resilience for complex systems as a relationship of performance of the systems against time. The technical content in the proposed work introduces a new model that allows, for the first time, to compare the system resilience among systems (or different modifications to a system), by introducing a new dimension to system resilience models, called stress, to mimic the definition of resilience in material science. The applicability and usefulness of the model is shown with a new heat map visualization proposed in this work, and it is applied to a simulated network resilience case to exemplify its potential benefits. - Highlights: • We analyzed two of the main current metrics of resilience. • We create a new model that relates events with the effects they have. • We develop a novel heat map visualization to compare system resilience. • We showed the model and visualization usefulness in a simulated case.

Resilience Design Patterns - A Structured Approach to Resilience at Extreme Scale (version 1.0)

Energy Technology Data Exchange (ETDEWEB)

Hukerikar, Saurabh [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Engelmann, Christian [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2016-10-01

Reliability is a serious concern for future extreme-scale high-performance computing (HPC) systems. Projections based on the current generation of HPC systems and technology roadmaps suggest that very high fault rates in future systems. The errors resulting from these faults will propagate and generate various kinds of failures, which may result in outcomes ranging from result corruptions to catastrophic application crashes. Practical limits on power consumption in HPC systems will require future systems to embrace innovative architectures, increasing the levels of hardware and software complexities. The resilience challenge for extreme-scale HPC systems requires management of various hardware and software technologies that are capable of handling a broad set of fault models at accelerated fault rates. These techniques must seek to improve resilience at reasonable overheads to power consumption and performance. While the HPC community has developed various solutions, application-level as well as system-based solutions, the solution space of HPC resilience techniques remains fragmented. There are no formal methods and metrics to investigate and evaluate resilience holistically in HPC systems that consider impact scope, handling coverage, and performance & power eciency across the system stack. Additionally, few of the current approaches are portable to newer architectures and software ecosystems, which are expected to be deployed on future systems. In this document, we develop a structured approach to the management of HPC resilience based on the concept of resilience-based design patterns. A design pattern is a general repeatable solution to a commonly occurring problem. We identify the commonly occurring problems and solutions used to deal with faults, errors and failures in HPC systems. The catalog of resilience design patterns provides designers with reusable design elements. We define a design framework that enhances our understanding of the important

Promoting resilience among nursing students in clinical education.

Science.gov (United States)

Thomas, Lisa Jean; Asselin, Marilyn

2018-01-01

Resilience is the ability to overcome adversity and grow stronger from the experience. Increased resilience has been shown to positively impact nurses in practice. With this knowledge, recommendations to incorporate resilience training into nursing education have been made. Research, integrative reviews and a theoretical model of resilience in nursing students are explored in this paper. The authors posit that facilitating resilience is important in the setting of clinical education. Through incorporating resilience training in the clinical setting, educators can better prepare students for challenges in their educational environment and ultimately for nursing practice. Specific strategies for clinical educators to incorporate resilience training are suggested. Strategies are organized into three categories, support, education and reflection. The position of facilitating resilience in clinical education may open a discussion for future educational practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Distributed Energy Planning for Climate Resilience

Energy Technology Data Exchange (ETDEWEB)

Stout, Sherry R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hotchkiss, Elizabeth L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Day, Megan H [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lee, Nathan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holm, Alison [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-05-01

At various levels of government across the United States and globally climate resilient solutions are being adopted and implemented. Solutions vary based on predicted hazards, community context, priorities, complexity, and available resources. Lessons are being learned through the implementation process, which can be replicated regardless of level or type of government entity carrying out the resiliency planning. Through a number of analyses and technical support across the world, NREL has learned key lessons related to resilience planning associated with power generation and water distribution. Distributed energy generation is a large factor in building resilience with clean energy technologies and solutions. The technical and policy solutions associated with distributed energy implementation for resilience fall into a few major categories, including spatial diversification, microgrids, water-energy nexus, policy, and redundancy.

Comparison of the inertial properties and forces required to initiate movement for three gait trainers.

Science.gov (United States)

Paleg, Ginny; Huang, Morris; Vasquez Gabela, Stephanie C; Sprigle, Stephen; Livingstone, Roslyn

2016-01-01

The purpose of this study was to evaluate the inertial properties and forces required to initiate movement on two different surfaces in a sample of three commonly prescribed gait trainers. Tests were conducted in a laboratory setting to compare the Prime Engineering KidWalk, Rifton Pacer, and Snug Seat Mustang with and without a weighted anthropometric test dummy configured to the weight and proportions of a 4-year-old child. The Pacer was the lightest and the KidWalk the heaviest while footprints of the three gait trainers were similar. Weight was borne fairly evenly on the four casters of the Pacer and Mustang while 85% of the weight was borne on the large wheels of the mid-wheel drive KidWalk. These differences in frame style, wheel, and caster style and overall mass impact inertial properties and forces required to initiate movement. Test results suggest that initiation forces on tile were equivalent for the Pacer and KidWalk while the Mustang had the highest initiation force. Initiation forces on carpet were lowest for the KidWalk and highest for the Mustang. This initial study of inertia and movement initiation forces may provide added information for clinicians to consider when selecting a gait trainer for their clients.

Interprofessional SDM train-the-trainer program "Fit for SDM": provider satisfaction and impact on participation.

Science.gov (United States)

Körner, Mirjam; Ehrhardt, Heike; Steger, Anne-Kathrin; Bengel, Jürgen

2012-10-01

The aim of the study was to evaluate the interprofessional SDM training program "Fit for SDM" in medical rehabilitation, which was implemented in two steps: (1) university staff trained providers in executive positions as trainers and (2) the providers trained their staff. For the evaluation of the first step a questionnaire for shared decision-making (SDM) skills and satisfaction with the training was completed by the providers in executive positions. A staff survey was used in a cluster-randomized controlled study to determine the overall impact of the train-the-trainer program on internal and external participation in the team. The providers in the six clinics evaluated their SDM competences and satisfaction very positively after training (step 1). External participation was enhanced by application of the training content, with significant changes recorded for females and nurses in particular. However, it had no direct influence on internal participation. This is the first interprofessional SDM train-the-trainer program in Germany to bridge interprofessionalism (internal participation) and SDM (external participation); it was implemented successfully and evaluated positively. Establishing interprofessional SDM training programs should be encouraged for all health care professionals. Implementation in the interprofessional setting should consider interprofessional team factors. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

Science.gov (United States)

Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

2011-01-01

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the

Positive Factors Influencing the Advancement of Women to the Role of Head Athletic Trainer in the National Collegiate Athletic Association Divisions II and III.

Science.gov (United States)

Mazerolle, Stephanie M; Eason, Christianne M

2016-07-01

Research suggests that women do not pursue leadership positions in athletic training due to a variety of reasons, including family challenges, organizational constraints, and reluctance to hold the position. The literature has been focused on the National Collegiate Athletic Association Division I setting, limiting our full understanding. To examine factors that help women as they worked toward the position of head athletic trainer. Qualitative study. Divisions II and III. Seventy-seven women who were employed as head athletic trainers at the Division II or III level participated in our study. Participants were 38 ± 9 (range = 24-57) years old and had an average of 14 ± 8 (range = 1-33) years of athletic training experience. We conducted online interviews. Participants journaled their reflections to a series of open-ended questions pertaining to their experiences as head athletic trainers. Data were analyzed using a general inductive approach. Credibility was secured by peer review and researcher triangulation. Three organizational facilitators emerged from the data, workplace atmosphere, mentors, and past work experiences. These organizational factors were directly tied to aspects within the athletic trainer's employment setting that allowed her to enter the role. One individual-level facilitator was found: personal attributes that were described as helpful for women in transitioning to the role of the head athletic trainer. Participants discussed being leaders and persisting toward their career goals. Women working in Divisions II and III experience similar facilitators to assuming the role of head athletic trainer as those working in the Division I setting. Divisions II and III were viewed as more favorable for women seeking the role of head athletic trainer, but like those in the role in the Division I setting, women must have leadership skills.

Quantitatively evaluated dynamic MRT in rheumatoid arthritis of the knee joint. Follow-up after intraarticular steroid therapy. Quantitativ evaluierte dynamische Magnetresonanztomographie bei chronischer Polyarthritis des Kniegelenkes. Therapiekontrolle nach intraartikulaerer Kortisonapplikation

Energy Technology Data Exchange (ETDEWEB)

Koenig, H.; Bolze, X.; Wolf, K.J. (Klinikum Steglitz, FU Berlin, Radiologische Klinik und Poliklinik, Abt. fuer Radiologische Diagnostik und Nuklearmedizin (Germany)); Sieper, J. (Klinikum Steglitz, FU Berlin, Medizinische Klinik und Poliklinik, Abt. fuer Allgemeine Innere Medizin und Nephrologie (Germany))

1992-08-01

32 patients with chronic polyarthritis were examined by MRT. Following intra-articular application of 25 mg prednisolon, 18 patients were reexamined after two of three weeks and 7 out of 18 patients were re-examined after 8 to 16 weeks, both by MRT and clinically. After an initial double echo sequence, we carried out a dynamic series of FLASH measurements (TR 30, TE 10 ms, 70deg) following an intravenous bolus of 0.1 mmol gadolinium-DTPA. Single intensity-time curves were treated quantitatively in relation to the pannus, muscles and effusions. Two or three weeks after treatment the curve parameters showed a reduction in pannus vascularisation which remained constant for the 8 to 16 weeks of further observation. Contrast diffusion in the pannus is initially reduced but approaches the early measurements at the time of the second examination. (orig.).

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project.

Science.gov (United States)

Bromley, Elizabeth; Eisenman, David P; Magana, Aizita; Williams, Malcolm; Kim, Biblia; McCreary, Michael; Chandra, Anita; Wells, Kenneth B

2017-10-21

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups ( n = 5) and interviews ( n = 6 coalition members; n = 16 facilitators) to compare coalitions' strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project

Directory of Open Access Journals (Sweden)

Elizabeth Bromley

2017-10-01

Full Text Available Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups (n = 5 and interviews (n = 6 coalition members; n = 16 facilitators to compare coalitions’ strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education. We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.

The Resilience-Enabling Value of African Folktales: The Read-Me-To-Resilience Intervention

Science.gov (United States)

Theron, Linda; Cockcroft, Kate; Wood, Lesley

2017-01-01

Resilience, or the process of adjusting well to adversity, draws on personal and social ecological resources (i.e., caregiving and community supports). Previous research--conducted mostly in the Global North--has shown that bibliotherapy offers a way to support children in identifying and utilizing resilience-enabling resources. In so doing,…

Economic resilience lessons from the ShakeOut earthquake scenario

Science.gov (United States)

Wein, A.; Rose, A.

2011-01-01

Following a damaging earthquake, “business interruption” (BI)—reduced production of goods and services—begins and continues long after the ground shaking stops. Economic resilience reduces BI losses by making the best use of the resources available at a given point in time (static resilience) or by speeding recovery through repair and reconstruction (dynamic resilience), in contrast to mitigation that prevents damage in the first place. Economic resilience is an important concept to incorporate into economic loss modeling and in recovery and contingency planning. Economic resilience framework includes the applicability of resilience strategies to production inputs and output, demand- and supply-side effects, inherent and adaptive abilities, and levels of the economy. We use our resilience framework to organize and share strategies that enhance economic resilience, identify overlooked resilience strategies, and present evidence and structure of resilience strategies for economic loss modelers. Numerous resilience strategies are compiled from stakeholder discussions about the ShakeOut Scenario (Jones et. al. 2008). Modeled results of ShakeOut BI sector losses reveal variable effectiveness of resilience strategies for lengthy disruptions caused by fire-damaged buildings and water service outages. Resilience is a complement to mitigation and may, in fact, have cost and all-hazards advantages.

Resilience of primary healthcare professionals: a systematic review.

Science.gov (United States)

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

2016-06-01

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

Resilience concepts in psychiatry demonstrated with bipolar disorder.

Science.gov (United States)

Angeler, David G; Allen, Craig R; Persson, Maj-Liz

2018-02-09

The term resilience describes stress-response patterns of subjects across scientific disciplines. In ecology, advances have been made to clearly distinguish resilience definitions based on underlying mechanistic assumptions. Engineering resilience (rebound) is used for describing the ability of subjects to recover from adverse conditions (disturbances), and is the rate of recovery. In contrast, the ecological resilience definition considers a systemic change: when complex systems (including humans) respond to disturbances by reorganizing into a new regime (stable state) where structural and functional aspects have fundamentally changed relative to the prior regime. In this context, resilience is an emergent property of complex systems. We argue that both resilience definitions and uses are appropriate in psychology and psychiatry, but although the differences are subtle, the implications and uses are profoundly different. We borrow from the field of ecology to discuss resilience concepts in the mental health sciences. In psychology and psychiatry, the prevailing view of resilience is adaptation to, coping with, and recovery (engineering resilience) from adverse social and environmental conditions. Ecological resilience may be useful for describing vulnerability, onset, and the irreversibility patterns of mental disorders. We discuss this in the context of bipolar disorder. Rebound, adaptation, and coping are processes that are subsumed within the broader systemic organization of humans, from which ecological resilience emanates. Discerning resilience concepts in psychology and psychiatry has potential for a mechanistically appropriate contextualization of mental disorders at large. This might contribute to a refinement of theory and contextualize clinical practice within the broader systemic functioning of mental illnesses.

Clinical correlates of resilience factors in geriatric depression.

Science.gov (United States)

Laird, Kelsey T; Lavretsky, Helen; Paholpak, Pattharee; Vlasova, Roza M; Roman, Michael; St Cyr, Natalie; Siddarth, Prabha

2018-01-16

Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults. Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables. The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience. Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

Resilience of primary healthcare professionals: a systematic review

Science.gov (United States)

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

2016-01-01

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

Ocena preferowanych predyspozycji trenera personalnego = Rating preferred predisposition personal trainer

Directory of Open Access Journals (Sweden)

Tadeusz Stefaniak

2016-09-01

Abstract                 Services provided by personal trainers in Poland are becoming more popular. The legal situation of this professional group in Poland is unregulated, which creates many doubts about the competence and suitability personal trainer.                 The essence of the work presented in the study is to determine the changes in terms of perception of competence coach, taking place in recent years. The research was conducted in 2009 and repeated in 2015 in fitness clubs coming in Lower Silesia.                 The study involved 240 respondents, including 72 women and 168 men.                 Research results indicate that over the years, the number of people regularly using the services of a coach nearly doubled. The significant number of people for whom the profession of coaching combined with better and better assessment of the social and his authority continues to grow. 67.5% of respondents think that the coach should be well built and have mixed personality traits.

Resilience engineering and the built environment

DEFF Research Database (Denmark)

Hollnagel, Erik

2014-01-01

important to understand the range of conditions about why and how the system functions in the desired' mode as well as unwanted' modes. Resilience is the capacity to sustain operations under both expected and unexpected conditions. The unexpected conditions are not only threats but also opportunities.......The possible relations between resilience engineering and built environments are explored. Resilience engineering has been concerned with the safe and efficient functioning of large and small industrial systems. These may be described as built systems or artefacts. The resilience engineering...... approach argues that if the performance of systems is to be resilient, then they must be able to respond, monitor, learn and anticipate. The last ability in particular means that they must be able to consider themselves vis-a-vis their environment, i.e. be sentient and reflective systems. In practice...

Alzheimer's aggression: influences on caregiver coping and resilience.

Science.gov (United States)

Wilks, Scott E; Little, Kristina G; Gough, Heather R; Spurlock, Wanda J

2011-04-01

This study assessed impact of Alzheimer's patients' aggressive behavior (AD aggression) on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression-caregiver resilience relationship. Informal caregivers across Louisiana (N = 419) completed surveys with measures of demographics, AD aggression, caregiver coping strategies, and caregiver resilience. Task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. Implications for social work professionals are discussed.

Building Resilience through Humor.

Science.gov (United States)

Berg, Debra Vande; Van Brockern, Steve

1995-01-01

Research on resilience suggests that a sense of humor helps to stress-proof children in conflict. Reports on a workshop for educators and youth workers convened to explore ways humor is being used to foster positive development and resilience with troubled youth. Describes applications of humor front-line professionals report as useful in their…

First trainer six practice tests with answers

CERN Document Server

May, Peter

2014-01-01

Six full practice tests with tips and training for the 2015 revised Cambridge English: First (FCE). First Trainer Second edition offers six practice tests for the revised Cambridge English: First (FCE) exam combined with easy-to-follow guidance and exam tips. The first two tests are fully guided with advice on how to tackle each paper. Extra practice activities, informed by the Cambridge Learner Corpus, a bank of real candidates' exam papers, focus on areas where students typically need the most help. This version contains a full answer key. Audio for the listening and speaking test activities is available online for download. Audio CDs featuring the listening material are also available, separately.

Technical realization of a sensorized neonatal intubation skill trainer for operators' retraining and a pilot study for its validation.

Science.gov (United States)

Panizza, Davide; Scaramuzzo, Rosa T; Moscuzza, Francesca; Vannozzi, Ilaria; Ciantelli, Massimiliano; Gentile, Marzia; Baldoli, Ilaria; Tognarelli, Selene; Boldrini, Antonio; Cuttano, Armando

2018-01-04

In neonatal endotracheal intubation, excessive pressure on soft tissues during laryngoscopy can determine permanent injury. Low-fidelity skill trainers do not give valid feedback about this issue. This study describes the technical realization and validation of an active neonatal intubation skill trainer providing objective feedback. We studied expert health professionals' performances in neonatal intubation, underlining chance for procedure retraining. We identified the most critical points in epiglottis and dental arches and fixed commercial force sensors on chosen points on a ©Laerdal Neonatal Intubation Trainer. Our skill trainer was set up as a grade 3 on Cormack and Lehane's scale, i.e. a model of difficult intubation. An associated software provided real time sound feedback if pressure during laryngoscopy exceeded an established threshold. Pressure data were recorded in a database, for subsequent analysis with non-parametric statistical tests. We organized our study in two intubation sessions (5 attempts each one) for everyone of our participants, held 24 h apart. Between the two sessions, a debriefing phase took place. In addition, we gave our participants two interview, one at the beginning and one at the end of the study, to get information about our subjects and to have feedback about our design. We obtained statistical significant differences between consecutive attempts, with evidence of learning trends. Pressure on critical points was significantly lower during the second session (p < 0.0001). Epiglottis' sensor was the most stressed (p < 0.000001). We found a significant correlation between time spent for each attempt and pressures applied to the airways in the two sessions, more significant in the second one (shorter attempts with less pressure, r s  = 0.603). Our skill trainer represents a reliable model of difficult intubation. Our results show its potential to optimize procedures related to the control of trauma risk and to improve

A resilience markers framework for small teams

Energy Technology Data Exchange (ETDEWEB)

Furniss, Dominic, E-mail: d.furniss@ucl.ac.u [UCL Interaction Centre, University College London, Gower Street, London WC1E 6BT (United Kingdom); Back, Jonathan; Blandford, Ann [UCL Interaction Centre, University College London, Gower Street, London WC1E 6BT (United Kingdom); Hildebrandt, Michael; Broberg, Helena [OECD Halden Reactor Project, PO Box 173, 1751 Halden (Norway)

2011-01-15

Processes that enable an effective response to unexpected events and vulnerabilities that lie outside the scope of formal procedures can be described as being resilient. There are many such descriptions of resilience within and across different domains. Comparison and generalisation is difficult because resilience is not a component of a system and should be understood as an emergent property. Here we provide a framework for reasoning about resilience that requires representation of the level of analysis (from the individual to operational), a traceable link from abstract theory to specific observations, resilience mechanisms, and contextual factors. This moves forward an agenda to systematically observe concrete manifestations of resilience within and across domains. We illustrate the application of the framework by considering a case study of the performance of nuclear power plant (NPP) operators in an experimental scenario. This paper focuses on the small team level of analysis. The framework presented here provides the basis for developing concrete measures for improving the resilience of organisations through training, system design, and organisational learning.

A resilience markers framework for small teams

International Nuclear Information System (INIS)

Furniss, Dominic; Back, Jonathan; Blandford, Ann; Hildebrandt, Michael; Broberg, Helena

2011-01-01

Processes that enable an effective response to unexpected events and vulnerabilities that lie outside the scope of formal procedures can be described as being resilient. There are many such descriptions of resilience within and across different domains. Comparison and generalisation is difficult because resilience is not a component of a system and should be understood as an emergent property. Here we provide a framework for reasoning about resilience that requires representation of the level of analysis (from the individual to operational), a traceable link from abstract theory to specific observations, resilience mechanisms, and contextual factors. This moves forward an agenda to systematically observe concrete manifestations of resilience within and across domains. We illustrate the application of the framework by considering a case study of the performance of nuclear power plant (NPP) operators in an experimental scenario. This paper focuses on the small team level of analysis. The framework presented here provides the basis for developing concrete measures for improving the resilience of organisations through training, system design, and organisational learning.

National collegiate athletic association division and primary job title of athletic trainers and their job satisfaction or intention to leave athletic training.

Science.gov (United States)

Terranova, Aaron B; Henning, Jolene M

2011-01-01

Membership in the National Athletic Trainers' Association (NATA) has declined in recent years, generating much debate about professional commitment. To compare the contributing factors of job satisfaction and intention to leave athletic training of certified athletic trainers (ATs) employed in National Collegiate Athletic Association (NCAA) institutions. Cross-sectional study. A link to a Web-based questionnaire containing the Spector Job Satisfaction Survey (JSS) and an original Intention to Leave Survey (ITLS) was distributed by e-mail to 1003 certified members of the National Athletic Trainers' Association. A total of 191 certified members of the NATA employed in a college or university setting in a primarily clinical capacity; representing all NCAA divisions; and having the job title of head athletic trainer, associate/assistant athletic trainer, or graduate assistant/intern athletic trainer. We used separate 3 x 3 factorial analyses of variance to compare the mean scores of each JSS subscale and of the ITLS with NCAA division and job title. A stepwise multiple regression was used to determine the strength of the relationships between the JSS subscales and the ITLS. We found differences for job title in the subscales of Fringe Benefits (F(2182) = 7.82, P = .001 ) and Operating Conditions (F(2,182) = 12.01, P < .001). The JSS subscale Nature of Work was the'greatest indicator of intention to leave (β = -0.45). We found a strong negative correlation between various facets of job satisfaction and intention to leave athletic training. The NCAA division seemed to have no effect on an individual's job satisfaction or intention to leave the profession. In addition, only Fringe Benefits and Operating Conditions seemed to be affected by job title. The ATs had similar levels of job satisfaction regardless of NCAA division, and their job titles were not a major factor in job satisfaction.

Systems Measures of Water Distribution System Resilience

Energy Technology Data Exchange (ETDEWEB)

Klise, Katherine A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Murray, Regan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walker, La Tonya Nicole [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-01-01

Resilience is a concept that is being used increasingly to refer to the capacity of infrastructure systems to be prepared for and able to respond effectively and rapidly to hazardous events. In Section 2 of this report, drinking water hazards, resilience literature, and available resilience tools are presented. Broader definitions, attributes and methods for measuring resilience are presented in Section 3. In Section 4, quantitative systems performance measures for water distribution systems are presented. Finally, in Section 5, the performance measures and their relevance to measuring the resilience of water systems to hazards is discussed along with needed improvements to water distribution system modeling tools.

Resilience in a reborn nation: Validation of the Lithuanian Resilience Scale for Adults (RSA).

Science.gov (United States)

Hilbig, Jan; Viliūnienė, Rima; Friborg, Oddgeir; Pakalniškienė, Vilmantė; Danilevičiūtė, Vita

2015-07-01

Resilience, as an ability to withstand or rebound from crisis or adversity, is becoming an increasingly significant concept in health promotion and well-being. Individuals exhibiting resilience use skills or resources flexibly to solve situational demands. The Resilience Scale for Adults (RSA) may be used to assess protective resources, and the aim of the present study was to validate the Lithuanian translation. The translated RSA was administered to a clinical (n=125) and a non clinical sample (n=499) to examine the discriminant validity of the RSA items with a confirmatory factor analysis, the internal consistency as well as construct validity by correlating it with the Quick Psycho-Affective Symptoms Scan (QPASS). The internal consistency, the test-retest stability and the factor structure were replicated as adequate, thus indicating good psychometric properties and support of discriminant validity. Females reported more resilience resources for the domains of social competence, family cohesion and social resources compared to men. The RSA subscales correlated negatively with the QPASS scores, and patients reported significantly less resilience resources than non-patients, thus indicating construct validity. Valid psychometric tools for research purposes and routine every-day use are urgently needed in Lithuania, a young nation still under numerous challenges due to social, economic and political transitions. The RSA represents a reliable and valid tool for assessing protective factors. Assessing resilience factors may extend the understanding of factors relevant for mental health problems as well as treatment prognosis beyond the capabilities of mere symptom oriented approaches. Copyright © 2015 Elsevier Inc. All rights reserved.

Whole Community Resilience: Engaging Multiple Sectors with the Coastal Community Resilience Index and the Climate and Resilience Community of Practice in the Gulf of Mexico

Science.gov (United States)

Sempier, T.

2017-12-01

Communicating risk due to flooding, sea level rise, storm surge, and other natural hazards is a complex task when attempting to build resilience in coastal communities. There are a number of challenges related to preparing for, responding to, and recovering from coastal storms. Successful resilience planning must include a wide range of sectors including, but not limited to local government, business, non-profit, religious, academia, and healthcare. Years of experience working with communities in the Gulf of Mexico has helped create a process that is both inclusive and effective at bringing the right people to the table and gaining momentum towards resilience efforts. The Coastal Community Resilience Index (CRI), a self-assessment for community leaders, has been implemented in 54 Gulf communities with funding that provides small grant awards to help communities take action to address gaps and vulnerabilities identified in the assessment process. To maintain momentum with resilience actions, the Gulf Climate and Resilience Community of Practice (CoP) encourages local municipality participants to share lessons learned and best practices from their implementation projects in an annual symposium. Recently, both graduate and undergraduate students have been exposed to the CRI and CoP as avenues to work through solutions to complex problems at the local level. In addition, a new generation of high school students has been introduced to the CRI. Their engagement in the process is building a more informed citizenry that will take on the leadership and decision-making roles in the future. Investing in multiple age groups and sectors through the CRI and CoP is building capacity for whole community resilience in the Gulf of Mexico. This presentation will focus on methods that have been successful in the Gulf of Mexico for creating effective change in local municipalities towards resilience actions. Discussion will include decision support tools for engaging local

A quantitative framework for assessing ecological resilience

Science.gov (United States)

Quantitative approaches to measure and assess resilience are needed to bridge gaps between science, policy, and management. In this paper, we suggest a quantitative framework for assessing ecological resilience. Ecological resilience as an emergent ecosystem phenomenon can be de...

Resilient Renewable Energy Microgrids

Energy Technology Data Exchange (ETDEWEB)

Anderson, Katherine H [National Renewable Energy Laboratory (NREL), Golden, CO (United States); DiOrio, Nicholas A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Butt, Robert S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Cutler, Dylan S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Richards, Allison [Unaffiliated

2017-11-14

This presentation for the Cable-Tec Expo 2017 offers information about how renewable microgrids can be used to increase resiliency. It includes information about why renewable energy battery diesel hybrids microgrids should be considered for backup power, how to estimate economic savings of microgrids, quantifying the resiliency gain of microgrids, and where renewable microgrids will be successful.

Achieving enhanced organisational resilience by improved management of risk: Summary of research into the principles of resilience and the practices of resilient organisations.

Science.gov (United States)

Hopkin, Paul

There have been many high-profile incidents in recent times that have affected both individual organisations and large parts of society. In response to these disasters and their consequences, there has been increasing focus on the concept of 'resilience'. Airmic worked with Cranfield School of Management to investigate the features of resilient organisations and whether common characteristics could be identified. The research summarised in this paper discovered five principles that increase an organisation's level of resilence. The paper also reports on the actions taken by organisations to embed these resilience principles into four main business enablers. These business enablers in combination represent the business model of the organisation. The overall conclusion of the research was that, in order to achieve a state of enhanced resilience, organisations need to be aware of risks and threats they face and then combine the actions required to be 'risk compliant' with the ability to be 'risk responsive'.

Social ecology of resilience and Sumud of Palestinians.

Science.gov (United States)

Marie, Mohammad; Hannigan, Ben; Jones, Aled

2018-01-01

The aim of this article is to provide an overview of theoretical perspectives and practical research knowledge in relation to 'resilience', the resilience of Palestinians in particular and the related concept of 'Sumud'. 'Sumud' is a Palestinian idea that is interwoven with ideas of personal and collective resilience and steadfastness. It is also a socio-political concept and refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. The concept of 'resilience' has deep roots, going back at least to the 10th century when Arabic scholars suggested strategies to cope with life adversity. In Europe, research into resilience extends back to the 1800s. The understanding of resilience has developed over four overlapping waves. These focus on individual traits, protective factors, ecological assets and (in the current wave) social ecological factors. The current wave of resilience research focuses on the contribution of cultural contextualisation and is an approach that is discussed in this article, which draws on Arabic and English language literature located through a search of multiple databases (CINAHL, British Nursing Index, ASSIA, MEDLINE, PsycINFO and EMBASE). Findings suggest that 'Sumud' is linked to the surrounding cultural context and can be thought of as an innovative, social ecological, approach to promoting resilience. We show that resilience is a prerequisite to 'Sumud', meaning that the individual has to be resilient in order to stay and not to leave their place, position or community. We close by pressing the case for studies which investigate resilience especially in underdeveloped countries such as Palestine (occupied Palestinian territories), and which reveal how resilience is embedded in pre-existing cultural contexts.

Building Ecological and Community Resilience and Measuring Success of the Department of Interior Hurricane Sandy Resilience Projects

Science.gov (United States)

Taylor, S. M.; Worman, S. L.; Bennett, R.; Bassow, A.

2017-12-01

The Department of the Interior (DOI) partnered with the National Fish and Wildlife Foundation (NFWF) to administer an external funding competition to support coastal resilience projects in the region affected by Hurricane Sandy. The projects complement the DOI Bureau-led projects, but are led by state and local governments, universities, non-profits, community groups, tribes, and other non-Federal entities. In total, the Hurricane Sandy Resilience Program invested over $750 million in approximately 180 projects to repair damage and improve the resilience of habitats, communities and infrastructure to future storms and sea level rise. Project activities include waterway connection and opening, living shoreline, marsh restoration, community resilience planning, data/mapping/modeling, and beach and dune restoration. DOI and NFWF initiated a resilience assessment in 2015 to evaluate the impact of this investment. The assessment began by clarifying the program's resilience goals and the development of ecological and socio-economic metrics across the project activities. Using these metrics, the evaluation is assessing the ecological and community outcomes, cost effectiveness of activities, improved scientific understanding, and temporal and spatial scaling of benefits across resilience activities. Recognizing the unique opportunity afforded by the scale and distribution of projects, NFWF and DOI have invested in monitoring through 2024 to better understand how these projects perform over time. This presentation will describe the evaluation questions, approach, long-term monitoring, online metrics portal, and findings to date.

Social-ecological resilience and geomorphic systems

Science.gov (United States)

Chaffin, Brian C.; Scown, Murray

2018-03-01

Governance of coupled social-ecological systems (SESs) and the underlying geomorphic processes that structure and alter Earth's surface is a key challenge for global sustainability amid the increasing uncertainty and change that defines the Anthropocene. Social-ecological resilience as a concept of scientific inquiry has contributed to new understandings of the dynamics of change in SESs, increasing our ability to contextualize and implement governance in these systems. Often, however, the importance of geomorphic change and geomorphological knowledge is somewhat missing from processes employed to inform SES governance. In this contribution, we argue that geomorphology and social-ecological resilience research should be integrated to improve governance toward sustainability. We first provide definitions of engineering, ecological, community, and social-ecological resilience and then explore the use of these concepts within and alongside geomorphology in the literature. While ecological studies often consider geomorphology as an important factor influencing the resilience of ecosystems and geomorphological studies often consider the engineering resilience of geomorphic systems of interest, very few studies define and employ a social-ecological resilience framing and explicitly link the concept to geomorphic systems. We present five key concepts-scale, feedbacks, state or regime, thresholds and regime shifts, and humans as part of the system-which we believe can help explicitly link important aspects of social-ecological resilience inquiry and geomorphological inquiry in order to strengthen the impact of both lines of research. Finally, we discuss how these five concepts might be used to integrate social-ecological resilience and geomorphology to better understand change in, and inform governance of, SESs. To compound these dynamics of resilience, complex systems are nested and cross-scale interactions from smaller and larger scales relative to the system of interest

Is the learning value of workplace-based assessment being realised? A qualitative study of trainer and trainee perceptions and experiences.

Science.gov (United States)

Barrett, Aileen; Galvin, Rose; Scherpbier, Albert J J A; Teunissen, Pim W; O'Shaughnessy, Ann; Horgan, Mary

2017-03-01

Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of experience, trajectories and reifications in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs. Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value. Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into learning values. WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning practice . Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Developing a community-based flood resilience measurement standard

Science.gov (United States)

Keating, Adriana; Szoenyi, Michael; Chaplowe, Scott; McQuistan, Colin; Campbell, Karen

2015-04-01

Given the increased attention to resilience-strengthening in international humanitarian and development work, there has been concurrent interest in its measurement and the overall accountability of "resilience strengthening" initiatives. The literature is reaching beyond the polemic of defining resilience to its measurement. Similarly, donors are increasingly expecting organizations to go beyond claiming resilience programing to measuring and showing it. However, key questions must be asked, in particular "Resilience of whom and to what?". There is no one-size-fits-all solution. The approach to measuring resilience is dependent on the audience and the purpose of the measurement exercise. Deriving a resilience measurement system needs to be based on the question it seeks to answer and needs to be specific. This session highlights key lessons from the Zurich Flood Resilience Alliance approach to develop a flood resilience measurement standard to measure and assess the impact of community based flood resilience interventions, and to inform decision-making to enhance the effectiveness of these interventions. We draw on experience in methodology development to-date, together with lessons from application in two case study sites in Latin America. Attention will be given to the use of a consistent measurement methodology for community resilience to floods over time and place; challenges to measuring a complex and dynamic phenomenon such as community resilience; methodological implications of measuring community resilience versus impact on and contribution to this goal; and using measurement and tools such as cost-benefit analysis to prioritize and inform strategic decision making for resilience interventions. The measurement tool follows the five categories of the Sustainable Livelihoods Framework and the 4Rs of complex adaptive systems - robustness, rapidity, redundancy and resourcefulness -5C-4R. A recent white paper by the Zurich Flood Resilience Alliance traces the

Assessment instruments of urban resilience

Directory of Open Access Journals (Sweden)

Giovanna Saporiti

2012-07-01

Full Text Available The objective of this work is to highlight the aspects related to the resilient capacity of a neoecosistema. Clarifying what does it means to speak about a resilient neoecosistema and which are the specific characters that make him capable of change and adaptation when facing an environmental, social or economic threat, it will be possible to understand the efficacy related to the model of urban development. From the individuation of perturbing factors of this capacity, it will be possible to generate a panel of the resilient capacity linked to three different ambits that represent the three characteristic elements of natural ecosystems: its physic structure, the persons and the interaction processes between them so we would be able to make explicit the specific characters of resilience distinguished from those of sustainability and urban quality.  

Priority Queues Resilient to Memory Faults

DEFF Research Database (Denmark)

Jørgensen, Allan Grønlund; Moruz, Gabriel; Mølhave, Thomas

2007-01-01

In the faulty-memory RAM model, the content of memory cells can get corrupted at any time during the execution of an algorithm, and a constant number of uncorruptible registers are available. A resilient data structure in this model works correctly on the set of uncorrupted values. In this paper we...... introduce a resilient priority queue. The deletemin operation of a resilient priority queue returns either the minimum uncorrupted element or some corrupted element. Our resilient priority queue uses $O(n)$ space to store $n$ elements. Both insert and deletemin operations are performed in $O(\\log n......+\\delta)$ time amortized, where $\\delta$ is the maximum amount of corruptions tolerated. Our priority queue matches the performance of classical optimal priority queues in the RAM model when the number of corruptions tolerated is $O(\\log n)$. We prove matching worst case lower bounds for resilient priority...

RESILIENCE AND ENTERPRISE ARCHITECTURE IN SMES

Directory of Open Access Journals (Sweden)

Rui Gomes

2015-12-01

Full Text Available Considering that SMEs need to embrace the drivers of resilience and that a well-defined and readily available Enterprise Architecture (EA supports enterprise integration by enabling the common view of business processes, data and systems across the enterprise and its partners, we can say that EA is one of the tracks making resilience predictable and it should support and collaborate with other resilience tracks. However, the EA frameworks do not give relevance to the activities that contribute most to business resilience, so this paper aims to clarify the dimensions and the activities related to the development of an EA and the touching points with other enterprise wide processes in order to guarantee that resilience requirements are met in SMEs. For this I propose an approach of ecological adaptation, and four architectures: business, organizational, information, and technological, although this paper only presents the Business and Organizational Architectures.

Real-time knee adduction moment feedback training using an elliptical trainer.

Science.gov (United States)

Kang, Sang Hoon; Lee, Song Joo; Ren, Yupeng; Zhang, Li-Qun

2014-03-01

The external knee adduction moment (EKAM) is associated with knee osteoarthritis (OA) in many aspects including presence, progression, and severity of knee OA. Despite of its importance, there is a lack of EKAM estimation methods that can provide patients with knee OA real-time EKAM biofeedback for training and clinical evaluations without using a motion analysis laboratory. A practical real-time EKAM estimation method, which utilizes kinematics measured by a simple six degree-of-freedom goniometer and kinetics measured by a multi-axis force sensor underneath the foot, was developed to provide real-time feedback of the EKAM to the patients during stepping on an elliptical trainer, which can potentially be used to control and alter the EKAM. High reliability (ICC(2,1): 0.9580) of the real-time EKAM estimation method was verified through stepping trials of seven subjects without musculoskeletal disorders. Combined with advantages of elliptical trainers including functional weight-bearing stepping and mitigation of impulsive forces, the real-time EKAM estimation method is expected to help patients with knee OA better control frontal plane knee loading and reduce knee OA development and progression.

Priority Queues Resilient to Memory Faults

DEFF Research Database (Denmark)

Jørgensen, Allan Grønlund; Moruz, Gabriel; Mølhave, Thomas

2007-01-01

In the faulty-memory RAM model, the content of memory cells can get corrupted at any time during the execution of an algorithm, and a constant number of uncorruptible registers are available. A resilient data structure in this model works correctly on the set of uncorrupted values. In this paper we...... introduce a resilient priority queue. The deletemin operation of a resilient priority queue returns either the minimum uncorrupted element or some corrupted element. Our resilient priority queue uses $O(n)$ space to store $n$ elements. Both insert and deletemin operations are performed in $O(\\log n...... queues storing only structural information in the uncorruptible registers between operations....

Resilience to Surprises through Communicative Planning

Directory of Open Access Journals (Sweden)

Bruce Evan. Goldstein

2009-12-01

Full Text Available Resilience thinkers share an interest in collaborative deliberation with communicative planners, who aim to accommodate different forms of knowledge and styles of reasoning to promote social learning and yield creative and equitable agreements. Members of both fields attended a symposium at Virginia Tech in late 2008, where communicative planners considered how social-ecological resilience informed new possibilities for planning practice beyond disaster mitigation and response. In turn, communicative planners offered resilience scholars ideas about how collaboration could accomplish more than enhance rational decision making of the commons. Through these exchanges, the symposium fostered ideas about collaborative governance and the critical role of expertise in fostering communicative resilience.

Social-ecological resilience and law

Science.gov (United States)

Garmestani, Ahjond S.; Allen, Craig R.

2014-01-01

Environmental law envisions ecological systems as existing in an equilibrium state, reinforcing a rigid legal framework unable to absorb rapid environmental changes and innovations in sustainability. For the past four decades, “resilience theory,” which embraces uncertainty and nonlinear dynamics in complex adaptive systems, has provided a robust, invaluable foundation for sound environmental management. Reforming American law to incorporate this knowledge is the key to sustainability. This volume features top legal and resilience scholars speaking on resilience theory and its legal applications to climate change, biodiversity, national parks, and water law.

Resilience in ecotoxicology: Toward a multiple equilibrium concept.

Science.gov (United States)

Bundschuh, Mirco; Schulz, Ralf; Schäfer, Ralf B; Allen, Craig R; Angeler, David G

2017-10-01

The term resilience describes stress-response patterns across scientific disciplines. In ecology, advances have been made to clearly define resilience based on underlying mechanistic assumptions. Engineering resilience (rebound) is used to describe the ability of organisms to recover from adverse conditions (disturbances), which is termed the rate of recovery. By contrast, the ecological resilience definition considers a systemic change, that is, when ecosystems reorganize into a new regime following disturbance. Under this new regime, structural and functional aspects change considerably relative to the previous regime, without recovery. In this context, resilience is an emergent property of complex systems. In the present study, we argue that both definitions and uses are appropriate in ecotoxicology, and although the differences are subtle, the implications and uses are profoundly different. We discuss resilience concepts in ecotoxicology, where the prevailing view of resilience is engineering resilience from chemical stress. Ecological resilience may also be useful for describing systemic ecological changes because of chemical stress. We present quantitative methods that allow ecotoxicologists and risk managers to assess whether an ecosystem faces an impending regime shift or whether it has already undergone such a shift. We contend that engineering and ecological resilience help to distinguish ecotoxicological responses to chemical stressors mechanistically and thus have implications for theory, policy, and application. Environ Toxicol Chem 2017;36:2574-2580. © 2017 SETAC. © 2017 SETAC.

A New Resilience Measure for Supply Chain Networks

Directory of Open Access Journals (Sweden)

Ruiying Li

2017-01-01

Full Text Available Currently, supply chain networks can span the whole world, and any disruption of these networks may cause economic losses, decreases in sales and unsustainable supplies. Resilience, the ability of the system to withstand disruption and return to a normal state quickly, has become a new challenge during the supply chain network design. This paper defines a new resilience measure as the ratio of the integral of the normalized system performance within its maximum allowable recovery time after the disruption to the integral of the performance in the normal state. Using the maximum allowable recovery time of the system as the time interval under consideration, this measure allows the resilience of different systems to be compared on the same relative scale, and be used under both scenarios that the system can or cannot restore in the given time. Two specific resilience measures, the resilience based on the amount of product delivered and the resilience based on the average delivery distance, are provided for supply chain networks. To estimate the resilience of a given supply chain network, a resilience simulation method is proposed based on the Monte Carlo method. A four-layered hierarchial mobile phone supply chain network is used to illustrate the resilience quantification process and show how network structure affects the resilience of supply chain networks.

A Different Kind of Postgraduate Education. EIT's Educational Program for International Trainers.

Science.gov (United States)

Haslebo, Gitte; And Others

EIT, or the European Institute for Transnational Studies in Group and Organisational Development, was founded in 1965 as a forum for international trainers in Europe. At present EIT has about 48 members, among which 7 are in the Scandinavian countries. EIT's most important tasks lie within the field of applied social psychology. After many years…

Resilient mounting systems in buildings

NARCIS (Netherlands)

Breeuwer, R.; Tukker, J.C.

1976-01-01

The basic elements of resilient mounting systems are described and various measures for quantifying the effect of such systems defined. Using electrical analogue circuits, the calculation of these measures is illustrated. With special reference to resilient mounting systems in buildings, under

Exploring Trainer and Trainee Emotional Talk in Narratives about Workplace-Based Feedback Processes

Science.gov (United States)

Dennis, A. A.; Foy, M. J.; Monrouxe, L. V.; Rees, C. E.

2018-01-01

Emotion characterises learners' feedback experiences. While the failure-to-fail literature suggests that emotion may be important, little is known about the role of emotion for educators. Secondary analyses were therefore conducted on data exploring 110 trainers' and trainees' feedback experiences. Group and individual narrative interviews were…

A comprehensive approach to assess operational resilience

NARCIS (Netherlands)

Stolker, R.J.M.; Karydas, D.M.; Rouvroye, J.L.; Hollnagel, E.; Pieri, F.

2008-01-01

This paper presents a first attempt to apply Multi-Attribute Utility Theory (MAUT) to the concept of resilience. The focus of this paper is measuring the management performance of operational resilience in an organization. Operational resilience refers to the ability of an organization to prevent

Marine light attack helicopter close air support trainer for situation awareness

Science.gov (United States)

2017-06-01

JTAC Joint Terminal Attack Controller MAGTF Marine Air Ground Task Force MATSS Marine Aviation Training System Sites MAW Marine Aircraft Wing...relevant to aircraft performance not CAS. Therefore, the SA training system should provide visual and audio cues relevant to the CAS environment ... environmental elements outside the aircraft . The initial environment elements included in the trainer are those relating directly to the CAS execution

Primary school teachers' resilience and their readiness for enhancing children's resilience

OpenAIRE

Bon, Barbara

2017-01-01

Resilience is an important trait, which enables people to successfully recover from difficulties and stress. For teachers, resilience is of vital importance, as it offers different ways and solutions to successfully cope with difficult and stressful situations they face on a daily basis. The way teachers experience and react to stress often affects their pupils, who are under a lot of stress as well. Teachers could help and teach them how to cope with stressful situations by spending some sch...

Work-family conflict among athletic trainers in the secondary school setting.

Science.gov (United States)

Pitney, William A; Mazerolle, Stephanie M; Pagnotta, Kelly D

2011-01-01

Work-family conflict (WFC) negatively affects a professional's ability to function at work or home. To examine perceptions of and contributing factors to WFC among secondary school athletic trainers. Sequential explanatory mixed-methods study. Secondary school. From a random sample of 1325 individuals selected from the National Athletic Trainers' Association Member Services database, 415 individuals (203 women, 212 men; age = 36.8 ± 9.3 years) provided usable online survey data. Fourteen individuals participated in follow-up interviews. Online WFC questionnaire followed by in-depth phone interviews. Descriptive statistics were obtained to examine perceived WFC. Pearson product moment correlations were calculated to examine the relationship between work hours, total athletic training staff, and number of children and WFC score. We performed analysis of variance to examine differences between the independent variables of sex and control over work schedule and the dependent variable of WFC score. The a priori α was set at P ≤ .05. Qualitative data were analyzed using inductive content analysis. Multiple-analyst triangulation and member checks established trustworthiness of the qualitative data. Mean WFC scores were 23.97 ± 7.78 for scale 1 (family defined as having a partner or spouse with or without children) and 23.17 ± 7.69 for scale 2 (family defined as individuals, including parents, siblings, grandparents, and any other close relatives, involved in one's life), indicating moderate perceived WFC. A significant relationship was found between the average hours of work per week and WFC scores: those with less scheduling control experienced more WFC. Two dimensions emerged from the qualitative methods that relate to how WFC is mitigated in the secondary school environment: (1) organizational-having colleagues and administration that understood the role demands and allowed for modifications in schedule and personal time and (2) personal-taking time for oneself

How Robust is Your System Resilience?

Science.gov (United States)

Homayounfar, M.; Muneepeerakul, R.

2017-12-01

Robustness and resilience are concepts in system thinking that have grown in importance and popularity. For many complex social-ecological systems, however, robustness and resilience are difficult to quantify and the connections and trade-offs between them difficult to study. Most studies have either focused on qualitative approaches to discuss their connections or considered only one of them under particular classes of disturbances. In this study, we present an analytical framework to address the linkage between robustness and resilience more systematically. Our analysis is based on a stylized dynamical model that operationalizes a widely used concept framework for social-ecological systems. The model enables us to rigorously define robustness and resilience and consequently investigate their connections. The results reveal the tradeoffs among performance, robustness, and resilience. They also show how the nature of the such tradeoffs varies with the choices of certain policies (e.g., taxation and investment in public infrastructure), internal stresses and external disturbances.

Depression and Resilience in Breast Cancer Patients

Directory of Open Access Journals (Sweden)

Gordana Ristevska-Dimitrоvska

2015-11-01

CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.

Risk Behavior and Personal Resiliency in Adolescents

Science.gov (United States)

Prince-Embury, Sandra

2015-01-01

This study explores the relationship between self-reported risk behaviors and personal resiliency in adolescents; specifically whether youth with higher personal resiliency report less frequent risk behaviors than those with lower personal resiliency. Self-reported risk behavior is surveyed by the "Adolescent Risk Behavior Inventory"…

Is there room for resilience? A scoping review and critique of substance use literature and its utilization of the concept of resilience.

Science.gov (United States)

Rudzinski, Katherine; McDonough, Peggy; Gartner, Rosemary; Strike, Carol

2017-09-15

Research in the area of illicit substance use remains preoccupied with describing and analyzing the risks of people who use drugs (PWUD), however more recently there has been a drive to use a strengths-based or resilience approach as an alternative to investigating drug use. This leads us to ask: what can be known about PWUD from the point of view of resilience? The objective of this scoping review is to analyze how the concept of resilience is defined, operationalized, and applied in substance use research. Popular health, social science, psychology, and inter-disciplinary databases namely: SCOPUS, PUBMED, PsycINFO, and Sociological Abstracts were searched. Studies were selected if they used the concept of resilience and if substance use was a key variable under investigation. A total of 77 studies were identified which provided a definition of resilience, or attempted to operationalize (e.g., via scales) the concept of resilience in some manner. Data were charted and sorted using key terms and fundamental aspects of resilience. The majority of studies focus on youth and their resistance to, or engagement in, substance use. There is also a small but growing area of research that examines recovery from substance addiction as a form of resilience. Very few studies were found that thoroughly investigated resilience among PWUD. Consistently throughout the literature drug use is presented as a 'risk factor' jeopardizing one's ability to be resilient, or drug use is seen as a 'maladaptive coping strategy', purporting one's lack of resilience. Currently, substance use research provides a substantial amount of information about the internal strengths that can assist in resisting future drug use; however there is less information about the external resources that play a role, especially for adults. Though popular, outcome-based conceptualizations of resilience are often static, concealing the potential for developing resilience over time or as conditions change. Studies of

Evaluating multicast resilience in carrier ethernet

DEFF Research Database (Denmark)

Ruepp, Sarah Renée; Wessing, Henrik; Zhang, Jiang

2010-01-01

This paper gives an overview of the Carrier Ethernet technology with specific focus on resilience. In particular, we show how multicast traffic, which is essential for IPTV can be protected. We detail the ackground for resilience mechanisms and their control and e present Carrier Ethernet...... resilience methods for linear nd ring networks. By simulation we show that the vailability of a multicast connection can be significantly increased by applying protection methods....

Incorporating Resilience into Dynamic Social Models

Science.gov (United States)

2016-07-20

form contains classified information, stamp classification level on the top and bottom of this page. 17. LIMITATION OF ABSTRACT. This block must be...resilience as a multi- level resilience and study their resilience at individual, family and society levels . However, having more than one level on a...4] U. Fischbacher, S. Gächter, and E. Fehr, “Are People Conditionally Cooperative ? Evidence from a Public Goods Experiment,” Econ . Lett., vol

The politics of vulnerability and resilience

Directory of Open Access Journals (Sweden)

Georg Frerks

2011-12-01

Full Text Available Much conceptual confusion exists over the concepts of vulnerability and (social resilience, reinforced by the different paradigms (the article identifies four and disciplinary traditions underlying their use. While since the 1980s the social construction of "vulnerability" as a driver for disaster received considerable attention, in recent years we have seen increased attention to people's capacities and resilience. The currently popular "complexity" approach to risk moreover appears to offer ways of breaking through entrenched vulnerabilities. Resilience however is also a political project which, we argue, also has its dark, conservative overtones and overlooks structural sources of vulnerability that continue to affect hazard-prone actors. We may therefore need to conceive resilience as the potential for social transformation after disaster.Existe muita confusão conceitual em torno dos conceitos de vulnerabilidade e resiliência (social, reforçada pela diferença de paradigmas (este artigo identifica quarto e tradições disciplinares subjacentes à sua utilização. Enquanto desde os anos 80 a construção social de "vulnerabilidade" como condutor para desastres recebeu atenção considerável, nos últimos anos temos visto maior atenção às capacidades e resiliência das pessoas. Atualmente popular, a abordagem da "complexidade" do risco, além disso, parece oferecer maneiras transformadoras através das vulnerabilidades enraizadas. No entanto, defendemos que a resiliência é um projeto político que também tem seus sombrios sobretons conservadores e omite fontes estruturais de vulnerabilidade que continuam a afetar os atores propensos ao risco. Podemos, portanto, precisar conceber a resiliência como potencial para transformação social depois de desastres.

Toward quantifying metrics for rail-system resilience : Identification and analysis of performance weak resilience signals

NARCIS (Netherlands)

Regt, A. de; Siegel, A.W.; Schraagen, J.M.C.

2016-01-01

This paper aims to enhance tangibility of the resilience engineering concept by facilitating understanding and operationalization of weak resilience signals (WRSs) in the rail sector. Within complex socio-technical systems, accidents can be seen as unwanted outcomes emerging from uncontrolled

Does resilient mean eco-inefficient?

DEFF Research Database (Denmark)

Pizzol, Massimo

as long-term perfomance. Resilience is not explicitly taken into account within life cycle assessment (LCA). LCA determines the eco-efficiency of product systems, i.e. the ratio between the function provided by the product and its impact on the environment. The question is whether a product system which...... structure is improved or designed to be more resilient will not only be more inefficient, but also eco-inefficient, when studied by means of LCA. In this work a two steps approach is proposed to study resilience of product systems: 1) assessment of disturbance conditions and their inclusion within the scope......, because the redundant connections between elements of a system make it less efficient but also more flexible and adaptable and allow to perform a function even if some connections are interrupted or missing. Balancing between resilience and efficiency seems to be the key for sustainability intended...

Literature Review of Concepts: Psychological Resiliency

National Research Council Canada - National Science Library

Wald, Jaye; Taylor, Steven; Asmundson, Gordon J; Jang, Kerry L; Stapleton, Jennifer

2006-01-01

...; and resiliency measures, their development and validation. Existing definitions implicate resiliency with the ability to adapt and successfully cope with adversity, life stressors, and traumatic events...

Measures of emergency preparedness contributing to nursing home resilience.

Science.gov (United States)

Lane, Sandi J; McGrady, Elizabeth

2017-12-13

Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

Nurse leader resilience: career defining moments.

Science.gov (United States)

Cline, Susan

2015-01-01

Resilience is an essential component of effective nursing leadership. It is defined as the ability to survive and thrive in the face of adversity. Resilience can be developed and internalized as a measure to improve retention and reduce burnout. Nurse leaders at all levels should develop these competencies to survive and thrive in an increasingly complex health care environment. Building positive relationships, maintaining positivity, developing emotional insight, creating work-life balance, and reflecting on successes and challenges are effective strategies for resilience building. Nurse leaders have a professional obligation to develop resilience in themselves, the teams they supervise, and the organization as a whole. Additional benefits include reduced turnover, reduced cost, and improved quality outcomes through organizational mindfulness.

Women's Human Rights Education Trainers in Turkey: Situated Empowerment for Social Change

Science.gov (United States)

Tibbitts, Felisa L.

2016-01-01

This article presents evidence of the links between human rights education and social change by analyzing the long-term effects on 88 trainers engaged in a non-formal adult training program sponsored by a women's human rights group in Turkey, Women for Women's Human Rights--New Ways. In this article, I show the transformative impacts of carrying…

Special issue on Resilience and (in)security

DEFF Research Database (Denmark)

Kristensen, Kristian Søby

, and redefine relations of security and insecurity. We show the increased attention – scholarly as well as political – given to resilience in recent times and provide a review of the state of critical security studies literature on resilience. We argue that to advance this discussion, resilience needs...

Resilient children of injection drug users.

Science.gov (United States)

Pilowsky, Daniel J; Zybert, Patricia A; Vlahov, David

2004-11-01

To examine associations between resilience in children of injection drug users and children's coping strategies, parenting stress, and children's social support. Injection drug-using parents (n=91) and their children aged 6 to 11 (n=117) were recruited in Baltimore (1997-1999). Resilience was defined as scoring in the lowest quartile of the Child Behavior Checklist total psychopathology score. Coping strategies used by resilient and nonresilient children, the extent and types of social support that they received, and the level of parenting stress reported by their parents were compared and contrasted. Rates of depressive, anxiety, and disruptive behavior disorders were 15.4%, 22.2%, and 21.4%, respectively, for the entire sample. Compared with the nonresilient, resilient children were less likely to use two avoidance coping strategies (internalizing [p=.002] and externalizing [p=.017]). The level of actual support received by resilient and nonresilient children did not differ significantly (p=.202). Perceived support was greater among resilient children (as reported by their parents; p parents reported lower parenting stress (p=.042). A significant proportion of children of injection drug users are in need of clinical care. Interventions to help children of substance-abusing parents modify their coping style merit exploration.

Why resilience is unappealing to social science: Theoretical and empirical investigations of the scientific use of resilience

Science.gov (United States)

Olsson, Lennart; Jerneck, Anne; Thoren, Henrik; Persson, Johannes; O’Byrne, David

2015-01-01

Resilience is often promoted as a boundary concept to integrate the social and natural dimensions of sustainability. However, it is a troubled dialogue from which social scientists may feel detached. To explain this, we first scrutinize the meanings, attributes, and uses of resilience in ecology and elsewhere to construct a typology of definitions. Second, we analyze core concepts and principles in resilience theory that cause disciplinary tensions between the social and natural sciences (system ontology, system boundary, equilibria and thresholds, feedback mechanisms, self-organization, and function). Third, we provide empirical evidence of the asymmetry in the use of resilience theory in ecology and environmental sciences compared to five relevant social science disciplines. Fourth, we contrast the unification ambition in resilience theory with methodological pluralism. Throughout, we develop the argument that incommensurability and unification constrain the interdisciplinary dialogue, whereas pluralism drawing on core social scientific concepts would better facilitate integrated sustainability research. PMID:26601176

A Measurement of Vocational Education’s Student Satisfaction in Learning Electronic Appliance Repair and Maintenance Course with CCTV Trainer Kit

Science.gov (United States)

Rakhmawati, Lusia; Irwansyah Febriyanto, Fariz

2018-04-01

This study aimed to investigate satisfaction levels, among of the eleventh-grade students majoring in audio-video technique, towards the instructional media CCTV trainer kit: The CCTV Prototype and job sheet on to and analyzed perspectives of the practical approach to learning using CCTV prototype to improve installation skills in the electronic appliance repair and maintenance class. Survey questionnaires and instructional media were applied to data collection. The students’ satisfaction towards the instructional media in teaching and learning process was presented in positive responses, 91.94 % satisfied. The finding reveals that the instructional media using trainer could better to overcome the need a practical approach to learning. Furthermore, using trainer kit media creates an environment where students can support each other and receive feedback from their peers. They performed practice activities that help them apply the new information from the steps on the job sheet.

The prognostic value of quantified MRI at an early stage of Bell's palsy; Der prognostische Wert der dynamischen, kontrastmittelverstaerkten Region-of-Interest-MRT in der Akutphase der idiopathischen Fazialisparese

Energy Technology Data Exchange (ETDEWEB)

Kress, B.P.J.; Efinger, K.; Gottschalk, A.; Nissen, S.; Solbach, T.; Baehren, W. [Abt. fuer Radiologie, Bundeswehrkrankenhaus Ulm (Germany); Griesbeck, F.; Goriup, A.; Kornhuber, A.W. [Abt. fuer Neurologie und Psychiatrie, Bundeswehrkrankenhaus Ulm (Germany)

2002-04-01

Objective: The aim of the study was to assess whether MRI has a prognostic value at an early stage of Bell's palsy. Material and Methods: Prospective, blinded study on 30 patients suffering from Bell's palsy, who came to hospital until the sixth day of illness, to receive high dosis steroid therapy. MRI was done on the first day of inpatient treatment as a gradient-echo-sequence with a slice thickness of 0.7 mm before and after i.v. administration of 0.1 mmol GdDTPA/kg weight. The signal intensity increase was evaluated quantitatively by region on interest (ROI). The results were compared to the clinical outcome and the results of electrophysiology. Results: The examinations of all patients could be evaluated. The 3 patients who developed a chronic facial paralysis were detected by MRI on the first day of inpatient treatment. The patients, who showed MR signs for an unfavorable course, had a highly significant pathologic compound muscle action potential (CMAP) as a result of the electrophysiologic measurement. Rather than using complex measurement procedures it is possible to obtain reliable prognostic information from just one measurement within the Internal auditory canal before and after i.v. administration of contrast. Conclusion: MRI has a prognostic value at an early stage of the illness. In the clinical setting this measurement is easy to perform, so that it is possible to obtain prognostic information at a stage when causal treatment is still possible. (orig.) [German] Ziel: Das Ziel der Studie war, die prognostische Wertigkeit der MRT in den ersten Tagen einer idiopathischen Fazialisparese zu ueberpruefen. Methodik: Prospektive, fuer den Radiologen geblindete Studie an 30 Patienten mit idiopathischer Fazialisparese, die in den ersten 6 Tagen der Erkrankung stationaer zur Hochdosissteroidtherapie aufgenommen wurden. Das MRT wurde durchgefuehrt am Aufnahmetag als Duennschicht-Gradientenechosequenz nativ und nach i.v. Gabe von 0,1 mmol Gd

Teaching Resiliency Theory to Substance Abuse Counselors

Science.gov (United States)

Ward, Kelly

2003-01-01

Resiliency is the ability to cope in the face of adversity. One protective factor that promotes resiliency in substance-abusing dysfunctional families is family rituals and traditions. Social workers and substance abuse counselors can teach family members how to instill resiliency in their families and themselves through rituals and traditions. To…

Resilience and Complexity

DEFF Research Database (Denmark)

Dahlberg, Rasmus

2015-01-01

This paper explores two key concepts: resilience and complexity. The first is understood as an emergent property of the latter, and their inter-relatedness is discussed using a three tier approach. First, by exploring the discourse of each concept, next, by analyzing underlying relationships and...... robust. Robustness is a property of simple or complicated systems characterized by predictable behavior, enabling the system to bounce back to its normal state following a perturbation. Resilience, however, is an emergent property of complex adaptive systems. It is suggested that this distinction...

Multi-Sited Resilience

DEFF Research Database (Denmark)

Olwig, Mette Fog

2012-01-01

with natural disasters and climate change. In a globalized world, however, it is hard to discern what is “local” as global organizations play an increasingly visible and powerful role. This paper will argue that local understandings and practices of resilience cannot be disentangled from global understandings...... flooding in northern Ghana, this paper examines the mutual construction of “local” and “global” notions and practices of resilience through multi-sited processes. It is based on interviews and participant observation in multiple sites at the “local,” “regional” and “global” levels....

SUPPLY CHAIN RESILIENCE ANALYSIS: A BRAZILIAN AUTOMOTIVE CASE

Directory of Open Access Journals (Sweden)

Luiz Felipe Scavarda

2015-04-01

Full Text Available Supply chain (SC resilience and flexibility are important research topics receiving growing attention. However, the academic literature needs empirical studies on SC resilience capable of investigating the inter-organizational components of flexibility along different tiers. Therefore, this paper analyzes the main lack of flexibilities in three Brazilian automotive SCs that limit their resilience and therefore their capacity to better support and meet the demand changes in the marketplace. A multi-tier case study approach is adopted. Research findings identify lack of flexibilities in different tiers that inhibit the SC resilience as well as manufacturing and SC flexibilities that build SC resilience. The findings also highlight that the same SC may have the flexibility to be resilient for one of its products but not for another product, what sheds new lights on the academic literature. Finally, flexible SCs should be designed to increase SC resilience to cope with mishaps as significant demand changes.

Development of resilience evaluation method for nuclear power plants. Part 3. Study of evaluation method and applicability of resilience index

International Nuclear Information System (INIS)

Suzuki, Masaaki; Demachi, Kazuyuki; Miyano, Hiroshi

2017-01-01

We have developed a new index, called the resilience index, that evaluates the dynamic stability of the system safety of a nuclear power plant during a severe accident by considering the ability to recover system safety functions that have become lost in the situation. In this paper, a detailed evaluation procedure for the resilience index is described. The system safety of a pressurized water reactor plant during a severe accident is then assessed according to the resilience index in order to discuss the applicability of the index. We find that the resilience index successfully represents management capability and, therefore, the resilience capability of a nuclear power plant. (author)

Development of resilience evaluation method for nuclear power plants. Part 3. Study on evaluation method and applicability of resilience index

International Nuclear Information System (INIS)

Suzuki, Masaaki; Demachi, Kazuyuki; Murakami, Kenta

2016-01-01

We have developed a new index, called the resilience index, that evaluates the dynamic stability of the system safety of a nuclear power plant during a severe accident by considering the ability to recover system safety functions that have become lost in the situation. In this paper, a detailed evaluation procedure for the resilience index is described. The system safety of a PWR plant during a severe accident is then assessed according to the resilience index in order to discuss the applicability of the index. We find that the resilience index successfully represents management capability and, therefore, the resilience capability of a nuclear power plant. (author)

A resilience approach can improve anadromous fish restoration

Science.gov (United States)

Waldman, John R.; Wilson, Karen A.; Mather, Martha E.; Snyder, Noah P.

2016-01-01

Most anadromous fish populations remain at low levels or are in decline despite substantial investments in restoration. We explore whether a resilience perspective (i.e., a different paradigm for understanding populations, communities, and ecosystems) is a viable alternative framework for anadromous fish restoration. Many life history traits have allowed anadromous fish to thrive in unimpacted ecosystems but have become contemporary curses as anthropogenic effects increase. This contradiction creates a significant conservation challenge but also makes these fish excellent candidates for a resilience approach. A resilience approach recognizes the need to maintain life history, population, and habitat characteristics that increase the ability of a population to withstand and recover from multiple disturbances. To evaluate whether a resilience approach represents a viable strategy for anadromous fish restoration, we review four issues: (1) how resilience theory can inform anadromous fish restoration, (2) how a resilience-based approach is fundamentally different than extant anadromous fish restoration strategies, (3) ecological characteristics that historically benefited anadromous fish persistence, and (4) examples of how human impacts harm anadromous fish and how a resilience approach might produce more successful outcomes. We close by suggesting new research and restoration directions for implementation of a resilience-based approach.

[Resilience: an interdisciplinary approach to concept and findings].

Science.gov (United States)

Korn, Lena

2012-01-01

First, the concept of the term "resilience" is introduced and summarized as an adaptive, dynamic "buffering process" of children's mental power of resistance against biological, psychological and psychosocial development risks. Subsequently, based on a critical discussion of the current research findings, protective factors are presented, which is followed by an approach to the concept of resilience from interdisciplinary perspectives. The latest findings from developmental neurobiology show that genetic as well as environmental factors have their important share in the development of resilience. This builds a bridge to the consideration of resilience with regard to attachment theory. Accordingly secure attachment could be seen as a condition for a resilient conduct of life. In this context, the concept of "earned security" is additionally taken into account. Furthermore, the relevance of resilience for the field of pedagogics is shortly and critically considered. With reference to a psychoanalytic approach to the concept of resilience self-regulation, internal integrity, mentalization and self-reflection are elaborated on, as well as the similarity to the psychoanalytic concept of ego strength. In conclusion, a critical discussion of the concept of resilience and its benefits as well as potential risks related to it is presented.

Resilia cyber resilience best practices

CERN Document Server

, AXELOS

2015-01-01

RESILIA™ Cyber Resilience Best Practices offers a practical approach to cyber resilience, reflecting the need to detect and recover from incidents, and not rely on prevention alone. It uses the ITIL® framework, which provides a proven approach to the provision of services that align to business outcomes.

The Commanders' Integrated Training Tool for the Close Combat Tactical Trainer 3: Final Prototype Development

National Research Council Canada - National Science Library

Flynn, Michael

2001-01-01

...) for the Close Combat Tactical Trainer (CCTT), a system of armored vehicle manned-module simulators and workstations that allows units to train collective armor and infantry tasks at the platoon through battalion task force level...

A Methodology to Define Flood Resilience

Science.gov (United States)

Tourbier, J.

2012-04-01

Flood resilience has become an internationally used term with an ever-increasing number of entries on the Internet. The SMARTeST Project is looking at approaches to flood resilience through case studies at cities in various countries, including Washington D.C. in the United States. In light of U.S. experiences a methodology is being proposed by the author that is intended to meet ecologic, spatial, structural, social, disaster relief and flood risk aspects. It concludes that: "Flood resilience combines (1) spatial, (2) structural, (3) social, and (4) risk management levels of flood preparedness." Flood resilience should incorporate all four levels, but not necessarily with equal emphasis. Stakeholders can assign priorities within different flood resilience levels and the considerations they contain, dividing 100% emphasis into four levels. This evaluation would be applied to planned and completed projects, considering existing conditions, goals and concepts. We have long known that the "road to market" for the implementation of flood resilience is linked to capacity building of stakeholders. It is a multidisciplinary enterprise, involving the integration of all the above aspects into the decision-making process. Traditional flood management has largely been influenced by what in the UK has been called "Silo Thinking", involving constituent organizations that are responsible for different elements, and are interested only in their defined part of the system. This barrier to innovation also has been called the "entrapment effect". Flood resilience is being defined as (1) SPATIAL FLOOD RESILIENCE implying the management of land by floodplain zoning, urban greening and management to reduce storm runoff through depression storage and by practicing Sustainable Urban Drainage (SUD's), Best Management Practices (BMP's, or Low Impact Development (LID). Ecologic processes and cultural elements are included. (2) STRUCTURAL FLOOD RESILIENCE referring to permanent flood defense

The most effective way of delivering a Train-the-Trainers program: A systematic review

NARCIS (Netherlands)

Pearce, Jennifer; Mann, Mala K.; Jones, Caryl; van Buschbach, Susanne; Olff, Miranda; Bisson, Jonathan I.

2012-01-01

Introduction: Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall

The significance of diagnostic MRI for visualisation of trauma-induced cervical nerve root avulsion. Case report; Die Bedeutung der MRT-Diagnostik zur Darstellung traumatisch bedingter zervikaler Wurzelausrisse. Kasuistik

Energy Technology Data Exchange (ETDEWEB)

Muth, C P [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Biemelt, F [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Kamenz, M [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie

1996-11-01

The article is intended to show the value of MRI for diagnostic visualisation and evaluation of posttraumatic nerve root avulsion as a brachial plexus injury. (orig./MG) [Deutsch] Das Ziel der Arbeit besteht in der Darstellung des Wertes der MRT-Diagnostik bei der Abklaerung traumatischer Wurzelausrisse im Bereich des Plexus brachialis. (orig./MG)

What we know and do not know about organizational resilience

Directory of Open Access Journals (Sweden)

Cristina Ruiz-Martin

2018-01-01

Full Text Available We present a literature review about organizational resilience, with the goal of identifying how organizational resilience is conceptualized and assessed. The two research questions that drive the review are: (1 how is organizational resilience conceptualized? and (2 how is organizational resilience assessed? We answer the first question by analysing organizational resilience definitions and the attributes or characteristics that contribute to develop resilient organizations. We answer the second question by reviewing articles that focus on tools or methods to measure organizational resilience. Although there are three different ways to define organizational resilience, we found common ideas in the definitions. We also found that organizational resilience is considered a property, ability or capability that can be improved over time. However, we did not find consensus about the elements that contribute to improving the level of organizational resilience and how to assess it. Based on the results of the review, we propose a conceptualization of organizational resilience that integrates the three views found in the literature. We also propose a four-level Maturity Model for Organizational Resilience – MMOR. Using this model, the organization can be in one of the following levels based on its ability and capacity to handle disruptive events: fragile, robust, resilient or antifragile.

Clarifying Resilience in the Context of Homeland Security