Sample records for resilience trainer mrt

  1. Master Resilience Training in the U.S. Army (United States)

    Reivich, Karen J.; Seligman, Martin E. P.; McBride, Sharon


    The U.S. Army Master Resilience Trainer (MRT) course, which provides face-to-face resilience training, is one of the foundational pillars of the Comprehensive Soldier Fitness program. The 10-day MRT course is the foundation for training resilience skills to sergeants and for teaching sergeants how to teach these skills to their soldiers. The…

  2. Clinical dictionary of MRT

    International Nuclear Information System (INIS)

    Herborn, C.U.; Zink, C.


    MRT is the method of choice in many clinical problems. It is also one of the most complex imaging procedures, requiring much technical and physical knowledge and also detailed knowledge of the signal response of physiological and pathological tissues in the many variants of contrast enhancement, image reconstruction and image processing. In 2006, the pocket dictionary of MRT was published by the same publisher. It met with much positive response, which induced the publication of this new dictionary. With more than 3000 terms and definitions elaborated in cooperation with an excellent practician, the clinical applications of MRT are illustrated by typical findings and examples. (orig.)

  3. MRT in non-palbable testes; MRT bei nichttastbaren Hoden

    Energy Technology Data Exchange (ETDEWEB)

    Ivanov, A. [Humboldt-Univ., Berlin (Germany). Medizinische Fakultaet (Charite), Inst. fuer Roentgendiagnostik; Dewey, C. [Humboldt-Univ., Berlin (Germany). Medizinische Fakultaet (Charite), Inst. fuer Roentgendiagnostik; Fahlenkamp, D. [Humboldt-Univ., Berlin (Germany). Medizinische Fakultaet (Charite), Klinik und Poliklinik fuer Urologie; Luening, M. [Humboldt-Univ., Berlin (Germany). Medizinische Fakultaet (Charite), Inst. fuer Roentgendiagnostik


    Magnetic resonance imaging was performed in 22 male patients for localisation of 27 nonpalpable undescended testes. The operative verification, carried out in 19 testes (15 patients) served as basis for checking on the accuracy of MRI results and for their comparison with those of sonography and laparoscopy. The impalpable testis was localised via MRI in 13 cases and its lack was correctly established in three cases. There were three false MRI diagnoses. The suspicion of two intraabdominal localised testes were not confirmed at surgery and one intracanalicular testes were not seen by MRI. The low signal intensity of the undescended testes on T{sub 2}-weighted images is indicative for fibrotic changes and may be of value for more accurate planning of the operative volume. MRI offers a new promising opportunity for localisation and morphologic estimation of the undescended testis and should be performed before the invasive investigation methods. (orig.) [Deutsch] Bei 22 maennlichen Patienten wurde eine MRT-Untersuchung zur Lokalisationsbestimmung von 27 nichttastbaren Hoden durchgefuehrt. Die operative Verifikation von 19 Hoden (15 Patienten) diente als Basis fuer die Ueberpruefung der Richtigkeit der MRT-Ergebnisse und fuer ihre Korrelation mit denen der Sonographie und Laparoskopie. Mittels MRT wurde der nichttastbare Hoden 13mal lokalisiert, dreimal wurde sein Fehlen richtig erfasst. Es gab drei falsche MRT-Diagnosen. Der Verdacht auf zwei intraabdominal gelegene Hoden wurde operativ nicht bestaetigt, ein Leistenhoden mit MRT nicht gesehen. Die niedrige Signalintensitaet des undeszendierten Hodens auf dem T{sub 2}-gewichteten Bild erklaert sich durch fibrotische Veraenderungen und kann von Wert fuer die genauere Planung des Operationsausmasses sein. MRT bietet eine neue vielversprechende Moeglichkeit fuer die Lokalisation und morphologische Bewertung des undeszendierten Hodens und sollte vor den invasiven diagnostischen Methoden eingesetzt werden. (orig.)

  4. Resilience (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...

  5. MRI survival guide; MRT Basiskurs

    Energy Technology Data Exchange (ETDEWEB)

    Cardoza, J. [Alta Imaging Medical Group and Magnetic Imaging Affiliates, Berkeley, CA (United States); Herfkens, R.J. [eds.] [Stanford Univ., CA (United States). Medical Center


    The book is a German translation of an American textbook with the original title ''MRI Survival Guide'' and is intended to serve as an introductory guide for beginners or a reference book for quick information. Readers will find information on the fundamentals of the technology and methodology of MRI as well as all details of relevance to practice in a precise and easy-to-grasp arrangement, covering all anatomic areas of interest, illustrations and descriptions of characteristic signs of pathologic processes, high-quality and unusually large-sized diagnostic pictures, a modern didactic concept for quick orientiation, including surveys, tables, and reproductions for visualisation of contents. (orig./CB) [German] Praktisch jeder Mediziner wird im Laufe seiner Berufstaetigkeit mit der MRT konfrontiert - unabhaengig davon ob in der Radiologie, Orthopaedie, Gynaekologie, Chirurgie, Neurologie oder sonstigen Fachrichtung. Das Buch ist eine Uebersetzung eines amerikanischen Lehrbuches mit dem Originaltitel ''MRI Survival Guide'' und will eine wesentliche Erleichterung als 'Ueberlebenshandbuch fuer die MRT' bieten: - Darstellung aller relevanten Grundlagen zu Technik, verschiedenen Sequenzen und Methodik der MRT - knapp und mit maximalem Praxisbezug - Beruecksichtigung aller moeglichen Untersuchungsregionen und strukturierte Orientierung daran (Gehirn, Wirbelsaeule, Kopf/Nacken, Brustkorb, Bauch, Becken, Muskel-Skelett-Bereich) - Illustration und Beschreibung der charakteristischen Erscheinungsmerkmale aller haeufigen pathologischen Prozesse im MRT, inklusive direkt umsetzbarer differentialdiagnostischer Abgrenzungskriterien - hochwertiges und aussergewoehnlich gross dimensioniertes Bildmaterial - modernes, didaktisches Konzept fuer die rasche Orientierung mit vielen Uebersichten, Tabellen und Abbildungen zur Visualisierung der Inhalte, Praxistips und Aufzeigen von Fehlermoeglichkeiten - zum Einstieg, zur Rekapitulation

  6. Resilience Training for Healthcare Staff (RTHS) Implementation Evaluation Phase 1 (United States)


    05-01-2017 2. REPORT TYPE Technical Report 3. DATES COVERED (From - To) JUN 2016 - JAN 2017 4. TITLE AND SUBTITLE Resilience Training for...DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release: distribution unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Master Resilience ...Training (MRT) Medical Program includes a 2-hour Resilience Training for Healthcare Staff (RTHS) aimed to bolster resilience by preventing

  7. MRT of the central nervous system; MRT des Zentralnervensystems

    Energy Technology Data Exchange (ETDEWEB)

    Forsting, M.; Jansen, O. (eds.)


    The book presents the state of the art of MRT imaging of the central nervous system. Detailed information is presented in order to provide sufficient knowledge for the medical diagnostician to discuss any case encountered at eye level with the clinical physician. The book is an indispensable reference manual and a quick orientation already during examination in difficult cases. It contains images made with the most recent technology and with excellent representation of details. Even rare findings are described in detail. The imaging principle is illustrated by more than 1000 pictures and graphical representations as well as more than 100 complementary tables. Findings are classified by regions, i.e. 'brain' and 'spinal cord', including anatomical descriptions. (orig.)

  8. Building resilience. (United States)

    Seligman, Martin E P


    Failure is a familiar trauma in life, but its effects on people differ widely. Some reel, recover, and move on with their lives; others get bogged down by anxiety, depression, and fear of the future. Seligman, who is known as the father of positive psychology, has spent three decades researching failure, helplessness, and optimism. He created a program at the University of Pennsylvania to help young adults and children overcome anxiety and depression, and has worked with colleagues from around the world to develop a program for teaching resilience. That program is being tested by the U.S. Army, an organization of 1.1 million people where trauma is more common and more severe than in any corporate setting. Nevertheless, businesspeo-ple can draw lessons from resilience training, particularly in times of failure and stagnation. The program is called Comprehensive Soldier Fitness, and it has three components: the Global Assessment Tool, a test for psychological fitness (administered to more than 900,000 soldiers to date); self-improvement courses following the test; and "master resilience training" (MRT) for drill sergeants. MRT focuses on enhancing mental toughness, highlighting and honing strengths, and fostering strong relationships-core competencies for any successful manager.

  9. Superconducting MRI system, MRT-50A

    International Nuclear Information System (INIS)

    Sugimoto, Hiroshi; Asahina, Kiyotaka


    The writers' developmental work on MRI (magnetic resonance imaging) was started in 1983. The model used first was MRT-15A (0.15 T). The next model was MRT-22A (0.22 T) which had a magnetic self-shield. As for the development of superconducting MRI system, they started clinical evaluation at Toshiba Central Hospital MRI Center in 1984 and got the official approval in 1985. For the model, use was made of MRT-50A (0.5 T) employing a superconducting magnet made by Toshiba. Herein represented are the basis of the images obtained through MRT-50 and the fact that the application fields of MRI are going on increasing (not only to brain and spine areas but also to the areas of the chest, abdomen and joints), and also the results of the work-in-progress of application software. (author)

  10. Functional MRT in psychiatry and neurology

    International Nuclear Information System (INIS)

    Schneider, F.; Fink, G.R.


    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives

  11. The MR trainer. Lower limbs; Der MR-Trainer. Untere Extremitaet

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M. [Allgemeines Krankenhaus, Vienna (Austria)


    The book is intended as a guide to MRI of the lower limbs for newcomers from other fields, such as radiology, orthopaedics, sports medicine, rheumatology, and (trauma) surgery. The MR trainer imparts the practical knowledge and insights of a specialist, taking the MRI morphology as a starting point. Special features of the didactic concept: the split-page concept, displaying pictures and schematic illustrations on the right page, and explanatory text on the left page. (orig./CB) [German] Dieses Buch wendet sich an alle Einsteiger in der MRT der unteren Extremitaet aus Radiologie, Orthopaedie, Sportmedizin, Rheumatologie und (Unfall-)Chirurgie. Der MR-Trainer vermittelt das praxisbezogene Anwenderwissen ausgehend von der MRT-Morphologie. Besonderheiten des didaktischen Konzepts: Doppelseitenkonzept, rechts Schemata und Abbildungen, links erklaerender Text; MR-Morphologie als Ausgangsbasis, (nachgeschaltet Indikation, Diagnose/DD,Technik); mit Uebungsfaellen zur Ueberpruefung des Gelernten. Wenn Sie dieses Buch durchgearbeitet haben, haben Sie verstanden - warum bestimmte Untersuchungen so gemacht werden, - wann welche Protokolle gefahren werden, - was Sie tatsaechlich sehen, - was noch normal oder schon pathologisch ist, - welcher klinische Bezug dahinter steht und - wie Sie reagieren muessen. (orig./AJ)

  12. Magnetic resonance tomography (MRT) in bronchial carcinoma

    International Nuclear Information System (INIS)

    Felix, R.; Bittner, R.; Schoerner, W.; Weiss, T.


    Comparative studies were made of 47 patients suffering from histologically and cytologically confirmed bronchial carcinoma, using CT and MRT respectively. CT examinations were performed before and after intravenous administration of contrast medium, whereas the MR examinations were conducted via EEG-triggered T 1 and T 2 marked SE sequences in the axial and coronary planes. Both methods were assessed in respect of tumour visualisation and documentation of tumour spread. Staging of tumour and lymph nodes yielded largely concurring results for CT and MRT. Exceptions were seen in 7 of 10 patients with malignant involvement of the pericardium and in 3 of 27 patients with lymph node metastases located mediastinally and subcarinally where only MRT showed a positive involvement of the pericardium or lymph nodes (with possible consequences for the staging of the tumour or lymph nodes). Decisive advantages of MRT compared with CT were seen in the identification of infiltration of the aortic-wall, in the differentiation of the poststenotic syndrome, in the visualisation of the thoracic wall infiltration and functional information on blood flow rate in upper venolus obstruction caused by a carcinoma. (orig.) [de

  13. Functional MRT in psychiatry and neurology; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, F. [Universitaetsklinikum der RWTH Aachen (Germany). Klinik fuer Psychiatrie und Psychotherapie; Fink, G.R. (eds.) [Koeln Univ. (Germany). Klinik und Poliklinik fuer Neurologie


    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives.

  14. Developing Effective Clinical Trainers

    Directory of Open Access Journals (Sweden)

    Kevin Khamarko


    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.

  15. MRT of the locomotor system. 4. rev. and enl. ed.; MRT des Bewegungsapparats

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, Martin [Praxisnetz Radiologie und Nuklearmedizin Bonn Bad Godesberg - RheinSieg, Bonn (Germany); Reiser, Maximilian (ed.) [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Klinische Radiologie


    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.

  16. Training of Trainers. (United States)

    Gormley, Wilma J.; Austin, John H.


    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…

  17. 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


    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.

  18. 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)


    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.)

  19. Interactive MRT of the skeletomuscular system; MRT der Stuetz- und Bewegungsorgane. Interaktiv

    Energy Technology Data Exchange (ETDEWEB)

    Mauch, F.; Goldmann, A.; Mellerowicz, H.; Sell, I.; Sell, S. (eds.)


    Diagnostic imaging has gained immense importance in the treatment of orthopaedic diseases. However, in spite of its easy availability and wide range of options it should not be applied indiscriminately, especially in this age of rising cost pressure on the medical sector. This CD-ROM presents indications of MRT, technical aspects, and an outline of the normal and pathological MRT anatomy of the joints and spinal cord. The authors have experience with CD-ROM publications in ultrasonic diagnosis and draw on this experience in their attempt to provide an illustrative picture of the advantages and options of MRT imaging and its didactic aspects. (orig.) [German] Die Behandlung von orthopaedischen Erkrankungen wird immer differenzierter. Zentraler Bestandteil ist eine moderne und ausgefeilte klinische und bildgebende Diagnostik. Der Stellenwert der bildgebenden Diagnostik hat in der Gesamtschau des Behandlungsablaufes immens zu genommen. In vielen Bereichen stellt sie heute bereits eine diagnostische nicht invasive 'Gelenkspiegelung' dar. Die breite Verfuegbarkeit und die Moeglichkeiten stellen jedoch einen hohen Anspruch an den zielgerichteten Einsatz dieser Verfahren unter Beruecksichtigung des Kostendrucks der Medizin insgesamt. Der ungezielte, an dem klinischen Problem nicht orientierende, fast schon prophylaktische Einsatz wird der praxisorientierten Patientenversorgung nicht gerecht. Orthopaeden in interdisziplinaerer Kooperation mit radiologischen Kollegen ermoeglichen dieses Konzept. Die Vorerfahrungen der Herausgeber mit dem Medium CD-ROM im Bereich der Ultraschall-Diagnostik haben es erleichtert die besonderen Vorzuege und Moeglichkeiten in der Bilddarstellung und Didaktik dieses Mediums auszuschoepfen. (orig.)

  20. The diagnostic use of MRT in cases of suspected spondylitis; MRT-Differentialdiagnose bei Verdacht auf Spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, K. [Inst. fuer Roentgendiagnostik, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany)


    In cases where MRT fails to reveal abscess formation or typical vertebral changes to confirm the preliminary diagnosis, further examinations are necessary to exclude diseases other than spondylitis. More remote possibilities like insufficiency fracture, rheumatic disorders and neoplasm can mostly be ruled out on the basis of conventional X-ray pictures. Conventional tomography and computed tomography should also be carried out in addition to MRT in the rare case of unconfirmed activated arthrosis or disc removal syndrome. In order to distinguish between infective and non-infective/reactive changes, contrast-enhanced repeat MRT following antibiotic treatment may be very helpful. (orig.) [Deutsch] Wenn bei einer Spondylitis ein dafuer beweisender Abszess oder eine typische Destruktion des Wirbelkoerpers nicht vorliegt, ist auch nach Durchfuehrung einer MRT oft eine differentialdiagnostische Abgrenzung gegenueber anderen Ursachen erforderlich. Ferner stehende Differentialdiagnosen wie Insuffizienzfraktur, rheumatische Erkrankungen und eine Neoplasie koennen mit den Moeglichkeiten des konventionellen Roentgenbildes meist ausgeschlossen werden. An die konventionelle- und Computertomographie sollte - auch nach Durchfuehrung der MRT - noch in unklaren Einzelfaellen von aktivierter Arthrose oder Postdisketomie-Syndrom gedacht werden. Eine gute differentialdiagnostische Moeglichkeit zur Unterscheidung zwischen einem Infekt und einem nicht infektioesen/reaktivem Geschehen ist die Wiederholungs-MRT mit KM-Applikation nach durchgefuehrter antibiotischer Behandlung. (orig.)

  1. Differentiation of testicular diseases via dynamic MRT

    International Nuclear Information System (INIS)

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


    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

  2. Are family practice trainers and their host practices any better? comparing practice trainers and non-trainers and their practices

    NARCIS (Netherlands)

    Hombergh, P. van den; Schalk-Soekar, S.; Kramer, A.; Bottema, B.J.; Campbell, S.M.; Braspenning, J.C.


    BACKGROUND: Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how

  3. Working with a personal trainer (United States)

    ... sessions? What services do I get for that price? Are there any other fees I need to ... enough for exercise. Alternative Names Exercise - personal trainer References American College of Sports Medicine. Using a Personal ...

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

    International Nuclear Information System (INIS)

    Vahlensieck, Martin; Reiser, Maximilian


    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.

  5. Functional MRT in psychiatry and neurology. 2. rev. and upd. ed.; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Frank [Universitaetsklinikum Aachen (Germany); Fink, Gereon R. (eds.) [Forschungszentrum Juelich GmbH (Germany); Uniklinik Koeln (Germany)


    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).

  6. Social-pedagogical aspects of trainer's activity

    Directory of Open Access Journals (Sweden)

    Kramskoy S.I.


    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.

  7. [Peer feedback for trainers in general practice]. (United States)

    Damoiseaux, R A M J; Truijens, L


    In medical specialist training programmes it is common practice for residents to provide feedback to their medical trainers. The problem is that due to its anonymous nature, the feedback often lacks the specificity necessary to improve the performance of trainers. If anonymity is to be abolished, there is a need for residents to feel safe in giving their feedback. Another way to improve the performance of trainers might be peer feedback. For peer feedback it is necessary that trainers observe each other during their training sessions with the residents. In speciality training in general practice peer feedback is done in group sessions of 12 trainers. They show videos of their training sessions and get feedback from their fellow trainers. Trainers also visit each other in their practices to observe training sessions and provide feedback. In order to improve trainer performance there is a need for more focus on peer feedback in medical specialist training programmes.

  8. Evolution of a NASTRAN trainer (United States)

    Grooms, H. R.; Hinz, P. J.; Collier, M. A.


    The development is traced of a NASTRAN training system. The design and organization of the program is examined, including the static and dynamic modules. A discussion of how user feedback, in the form of questionnaire responses, was used to evaluate and improve the trainer is included. The trainer was used by a number of engineers, who found it to be a versatile low cost tool. It is particularly helpful in bridging the gap from theory to practical application of the finite element method for structural analysis. The program, along with documentation, is available through COSMIC.

  9. Job satisfaction of self employed trainers and personal trainers ...

    African Journals Online (AJOL)

    Personal trainers are responsible for the effective delivery of health and fitness programmes. Their roles are of importance to the fitness industry and therefore, the degree of job satisfaction they experience is of prime importance. The purpose of this paper is to identify the various factors that play a role in determining the job ...

  10. Are family practice trainers and their host practices any better? Comparing practice trainers and non-trainers and their practices. (United States)

    van den Hombergh, Pieter; Schalk-Soekar, Saskia; Kramer, Anneke; Bottema, Ben; Campbell, Stephen; Braspenning, Jozé


    Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how their practices are organized and their services are delivered. 203 practices (88 non-training and 115 training) with 512 FPs (335 non-trainers and 177 trainers) were assessed using the "Visit Instrument Practice organization (VIP)" on 369 items (142 FP-level; 227 Practice level). Analyses (ANOVA, ANCOVA) were conducted for each level by calculating differences between FP trainees and non-trainees and their host practices. Trainers scored higher on all but one of the items, and significantly higher on 47 items, of which 13 remained significant after correcting for covariates. Training practices scored higher on all items and significantly higher on 61 items, of which 23 remained significant after correcting for covariates. Trainers (and training practices) provided more diagnostic and therapeutic services, made better use of team skills and scored higher on practice organization, chronic care services and quality management than non-training practices. Trainers reported more job satisfaction and commitment and less job stress than non-trainers. There are positive differences between FP trainers and non-trainers in both the level and the quality of services provided by their host practices. Training institutions can use this information to promote the advantages of becoming a FP trainer and training practice as well as to improve the quality of training settings for FPs.

  11. MRI in mucoviscidosis (cystic fibrosis); MRT bei Mukoviszidose

    Energy Technology Data Exchange (ETDEWEB)

    Eichinger, M.; Puderbach, M.; Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Heussel, C.-P. [Universitaetsklinikum Mainz (Germany). Klinik und Poliklinik fuer Radiologie


    Cystic fibrosis (CF) is a multi-systemic disease with major impact on the lungs. Pulmonary manifestation is crucial for the prognosis and life expectancy of patients. Imaging modalities and lung function tests reflect the pulmonary status in these patients. The standard imaging modality for diagnosis and follow-up of pulmonary changes is chest x-ray. The gold standard for the detection of parenchymal lung changes remains high resolution computed tomography (HRCT), but this is not used routinely for CF-patients due to radiation exposure. Magnetic resonance imaging (MRI) used to be of no importance in monitoring cystic fibrosis lung disease, as shown in studies from the 1980s and early 1990s. The continuing improvement of MRI techniques, however, has allowed for an adequate application of this non-radiation method in diagnosing the major pulmonary findings in CF, in addition to the assessment of lung function. (orig.) [German] Die Lunge ist Hauptmanifestationsort der Mukoviszidose (zystischen Fibrose, CF) und entscheidend fuer Prognose und Lebenserwartung der Betroffenen. Bildgebende Verfahren spielen in der Diagnostik und Verlaufsbeurteilung der Lungenveraenderungen sowie dem Monitoring pulmonaler Komplikationen bei zystischer Fibrose eine wichtige Rolle. Obwohl die hochaufloesende Computertomographie (HRCT) als Goldstandard zur Beurteilung morphologischer Lungenveraenderungen bei zystischer Fibrose gilt, ist die Roentgenthoraxaufnahme aufgrund der geringeren Strahlenbelastung bei den meist jungen Patienten das derzeit eingesetzte Standardverfahren zur Diagnostik und Verlaufsbeurteilung. Die Magnetresonanztomographie (MRT) spielte bislang in der Diagnostik und Verlaufsbeobachtung der zystischen Fibrose keine Rolle, da Arbeiten aus den 80er und fruehen 90er Jahren keinen sinnvollen Beitrag der MRT zeigen konnten. Durch die kontinuierliche Verbesserung der Technik ist es seit neuestem erstmals moeglich, die MRT als Alternative fuer die Lungenbildgebung bei zystischer

  12. 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)


    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

  13. 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)


    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.)

  14. Magnetic resonance tomography and dental radiology (Dental-MRT); Die Magnetresonanztomographie in der Dentalradiologie (Dental-MRT)

    Energy Technology Data Exchange (ETDEWEB)

    Gahleitner, A. [Wien Univ. (Austria). Abt. fuer Osteologie; Wien Univ. (Austria). Abt. fuer Orale Chirurgie; Solar, P.; Ertl, L. [Wien Univ. (Austria). Abt. fuer Orale Chirurgie; Nasel, C.; Homolka, P. [Wien Univ. (Austria). Inst. fuer Biomedizinische Technik und Physik; Youssefzadeh, S.; Schick, S. [Wien Univ. (Austria). Abt. fuer Osteologie


    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.) [German] Ziel dieses Beitrags ist die Vorstellung der Untersuchungsmoeglichkeiten des Ober- und Unterkiefers mittels Magnetresonanztomographie (Dental-MRT) und ihre Anwendung bei der Diagnose zahnmedizinischer Erkrankungen. Sieben gesunde Probanden, 5 Patienten mit Pulpitis, 9 Patienten mit dentogenen Zysten, 5 Patienten nach Zahntransplantationen und 12 Patienten mit atrophem Unterkiefer wurden untersucht. Axiale T1- und T2-gewichtete Gradientenecho- und Spinecho-Sequenzen in 2D und 3D-Technik wurden durchgefuehrt. Nach der Untersuchung wurden zusaetzliche Panoramaschnitte und orhoradiale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebraeuchlichen Dental-Software, angefertigt. Der gesamte Ober- oder Unterkiefer, Zaehne, Pulpa und der Inhalt des Mandibularkanals koennen gut dargestellt werden. Patienten mit einer Entzuendung der

  15. 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)


    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.)

  16. 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.


    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

  17. Excel VBA 24-hour trainer

    CERN Document Server

    Urtis, Tom


    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

  18. Java programming 24-hour trainer

    CERN Document Server

    Fain, Yakov


    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

  19. HTML5 24-Hour Trainer

    CERN Document Server

    Lowery, Joseph W


    Comprehensive written and interactive instruction for learning HTML5 HTML is the core technology for building websites. Today, with HTML5 opening the Internet to new levels of rich content and dynamic interactivity, developers are looking for information to learn and utilize HTML5. HTML5 24-Hour Trainer provides that information, giving new and aspiring web developers the knowledge they need to achieve early success when building websites. Covers the most basic aspects of a web page, including a brief introduction to Cascading Style Sheets (CSS) Provides lessons that are backed up by prof

  20. Morphing into a 21st Century Trainer. (United States)

    Mager, R. F.


    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)

  1. Liability, Athletic Equipment, and the Athletic Trainer. (United States)

    Black, Richard

    Standards of conduct, roles, and responsibilities expected of athletic trainers should be developed and disseminated. These guidelines could be used in court to show that the athletic trainer was following basic standards if he should be charged with liability. A review of liability cases involving athletic injuries received while athletes were…

  2. Imaging of Nuclear Weapon Trainers

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  3. Understanding Resilience

    Directory of Open Access Journals (Sweden)

    Gang eWu


    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.

  4. 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)


    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

  5. Cardiodiagnostic imaging. MRT, CT, echocardiography and other methods

    International Nuclear Information System (INIS)

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


    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.)

  6. 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)


    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

  7. The experiences of female athletic trainers in the role of the head athletic trainer. (United States)

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


    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.

  8. Resilient ledelse


    Rygh, Bjørn


    Master i styring og ledelse Denne masteroppgaven bygger på litteraturanalyse og intervju med forskere, lederutviklere, ledere og tillitsvalgte. Oppgaven utvikler en hypotese om en resilient lederstil, diskuterer om og hvordan ledere kan bidra til å bedre resiliens hos underordnede, samt identifiserer hva som kan kjennetegne resilient ledelse. Resilient ledelse kan defineres som det en leder gjør for å bedre de underordnedes evne til å få mer psykologisk motstandskraft, det vil si gjør d...

  9. Bestimmung von Größe und Größenänderung des linken Vorhofes : MRT und transthorakale Echokardiographie im Vergleich


    Giesa, Christian


    Fragestellung Die Arbeit vergleicht MRT-Volumina des linken Vorhofes (LA) mit anderen Parametern aus Echokardiographie (TTE) und MRT, auch im zeitlichen Verlauf, sowie deren Reproduzierbarkeit. Methode Patienten mit Vorhofflimmern wurden ein bis drei Mal in MRT und TTE untersucht. Die Auswertung erfolgte retrospektiv aus einem Bildarchiv. Ergebnis Im MRT zeigt sich eine gute, im TTE eine deutlich schlechtere Reproduzierbarkeit. Am besten mit dem MRT-Volumen korreliert ...

  10. Cardiac functional analysis with MRI; Kardiale Funktionsanalyse mittels MRT

    Energy Technology Data Exchange (ETDEWEB)

    Sandner, T.A.; Theisen, D.; Bauner, K.U.; Picciolo, M.; Reiser, M.F.; Wintersperger, B.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)


    Cardiovascular diseases (CVD) are among the leading causes of death worldwide. Even in the 21{sup st} century CVD will still be the most frequent cause of morbidity and mortality. Precise evaluation of cardiac function is therefore mandatory for therapy planning and monitoring. In this article the contribution of MRI-based analysis of cardiac function will be addressed. Nowadays cine-MRI is considered as the standard of reference (SOR) in cardiac functional analysis. ECG-triggered steady-state free precession (SSFP) sequences are mainly used as they stand out due to short acquisition times and excellent contrast between the myocardium and the ventricular cavity. An indispensible requirement for cardiac functional analysis is an exact planning of the examination and based on that the coverage of the whole ventricle in short axial slices. By means of dedicated post-processing software, manual or semi-automatic segmentation of the endocardial and epicardial contours is necessary for functional analysis. In this way end-diastolic volume (EDV), end-systolic volume (ESV) and the ejection fraction (EF) are defined and regional wall motion abnormalities (RWMA) can be detected. (orig.) [German] Weltweit gehoeren Herz-Kreislauf-Erkrankungen zu den haeufigsten Todesursachen. Auch im 21. Jahrhundert werden diese Erkrankungen das Erkrankungsspektrum und die Todesursachenstatistik anfuehren. Eine genaue Beurteilung der kardialen Funktion ist fuer die Therapieplanung und -ueberwachung unerlaesslich. In diesem Beitrag wird der Stellenwert der MRT bei der Beurteilung der kardialen Funktion eroertert. Als Standard der kardialen Funktionsanalyse kann heute die Cine-MRT angesehen werden, wofuer man ueberwiegend EGK-getriggerte Steady-state-free-precession- (SSFP-)Sequenzen einsetzt, die sich durch kurze Messzeiten und einen hervorragenden Kontrast zwischen Myokard und Ventrikelkavum auszeichnen. Voraussetzung fuer kardiale Funktionsuntersuchungen ist eine exakte Einstellung der

  11. Presentation Trainer Prototype 1.0

    NARCIS (Netherlands)

    Börner, Dirk; Specht, Marcus


    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.

  12. Mapping Resilience

    DEFF Research Database (Denmark)

    Carruth, Susan


    Resilience theory is a growing discipline with great relevance for the discipline of planning, particularly in fields like energy planning that face great uncertainty and rapidly transforming contexts. Building on the work of the Stockholm Resilience Centre, this paper begins by outlining...... 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...... 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...

  13. The Teacher Trainer: A Practical Journal Mainly for Modern Language Teacher Trainers, 1995. (United States)

    Woodward, Tessa, Ed.


    This document consists of the three issues of "The Teacher Trainer" published during 1995. This journal of modern language teacher education contains articles by teacher trainees and teacher trainers, including: "The Use of Lesson Transcripts in Teacher Development" (Richard Cullen); "Pair and Group Work--Confessions of Ignorance" (Tessa…

  14. CT and MRI normal findings; CT- und MRT-Normalbefunde

    Energy Technology Data Exchange (ETDEWEB)

    Moeller, T.B.; Reif, E. [Caritas-Krankenhaus, Dillingen (Germany)


    This book gives answers to questions frequently heard especially from trainees and doctors not specialising in the field of radiology: Is that a normal finding? How do I decide? What are the objective criteria? The information presented is three-fold. The normal findings of the usual CT and MRI examinations are shwon with high-quality pictures serving as a reference, with inscribed important additional information on measures, angles and other criteria describing the normal conditions. These criteria are further explained and evaluated in accompanying texts which also teach the systematic approach for individual picture analysis, and include a check list of major aspects, as a didactic guide for learning. The book is primarily intended for students, radiographers, radiology trainees and doctors from other medical fields, but radiology specialists will also find useful details of help in special cases. (orig./CB) [German] Normalbefunde sind die haeufigsten Befunde ueberhaupt. Also kein Problem? Doch. Besonders Radiologen in der Ausbildung und Aerzte aus anderen Fachgebieten stellen sich immer wieder die entscheidende Frage: Ist das normal? Woran kann ich das erkennen? Wie kann ich das objektivieren? Dieses Buch leistet dreierlei: 1. Es zeigt klassische Normalbefunde der gaengigen CT- und MRT-Untersuchungen in hoher Abbildungsqualitaet als Referenz. Direkt in die Aufnahmen eingezeichnet sind wichtige Daten: Masse, Winkel und andere Kriterien des Normalen. Sie werden im Text nochmals zusammengefasst, erklaert und bewertet. 2. Es lehrt die Systematik der Bildbetrachtung - wie schaue ich mir ein Bild an, welche Strukturen betrachte ich in welcher Reihenfolge und worauf muss ich dabei besonders achten? Dies alles in Form einer uebersichtlichen Checkliste zu jeder Aufnahme. 3. Es gibt eine Befundformulierung vor, die sich wiederum an dem Schema der Bildanalyse orientiert, alle Kriterien des Normalen definiert und dadurch auch ein wichtiges didaktisches Element darstellt

  15. MRI in dementia-type diseases; MRT bei demenziellen Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Bodea, S.V.; Muehl-Benninghaus, R. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg (Germany)


    Dementia-inducing conditions represent a leading cause of disability and are a major health concern in industrialized countries. The burden these conditions put on society is certain to rise in the context of an ever-increasing elderly population. As these conditions feature an insidious onset and overlapping clinical features, imaging is a powerful tool in refining the diagnosis and assessing the progression of dementing conditions. The radiologist needs to be aware of and be able to detect underlying pathologies which could be reversible. Furthermore, imaging is important not only in excluding other pathologies but also in improving diagnostic accuracy. This article presents the typical clinical presentations as well as magnetic resonance imaging (MRI) features of the degenerative and the non-degenerative causes of dementia. The focus is on the core knowledge for MRI diagnostics in dementing conditions and a brief presentation of the latest MRI techniques which may become a part of standard imaging protocols in the future. (orig.) [German] Demenzielle Erkrankungen gehoeren in den Industrielaendern zu den haeufigsten Ursachen fuer Beeintraechtigungen im Alltag. Durch eine stetig alternde Population nimmt auch die Belastung fuer die Gesellschaft immer weiter zu. Bei haeufig schleichendem Symptombeginn sowie sich ueberlappender Klinik mit anderen Krankeitsbildern kann die Bildgebung ein gutes Werkzeug zur Praezisierung der Diagnose und Beurteilung eines Progresses sein. Der Radiologe sollte andere und reversible Pathologien erkennen und von demenztypischen Veraenderungen abgrenzen koennen. Dieser Artikel beschreibt typische klinische Symptome und auch bildmorphologische Veraenderungen verschiedener Demenzformen, die durch neurodegenerative und nichtdegenerative Ursachen bedingt sein koennen. Ausserdem werden aktuellste MRT-Techniken vorgestellt. Diese koennten kuenftig im Standartprotokoll zur Bildgebung bei der Abklaerung demenzieller Syndrome verankert sein. (orig.)

  16. Water Resilience (United States)

    The Drinking Water and Wastewater Resiliency site provides tools and resources for drinking water and wastewater utilities in the full spectrum of emergency management which includes prevention, mitigation, preparedness, response and recovery.

  17. 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


    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  19. O Personal Trainer na Perspectiva do Marketing

    Directory of Open Access Journals (Sweden)

    Cibele Biehl Bossle


    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.


    Directory of Open Access Journals (Sweden)

    Eko Nur Surachman


    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.

  1. 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.


    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

  2. Information for Librarians and Trainers: MedlinePlus (United States)

    ... this page: Information for Librarians and Trainers To use the sharing ... Tips Resources for Teaching How to Find Health Information Online General Evaluating Internet Health Information: A Tutorial ...

  3. Trainer module for security control center operations

    International Nuclear Information System (INIS)

    Bernard, E.A.


    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

  4. Educational CPD: how UK GP trainers develop themselves as teachers. (United States)

    Waters, Mark; Wall, David


    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.

  5. 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)


    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

  6. Blood-Borne Pathogens: Guidelines for Athletic Trainers. (United States)

    Journal of Athletic Training, 1995


    These guidelines cover athletic trainers and blood-borne pathogens at athletic events, student athletic trainer education, universal precautions and Occupational Safety and Health Administration regulations, medical records and confidentiality, infected athletic trainers, human immunodeficiency virus (HIV) and Hepatitis B Virus (HBV) testing, HBV…

  7. Tic Tac Toe Math. Train the Trainer. (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…

  8. The Athletic Trainer: Necessity or Luxury? (United States)

    Weldon, Gail

    This article emphasizes the importance of including an athletic trainer who is a qualified sports medicine professional in organized school sport programs, particularly football. Educational requirements for persons who wish to go into this profession are outlined, as well as employment opportunities. (JD)

  9. Recognizing resilience (United States)

    Erika S. Svendsen; Gillian Baine; Mary E. Northridge; Lindsay K. Campbell; Sara S. Metcalf


    In 2012, a year after a devastating tornado hit the town of Joplin, Missouri, leaving 161 people dead and leveling Joplin High School and St. John's Hospital, President Obama addressed the graduating seniors: "There are a lot of stories here in Joplin of unthinkable courage and resilience. . . . [People in Joplin] learned that we have the power to...

  10. Cerebral activation studies by PET and fMRT, clinical relevance?

    International Nuclear Information System (INIS)

    Brandt, T.


    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

  11. Applicability of TOD, MTDP, MRT and DMRT for dynamic image enhancement techniques

    NARCIS (Netherlands)

    Bijl, P.; Schutte, K.; Hogervorst, M.A.


    Current end-to-end sensor performance measures such as the TOD, MRT, DMRT and MTDP were developed to describe Target Acquisition performance for static imaging. Recent developments in sensor technology (e.g. microscan) and image enhancement techniques (e.g. Super Resolution and Scene-Based

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

    International Nuclear Information System (INIS)

    Schneider, Frank; Fink, Gereon R.


    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).

  13. The Effect of External Magnetic Fields on the MRT Instability in MagLIF (United States)

    Hess, Mark; Peterson, Kyle; Weis, Matthew; Lau, Yue Ying


    Recent experiments on MagLIF which incorporate an external B-field suggest that the MRT instability within the liner has a different behavior than without the B-field. Previous work by Chandrasekhar and Harris have illustrated how the MRT growth rate, assuming fixed liner density and fixed acceleration, can change due to the presence of an external B-field. In this work, we show how the growth rate of the MRT instability is dynamically affected by the rapidly varying acceleration, liner density, and surface magnetic field, which is composed of the external B-field and the drive B-field of the liner in the MagLIF experiments. In addition, we also examine the effects of finite liner resistivity on MRT growth, which gives rise to an additional time scale corresponding to magnetic diffusion. We discuss the implications of this result for future MagLIF designs. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy under Contract DE-AC04-94AL85000.

  14. The role of MRI in suspected inner ear malformations; Stellenwert der MRT bei Verdacht auf Innenohrmissbildung

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, S.; Juettemann, S.; Amaya, B. [Halle-Wittenberg Univ., Halle (Germany). Klinik fuer Diagnostische Radiologie; Rasinski, C.; Bloching, M. [Halle-Wittenberg Univ., Halle (Germany). Klinik fuer Hals-, Nasen-, Ohrenkrankheiten; Koenig, E. [Leipzig Univ. (Germany). Klinik fuer Hals-, Nasen-, Ohrenkrankheiten


    Purpose: This is a prospective analysis of the value of MRI in suspected inner ear malformations. Materials and Methods: In 50 patients (43 children and young adults, 7 adults) with suspected inner ear malformation MRI (1.5 T) was performed. In addition, 42 of these patients underwent CT. For the analysis of the inner ear structures, the constructive interference in steady state (CISS) sequence with 0.7 mm slice thickness was used. Functional tests revealed a sensorineural hearing loss or deafness in 82 temporal bones (TB) and a combined hearing loss in 4 TB. The hearing loss was unilateral in 14 patients. MRI and CT findings were compared. Results: Imaging findings were normal in 58 TB. The pathological findings included inner ear malformations (35 TB), inflammatory changes (4 TB), partial obliteration of labyrinth (2 TB) and congenital aural atresia (1 TB). An isolated absence of the cochlear nerve (1 TB) could only be found by MRI. In the remaining cases, an inner ear malformation was diagnosed by MRI and CT with the same confidence but MRI was superior in displaying the fine details. Conclusions: MRI will become the method of choice in the diagnosis of inner ear malformations. (orig.) [German] Ziel: Das Ziel der Arbeit bestand in einer prospektiven Analyse des Stellenwertes der MRT bei Verdacht auf eine Innenohrmissbildung. Material und Methodik: 50 Patienten (43 Kinder und Jugendliche, 7 Erwachsene) mit dringendem Verdacht auf eine Innenohrmissbildung erhielten eine MRT-Untersuchung (1,5 T), bei 42 dieser Patienten wurde auch eine CT durchgefuehrt. Bei der Beurteilung der Innenohrstrukturen kam die CISS-Sequenz mit einer Schichtdicke von 0,7 mm zur Anwendung. Durch Funktionstests wurde an 82 Schlaefenbeinen (SB) eine Innenohrhoerstoerung und an 4 SB eine kombinierte Hoerstoerung diagnostiziert. 14 Patienten hatten eine einseitige Hoerstoerung. MRT- und CT-Ergebnisse wurden verglichen. Ergebnisse: Einen bildgebenden Normalbefund wiesen 58 SB auf. Folgende

  15. Training aids: the motor operator valve trainer

    International Nuclear Information System (INIS)

    McCulloch, B.


    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

  16. Quantifying resilience (United States)

    Allen, Craig R.; Angeler, David G.


    The biosphere is under unprecedented pressure, reflected in rapid changes in our global ecological, social, technological and economic systems. In many cases, ecological and social systems can adapt to these changes over time, but when a critical threshold is surpassed, a system under stress can undergo catastrophic change and reorganize into a different state. The concept of resilience, introduced more than 40 years ago in the ecological sciences, captures the behaviour of systems that can occur in alternative states. The original definition of resilience forwarded by Holling (1973) is still the most useful. It defines resilience as the amount of disturbance that a system can withstand before it shifts into an alternative stable state. The idea of alternative stable states has clear and profound implications for ecological management. Coral reefs, for example, are high-diversity systems that provide key ecosystem services such as fisheries and coastal protection. Human impacts are causing significant, ongoing reef degradation, and many reefs have shifted from coral- to algal-dominated states in response to anthropogenic pressures such as elevated water temperatures and overfishing. Understanding and differentiating between the factors that help maintain reefs in coral-dominated states vs. those that facilitate a shift to an undesired algal-dominated state is a critical step towards sound management and conservation of these, and other, important social–ecological systems.

  17. Personal trainer demographics, current practice trends and common trainee injuries

    Directory of Open Access Journals (Sweden)

    Gregory R. Waryasz


    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.

  18. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries. (United States)

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


    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.

  19. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries (United States)

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


    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

  20. Vision Trainer Teaches Focusing Techniques at Home (United States)


    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

  1. Radiology trainer. Torso, internal organs and vessels

    International Nuclear Information System (INIS)

    Staebler, A.; Ertl-Wagner, B.


    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.)

  2. Glimpses for Effective implementation of Virtual Trainer


    S.Arumuga perumal


    This paper discusses and suggests some ideas and necessary changes in implementation of virtual trainer in an organization. With the invention of new technologies like high speed computer networks and multimedia computers, there is an increasing awareness that direct face to face teaching is not the only possible mode of training methodology in an organization. There is a demand for preparing high quality multimedia training material across all faculties, which can be used...

  3. Development of Laser Rifle Trainer with Full Shot Imitation


    Bansevicius, Ramutis; Fedaravicius, Algimantas; Ostasevicius, Vytautas; Ragulskis, Minvydas


    Laser trainers are effective tools for shot and sportsmen training. However, the majority of trainers have neither realistic recoil nor sound imitation systems. The objective of the development of laser rifle trainer with full shot imitation was to investigate and simulate the recoil of combat weapons under single and serial shooting regimes so that the training weapons could simulate complete recoil and sound imitation.Theoretical and experimental investigations lead to the development of sh...

  4. Development of Laser Rifle Trainer with Full Shot Imitation

    Directory of Open Access Journals (Sweden)

    Ramutis Bansevicius


    Full Text Available Laser trainers are effective tools for shot and sportsmen training. However, the majority of trainers have neither realistic recoil nor sound imitation systems. The objective of the development of laser rifle trainer with full shot imitation was to investigate and simulate the recoil of combat weapons under single and serial shooting regimes so that the training weapons could simulate complete recoil and sound imitation.

  5. 3D Bildgebung von zerebralen Aneurysmen Vergleich zwischen CT und MRT (United States)

    Goubergrits, Leonid; Pöthke, Jens; Petz, Christoph; Hege, Hans-Christian; Spuler, Andreas; Kertzscher, Ulrich

    Patientenspezifische Strömungs- und die Geometrieanalyse von Aneurysmen basiert auf der 3D-Rekonstruktion aus Daten, die mit modernen Methoden der Bildgebung (z.B. CT und MRT) gewonnen werden. Die unterschiedlichen Charakteristika der Bildgebungsverfahren und die damit verbundenen Unsicherheiten führen zu Variationen der rekonstruierten Geometrien, die sich auf die numerische Berechnung von Strömungsparametern, wie z.B. die Wandschubspannung, auswirken können. Basierend auf CT- und MRT-Aufnahmen eines anatomisch realistischen Referenzmodells eines zerebralen Aneurysmas der Arteria Basilaris vergleichen wir die rekonstruierten Geometrien und die hierin simulierten Blutströmungen. Die Segmentierung und Rekonstruktion des Aneurysmas erfolgte mit Hilfe des Programms AMIRA. Die numerischen Strömungsberechnungen wurden mit dem Strömungslöser FLUENT durchgeführt.

  6. Resilience thinking: integrating resilience, adaptability and transformability (United States)

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


    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...

  7. Resilience Thinking: Integrating Resilience, Adaptability and Transformability

    NARCIS (Netherlands)

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


    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

  8. 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)


    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.)

  9. 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


    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.)

  10. The MR trainer. Upper extremities. 2. rev. and enl. ed.; Der MR-Trainer. Obere Extremitaet

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Martin [Landesklinikum Waldviertel Horn (Austria). Inst. fuer Radiologie und Interventionelle Radiologie


    The MR (magnetic resonance) trainer covers the indications in NMR images of hands, elbows and shoulder, including fractures and instabilities at the wrist, tendon and ligament lesions, carpal tunnel syndrome, ulnar tunnel syndrome, scaphoid bone fracture, (posttraumatic) osteonecrosis, synovial lesions, luxations, osteocondrosis, soft tissue rumors and bone tumors. The book includes training tasks for each issue.

  11. Radiology trainer. Surgical ambulance. 2. rev. and enl. ed.; Roentgen-Trainer. Chirurgische Ambulanz

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, Ole [Wedau-Kliniken Duisburg (Germany). Klinik fuer Unfallchirurgie; Ruchholtz, Steffen [Universitaetsklinikum Giessen und Marburg GmbH, Marburg (Germany). Klinik fuer Unfall-, Hand- und Wiederherstellungschirurgie; Siemann, Holger [LVR Klinikum Essen (Germany); Barkhausen, Joerg [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin


    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.

  12. 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......, and transmitted via the Internet (live-streaming) in order to give access to as large an audience as possible. The material produced during the project and resulting from the seminar will be made available on the project website. The project thereby produces easily accessible results and thus facilitates...

  13. First trainer six practice tests with answers

    CERN Document Server

    May, Peter


    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.

  14. Effectiveness of box trainers in laparoscopic training

    Directory of Open Access Journals (Sweden)

    Dhariwal Anender


    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

  15. WordPress 24-hour trainer

    CERN Document Server

    Plumley, George


    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

  16. 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)


    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

  17. MRT diagnosis of intra- and paraspinal abscesses; Kernspintomographische Diagnostik intra- und paraspinaler Abszesse

    Energy Technology Data Exchange (ETDEWEB)

    Lanfermann, H. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Heindel, W. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Gierenz, M. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Haupt, W.F. [Klinik und Poliklinik fuer Neurologie, Univ. Koeln (Germany); Hildebrandt, G. [Klinik und Poliklinik fuer Neurochirurgie, Univ. Koeln (Germany); Lackner, K. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany)


    Analysis of the MRT signals and their extent from intra- and paraspinal abscesses with reference to predisposing factors, their causes and localisation. The histories and MRT findings in 34 Patients with intra- and paraspinal abscesses were evaluated retrospectively. Most of the patients (24/34) were older than 50 years. A second peak was below 30 years. 27/34 patients had some underlying disease which predisposed to infection, e.g., diabetes mellitus. The most common causal organisms were Staph. aureus (53%) and streptococci (15%). In 23/34 cases (68%), the abscesses were in the thoraco-lumbar or lumbar region, while only 6/34 occurred in the upper two-thirds of the thoracic spine and only 5/34 in the cervical region. In only 8/34 was the abscess confined to two vertebral lengths; in the remaining patients it was much more extensive. Intraspinal abscesses were about twice as large as the vertebral components and 1.5 times greater than paravertebral abscesses. The age of the abscesses could be estimated approximately from the signals. Contrast enhanced MRT permits detailed analysis of the compartments and exact estimation of the extent of the lesions and permits accurate monitoring of treatment. (orig.) [Deutsch] MR-tomographische Analyse des Signal- und Ausbreitungsverhaltens intra- und paraspinaler Abszesse unter Beruecksichtigung praedisponierender Faktoren, des Erregerspektrums und der Lokalisation. Die Krankengeschichten und MRT von 34 Patienten mit intra- und paraspinalen Abszessen wurden retrospektiv ausgewertet. Die Mehrzahl der Patienten (24/34) war aelter als 50 Jahre. Ein zweiter Altersgipfel lag bei unter 30 Jahren. 27/34 Patienten litten an Grunderkrankungen, die Infektionen beguenstigen, wie zum Beispiel Diabetes mellitus. Die haeufigsten Erreger waren Staphylococcus aureus (53%) und Streptokokken (15%). Die Abszesse waren in 23/34 Faellen (68%) im thorakolumbalen Uebergang und lumbal lokalisiert, waehrend die oberen zwei Drittel der BWS nur bei 6

  18. 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)


    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.)

  19. Anhydrous Ammonia Training Module. Trainer's Package. Participant's Package. (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…

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

    African Journals Online (AJOL)

    This article focussses on the competence of trainers in the South African workplace to provide training to underprepaired learners whose special learning need should be understood by the trainers. The National Qualifications Framework, brought into being by the South African Qualifications ity Act of 1995, has as one of its ...

  1. Importance of Health Science Education for Personal Fitness Trainers. (United States)

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


    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,…

  2. Teacher education and occupational trainers figure

    Directory of Open Access Journals (Sweden)



    Full Text Available We want to know if Cordoba occupational trainers to date and what type of training method they prefer. we also wonder if there is information and/or training sufficient training activities in e-learning by the Administration and if they consider that this formation has the same status as the classroom training. This study goes through three stages, exploratory, descriptive and explanatory, within a continuum, depending on the research phase where we are, and therefore, does not indicate clearly any of them, although it is mainly descriptive. It uses a nonrandom sample since it requires a controlled choice of subjects with specific characteristics in particular we refer to is called the sample of experts. The population we apply the questionnaires is the group of active occupational trainers, students who are conducting the course of Shaper Occupational and training managers. Data collected shows that the e-learning is not fully integrated into our society, because of the lack of information, lack of supply and, also, because of «fear of the unknown», so maybe we won’t consider it as a training option, further reinforced by the need for pre-literacy. There is not trust in e-learning, because at the beginning there was a concern over the technical aspects, ignoring the methodological and pedagogical, and now, the situation is improving, although it will need time to adapt.

  3. A Sleep Position Trainer for positional sleep apnea

    DEFF Research Database (Denmark)

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


    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

  4. 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


    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

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

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


    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

  6. Of resilient places: planning for urban resilience


    Mehmood, Abid


    This paper argues that resilience of a place cannot necessarily be associated only with the level of its vulnerability to the environment or security. A place-based perspective to resilience helps understand the capacity of communities to withstand or adapt with change. Resilience of a place does not only refer to contingencies—such as formulating immediate responses to crisis situations or incidents such as earthquakes, floods or other disasters in vulnerable areas—but also considers long-te...

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

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


    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

  8. 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)


    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

  9. Resilience Thinking: Integrating Resilience, Adaptability and Transformability

    Directory of Open Access Journals (Sweden)

    Carl Folke


    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.

  10. Influence of polarization and a source model for dose calculation in MRT

    Energy Technology Data Exchange (ETDEWEB)

    Bartzsch, Stefan, E-mail:; Oelfke, Uwe [The Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey SM2 5NG, United Kingdom and Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, D-69120 Heidelberg (Germany); Lerch, Michael; Petasecca, Marco [Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong 2522 (Australia); Bräuer-Krisch, Elke [European Synchrotron Radiation Facility, 6 Rue Jules Horowitz, 38000 Grenoble (France)


    Purpose: Microbeam Radiation Therapy (MRT), an alternative preclinical treatment strategy using spatially modulated synchrotron radiation on a micrometer scale, has the great potential to cure malignant tumors (e.g., brain tumors) while having low side effects on normal tissue. Dose measurement and calculation in MRT is challenging because of the spatial accuracy required and the arising high dose differences. Dose calculation with Monte Carlo simulations is time consuming and their accuracy is still a matter of debate. In particular, the influence of photon polarization has been discussed in the literature. Moreover, it is controversial whether a complete knowledge of phase space trajectories, i.e., the simulation of the machine from the wiggler to the collimator, is necessary in order to accurately calculate the dose. Methods: With Monte Carlo simulations in the Geant4 toolkit, the authors investigate the influence of polarization on the dose distribution and the therapeutically important peak to valley dose ratios (PVDRs). Furthermore, the authors analyze in detail phase space information provided byMartínez-Rovira et al. [“Development and commissioning of a Monte Carlo photon model for the forthcoming clinical trials in microbeam radiation therapy,” Med. Phys. 39(1), 119–131 (2012)] and examine its influence on peak and valley doses. A simple source model is developed using parallel beams and its applicability is shown in a semiadjoint Monte Carlo simulation. Results are compared to measurements and previously published data. Results: Polarization has a significant influence on the scattered dose outside the microbeam field. In the radiation field, however, dose and PVDRs deduced from calculations without polarization and with polarization differ by less than 3%. The authors show that the key consequences from the phase space information for dose calculations are inhomogeneous primary photon flux, partial absorption due to inclined beam incidence outside

  11. 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)


    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

  12. Manipulator for the therapy of breast cancer in the magnetic-resonance-tomography-device (MRT)

    International Nuclear Information System (INIS)

    Fischer, H.; Selig, M.; Vagner, J.; Kaiser, W.A.


    A significant progress has been achieved in the diagnosis of small sized mamma carcinomas by magnetic resonance mammography. Diagnosis and therapy in one turn using the same machine would enhance precision and reduce cost of the intervention, minimizing the patient's strain and side effects. A manipulator with a biopsy unit will be presented allowing the combination of diagnostic imaging with biopsy and subsequent therapy. Tests have shown that a marked target could be reached reproducibly. It was placed within a pig liver in the isocenter of a MRT running with a magnetic field of 1.5 T. (orig.)

  13. Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine. (United States)

    Lombardi, Nicholas J; Tucker, Bradford; Freedman, Kevin B; Austin, Luke S; Eck, Brandon; Pepe, Matthew; Tjoumakaris, Fotios P


    It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.

  14. Athletic Trainers' Attitudes Toward Drug Screening of Intercollegiate Athletes (United States)

    Starkey, Chad; Abdenour, Thomas E.; Finnane, David


    Since the inception of NCAA-mandated drug screening in 1986, college athletic trainers have found themselves involved at various levels in institutional drug-screening programs. Several legal, moral, and ethical questions have been raised regarding the drug screening of college athletes, and studies have been conducted to rate athletes' attitudes toward this practice. We examined the responses of certified athletic trainers employed in college settings to ascertain their attitudes toward the drug screening of athletes in general, and, specifically, how they view their role in this process. Surveys were distributed to 500 college athletic trainers randomly selected from the membership database maintained by the National Athletic Trainers' Association, Inc (Dallas, TX). The results of this survey indicate that the majority of athletic trainers feel that their association with the drug-screening process places them in the dual role of police and counselor, but that this relationship does not negatively affect their rapport with their athletes. Opinions regarding the drug-screening process and the importance of education in deterring drug use are somewhat dependent upon the athletic trainer's involvement in the drug-screening process. Athletic trainers possess a stronger desire to serve as resource persons who organize substance abuse education programs rather than serving as administrators of the sampling process. PMID:16558274

  15. 'Resilience thinking' in transport planning


    Wang, JYT


    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 "...

  16. Building Resilience in Children (United States)

    ... to succeed in life. That is why Kenneth Ginsburg, M.D., MS Ed, FAAP, a pediatrician specializing ... resilience in children, teens, and young adults. Dr. Ginsburg has identified seven “C”s of resilience, recognizing that “ ...

  17. Resiliant Space Systems Project (United States)

    National Aeronautics and Space Administration — The task goal is to develop and demonstrate an innovative software architecture, the “Resilient Spacecraft Executive”, that will enable highly-resilient...

  18. Developing the resilience typology

    DEFF Research Database (Denmark)

    Simonsen, Daniel Morten


    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....

  19. Resilience - A Concept (United States)


    Image designed by Diane Fleischer Resilience —A CONCEPT Col Dennis J. Rensel, USAF (Ret.) Resilience takes on many definitions and ideas depending...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...the assessment of the health of a network or system. The hypothesis is: resiliency is meaningful in the context of holistic assessments of

  20. 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)


    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.)

  1. 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.


    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

  2. Arctic species resilience

    DEFF Research Database (Denmark)

    Mortensen, Lars O.; Forchhammer, Mads C.; Jeppesen, Erik

    the predicted increase in climate variability. Whereas species may show relatively high phenological resilience to climate change per se, the resilience of systems may be more constrained by the inherent dependence through consumer-resource interactions across trophic levels. During the last 15 years...... and resources. This poster will present the conceptual framework for this project focusing on species resilience....

  3. Resilience among Military Youth (United States)

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


    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…

  4. 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


    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.

  5. 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)


    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

  6. Development of an Elliptical Trainer Physical Fitness Test (United States)


    rear-drive model elliptical trainer for placement in Navy gyms and ships. Despite the availability of the CT 9500 HR elliptical trainer for Navy...waiver for participation in the PRT, and were not on any chronic medications ( steroid inhalants or steroids , anti-inflammatory drugs). One individual was...Naval Region Southwest) to recruit from the general Navy population; (2) posting flyers in area gyms to recruit sailors who have experience using

  7. Athletic Trainers' Attitudes Toward Drug Screening of Intercollegiate Athletes


    Starkey, Chad; Abdenour, Thomas E.; Finnane, David


    Since the inception of NCAA-mandated drug screening in 1986, college athletic trainers have found themselves involved at various levels in institutional drug-screening programs. Several legal, moral, and ethical questions have been raised regarding the drug screening of college athletes, and studies have been conducted to rate athletes' attitudes toward this practice. We examined the responses of certified athletic trainers employed in college settings to ascertain their attitudes toward the ...

  8. An Onboard ISS Virtual Reality Trainer (United States)

    Miralles, Evelyn


    Prior to the retirement of the Space Shuttle, many exterior repairs on the International Space Station (ISS) were carried out by shuttle astronauts, trained on the ground and flown to the Station to perform these specific repairs. With the retirement of the shuttle, this is no longer an available option. As such, the need for ISS crew members to review scenarios while on flight, either for tasks they already trained for on the ground or for contingency operations has become a very critical issue. NASA astronauts prepare for Extra-Vehicular Activities (EVA) or Spacewalks through numerous training media, such as: self-study, part task training, underwater training in the Neutral Buoyancy Laboratory (NBL), hands-on hardware reviews and training at the Virtual Reality Laboratory (VRLab). In many situations, the time between the last session of a training and an EVA task might be 6 to 8 months. EVA tasks are critical for a mission and as time passes the crew members may lose proficiency on previously trained tasks and their options to refresh or learn a new skill while on flight are limited to reading training materials and watching videos. In addition, there is an increased need for unplanned contingency repairs to fix problems arising as the Station ages. In order to help the ISS crew members maintain EVA proficiency or train for contingency repairs during their mission, the Johnson Space Center's VRLab designed an immersive ISS Virtual Reality Trainer (VRT). The VRT incorporates a unique optical system that makes use of the already successful Dynamic On-board Ubiquitous Graphics (DOUG) software to assist crew members with procedure reviews and contingency EVAs while on board the Station. The need to train and re-train crew members for EVAs and contingency scenarios is crucial and extremely demanding. ISS crew members are now asked to perform EVA tasks for which they have not been trained and potentially have never seen before. The Virtual Reality Trainer (VRT

  9. 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)


    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.)

  10. Supervising athletic trainers' perceptions of professional socialization of graduate assistant athletic trainers in the collegiate setting. (United States)

    Thrasher, Ashley B; Walker, Stacy E; Hankemeier, Dorice A; Pitney, William A


    Many newly credentialed athletic trainers gain initial employment as graduate assistants (GAs) in the collegiate setting, yet their socialization into their role is unknown. Exploring the socialization process of GAs in the collegiate setting could provide insight into how that process occurs. To explore the professional socialization of GAs in the collegiate setting to determine how GAs are socialized and developed as athletic trainers. Qualitative study. Individual phone interviews. Athletic trainers (N = 21) who had supervised GAs in the collegiate setting for a minimum of 8 years (16 men [76%], 5 women [24%]; years of supervision experience = 14.6 ± 6.6). Data were collected via phone interviews, which were recorded and transcribed verbatim. Data were analyzed by a 4-person consensus team with a consensual qualitative-research design. The team independently coded the data and compared ideas until a consensus was reached, and a codebook was created. Trustworthiness was established through member checks and multianalyst triangulation. Four themes emerged: (1) role orientation, (2) professional development and support, (3) role expectations, and (4) success. Role orientation occurred both formally (eg, review of policies and procedures) and informally (eg, immediate role immersion). Professional development and support consisted of the supervisor mentoring and intervening when appropriate. Role expectations included decision-making ability, independent practice, and professionalism; however, supervisors often expected GAs to function as experienced, full-time staff. Success of the GAs depended on their adaptability and on the proper selection of GAs by supervisors. Supervisors socialize GAs into the collegiate setting by providing orientation, professional development, mentoring, and intervention when necessary. Supervisors are encouraged to use these socialization tactics to enhance the professional development of GAs in the collegiate setting.

  11. What makes an effective clinical trainer? (United States)

    Alsultan, Mohammed


    This study aims at identifying characteristics and behavioral patterns associated with the ideal tutor in different medical fields. This study is expected to answer two questions, first is effective supervision and how can this be determined? And secondly, what skills and qualities do effective supervisors need? An English limited search was performed in many databases including MEDLINE, BEI, and International ERIC for the last 20 years using many search items to identify characteristics cited in the literature as being important for effective clinical teaching. One hundred thirty two articles identified the review excluded literature relating to research supervision. Findings revealed that some of these investigations relied on the tutor's point of view, others on a resident's or a student's opinion or both. Descriptors for effective clinical teachers were categorized into three main classes: (a) teaching skills (i.e. well-prepared, practices evidence-based medicine and believes in its principles and applications, effective, accessible, and provides and accepts both positive and negative feedback), (b) personality (i.e. enthusiastic, respectable, sincere, confident, humanitarian, and compassionate), and (c) attitude (i.e. health advocate, good role-model, encouraging, non-judgmental, aware of learners' growth, well-groomed, and appropriately dressed). Other factors such as the trainer's health (i.e. professional, personal, and spiritual fulfillment) and his/her scholarly activities were also identified.

  12. Comparative survey of environmental health status of schools have health trainer and without health trainer in Bushehr province

    Directory of Open Access Journals (Sweden)

    Bahman Ramavandi


    Full Text Available Background: School, as a reliable place in student's education, has an important role in training. If health principles do not comply with in schools, students may be suffering from infectious diseases. Health trainer can be effective in improving school health. This study aimed to determine the effectiveness of health trainer on environmental health level of schools in Bushehr province. Material and Methods This study was a descriptive - analytic study. A total of 20 samples were selected from each of the elementary schools have and not have health trainer using the method of stratified random sampling in the Bushehr province in the year 91-92. Data collected by researcher direct observation and using an assessment form of school environmental health contains 30 questions in 9 different sections. The statistical method used to analyze and test questions in this study were the chi square and Fisher exact test. Results: Based on findings of this research, between the environment health situation in schools with and without health trainer in 19 cases of health variables the significant difference was observed. The statistical analysis showed significant differences between health status of toilets (p<0.005, drinking water taps and buffet (p<0.001, yard and corridors (p<0.01, and solid waste disposal (p<0.025 in schools with and without health trainer in the year 91-92. Conclusion: Overall, the results indicate that the presence of health trainers in schools can lead to improved health status of the school. The schools without health trainer had very poor health status this issue required further try of concerned authorities to employee health trainers in schools.

  13. 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)


    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

  14. Sources of practice knowledge among Australian fitness trainers. (United States)

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


    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.

  15. Medical physics aspects of the synchrotron radiation therapies: Microbeam radiation therapy (MRT) and synchrotron stereotactic radiotherapy (SSRT). (United States)

    Bräuer-Krisch, Elke; Adam, Jean-Francois; Alagoz, Enver; Bartzsch, Stefan; Crosbie, Jeff; DeWagter, Carlos; Dipuglia, Andrew; Donzelli, Mattia; Doran, Simon; Fournier, Pauline; Kalef-Ezra, John; Kock, Angela; Lerch, Michael; McErlean, Ciara; Oelfke, Uwe; Olko, Pawel; Petasecca, Marco; Povoli, Marco; Rosenfeld, Anatoly; Siegbahn, Erik A; Sporea, Dan; Stugu, Bjarne


    Stereotactic Synchrotron Radiotherapy (SSRT) and Microbeam Radiation Therapy (MRT) are both novel approaches to treat brain tumor and potentially other tumors using synchrotron radiation. Although the techniques differ by their principles, SSRT and MRT share certain common aspects with the possibility of combining their advantages in the future. For MRT, the technique uses highly collimated, quasi-parallel arrays of X-ray microbeams between 50 and 600 keV. Important features of highly brilliant Synchrotron sources are a very small beam divergence and an extremely high dose rate. The minimal beam divergence allows the insertion of so called Multi Slit Collimators (MSC) to produce spatially fractionated beams of typically ∼25-75 micron-wide microplanar beams separated by wider (100-400 microns center-to-center(ctc)) spaces with a very sharp penumbra. Peak entrance doses of several hundreds of Gy are extremely well tolerated by normal tissues and at the same time provide a higher therapeutic index for various tumor models in rodents. The hypothesis of a selective radio-vulnerability of the tumor vasculature versus normal blood vessels by MRT was recently more solidified. SSRT (Synchrotron Stereotactic Radiotherapy) is based on a local drug uptake of high-Z elements in tumors followed by stereotactic irradiation with 80 keV photons to enhance the dose deposition only within the tumor. With SSRT already in its clinical trial stage at the ESRF, most medical physics problems are already solved and the implemented solutions are briefly described, while the medical physics aspects in MRT will be discussed in more detail in this paper. Copyright © 2015. Published by Elsevier Ltd.

  16. Resilience in disaster research

    DEFF Research Database (Denmark)

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


    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....

  17. A 3-Dimensional Printed Ultrasound Probe Visuospatial Trainer. (United States)

    McKenna, Ryan T; Dove, Jesse C; Ratzlaff, Robert A; Diaz-Gomez, Jose L; Cox, Daniel J; Simon, Leslie V


    Training adult learners to use ultrasound in clinical practice relies on the ability of the learner to apply visuospatial concepts to the anatomy of the human body. We describe a visuospatial trainer that replicates the housing of an ultrasound transducer, through which a linear laser projects light in the same plane and orientation as the ultrasonic sound waves. We use this trainer in combination with a porcine heart dissection laboratory to teach bedside cardiac ultrasound and transthoracic echocardiography (TTE). Off-the-shelf components, including an on/off switch, a laser, and 2 ampere batteries are connected in series and placed inside the 3-dimensional (3D)-printed housing. The trainer's laser emission projects a red line that visually represents the ultrasound's field. Learners project the laser against a porcine or human heart in the orientation of the TTE window they wish to obtain and then dissect the heart in that plane, allowing for visualization of how grayscale images are obtained from 3D structures. Previous research has demonstrated that visuospatial aptitude is correlated with ultrasound procedural performance. We present this trainer and educational method as a specific training intervention that could enhance the visuospatial ability of the ultrasound learner. This visuospatial trainer and educational method present a novel process for enhancing learner understanding of 2-dimensional ultrasound images as they relate to 3D structures. Having a clear understanding of how images are generated in cross section may translate into more proficient adaptation of cardiac ultrasound and TTE.

  18. Evaluation of a novel high-fidelity epistaxis task trainer. (United States)

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


    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.

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

    International Nuclear Information System (INIS)

    Stater, R.G.


    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)

  20. Systemic resilience model

    International Nuclear Information System (INIS)

    Lundberg, Jonas; Johansson, Björn JE


    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

  1. The psychobiology of resilience. (United States)

    Stein, Dan J


    Although adverse environments are well known to be a risk factor for psychopathology, many individuals respond adaptively to such environments. There is growing interest in the underlying mechanisms involved in such resilience. Several cognitive-affective processes may be involved, and these may be mediated by particular neuronal circuits and neurochemical systems. This article summarizes some of the relevant work on the role of fear conditioning, reward processing, and social behavior in resilience. There is a growing body of data on how particular gene-environment interactions affect these processes, and thus underpin resilience. Ultimately, a better understanding of the mechanisms underpinning resilience may lead to novel interventions.

  2. Clinical value of kinematic MR imaging in the evaluation of patients with exacerbated pain in cervical spine motion; Stellenwert der kinematischen MRT der Halswirbelsaeule bei bewegungsabhaengigen Radikulopathien im Vergleich zur statischen MRT

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin; Brossmann, J.; Biederer, J.; Grimm, J.; Mohr, A.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie


    Objective: To assess the clinical value of kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms after provocative maneuvers at flexion, extension, axial rotation and coupled motion of the cervical spine. Methods: Thirty-five patients with cervical disc herniation or cervical spondylosis in whom symptoms were elicited at flexion, extension, axial rotation and coupled motion were studied inside a positioning device using T{sub 2}-weighted TSE, 2D-FLASH, and reformatted 3D DESS and 3D-FISP sequences. The images were evaluated for the size of disc herniations, the foraminal size and cervical cord displacement at provocative position compared with neutral position (0 ). In addition, the value of kinematic MR images were interpretated with regard to changes in the therapeutic procedure and intraoperative patient positioning. Results: Compared with the neutral position (0 ) a change in disc herniations was not found in any (0%) of the provocative positions. In five patients (14%) cervical cord displacement was noted at axial rotation. The foraminal size varied depending on the provocative position, increasing at flexion and decreasing at extension. Conclusion: Kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms at provocative maneuvers provides no additional information for the therapeutic decision-making process. (orig.) [German] Ziel: Bewertung des klinischen Stellenwertes der kinematischen MRT im Vergleich zur statischen MRT Untersuchung in der Abklaerung von Patienten mit bewegungsabhaengigen, zervikalen Radikulopathien. Methode: 35 Patienten mit bewegungsabhaengigen Zervikobrachialgien wurden innerhalb eines Positionsgestells in der Neutralnullstellung (0 ) sowie in der Schmerzprovokationsstellung unter Verwendung einer sagittalen T{sub 2}-gewichteten TSE Sequenz, einer axialen T{sub 2}-gewichteten 2D-FLASH Sequenz sowie einer schraeg-koronar rekonstruierten 3D-FISP- und 3D-DESS Sequenz bei 1,5 Tesla

  3. High-definition displays for realistic simulator and trainer systems (United States)

    Daniels, Reginald; Hopper, Darrel G.; Beyer, Steve; Peppler, Philipp W.


    Current flight simulators and trainers do not provide acceptable levels of visual display performance (performance that would allow ground based trainers to economically replace aircraft flying training) for many air-to-air and air-to- ground training scenarios. Ground training for pilots could be made significantly more realistic, allowing the ground-based curricula to be enlarged. The enhanced ground based training could then more readily augment actual aircraft flying (training) time. This paper presents the technology need and opportunity to create a new class of immersive simulator- trainer systems having some 210 million pixels characterized especially by a 20-20 visual acuity synthetic vision system having some 150 million pixels. The same new display technology base is needed for planned crew stations for uninhabited combat air vehicles (UCAV), advanced aircraft cockpits and mission crewstations, and for the space plane.

  4. Math, blackboard and the trainers of mathematics' teachers: interpreting relations

    Directory of Open Access Journals (Sweden)

    Ana Cláudia de Melo Sanches


    Full Text Available The relation of teachers with the blackboard and the practical skills teachers developed in the educational process was and still is subject little discussed in the setting of educational research, because for a long time, the blackboard was synonymous of traditional and bank education and without any possibility of transformation didactic. The objective this work is to show important results on the subject, from the voices of some trainers of mathematics' teachers of Para, since the research identified in the constitution of trainers, personal and collective influences about particular knowledge to how use the blackboard as tool mediation in the educational space. At times and in different discourses, the blackboard was regarded as "auxiliary memory" of the construction of mathematical reasoning, and, for some trainers, mathematics is essentially visual. Thus, this article aims to contribute to theoretical discussions from the action in the classroom

  5. National Athletic Trainers' Association Position Statement: Management of Sport Concussion (United States)

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


    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

  6. How Resilience Works. (United States)

    Coutu, Diane L.


    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)

  7. Multifractal resilience and viability (United States)

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


    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 -.

  8. Resilient health care

    DEFF Research Database (Denmark)

    Hollnagel, E.; Braithwaite, J.; Wears, R. L.

    . Whereas current safety approaches primarily aim to reduce or eliminate the number of things that go wrong, Resilient Health Care aims to increase and improve the number of things that go right. Just as the WHO argues that health is more than the absence of illness, so does Resilient Health Care argue...... rights reserved....

  9. 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


    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.

  10. Resilience in disaster research

    DEFF Research Database (Denmark)

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


    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...

  11. Cluster Decline and Resilience

    DEFF Research Database (Denmark)

    Østergaard, Christian Richter; Park, Eun Kyung

    -2011. Our longitudinal study reveals that technological lock-in and exit of key firms have contributed to impairment of the cluster’s resilience in adapting to disruptions. Entrepreneurship has a positive effect on cluster resilience, while multinational companies have contradicting effects by bringing...

  12. The Resilient Leader (United States)

    Allison, Elle


    School leaders currently face so many challenges--some as basic as a lack of money to hire enough teachers--that they know they need to increase their resilience. According to Allison, who coaches school leaders, strong leaders know how important maintaining resilience is. They recognize when their reserves of hope--and those of their…

  13. From Risk to Resilience

    DEFF Research Database (Denmark)

    Dahlberg, Rasmus

    This thesis investigates unpredictability in contemporary disaster and emergency management. The thesis traces the shift from risk thinking towards the resilience approach that has recently characterized the field. It asks how resilience manifests itself in practice and discusses how to incorporate...... this approach into preparedness planning to improve the ability of socio-technological systems to cope with unexpected disruptions. Those working in the field understand resilience as a broad umbrella term linked to risk thinking and concerned with flexible systems that are able to absorb and adapt...... resilience and complexity discourses in an attempt to conjoin the two concepts. This broad discussion leads into a case study of resilience thinking in contemporary disaster and emergency management: preparedness planning for long-term disruptions of the Øresund Bridge between Denmark and Sweden. Through...

  14. Zoogeomorphology and resilience theory (United States)

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


    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.

  15. Teacher Trainers' Beliefs about Feedback on Teaching Practice: Negotiating the Tensions between Authoritativeness and Dialogic Space (United States)

    Louw, Stephen; Todd, Richard Watson; Jimarkon, Pattamawan


    Contradictory tensions are apparent during the feedback given to pre-service English language teachers by trainers following their practice teaching. Trainers' beliefs may serve as a resource in dealing with these conflicting tensions. Trainers' beliefs about the feedback they provide during teaching practice conferences were elicited, and…

  16. TRAINER: Computer Assisted Learning and Practice for Users of DIALOG/ORBIT. Final Report. (United States)

    Caruso, Elaine

    Trainee development, TRAINER programs, and dissemination strategies are treated in this summary of the TRAINER computer assisted learning program for scientists and other professionals who wish to do literature searches using online services. A discussion of TRAINER's rationale, design, constraints, and differing institutional implementations…

  17. 21 CFR 874.3320 - Group hearing aid or group auditory trainer. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Group hearing aid or group auditory trainer. 874... hearing aid or group auditory trainer. (a) Identification. A group hearing aid or group auditory trainer is a hearing aid that is intended for use in communicating simultaneously with one or more listeners...

  18. 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.


    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

  19. Multiparametric prostate MRI for follow-up monitoring after radiation therapy; Multiparametrische MRT der Prostata zum Therapiemonitoring nach Strahlentherapie

    Energy Technology Data Exchange (ETDEWEB)

    Weidner, A.M.; Dinter, D.J.; Bohrer, M.; Sertdemir, M.; Hausmann, D.; Wenz, F.; Schoenberg, S.O. [Universitaetsmedizin Mannheim, Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Institut fuer Klinische Radiologie und Nuklearmedizin, Mannheim (Germany)


    Radiation therapy is a therapeutic option with curative intent for patients with prostate cancer. Monitoring of prostate-specific antigen (PSA) values is the current standard of care in the follow-up. Imaging is recommended only for symptomatic patients and/or for further therapeutic options. For detection of local recurrence magnetic resonance imaging (MRI) of the prostate is acknowledged as the method of choice. Good results for primary diagnosis were found especially in combination with functional techniques, whereas in recurrent prostate cancer only few studies with heterogeneous study design are available for prostate MRI. Furthermore, changes in different MRI modalities due to radiation therapy have been insufficiently investigated to date. As the initial results were promising prostate MRI and available therapeutic options for detection of local recurrence should be considered in patients with increased PSA. (orig.) [German] Fuer Patienten mit Prostatakarzinom stellt die Radiatio eine potenziell kurative lokale Therapieoption dar. Im Rahmen der Nachsorge nach lokal kurativ intendierter Therapie wird aktuell der Verlauf des PSA-Werts (PSA prostataspezifisches Antigen) kontrolliert, der Einsatz bildgebender Verfahren wird lediglich bei symptomatischen Patienten und/oder zur Planung einer Salvagetherapie empfohlen. Die MRT der Prostata stellt derzeit die Methode der Wahl zur lokalen Rezidivdiagnostik dar. Insbesondere in Verbindung mit funktionellen Untersuchungstechniken zeigen Studien gute Ergebnisse in der Primaerdiagnostik. Zum Einsatz der MRT der Prostata in der Rezidivsituation wurden bisher nur wenige Studien mit heterogenem Studiendesign publiziert. Auch die in der MRT nach Bestrahlung sichtbaren Veraenderungen in den unterschiedlichen Modalitaeten sind noch wenig evaluiert. Da die ersten Studienergebnisse auch bei Patienten nach Radiatio viel versprechend sind, sollte bei unklarem PSA-Anstieg und vorhandener Therapieoption eine MRT der Prostata zur

  20. 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)


    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.)

  1. 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)


    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.)

  2. 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)


    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.)

  3. Designing Training Programmes for EIU and ESD: A Trainer's Guide (United States)

    UNESCO Bangkok, 2006


    The training guide is based on a TOT (Training of Trainer) workshop conducted in September 2005 in Chiangmai, Thailand jointly by Asia Pacific Centre of Education for International Understanding (APCEIU) and UNESCO's Asia Pacific Programme of Educational Innovation for Development (APEID). The publication provides a comprehensive guide to trainers…

  4. 24 CFR 3286.307 - Process for obtaining trainer's qualification. (United States)


    ..., including the dates and type of such employment. A trainer who is licensed, or otherwise certified, to... training provided in accordance with this subpart D will meet the curriculum requirements established in... confirms that an applicant has met the experience and curriculum requirements in this section, HUD will...

  5. In the Trainer's Voice: A Study of Training Transfer Practices (United States)

    Hutchins, Holly M.


    Data were gathered from members of a large professional training organization regarding their practices for supporting training transfer. Transfer factor categories grounded in the literature were used to code the data using content analysis procedures. Commensurate with the transfer literature, results suggest that trainers reported strategies…

  6. A Comparison of Three Models of Ellipticdal Trainer (United States)


    Medicine and Science in Sports and Exercise , 31...on the elliptical trainer compared to the treadmill. Medicine and Science in Sports and Exercise , 31, S158. Popper, K. R. (1959). The logic of...comparison to treadmill walking and running, stationary cycling, and stepping. Medicine and Science in Sports and Exercise , 30, S168. Rogosa, D.

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


    Objective  To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Background  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. Recommendations  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. PMID:26381473

  8. Intelligent Virtual Agents as Language Trainers Facilitate Multilingualism

    Directory of Open Access Journals (Sweden)

    Manuela eMacedonia


    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.

  9. Pindar's Tenth Olympian and athlete-trainer pederasty. (United States)

    Hubbard, Thomas


    The comparison of the adolescent boxer Hagesidamus and his trainer Ilas to Patroclus and Achilles in Pindar's Olympian 10.16-21 and the subsequent comparison of Hagesidamus to Ganymede in Olympian 10.99-105 suggest that the relationship was in some sense pederastic, particularly in the wake of Aeschylus' treatment of Achilles and Patroclus in these terms in Myrmidons. This possibility motivates a broader examination of the evidence for such relationships in fifth-century Greece. There is no doubt that the palaestra was a central locus for the formation of pederastic liaisons and that athletic nudity was integral to the esthetic construction of adolescent beauty. There is also no doubt that the trainer's position afforded him regular intimacy and close physical contact with boys; several Hellenistic texts take for granted the erotic opportunities connected with the position. The Solonian law presuming to protect pupils from such relationships, attested in Aeschines, was probably a late fifth-century development in reaction to their common occurrence in earlier generations. Evidence also exists for lovers acting as financial backers to boy athletes or as informal trainers. Some of the most intriguing evidence for the conflation of the trainer's and lover's roles can be found in red-figure vase painting of the late sixth and fifth centuries.

  10. Practice until you can preach anything: The Presentation Trainer

    NARCIS (Netherlands)

    Schneider, Jan


    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

  11. Development Aspects of a Robotised Gait Trainer for Neurological Rehabilitation

    National Research Council Canada - National Science Library

    Schmidt, H


    ... of constructing a sensorised robot gait trainer is under way. The aim of this project is to build a robotic device which enables the therapist to let the machine move the patients feet, fixed on two footplates, on programmable foot trajectories (e.g...

  12. Management of Cerebral Concussion in Sports: The Athletic Trainer's Perspective. (United States)

    Oliaro, Scott; Anderson, Scott; Hooker, Dan


    Presents a new approach in the evaluation and management of concussions from the athletic trainer's perspective. This quantifiable assessment technique provides more information on which return-to-play decisions can be made based on the athlete's symptoms and performance on objective tests. It can be used during initial sideline examinations as…

  13. Teacher Resilience: Theorizing Resilience and Poverty (United States)

    Ebersöhn, Liesel


    In this article, I hope to provide some novel insights into teacher resilience and poverty on the basis of ten-year long-term ethnographic participatory reflection and action data obtained from teachers (n?=?87) in rural (n?=?6) and urban (n?=?8) schools (n?=?14, high schools?=?4, primary schools?=?10) in three South African provinces. In…

  14. Foundations of resilience thinking. (United States)

    Curtin, Charles G; Parker, Jessica P


    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.

  15. 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)


    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

  16. Aorta cross-section calculation and 3D visualization from CT or MRT data using VRML (United States)

    Grabner, Guenther; Modritsch, Robert; Stiegmaier, Wolfgang; Grasser, Simon; Klinger, Thomas


    Quantification of vessel diameters of artherosclerotic or congenital stenosis is very important for the diagnosis of vascular diseases. The aorta extraction and cross-section calculation is a software-based application that offers a three-dimensional, platform-independent, colorized visualization of the extracted aorta with augmented reality information of MRT or CT datasets. This project is based on different types of specialized image processing algorithms, dynamical particle filtering and complex mathematical equations. From this three-dimensional model a calculation of minimal cross sections is performed. In user specified distances, the aorta is cut in differently defined directions which are created through vectors with varying length. The extracted aorta and the derived minimal cross-sections are then rendered with the marching cube algorithm and represented together in a three-dimensional virtual reality with a very high degree of immersion. The aim of this study was to develop an imaging software that delivers cardiologists the possibility of (i) furnishing fast vascular diagnosis, (ii) getting precise diameter information, (iii) being able to process exact, local stenosis detection (iv) having permanent data storing and easy access to former datasets, and (v) reliable documentation of results in form of tables and graphical printouts.

  17. Toward a digital resilience

    Directory of Open Access Journals (Sweden)

    Dawn J. Wright


    Full Text Available Abstract As we contend with human impacts on the biosphere, there is rightfully a great emphasis now on community adaptation and resilience to climate change. Recent innovations in information technologies and analyses are helping communities to become more resilient. However, not often discussed in this vein is a path toward digital resilience. If mapping and information tools are to help communities, it stands to reason that they must be resilient themselves, as well as the data that they are based on. In other words, digital tools can help make communities resilient by providing data, evidence-based advice on community decisions, etc., but the resilience of the tools themselves can also be an issue. Digital resilience means that to the greatest extent possible, data and tools should be freely accessible, interchangeable, operational, of high quality, and up-to-date so that they can help give rise to the resilience of communities or other entities using them. Given the speed at which humans are altering the biosphere, the usefulness and effectiveness of these technologies must keep pace. This article reviews and recommends three fundamental digital practices, particularly from the standpoint of geospatial data and for community resilience and policy-making. These are: (1 create and implement a culture that consistently shares not only data, but workflows and use cases with the data, especially within maps and geographic information systems or GIS; (2 use maps and other visuals to tell compelling stories that many different kinds of audiences will understand and remember; and (3 be more open to different kinds of partnerships to reduce project costs, yield better results, and foster public awareness and behavioral change.

  18. Perawatan Pergeseran Mandibula dan Kliking Menggunakan Teknik Edgewise dan Trainer

    Directory of Open Access Journals (Sweden)

    Rully Utami


    Full Text Available Kasus ini terjadi pada perempuan usia 22 tahun yang bersedia dipublikasikan untuk kepentingan  ilmu pengetahuan. Keluhan utama mandibula dan dagunya bergeser ke kanan, gigitan terbuka posterior dan bunyi click di persendian temporomandibular. Diagnosis pasien adalah maloklusi Angle kelas III tipe dento skeletal, pergeseran garis tengah mandibula dan dagu ke kanan, gigitan terbuka posterior dan clicking pada sendi temporomandibular. Perawatan dilakukan dengan teknik Edgewise dan trainer. Leveling dan unraveling dilakukan menggunakan kawat stainless steel bulat diameter 0,014 mm dengan multiloop. Trainer digunakan untuk koreksi pergeseran mandibula. Perawatan dilakukan selama 11 bulan, dan menunjukkan hasil hubungan molar pertama kanan menjadi kelas I. Overjet meningkat dari 0,1 mm menjadi 2 mm, overbite meningkat dari 0,2 mm menjadi 2,57 mm, garis tengah mandibula yang semula bergeser ke kanan 4,38 mm menjadi 2,53 mm, gigitan terbuka posterior dan clicking telah terkoreksi. Compromised Treatment of Class III Malocclusion with Mandibular Shifting, Posterior Openbite and Clicking Using Edgewise Technique and Trainer In Adult. This case report described the treatment of an adult female 22 years old who complained that her mandibula and chin shift to the right, posterior openbite and clicking. The patient diagnosed class III molar relationship, skeletal class III malocclusion, mandibular midline and chin shift to the right, posterior openbite and clicking on temporomandibular joint. Treatment was conducted using combination between  Edgewise Technique and trainer.  Leveling and unraveling are achieved by round stainless steel archwire 0,014 mm with multiloop. Trainer used to corrected the mandibular shifting. Result after 1 years treatment showed that the right molar relationship became class I, overjet increased  from 0,1 mm to 2 mm, overbite increased  from 0,2 mm to 2,57 mm, mandibular midline shifting decresed from 4,38 mm to 2,53 mm

  19. Athletic trainers' barriers to maintaining professional commitment in the collegiate setting. (United States)

    Mazerolle, Stephanie M; Eason, Christianne M; Pitney, William A


    Professional commitment simply describes one's obligation to his or her work. For athletic trainers (ATs), the demanding work environment and job expectations may affect their characterization of professional commitment. Our breadth of knowledge regarding professional commitment within athletic training is narrow. To evaluate the professional commitment of ATs in the collegiate setting. Qualitative study. Collegiate. Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. Online journaling via QuestionPro was completed by all participants. Multiple-analyst triangulation and peer review were conducted for data credibility. Analysis followed a general inductive method. Four themes speak to the factors that negatively affect ATs' professional enthusiasm and commitment: (1) life stage, (2) work overload, (3) organizational climate, and (4) human resources. The latter 3 speak to the effect the workplace can have on ATs' professional commitment, and the first speaks to the effect outside responsibilities can have. Our results suggest that several of the factors that negatively influence the professional commitment of collegiate ATs are modifiable organizational components. Developing resiliency strategies at the individual and organizational levels may help to facilitate improved professional commitment for the AT.

  20. Athletic Trainers' Barriers to Maintaining Professional Commitment in the Collegiate Setting (United States)

    Mazerolle, Stephanie M.; Eason, Christianne M.; Pitney, William A.


    Context: Professional commitment simply describes one's obligation to his or her work. For athletic trainers (ATs), the demanding work environment and job expectations may affect their characterization of professional commitment. Our breadth of knowledge regarding professional commitment within athletic training is narrow. Objective: To evaluate the professional commitment of ATs in the collegiate setting. Design: Qualitative study. Setting: Collegiate. Patients or Other Participants: Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. Data Collection and Analysis: Online journaling via QuestionPro was completed by all participants. Multiple-analyst triangulation and peer review were conducted for data credibility. Analysis followed a general inductive method. Results: Four themes speak to the factors that negatively affect ATs' professional enthusiasm and commitment: (1) life stage, (2) work overload, (3) organizational climate, and (4) human resources. The latter 3 speak to the effect the workplace can have on ATs' professional commitment, and the first speaks to the effect outside responsibilities can have. Conclusions: Our results suggest that several of the factors that negatively influence the professional commitment of collegiate ATs are modifiable organizational components. Developing resiliency strategies at the individual and organizational levels may help to facilitate improved professional commitment for the AT. PMID:25761133

  1. [Certification of therapy institutions, obesity trainers, and obesity trainer academies by the German Working Group on Obesity in Children and Adolescents (AGA)]. (United States)

    Holl, R W; Kersting, M; Kromeyer-Hauschild, K; Reinehr, T; Schäfer, A; Tiedjen, U; Widhalm, K


    There is a vast choice of behavioral therapy for obesity in children and adolescents, with wide differences in quality. In order to provide orientation for families, physicians, and health insurance companies, the German Working Group on Obesity in Children and Adolescents (AGA), which is affiliated with the German Obesity Society (DAG) and the German Pediatric Society (DGKJ), offers to certify institutions providing patient education programs for obese children and adolescents, obesity trainers, and academies for obesity trainers. Currently, 60 institutions offer obesity care, while 81 obesity trainers and 8 trainer academies are certified. This article summarizes requirements for certification and preliminary experience.

  2. Resilience of the IMS system

    DEFF Research Database (Denmark)

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


    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....

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

    Directory of Open Access Journals (Sweden)

    Baumgartner L.


    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.

  4. Formal aspects of resilience

    Directory of Open Access Journals (Sweden)

    Diana-Maria Drigă


    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.

  5. Resilient Diffusive Clouds (United States)


    RESILIENT DIFFUSIVE CLOUDS TRUSTEES OF DARTMOUTH COLLEGE FEBRUARY 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC...To) SEP 2011 – SEP 2016 4. TITLE AND SUBTITLE RESILIENT DIFFUSIVE CLOUDS 5a. CONTRACT NUMBER FA8750-11-2-0257 5b. GRANT NUMBER N/A 5c. PROGRAM...diversified virtual machines. The concepts lead to a view of cloud computing in which vulnerabilities are different at every host, attackers cannot

  6. Resilience and reworking practices

    DEFF Research Database (Denmark)

    Hauge, Mads Martinus; Fold, Niels


    of this article is to shed light on the agency of individual workers involved in rapid industrialization processes. In this endeavor we draw inspiration from recent contributions that have integrated Cindi Katz's threefold categorization of agency as reworking, resilience and resistance. In combination...... and resilience can be conceptualized as transformative trajectories - workers’ situated knowledge and practices evolve and change over time and is conditioned by the specific labor market contexts through which the individual moves....

  7. 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)


    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

  8. Hydro-MRI for abdominal diagnostics in children; Hydro-MRT in der Darmdiagnostik bei Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Kern, A.; Schunk, K.; Oberholzer, K.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Kessler, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Kinderchirurgie


    A clinical evaluation of hydro-MRI as an alternative method to barium studies in children with abdominal pain of unknown origin is presented. Patients and Methods: 20 children with abdominal pain of unknown origin aged from 9 - 16 years were examined after oral bowel opacification using 1000 ml of 2.5% mannitol solution with a 1.0T MRI system. The investigation was done in 2 planes (coronal and axial) under breath-hold conditions. Imaging procedures included various sequences (T2W HASTE + FS, contrast-enhanced T1W FLASH FS). Suspicious findings in bowel segments and extra-intestinal changes were assessed. Results: In 21/24 examinations the small bowel was completely visualized, in 15/24 cases colon segments were identified. An accurate assessment of the terminal ileum was not possible in 3/24 procedures. Breathing artefacts occurred in 3/24 examinations. Signs of Crohn's disease were found in 4 examinations, inflammatory changes of the ileum were detected in 3 cases. Inflammation of the colon was demonstrated in 2 children. Furthermore, pathological findings included constipation in one child and inflammation of the ileo-colic and mesenterial lymph nodes were found in another child. Extra-intestinal changes in 3 children were caused by ovarian cysts, and in one case by pleural effusion. In 4 examinations we detected ascites in the absence of other pathological findings. In 5 children there was no pathological correlation in the bowel or extra-intestinal region for the complaints. The children tolerated the hydro-MRI very well. There were no side effects using oral mannitol. (orig.) [German] Ziel: Klinische Evaluation der Hydro-MRT bei Kindern mit unklarer abdomineller Symptomatik als alternative Methode zur fraktionierten Magen-Darm-Passage. Patienten und Methoden: 20 Kinder und Jugendliche im Alter von 9 bis 16 Jahren mit unklaren abdominellen Beschwerden bzw. mit Verdacht auf eine chronisch entzuendliche Darmerkrankung wurden nach einer oralen

  9. Clinical MR at 3 Telsa: Current Status; Klinische MRT bei 3 Tesla: Aktueller Stand

    Energy Technology Data Exchange (ETDEWEB)

    Baudendistel, K.T. [Department of Radiology, College of Medicine, Ohio State University, Columbus (United States); Division of Imaging Research, Department of Radiology, Ohio State University, 1654 Upham Drive, 646, Means Hall, Columbus (United States); Heverhagen, J.T.; Knopp, M.V. [Department of Radiology, College of Medicine, Ohio State University, Columbus (United States)


    Clinical MRI is mostly performed at field strengths up to 1.5 Tesla (T). Recently, approved clinical whole-body MR-systems with a field strength of 3 T became available. Its installation base is more rapidly growing than anticipated. While siting requirements and operation of these systems do not differ substantially from systems with lower field strength, there are differences in practical applications. Imaging applications can use the gain in signal-to-noise for increased spatial resolution or gain in speed. This comes at a trade off in increased sensitivity to field inhomogeneities and changes in relaxation times, which lead to changes in image contrast. The benefit of high field for spectroscopy consists in increased signal-to-noise-ratio and improvement in frequency resolution. The increase in energy deposition necessitates the use of special strategies to reduce the specific absorption rate (SAR). This paper summarizes the current state of MR at 3 T. (orig.) [German] Waehrend die klinische MRT zumeist bei Feldstaerken von bis zu 1,5 Tesla (T) durchgefuehrt wird, sind seit juengster Zeit zugelassene klinische 3-T-Ganzkoerper-MR-Systeme verfuegbar. Deren Verbreitung waechst schneller als erwartet. Waehrend sich die Aufstellungsbeduerfnisse und Handhabung dieser Systeme nicht mehr wesentlich von denen mit kleineren Feldstaerken unterscheidet, bestehen jedoch Unterschiede im praktischen Einsatz. Fuer die Bildgebung bei 3 T laesst sich das erhoehte Signal-zu-Rausch-Verhaeltnis (SNR) sowohl zu verbesserter raeumlicher Aufloesung oder schnellerer Bildaufnahme nutzen. Nachteilig fuehrt dies zu einer Erhoehung der Empfindlichkeit auf Feldinhomogenitaeten und veraenderten Relaxationszeiten, die zu Kontrastaenderungen fuehren. Fuer die MR-Spektroskopie liegt der Vorteil in der Erhoehung des SNR und der spektralen Aufloesung. Der Anstieg der pro Hochfrequenzanregung deponierten Energie macht darueber hinaus die Anwendung spezieller Strategien zur Reduktion der

  10. In-depth investigation of escalator riding accidents in heavy capacity MRT stations. (United States)

    Chi, Chia-Fen; Chang, Tin-Chang; Tsou, Chi-Lin


    In 2000, the accident rate for escalator riding was about 0.815 accidents per million passenger trips through Taipei Metro Rapid Transit (MRT) heavy capacity stations. In order to reduce the probability and severity of escalator riding accidents and enhance the safety of passengers, the Drury and Brill model [Drury, C.G., Brill, M., 1983. Human factors in consumer product accident investigation. Hum. Factors 25 (3), 329-342] for in-depth investigation was adopted to analyze the 194 escalator riding accidents in terms of victim, task, product and environment. Prevention measures have been developed based on the major causes of accidents and other related contributing factors. The results from the analysis indicated that the majority of the escalator riding accidents was caused by passengers' carrying out other tasks (38 cases, including carrying luggage 24 cases, looking after accompany persons 9 cases, and 5 others), loss of balance (26 cases, 13.4%), not holding the handrail (20 cases, 10.3%), unhealthy passengers (18 cases, 9.3%), followed by people struck by other passenger (16 cases, 8.2%). For female passengers aged 15-64 years, their rushing for trains accidents could have been prevented by wearing safer footwear or by appropriate signing being provided indicating the location and traveling direction of escalators. Female passengers aged 65 years and above whose accidents were caused by loss of balance, should be encouraged to take the elevator instead. To prevent entrapment injuries, following a stricter design code can be most effective. Further in-depth accident investigation is suggested to cover the activity of the victim prior to the accident, any involved product, the location of the accident on the escalator, any medical treatment, what went wrong, opinion of the respondent on the causes of the accident, and personal characteristics of the passengers. Also, management must trade off productivity and safety appropriately to prevent "Organizational

  11. 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

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    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


    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

  12. Personal Trainer Perceptions of Providing Nutrition Care to Clients: A Qualitative Exploration. (United States)

    Barnes, Katelyn; Ball, Lauren; Desbrow, Ben


    Personal trainers are well placed to provide basic nutrition care in line with national dietary guidelines. However, many personal trainers provide nutrition care beyond their scope of practice and this has been identified as a major industry risk due to a perceived lack of competence in nutrition. This paper explores the context in which personal trainers provide nutrition care, by understanding personal trainers' perceptions of nutrition care in relation to their role and scope of practice. Semistructured telephone interviews were conducted with 15 personal trainers working within Australia. Thematic analysis was used to identify key themes. All personal trainers reported to provide nutrition care and reported that nutrition care was an important component of their role. Despite this, many were unaware or uncertain of the scope of practice for personal trainers. Some personal trainers reported a gap between the nutrition knowledge they received in their formal education, and the knowledge they needed to optimally support their clients to adopt healthy dietary behaviors. Overall, the personal training context is likely to be conducive to providing nutrition care. Despite concerns about competence personal trainers have not modified their nutrition care practices. To ensure personal trainers provide nutrition care in a safe and effective manner, greater enforcement of the scope of practice is required as well as clear nutrition competencies or standards to be developed during training.


    Directory of Open Access Journals (Sweden)

    Miroslava Dinkova


    Full Text Available Purpose. The purpose of this study is to follow-up the biometrical and skeletal vertical changes in patients with deep overbite in mixed dentition after a functional orthodontic treatment with Trainer System™ is conducted. Material and Methods. 32 patients (20 girls and 12 boys with deep overbite in mixed dentition were followed-up. An orthodontic treatment with Trainer System™, including Trainer for kids (T4K-blue, T4K-red and Myobrace was conducted. The recommended time for wearing the appliances was 8–12 hours, mostly at the night and 1–2 hours total time during the day. All the patients were photo-documented. Impressions, panoramic radiographs and lateral cephalograms were taken before the beginning of the treatment and at the end of every single step in relation with every change of appliances. Comparative biometrical and cephalometric analyses were made. The data was statistically processed. Results. The comparative biometrical analyses showed reduction of overbite with 2.5–3.5 mm after the end of the orthodontic treatment. 62% of cases showed relapse from 0.5 to 1mm. After the end of the orthodontic treatment an inclination of upper and lower incisors and changes with M/SN, М/F, ANB, SNA, SNB values were established. Conclusions. If untreated during the growing period, deep overbite leads to serious functional disorders, pathologic abrasion and myo-articular problems. Myofunctional Trainer System™ is successfully applied in the management of deep overbite in growing kids with early mixed dentition. The design of appliances helps the right positioning of tongue and jaws, removes bad habits, harmonizes tooth arches, corrects the vertical problems.

  14. Blended learning in CME: the perception of GP trainers. (United States)

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


    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.

  15. The Organizational Climate in Collegiate Athletics: An Athletic Trainer's Perspective. (United States)

    Mazerolle, Stephanie M; Eason, Christianne M


      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.

  16. Resilience Indicator Summaries and Resilience Scores CNMI Excel database (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...

  17. Resilience Indicator Summaries and Resilience Scores CNMI JPEG Maps (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...

  18. Stress cine MRI for detection of coronary artery disease; Stress-Cine-MRT zur Primaeridagnostik der koronaren Herzkrankheit

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, T.; Hofer, U.; Schild, H. [Bonn Univ. (Germany). Radiologische Klinik; Omran, H. [Medizinische Universitaetsklinik II Bonn (Germany)


    mainly be explained by the better image quality with sharp delineation of the endocardial and epicardial borders. Currently, stress MRI is already a realistic clinical alternative for the non-invasive assessment of CAD in patients with impaired image quality in echocardiography. (orig.) [German] Belastungsuntersuchungen sind einer der wesentlichen Pfeiler der nicht-invasiven Diagnostik der koronaren Herzkrankheit (KHK). Die Stress-Cine-Magnetresonanztomographie (Stress-MRT) beruht wie die Stressechokardiographie auf dem direkten Nachweis ischaemieinduzierter Wandbewegungsstoerungen. Ihr Einsatz bei kardialen Belastungsuntersuchungen wurde bisher vor allem durch die langen Untersuchungszeiten und die limitierten Ueberwachungsmoeglichkeiten der Patienten eingeschraenkt. Erst seit kurzem wurden durch technische Weiterentwicklungen (insbesondere ultraschnelle k-Raum-segmentierte Sequenzen) die wesentlichen Rahmenbedingungen fuer eine klinisch praktikable kardiale MRT-Belastungsdiagnostik geschaffen. Als Stress-Induktoren koennen physikalische (Fahrradergometrie) und pharmakologische Belastungsverfahren ({beta}{sub 1}-Mimetika [Dobutamin] oder Vasodilatatoren [Dipyridamol, Adenosin]) eingesetzt werden. Insbesondere seit der Etablierung von Hochdosis-Protokollen mit fakultativer Atropingabe wird die Belastung mit Dobutamin bei der Stress-MRT zum Nachweis einer KHK (Sensitivitaet: 83 - 87%; Spezifitaet: 83 - 86%) von den meisten Arbeitsgruppen favorisiert. Schwerere Komplikationen treten in 0,25% der Faelle auf. Im direkten Vergleich zeigte sich die Dobutamin-Stress-MRT aufgrund der besseren Bildqualitaet der Dobutamin-Stressechokardiographie ueberlegen (Sensitivitaet: 86,2% vs. 74,3%, p < 0,05; Spezifitaet: 85,7% vs. 69,8%, p < 0,05). Die Stress-MRT ist bereits zum jetzigen Zeitpunkt eine realistische - in der Routinediagnostik anwendbare - Alternative zur Stressechokardiographie. Vom Einsatz der Stress-MRT profitieren zur Zeit v.a. Patienten, bei denen aufgrund grundsaetzlich

  19. Diagnostic problem solving in male collegiate athletic trainers. (United States)

    Gardin, Fredrick A; Mensch, James M


    Knowledge and experience may be important factors for understanding expertise based upon a clinician's ability to select and execute an appropriate response as a clinician during injury evaluation. To describe how collegiate male certified athletic trainers represent injury-evaluation domain knowledge during a situational interview using a think-aloud protocol. Qualitative. National Collegiate Athletic Association Division I and II colleges in National Athletic Trainers' Association District 3. A total of 20 male certified athletic trainers (n = 10 with less than 2 years of experience in the college setting and n = 10 with at least 10 years of experience in the college setting) participated in the study. We collected data using a situational interview and questionnaire. Data were transcribed, reduced to meaningful units, and analyzed using verbal analysis procedures. Member checks, triangulation of data, field journaling, and peer-debriefing techniques were used to ensure trustworthiness of the data. Knowledge concepts were enumerated to describe differences between experts and novices. Compared with novices, experts had more knowledge concepts of patient history and predictions and fewer concepts of situation appraisal. Expertise in athletic training shares traits with other areas in health care. Athletic training education and professional development may benefit from our understanding which cognitive processes differentiate expert practice. Future investigators should attempt to describe other settings and study diagnostic problem solving in a natural environment.


    Directory of Open Access Journals (Sweden)

    Laurizete Ferragut Passos


    Full Text Available The research assumes that the presence of a renewed faculty has been working in the Teaching Degree and Pedagogy courses, specific contexts of initial teacher training. These training teachers are starting a career in higher education and part of them carries significant experience as a teacher of basic education. Knowing what constitutes the professional development of this trainer, beginner in a segment, higher education, and experienced in another, basic education, and reflect on the perception of their performance and their role as trainers of future teachers constituted the research objectives. For this article we will analyze the interview data from a beginning teacher in the Bachelor's Degree. The text is provided by the studies by Marcelo Garcia (1999; Day (2001; Wedge (2005; Imbernon (2009, 2011; Vaillant and Marcelo (2012; among others. The results show that the teacher realizes the process of their professional development to be always in progress, non-linear, crossed by different factors, with a permanent feeling of incompleteness; recalls the importance of the work period in basic education schools for their professional development and performance as a teacher trainer.

  1. Intelligent virtual agents as language trainers facilitate multilingualism. (United States)

    Macedonia, Manuela; Groher, Iris; Roithmayr, Friedrich


    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.

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

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


    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

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

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


    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.

  4. Advancing empirical resilience research. (United States)

    Kalisch, Raffael; Müller, Marianne B; Tüscher, Oliver


    We are delighted by the broad, intense, and fruitful discussion in reaction to our target article. A major point we take from the many comments is a prevailing feeling in the research community that we need significantly and urgently to advance resilience research, both by sharpening concepts and theories and by conducting empirical studies at a much larger scale and with a much more extended and sophisticated methodological arsenal than is the case currently. This advancement can be achieved only in a concerted international collaborative effort. In our response, we try to argue that an explicitly atheoretical, purely observational definition of resilience and a transdiagnostic, quantitative study framework can provide a suitable basis for empirically testing different competing resilience theories (sects. R1, R2, R6, R7). We are confident that it should be possible to unite resilience researchers from different schools, including from sociology and social psychology, behind such a pragmatic and theoretically neutral research strategy. In sections R3 to R5, we further specify and explain the positive appraisal style theory of resilience (PASTOR). We defend PASTOR as a comparatively parsimonious and translational theory that makes sufficiently concrete predictions to be evaluated empirically.

  5. 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)


    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

  6. Functional MRI of the pelvic floor. Method and references values; Funktionelle MRT des Beckenbodens. Methodik und Referenzwerte

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, A.; Sprenger, D.; Reiser, M. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Radiologische Diagnostik; Janssen, U.; Anthuber, C. [Klinikum Grosshadern, Muenchen (Germany). Frauenklinik


    Purpose. Functional cine MRI of the pelvic floor is a yet another modality in addition to various radiological fluoroscopic techniques. This article describes our own method in view of the recent literatur and provides morphometric reference values. Material and method. We examined 20 nulliparous women (range of age: 25-51 years) with normal findings in the gynecological and urodynamic examination. Functional cine MRI was performed on a 1.5 Tesla equipment after opacification of the vagina and rectum. We used a T2-weighted gradient-echo sequence (True-FISP) to determine the position of the reference organs at rest and during straining/defecation. Two different reference lines were used. In addition 29 morphometric and functional parameters were measured, all of them being observer independent. Results. Functional cine MRI was able to show the extent and interaction of the pelvic floor organs in all cases with the reference organs always remaining above the pubococcygeal reference line. The depth of the rectocele was 2 cm. With the exception of the diameter of urogenital hiatus the different parts of the levator ani muscle could not be determined. Discussion. Functional cine MRI using an appropiate organ opacification and slice positioning is an objective, unifying diagnostic approach of the pelvic floor. The reference data given can be of help to distinguish normal from abnormal findings. (orig.) [German] Zielsetzung. Die funktionelle MRT des Beckenbodens eroeffnet neue Perspektiven in der Diagnostik. In diesem Beitrag soll die eigene Methodik dargestellt und Referenzwerte bei einem Kollektiv gesunder Nulliparen ermittelt werden. Material und Methode. 20 Nulliparae (Alter 25-51 Jahre) mit unauffaelligem gynaekologischen und urodynamischen Befund. Funktionelle MRT mit Kontrastierung von Scheide und Rektum an einem 1,5-Tesla-System. Mit Hilfe einer T2-gewichteten Gradientenechosequenz (True-FISP) wurden die Veraenderungen der Referenzorgane in Ruhe und waehrend des

  7. Family Resilience in the Military (United States)

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


    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

  8. 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


    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.  

  9. Fishing for resilience (United States)

    Pope, Kevin L.; Allen, Craig R.; Angeler, David G.


    Management approaches that focus on social–ecological systems—systems comprised of ecosystems, landscapes, and humans—are needed to secure the sustainability of inland recreational fisheries without jeopardizing the integrity of the underlying social and ecological components. Resilience management can be useful because it focuses on providing recreational capacity for fishermen under a variety of conditions while assuring that the social–ecological system is not pushed to a critical threshold that would result in a new, undesired system regime. Resilience management is based on a system perspective that accounts for the possible regimes a system could manifest. It aims to enhance system properties that allow continued maintenance of the system in a desired regime in which multiple goods and services, including recreational capacity, are provided. In this forum paper, we provide an overview of the potential of a resilience approach to the management of recreational fisheries and highlight the scientific and administrative challenges to its successful implementation.

  10. Resilience in IMS

    DEFF Research Database (Denmark)

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


    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......) 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......). 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....

  11. Resilience in adolescents with cancer


    ISHIBASHI, Akiko; UEDA, Reiko


    Children and adolescents with cancer experience multiple stressors, evertheless some function well or are "resilient." Focusing on resilience in childhood cancer patients and understanding why and how resilience develops during the cancer experience is of great value . This knowledge may provide information to health care professionals to facilitate intervention for promoting resilience and improving quality of life in adolescents with cancer . The purpose of thisarticle is to review the lite...

  12. MRI of the osteophytosis in experimental osteorthritis of the knee; MRT der Osteophytose bei experimentellen Gonarthrosen

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.C.A. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Adam, G. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Buehne, M. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Prescher, A. [RWTH Aachen (Germany). Inst. fuer Anatomie, Lehrstuhl I; Scherer, K. [RWTH Aachen (Germany). Inst. fuer Versuchstierkunde; Kuepper, W. [RWTH Aachen (Germany). Inst. fuer Versuchstierkunde; Guenther, R.W. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik


    The value of MRI for the detection of knee osteophytosis was determined in an animal osteoarthritis model. 10 dogs with experimentally induced unilateral osteoarthritis of the knee were investigated with MRI including 2-D-spin echo (SE) and 3-D-gradient echo (GE) imaging. The results were correlated with gross and histopathologic findings and with radiography. Osteophyte formation appeared early in the osteoarthritic process. Pathological analysis yielded 65 osteophytes. With 3-D-GE imaging. 91% of the osteophytes were detected, while 68% were visible on 2-D-SE images. With two-level radiography, 43% of the osteophytes were diagnosed. Additional use of tunnel view and conventional tomography increased the detection rate to 65%. Independent of the imaging technique, MRI revealed three different signal patterns of the osteophyte bone structure. Compared with the histologically evident fat marrow content and the grade of bone sclerosis, best agreement was achieved with 2-D-SE sequences. However, a discrepancy remained in 22%. A fibrocartilaginous layer at the osteophyte surface could be delineated especially on 3-D-GE images. (orig./MG) [Deutsch] Die Wertigkeit der MRT zur Diagnostik der Osteophytose bei Gonarthrosen wurde anhand eines Tiermodells ueberprueft. 10 Hundekniegelenke mit experimentell induzierter Arthrose wurden MR-tomographisch mit 2-D-Spin-echo(SE)- und 3-D-Gradienten-Echo(GE)-Sequenzen untersucht. Die Ergebnisse wurden mit dem makro- und histopathologischen Befund sowie mit der Roentgendiagnostik korreliert. Osteophyten traten bereits fruehzeitig im arthrotischen Krankheitsprozess auf. Die pathologische Auswertung ergab 65 Osteophyten. Hiervon wurden in 3-D-GE-Sequenzen 91% nachgewiesen, gegenueber 68% in 2-D-SE-Sequenzen. Die Nachweisrate betrug bei Roentgenaufnahmen in zwei Ebenen 43%, wobei die zusaetzliche Beruecksichtigung von Tunnelprojekten und konventioneller Tomographie einen Anstieg auf 65% zur Folge hatte. MR-tomographisch liessen sich

  13. Metrics for energy resilience

    International Nuclear Information System (INIS)

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


    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

  14. 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)


    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)

  15. Introduction 'Governance for Drought Resilience'

    NARCIS (Netherlands)

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


    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

  16. Experimenting for resilience

    DEFF Research Database (Denmark)

    Hagedorn-Rasmussen, Peter; Dupret, Katia

    Focusing on how an experimental approach to organizing may pave the way for organizational resilience, we explore opportunities and barriers of experimental organizing by following a concrete social experiment in civil society and discuss its adaptability in traditional organizations. The social...... experiment is called Civic Desire. The founders explicitly call for new ways of organizing that can develop social sustainability. We discuss how these experiments may create platforms of new unforeseen goals that organizations may choose to follow. In conclusion we argue for organizational resilience...

  17. Resilience and Complexity

    DEFF Research Database (Denmark)

    Dahlberg, Rasmus


    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...

  18. The Professional Socialization of Certified Athletic Trainers in the National Collegiate Athletic Association Division I Context


    Pitney, William A.; Ilsley, Paul; Rintala, Jan


    Objective: To describe the professional socialization process of certified athletic trainers (ATCs) in National Collegiate Athletic Association (NCAA) Division I to guide athletic training education and professional development.

  19. Key attributes of a modern surgical trainer: perspectives from consultants and trainees in the United kingdom. (United States)

    Nisar, Pasha J; Scott, Humphrey J


    This study identifies key attributes of a modern surgical trainer as defined by individual trainees and consultant training faculty members. Using a collaborative inquiry process, we conducted focus groups and semistructured interviews with 32 trainees and 10 consultant trainers in general surgery. This study was undertaken in a single postgraduate deanery in the United Kingdom. Key trainer attributes were identified and categorized into themes. Key attributes identified by core trainees (CTs) were enthusiasm, giving feedback, setting targets, completing online assessments, and inspiring trainees. From specialty trainees (STs), key attributes were leading in difficult situations, patience, ensuring trainees perform cases, inspiring trainees, and being a role model. Key attributes from consultants were engaging other trainers, awareness of individual needs, ensuring trainees perform cases, discussing problems sympathetically, and patience. Effective communication was the principal trainer theme for CTs and STs identified the principal theme of leadership. These themes were emphasized also by trainers. Trainees and trainers have different beliefs on the attributes a good surgical trainer should possess. These findings may be used to promote understanding between trainees and trainers of the expectations and difficulties faced by surgical consultants. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. Infectious spondylitis. A retrospective evaluation of the MRI signs; Die infektioese Spondylitis. Eine retrospektive Auswertung der MRT-Merkmale

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, M. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Vogel, J. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Rilinger, N. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany); Diepers, M. [Rehabilitationskrankenhaus Ulm (Germany). Neurologische Abt.; Hartwig, E. [Abt. fuer Unfallchirurgie, Chirurgische Universitaetsklinik und Poliklinik, Ulm Univ. (Germany); Rieber, A. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik und Poliklinik, Univ. Ulm (Germany)


    Aim and methods: The aim of the present study was to evaluate the MRI criteria of infectious spondylitis (spondylodiscitis). The MR images of 23 patients suffering from spondylodiscitis (78% unspecific, 22% specific) were retrospectively analyzed. Results: The height of the intervertebral discs involved was normal in 40%, reduced in 43% and increased in 17% of the cases. The most common findings can be summarized in an MR triad: (1) The vertebral bodies involved are hypointense in T1-weighted images (100%) with a lack of delineation of the intervertebral discs (53%). (2) The injection of Gd-DTPA yields an enhancement of the vertebral bodies involved and intervertebral discs (95% and 74% respectively). (3) The vertebral bodies and intervertebral discs are hyperintense in T2-weighted sequences (76% and 90% respectively). (orig.) [Deutsch] Um die kernspintomographischen Merkmale der Spondylitis zu ueberpruefen, wurden die MRT-Bilder von 23 Patienten mit einer Spondylitis (78% unspezifisch, 22% spezifisch) retrospektiv analysiert; 40% der befallenen Bandscheiben zeigten eine normale Hoehe, 43% waren verschmaelert und 17% zeigten eine Hoehenzunahme. Die haeufigsten Veraenderungen lassen sich in einer MRT-Trias zusammenfassen: 1. In T1-gewichteten Sequenzen sind die befallenen Wirbelkoerper hypointens (100%) und die Bandscheiben nicht abgrenzbar (53%). 2. Wirbelkoerper und Bandscheiben nehmen Kontrastmittel auf (95 bzw. 74%). 3. Wirbelkoerper und Bandscheiben sind in T2-gewichteten Sequenzen hyperintens (76 bzw. 90%). Dabei stellt sich ein paravertebraler Weichteilbefall in allen Sequenzen isointens zum befallenen Wirbelkoerper dar. Eine Differenzierung zwischen unspezifischer und spezifischer Aetiologie war kernspintomographisch nicht moeglich. (orig.)

  1. 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.


    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

  2. 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)


    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

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

    Directory of Open Access Journals (Sweden)

    Margot Hill Clarvis


    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.

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

    Directory of Open Access Journals (Sweden)

    Jan Sebastian Novotný


    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

  5. 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)


    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

  6. Measuring resilience in integrated planning

    DEFF Research Database (Denmark)

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


    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....

  7. Optimal Resilient Dynamic Dictionaries

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Brodal, Gerth Stølting; Moruz, Gabriel


    updates in $O(\\log n+\\delta)$ amortized time. Our dynamic dictionary also supports range queries in $O(\\log n+\\delta+t)$ worst case time, where $t$ is the size of the output. Finally, we show that every resilient search tree (with some reasonable properties) must take~$\\Omega(\\log n + \\delta)$ worst...

  8. [Resilience in old age]. (United States)

    Cárdenas-Jiménez, Andrea; López-Díaz, Alba L


    The aim of this study was to characterise and analyse articles published on resilience and old-age from 1990-2006. After a systematic search of five databases (Academic Search Premier-Ebsco Host, Medline, Psyc Articles, Ovid and Science Direct) 33 pieces of literature were included in the analysis. The selected articles had 31 different definitions of resilience, from eight disciplines, mainly health-related fields. It was also found that the research studied the association of resilience with individual (68 variables) and social/environmental factors (17 variables); the most frequent were age and health self-perception. Cultural and religious values were of special interest amongst the latter variables. The literature review demonstrated that resilience in old age is a topic having increasing research interest; this has been linked to various individual, social and cultural factors. However, this is a rapidly developing area that requires that a unified definition be established and that a theoretical and intervention model be created.

  9. Resilience of Amazonian forests

    NARCIS (Netherlands)

    Monteiro Flores, B.


    The Amazon has recently been portrayed as a resilient forest system based on quick recovery of biomass after human disturbance. Yet with climate change, the frequency of droughts and wildfires may increase, implying that parts of this massive forest may shift into a savanna state. Although the

  10. Multi-Sited Resilience

    DEFF Research Database (Denmark)

    Olwig, Mette Fog


    Participatory methods to build local resilience often involve the organization of local community groups. When global organizations use such methods, it reflects a desire to incorporate local agency. They thereby acknowledge the ability of a society to be innovative and adapt when faced with natu......Participatory methods to build local resilience often involve the organization of local community groups. When global organizations use such methods, it reflects a desire to incorporate local agency. They thereby acknowledge the ability of a society to be innovative and adapt when faced...... 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....

  11. Wellbeing And Resilience

    DEFF Research Database (Denmark)

    Harder, Susanne; Davidsen, Kirstine; MacBeth, Angus


    , 16 and 52 weeks in terms of evolution of very early indicators of developmental risk and resilience focusing on three possible environmental transmission mechanisms: stress, maternal caregiver representation, and caregiver-infant interaction. DISCUSSION: The study will provide data on very early risk...

  12. New pathways to resilience

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


    droughts, floods, and heat waves, along with shifting rainfall patterns, threaten to overwhelm the natural resilience of African communities, risking livelihoods and food security. .... As of March 2012, 68Fellows have pursued advanced research through a scholarship program on adaptation to climate change. • 11people ...

  13. State Energy Resilience Framework

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Finster, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Pillon, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Petit, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Trail, J. [Argonne National Lab. (ANL), Argonne, IL (United States)


    The energy sector infrastructure’s high degree of interconnectedness with other critical infrastructure systems can lead to cascading and escalating failures that can strongly affect both economic and social activities.The operational goal is to maintain energy availability for customers and consumers. For this body of work, a State Energy Resilience Framework in five steps is proposed.

  14. Resilience: Building immunity in psychiatry (United States)

    Shastri, Priyvadan Chandrakant


    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

  15. Resilience in aging: literature review. (United States)

    Fontes, Arlete Portella; Neri, Anita Liberalesso


    Psychological resilience is comprised of an adaptive functioning standard before the current and accumulated risks of life. Furthermore, it has a comprehensive range of psychological resources which are essential to overcome adversities, such as personal competences, self-beliefs and interpersonal control which interact with the social networks support. The objectives are to show the concepts of psychological resilience in elderly, relative to dominant theoretical models and the main data about psychological resilience in aging, found in an international and Brazilian review from 2007 to 2013. The descriptors "resilience, psychological resilience and aging", "resiliência e envelhecimento, velhice e velho", were used in PubMed, PsychInfo, SciELO and Pepsic databases. Fifty three international and eleven national articles were selected. The international articles were classified in four categories: psychological and social coping resources, emotional regulation before stressing experiences, successful resilience and aging and correlates, and resilience measures. The Brazilian articles were grouped in three: psychological and social resources, resilience in carers and theory review. Articles on psychological resources and on emotional regulation prevailed as key factors associated with psychological resilience in aging.

  16. 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....

  17. Concussion Assessment in California Community College Football: Athletic Trainers' Strides toward a Safer Return to Play (United States)

    Chinn, Nancy Resendes


    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…

  18. The attributes of the clinical trainer as a role model: a systematic review

    NARCIS (Netherlands)

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


    Medical trainees (interns and residents) and their clinical trainers need to be aware of the differences between positive and negative role modeling to ensure that trainees imitate and that trainers demonstrate the professional behavior required to provide high-quality patient care. The authors

  19. Guide for Trainers. Interdisciplinary Team Training and Humanistic Patient Care for Hospices. Monograph 2. (United States)

    Wilson, Dottie C.; Grady, Kathleen A.

    This monograph, the second in a series of five, provides information for trainers on interdisciplinary team training and humanistic patient care in hospices. Designed to help outside trainers who may be invited by a hospice to conduct its training, the materials help instructors to understand the nature of hospices, to determine whether or not the…

  20. Factors influencing the EBM behaviour of GP trainers: a mixed method study

    NARCIS (Netherlands)

    te Pas, E.; van Dijk, N.; Bartelink, M. E. L.; Wieringa-de Waard, M.


    General practitioner (GP) trainees state that their trainers are not consistent in using evidence-based medicine (EBM) or are even dismissive of it. As trainers are important role models in the Dutch GP training system this could have a large influence on the EBM training of GP trainees. To

  1. Ethical Issues of ICT Use by Teacher Trainers: Use of E-Books in Academic Settings (United States)

    Kilickaya, Ferit; Krajka, Jaroslaw


    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…

  2. Realism of procedural task trainers in a pediatric emergency medicine procedures course. (United States)

    Shefrin, Allan; Khazei, Afshin; Cheng, Adam


    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.

  3. Adaptive soft tissue deformation for a virtual reality surgical trainer. (United States)

    Jerabkova, Lenka; Wolter, Timm P; Pallua, Norbert; Kuhlen, Torsten


    Real time tissue deformation is an important aspect of interactive virtual reality (VR) environments such as medical trainers. Most approaches in deformable modelling use a fixed space discretization. A surgical trainer requires high plausibility of the deformations especially in the area close to the instrument. As the area of intervention is not known a priori, adaptive techniques have to be applied. We present an approach for real time deformation of soft tissue based on a regular FEM mesh of cube elements as opposed to a mesh of tetrahedral elements used by the majority of soft tissue simulators. A regular mesh structure simplifies the local refinement operation as the elements topology and stiffness are known implicitly. We propose an octree-based adaptive multiresolution extension of our basic approach. The volumetric representation of the deformed object is created automatically from medical images or by voxelization of a surface model. The resolution of the volumetric representation is independent of the surface geometry resolution. The surface is deformed according to the simulation performed on the underlying volumetric mesh.

  4. Study on Earthquake Emergency Evacuation Drill Trainer Development (United States)

    ChangJiang, L.


    With the improvement of China's urbanization, to ensure people survive the earthquake needs scientific routine emergency evacuation drills. Drawing on cellular automaton, shortest path algorithm and collision avoidance, we designed a model of earthquake emergency evacuation drill for school scenes. Based on this model, we made simulation software for earthquake emergency evacuation drill. The software is able to perform the simulation of earthquake emergency evacuation drill by building spatial structural model and selecting the information of people's location grounds on actual conditions of constructions. Based on the data of simulation, we can operate drilling in the same building. RFID technology could be used here for drill data collection which read personal information and send it to the evacuation simulation software via WIFI. Then the simulation software would contrast simulative data with the information of actual evacuation process, such as evacuation time, evacuation path, congestion nodes and so on. In the end, it would provide a contrastive analysis report to report assessment result and optimum proposal. We hope the earthquake emergency evacuation drill software and trainer can provide overall process disposal concept for earthquake emergency evacuation drill in assembly occupancies. The trainer can make the earthquake emergency evacuation more orderly, efficient, reasonable and scientific to fulfill the increase in coping capacity of urban hazard.

  5. Quantifying resilience for resilience engineering of socio technical systems


    Häring, Ivo; Ebenhöch, Stefan; Stolz, Alexander


    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...

  6. From resilience thinking to Resilience Planning: Lessons from practice. (United States)

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


    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

  7. 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)


    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

  8. Magnetic resonance imaging of meniscal and anterior cruciate ligament injuries of the knee; MRT des Kniegelenkes: Fehleranalyse bezueglich der Meniskus- und Kreuzbanddiagnostik an einem arthroskopisch kontrollierten Patientenkollektiv

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Herrig, A.; Grebe, P. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Runkel, M.; Regentrop, H.J. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie


    To categorise discrepancies in findings of the menisci and anterior cruciate ligament (ACL) between arthroscopy and MRI. Materials and methods: The MRIs of 236 patients were retrospectively analysed by an experienced radiologist without knowledge of clinical and/for operative findings. Discrepancies in arthroscopic findings were reevaluated together with the arthroscopist to determine their cause of error. Results: The diagnostic accuracies for injuries of the medial and lateral meniscus and the ACL were 92.4%, 92.4%, and 94.1%. respectively. For the menisci, causes for discrepancies in findings (n=31) were: overinterpretation of central signal intensities with contact to the meniscal surface but without disturbance of the meniscal contour as a tear (n=12), insufficient arthroscopie evaluation of the knee joint (n=11), overlooked tears on MR imaging (n=6), misinterpretation of normal anatomic structures (n=1), ``magic angle`` phenomenon (n=1), and missed tears at MRI (n=1). Causes for discrepancies for the ACL (n=18) were: nearly complete versus complete rupture either at MRI or arthroscopy and vice versa (n=9), insufficient arthroscopic evaluation (n=6), insufficient MRI technique (n=2), and overlooked tear on MR imaging (n=1). Conclusions: Discrepant findings between MRI and arthroscopy may be also due to an insufficient arthroscopic evaluation in clinical routine. The close cooperation between surgeons and radiologists improves the understanding of the methods of each other. (orig.) [Deutsch] Evaluation von Befunddiskrepanzen in der Meniskus- und Kreuzbanddiagnostik bei der MRT des Kniegelenkes. Material und Methode: Die MRTs von 236 Patienten wurden retrospektiv in Unkenntnis klinischer und operativer Befunde von einem erfahrenen Untersucher ausgewertet. Anschliessend wurden zur Arthroskopie abweichende Befunde zusammen mit dem Operateur besprochen, um die Ursache der Fehlbefunde im Konsens festzulegen. Ergebnisse: Die MRT erzielte bezueglich der Verletzungen

  9. 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)


    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

  10. Creating resilient SMEs

    DEFF Research Database (Denmark)

    Dahlberg, Rasmus; Guay, Fanny


    According to the EU, during the past five years, small and medium enterprises (SMEs) have created 85% of new jobs and two-thirds of private sector employment in the region. SMEs are considered the backbone of the economy in Europe and represent more than 95% of enterprises in USA and Australia...... if certain criteria are met. With this in mind, this paper will be examining how to create resilient SMEs. A well-known concept in the field is business continuity management. BCM is defined as “a holistic management process that identifies potential threats to an organization and the impacts to business...... and efficient manner, including through the preservation and restoration of its essential basic structures and functions.” This paper will define resilience and business continuity management by retracing the origins of both concepts through time. It will then compare them by highlighting their similarities...

  11. Standardisation or Resilience?

    DEFF Research Database (Denmark)

    Zinck Pedersen, Kirstine


    stability and predictability is presently being challenged by critics who insist that healthcare systems are complex and changing entities, thereby shifting focus towards the healthcare organisation's resilient and adaptive capacities. Based on a close reading of predominant patient safety literature...... begin to address the uncertainty of medical practice as well as the necessary competences of healthcare professionals to act with ‘safety dispositions’ as a precondition for delivering safe care....

  12. Resilience Through Ecological Network

    Directory of Open Access Journals (Sweden)

    Grazia Brunetta


    Full Text Available The paper explores the strategic role that urban biodiversity and ecosystem services management, natural infrastructure and adaptive governance approaches can play in making our economies and societies more resilient and in linking human societies and the natural environment. Resilience – a concept that entered the debate on urban governance – means the ability of urban systems, considered as linear-systems, to react to external disturbances by returning to some socio-ecological equilibrium steady-state by overcoming a crisis period (Gunderson & al. 2010, Newman & al. 2009. In this view, green infrastructures can assume a strategic role in restoring and enhancing the ecological and environmental livability in urban areas. Starting from the International and European context, the paper discusses innovative programs and interdisciplinary projects and practices (some cases in Turin Metropolitan Area to demonstrate how green infrastructures can increase the adaptive capacity of urban systems in term of resilience. They can contribute to increase the ability of European cities to adapt to climate change and to reduce their ecological footprints, to enhance security and life quality.

  13. Metrics for Energy Resilience

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  14. Resilience and (in)security

    DEFF Research Database (Denmark)

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


    Diverse, sometimes even contradictory concepts and practices of resilience have proliferated into a wide range of security policies. In introducing this special issue, we problematize and critically discuss how these forms of resilience change environments, create subjects, link temporalities......, 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...... to be conceptualized and investigated in plural terms. We use temporalities and subjectivities as key analytical aspects to investigate the plural instantiations of resilience in actual political practice. These two issues – subjectivity and temporality – form the overall context for the special issue and are core...

  15. 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


    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.

  16. MRT of the knee joint of juvenile footballers. Are there early changes in the knee due to competitive sport?

    International Nuclear Information System (INIS)

    Wacker, F.; Koenig, H.; Felsenberg, D.; Wolf, K.J.


    In a prospective study, the right knee of 21 symptom free juvenile footballers was examined by MRT (group I) and the results were compared with 12 juveniles of similar age but who did not take part in any special sorting activities (group II). A 1.5 Tesla Magnetome with an extremity coil was used. There were no abnormal changes in either group in the cruciate ligaments. The hyaline cartilage medially was about 10% thicker than laterally in both groups but in group I it was, on average, 24.8% thicker than in group II. Increased signals in the centre of the menisci were observed in 8 members of group I and two in group II. 5 on the 8 in group I, but none in group II, also showed an increase in the joint fluid. (orig.) [de

  17. Rules of Engagement: The Joint Influence of Trainer Expressiveness and Trainee Experiential Learning Style on Engagement and Training Transfer (United States)

    Rangel, Bertha; Chung, Wonjoon; Harris, T. Brad; Carpenter, Nichelle C.; Chiaburu, Dan S.; Moore, Jenna L.


    We investigated the joint effect of trainer expressiveness and trainee experiential learning style on training transfer intentions. Extending prior research where trainer expressiveness has been established as a positive predictor of transfer, we show that trainer expressiveness is more impactful for trainees with high (vs. low) experiential…

  18. 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)


    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.)

  19. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)


    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  20. Resilience in Homeland Security [video


    O'Connor, Dan; Center for Homeland Defense and Security Naval Postgraduate School


    In this interview, Dan O'Connor, Director Field Operations for the Chief Security Officer at FEMA, talks about the importance of resilience in Homeland Security. The term "resilience" refers to the ability to adapt to changing conditions and withstand and rapidly recover from disruption due to emergencies. Whether it is resilience towards acts of terrorism, cyber attacks, pandemics, and catastrophic natural disasters, our national preparedness is the shared responsibility of all levels of gov...

  1. Assessing Resilience in Stressed Watersheds

    Directory of Open Access Journals (Sweden)

    Kristine T. Nemec


    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.

  2. Communal resilience: the Lebanese case

    Directory of Open Access Journals (Sweden)

    Eric BOUTIN


    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.

  3. A quantitative framework for assessing ecological resilience (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 dec...

  4. The International Resilience Project: Promoting Resilience in Children. (United States)

    Grotberg, Edith H.

    The International Resilience Project was intended to determine the multidimensional, reciprocal, and dynamic factors--and relationships of factors--that parents, teachers, caregivers, and children themselves use to promote resilience in children. The samples were 589 children and their caregivers from 14 countries: Lithuania, Russia, Costa Rica,…

  5. Framing resilience: social uncertainty in designing urban climate resilience

    NARCIS (Netherlands)

    Wardekker, J.A.


    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

  6. Training of Trainers (ToT) Program in Team Teaching (United States)

    Febrianti, Werry; Wiryanto, Leo Hari


    The first year students in Sumatera Institute of Technology (ITERA) follow the first year program (TPB). They will learn about mathematics, physics, chemistry, and all of the basic subjects that they need for learning in ITERA. They will study in the big classrooms with different background department of their friends. This situation makes the lectures become more challenging in teaching their lessons. Besides the classrooms, the experience of the lecturers is still need to be improved because the lecturers are young and less of experience in teaching so that they need guidance from their senior lecturer. Because of that situation, Training of Trainers (ToT) program in team teaching is one of the solution that can increase the young lecturers’s ability so that they can teach well in the massal conditions of the classrooms. ToT program in team teaching indicated the better result than regular teaching.

  7. National Athletic Trainers' Association Position Statement: Anabolic-Androgenic Steroids (United States)

    Kersey, Robert D.; Elliot, Diane L.; Goldberg, Linn; Kanayama, Gen; Leone, James E.; Pavlovich, Mike; Pope, Harrison G.


    This NATA position statement was developed by the NATA Research & Education Foundation. Objective This manuscript summarizes the best available scholarly evidence related to anabolic-androgenic steroids (AAS) as a reference for health care professionals, including athletic trainers, educators, and interested others. Background Health care professionals associated with sports or exercise should understand and be prepared to educate others about AAS. These synthetic, testosterone-based derivatives are widely abused by athletes and nonathletes to gain athletic performance advantages, develop their physiques, and improve their body image. Although AAS can be ergogenic, their abuse may lead to numerous negative health effects. Recommendations Abusers of AAS often rely on questionable information sources. Sports medicine professionals can therefore serve an important role by providing accurate, reliable information. The recommendations provide health care professionals with a current and accurate synopsis of the AAS-related research. PMID:23068595

  8. Therapists, Trainers, and Acupuncturists: Focused Review for the Orthopedic Surgeon. (United States)

    Domes, Christopher M; Kruger, Cori L


    Effective treatment of orthopedic injuries requires a multidisciplinary team, including physical and occupational therapists, athletic trainers, massage therapists, and acupuncturists. Orthopedic surgeons commonly encounter these practitioners but may not be familiar with the training, credentialing, and most importantly, the appropriate use of members of this team. There are general similarities in practice locations as well as types of symptoms addressed by the providers discussed, which include the treatment of physical pain, evaluation and treatment of physical impairment, and some facilitation of adaptation to the limitations caused by injuries. Across the 5 types of providers discussed there are widely varying training and licensing requirements, specializations, and continuing education requirements to maintain licensure. This article provides a focused review of these members of the multidisciplinary team and highlights the current American Academy of Orthopaedic Surgeons recommendations for the use of occupational and physical therapists for orthopedic conditions, including hip fractures, total hip arthroplasty, and anterior cruciate ligament reconstruction. Copyright 2015, SLACK Incorporated.

  9. 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


    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

  10. Robotics On-Board Trainer (ROBoT) (United States)

    Johnson, Genevieve; Alexander, Greg


    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.

  11. A robotic wheelchair trainer: design overview and a feasibility study

    Directory of Open Access Journals (Sweden)

    Marchal-Crespo Laura


    Full Text Available Abstract Background Experiencing independent mobility is important for children with a severe movement disability, but learning to drive a powered wheelchair can be labor intensive, requiring hand-over-hand assistance from a skilled therapist. Methods To improve accessibility to training, we developed a robotic wheelchair trainer that steers itself along a course marked by a line on the floor using computer vision, haptically guiding the driver's hand in appropriate steering motions using a force feedback joystick, as the driver tries to catch a mobile robot in a game of "robot tag". This paper provides a detailed design description of the computer vision and control system. In addition, we present data from a pilot study in which we used the chair to teach children without motor impairment aged 4-9 (n = 22 to drive the wheelchair in a single training session, in order to verify that the wheelchair could enable learning by the non-impaired motor system, and to establish normative values of learning rates. Results and Discussion Training with haptic guidance from the robotic wheelchair trainer improved the steering ability of children without motor impairment significantly more than training without guidance. We also report the results of a case study with one 8-year-old child with a severe motor impairment due to cerebral palsy, who replicated the single-session training protocol that the non-disabled children participated in. This child also improved steering ability after training with guidance from the joystick by an amount even greater than the children without motor impairment. Conclusions The system not only provided a safe, fun context for automating driver's training, but also enhanced motor learning by the non-impaired motor system, presumably by demonstrating through intuitive movement and force of the joystick itself exemplary control to follow the course. The case study indicates that a child with a motor system impaired by CP can

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

    Directory of Open Access Journals (Sweden)

    Cassie Maxwell


    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.

  13. Acquisition of fundamental laparoscopic skills: is a box really as good as a virtual reality trainer? (United States)

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


    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.

  14. Injury surveillance in community sport: Can we obtain valid data from sports trainers? (United States)

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


    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.


    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Vina Widiadnya Putri


    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.

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

    Directory of Open Access Journals (Sweden)

    Mehmet Günay


    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.

  17. The quest for resilience. (United States)

    Hamel, Gary; Välikangas, Liisa


    In less turbulent times, executives had the luxury of assuming that business models were more or less immortal. Companies always had to work to get better, but they seldom had to get different--not at their core, not in their essence. Today, getting different is the imperative. It's the challenge facing Coca-Cola as it struggles to raise its "share of throat" in noncarbonated beverages. It's the task that bedevils McDonald's as it tries to restart its growth in a burger-weary world. It's the hurdle for Sun Microsystems as it searches for ways to protect its high-margin server business from the Linux onslaught. Continued success no longer hinges on momentum. Rather, it rides on resilience-on the ability to dynamically reinvent business models and strategies as circumstances change. Strategic resilience is not about responding to a onetime crisis or rebounding from a setback. It's about continually anticipating and adjusting to deep, secular trends that can permanently impair the earning power of a core business. It's about having the capacity to change even before the case for change becomes obvious. To thrive in turbulent times, companies must become as efficient at renewal as they are at producing today's products and services. To achieve strategic resilience, companies will have to overcome the cognitive challenge of eliminating denial, nostalgia, and arrogance; the strategic challenge of learning how to create a wealth of small tactical experiments; the political challenge of reallocating financial and human resources to where they can earn the best returns; and the ideological challenge of learning that strategic renewal is as important as optimization.

  18. Measuring Operational Resilience (United States)


    Julia Allen CERT Allen is a principal researcher within the CERT Program at the SEI. Allen’s areas of interest include operational resilience...funded research and development center. The government of the United States has a royalty-free government-purpose license to use, duplicate, or...Technologies Forum Twitter: #SEIVirtualForum We offer a diverse range of learning products—including classroom training, eLearning , certification, and more—to serve the needs of customers and partners worldwide.

  19. Stiffness, resilience, compressibility

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    Leu, Bogdan M. [Argonne National Laboratory, Advanced Photon Source (United States); Sage, J. Timothy, E-mail: [Northeastern University, Department of Physics and Center for Interdisciplinary Research on Complex Systems (United States)


    The flexibility of a protein is an important component of its functionality. We use nuclear resonance vibrational spectroscopy (NRVS) to quantify the flexibility of the heme iron environment in the electron-carrying protein cytochrome c by measuring the stiffness and the resilience. These quantities are sensitive to structural differences between the active sites of different proteins, as illustrated by a comparative analysis with myoglobin. The elasticity of the entire protein, on the other hand, can be probed quantitatively from NRVS and high energy-resolution inelastic X-ray scattering (IXS) measurements, an approach that we used to extract the bulk modulus of cytochrome c.

  20. Leakage resilient password systems

    CERN Document Server

    Li, Yingjiu; Deng, Robert H


    This book investigates tradeoff between security and usability in designing leakage resilient password systems (LRP) and introduces two practical LRP systems named Cover Pad and ShadowKey. It demonstrates that existing LRP systems are subject to both brute force attacks and statistical attacks and that these attacks cannot be effectively mitigated without sacrificing the usability of LRP systems. Quantitative analysis proves that a secure LRP system in practical settings imposes a considerable amount of cognitive workload unless certain secure channels are involved. The book introduces a secur

  1. Resilient ageing: a concept analysis. (United States)

    Hicks, Maxine M; Conner, Norma E


    This paper is a report of an analysis of the concept resilient ageing. Unique in comparison with other healthy ageing concepts, resilient ageing can be applied to all older people, regardless of age or affliction. The state of global population expansion in older people over the next 50 years calls for increased health promotion research efforts to ensure the maintenance of health and optimal quality of life for all older people. Literature for this concept analysis was retrieved from several databases, CINAHL, PubMed PsycINFO, for the years 1990-2012. Rodgers's evolutionary method of concept analysis was used because of its applicability to concepts that are still evolving. An integrative research review methodology was applied to peer-reviewed journal articles (n = 46) for an inductive analysis of the concept of resilient ageing. The antecedents, defining attributes, and consequence of resilient ageing were identified. Antecedents to resilient ageing were found to be adversity and protective factors, while the core attributes include coping, hardiness and self-concept. The consequence of the process of resilient ageing was optimal quality of life. Sense of coherence was found to be the surrogate term. The results obtained were further substantiated using Antonovsky's (1979) theory of salutogenesis. A theoretical definition and a model of resilient ageing were developed. In addition, a discussion was provided on the practice, policy and research implications for promoting the development of protective factors and resilient ageing. © 2013 John Wiley & Sons Ltd.

  2. Adventure Education and Resilience Enhancement (United States)

    Beightol, Jesse; Jevertson, Jenn; Carter, Susan; Gray, Sky; Gass, Michael


    This study assessed the effect of an experiential, adventure-based program on levels of resilience in fifth-grade Latino students. A mixed methods, quasi-experimental design was used to measure the impact of the Santa Fe Mountain Center's Anti-Bullying Initiative on internal assets commonly associated with resilient individuals. Results indicated…

  3. Resilia cyber resilience best practices

    CERN Document Server

    , AXELOS


    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.

  4. Developing a workplace resilience instrument. (United States)

    Mallak, Larry A; Yildiz, Mustafa


    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.

  5. Resiliency against stress among athletes

    Directory of Open Access Journals (Sweden)

    Kamila Litwic-Kaminska


    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.

  6. Tiered Approach to Resilience Assessment. (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


    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.

  7. [Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting]. (United States)

    Gachoud, D; Félix, S; Monti, M


    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.

  8. About the problems of teaching future teacher-trainers in the condition of informatization of education

    Directory of Open Access Journals (Sweden)

    Бакитжан Калжанович Мухамеджанов


    Full Text Available In this article are considered actuality of informatization of professional education, about problems of readiness to use information and computer technology of professional activity of future teacher-trainers. Authors state that according to the accepted concept of the education, the offered technology of creation of models of activity of future teacher-trainers in most part has to be realized on the basis of information technology. Training of future teacher-trainers on the computer technologies, created on the basis of activity models of specialists, is applicable for model of training of specialists to natural-science specialties.

  9. The WalkTrainer--a new generation of walking reeducation device combining orthoses and muscle stimulation. (United States)

    Stauffer, Y; Allemand, Y; Bouri, M; Fournier, J; Clavel, R; Metrailler, P; Brodard, R; Reynard, F


    This paper presents a novel reeducation device for paraplegics that combines hybrid orthoses and closed-loop electrical muscle stimulation. Based on the so called Cyberthosis concept, the WalkTrainer enables an active muscular participation of the subject in the walking reeducation process by the mean of closed-loop muscle stimulation. The WalkTrainer is also equipped with a leg and pelvic orthosis, an active bodyweight support, and motorized wheels to allow true over ground deambulation. This paper will focus on the development of the WalkTrainer, the presentation of the control strategies, and also give some preliminary results of the first clinical trials.

  10. Improvement of training process of powerlifters on the basis of an interactive program "PersTrainer"

    Directory of Open Access Journals (Sweden)

    Volodymyr Ashanin


    Full Text Available Purpose: to develop and scientifically substantiate the program "PersTrainer" for improving the training process of powerlifters. Material & Methods: the study involved the powerlifters of 16–18 years. The following research methods were used: analysis and generalization of the literary sources and data of the Internet, pedagogical observation and the method of information modeling. Results: the interactive program "PersTrainer" is developed and theoretically justified, which allows individually calculating the training load in different training cycles. Conclusion: it is possible to plan training loads on the basis of individually proposed exercise complexes, which are presented in the interactive program "PersTrainer".

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

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    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


    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

  12. 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)


    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

  13. 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)


    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

  14. Resilient Grid Operational Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Pasqualini, Donatella [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    Extreme weather-related disturbances, such as hurricanes, are a leading cause of grid outages historically. Although physical asset hardening is perhaps the most common way to mitigate the impacts of severe weather, operational strategies may be deployed to limit the extent of societal and economic losses associated with weather-related physical damage.1 The purpose of this study is to examine bulk power-system operational strategies that can be deployed to mitigate the impact of severe weather disruptions caused by hurricanes, thereby increasing grid resilience to maintain continuity of critical infrastructure during extreme weather. To estimate the impacts of resilient grid operational strategies, Los Alamos National Laboratory (LANL) developed a framework for hurricane probabilistic risk analysis (PRA). The probabilistic nature of this framework allows us to estimate the probability distribution of likely impacts, as opposed to the worst-case impacts. The project scope does not include strategies that are not operations related, such as transmission system hardening (e.g., undergrounding, transmission tower reinforcement and substation flood protection) and solutions in the distribution network.

  15. Resilient leadership and the organizational culture of resilience: construct validation. (United States)

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


    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".

  16. Resilient Salmon, Resilient Fisheries for British Columbia, Canada

    Directory of Open Access Journals (Sweden)

    Michael C. Healey


    Full Text Available Salmon are inherently resilient species. However, this resiliency has been undermined in British Columbia by a century of centralized, command-and-control management focused initially on maximizing yield and, more recently, on economic efficiency. Community and cultural resiliency have also been undermined, especially by the recent emphasis on economic efficiency, which has concentrated access in the hands of a few and has disenfranchised fishery-dependent communities. Recent declines in both salmon stocks and salmon prices have revealed the systemic failure of the current management system. If salmon and their fisheries are to become viable again, radically new management policies are needed. For the salmon species, the emphasis must shift from maximizing yield to restoring resilience; for salmon fisheries, the emphasis must shift from maximizing economic efficiency to maximizing community and cultural resilience. For the species, an approach is needed that integrates harvest management, habitat management, and habitat enhancement to sustain and enhance resilience. This is best achieved by giving fishing and aboriginal communities greater responsibility and authority to manage the fisheries on which they depend. Co-management arrangements that involve cooperative ownership of major multistock resources like the Fraser River and Skeena River fisheries and community-based quota management of smaller fisheries provide ways to put species conservation much more directly in the hands of the communities most dependent on the well-being and resilience of these fisheries.

  17. 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)


    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

  18. MRI and MRS in patients with silicon implants of the breast; MRT und MRS nach Silikonaufbau der weiblichen Brust

    Energy Technology Data Exchange (ETDEWEB)

    Pfleiderer, B.; Heindel, W. [Muenster Univ. (Germany). Radiologische Klinik und Poliklinik


    This paper reviews the evaluation of the breast of women by MR-techniques after implantation with silicon gel protheses. The main topics are the diagnosis of implant defects such as extensive ''gel bleed'' and intra- and extracapsular ruptures. Moreover, the MR-detection of siliconomas (encapsulated silicone) and differentiation from malignomas as well as MR-features of chronic foreign body reactions are presented. ''Gel bleed'' is difficult to diagnose unambiguously by MRI alone. The ''linguini'' sign is the only reliable mans to diagnose intracapsular ruptures. The presence of silicone outside the implant capsule indicates extracapsular rupture. The MR-spectroscopic detection of silicone in the liver suggests after short implantation times and a normal MR scan the diagnosis ''gel bleed'', and after longer implantation times of more than 10 years and missing ''linguini'' sign the diagnosis of ruptures due to a dissolved shell of the implant. MRI, in comparison to other imaging modalities, has the highest specificity and sensitivity in the diagnosis of implant defects. Due to its high costs, however, MR is not suitable as a screening tool and should only be used in cases of sonographic suspected rupture or after radical mastectomy. In these cases MRI is the method of choice. (orig.) [German] In dieser Uebersicht wird die Evaluation der weiblichen Brust nach Aufbau mit Silikonmammaprothesen mittels MR-Techniken vorgestellt. Ein Schwerpunkt liegt dabei auf der Defektdiagnostik, d.h. dem Nachweis des so genannten ''Gelblutens'', der intra- und der extrakapsulaeren Ruptur. Daneben wird auf die MR-Detektion von Silikonomen (abgekapseltes Silikon) und deren Abgrenzung von einem Malignom eingegangen und das typische MR-Erscheinungsbild von chronischer Fremdkoerperreaktion vorgestellt. ''Gelbluten'' ist mittels MR-Bildgebung (MRT

  19. MRI of the musculature in patients with myalgia - indications and imaging results; MRT der Muskulatur bei Myalgien - Indikationen und Bildbefunde

    Energy Technology Data Exchange (ETDEWEB)

    Beese, M.S. [Universitaetsklinik Hamburg-Eppendorf (Germany). Radiologische Klinik; Winkler, G. [Universitaetsklinik Hamburg-Eppendorf (Germany). Neurologische Klinik; Maas, R. [Universitaetsklinik Hamburg-Eppendorf (Germany). Radiologische Klinik; Buechler, E. [Universitaetsklinik Hamburg-Eppendorf (Germany). Radiologische Klinik


    241 patients suffering from myalgic symptoms were examined by axial scans of the muscular system with T1w and STIR-sequences. All patients underwent a complete neuromuscular examination, which included an MRI guided muscle-biopsy of 203 patients. The images were retrospectively analysed as to the typical characteristics of differential diagnosis. In cases of idiopathic or bacterial/viral induced myositis, primary vasculitis, and rhabdomyolysis, edematous changes of the muscles could always be found. Abscesses were only found in bacterial myositis. In cases of poly- and dermatomyositis as well as inclusion-body-myositis, MRI showed a uniform distribution pattern with emphasis on the quadriceps muscles. In contrast to other neuromuscular diseases in bacterial induced myositis, focal myositis, and rhabdomyolysis a strong contrast agent enhancement was seen. All patients with myalgic syndromes without any other additional neuropathological findings and 86% of the patients suffering from polymyalgia rheumatica had normal MR-findings. MRI allows a correct exclusion of an inflammatory, tumorous, or rhabdomyolitic cause of a myalgia and leads to pathognomonic findings for these diseases. Diseases belonging to the group of endocrine, toxic, or metabolic myopathies might be normal in MRI. (orig./MG) [Deutsch] Bei 241 Patienten mit myalgischen Beschwerden wurden axiale Aufnahmen der Muskulatur mit T1w- und STIR-Sequenzen angefertigt. Bei allen Patienten wurde eine vollstaendige neuromuskulaere Untersuchung durchgefuehrt, die bei 203 Patienten eine MRT-gezielte Muskelbiopsie beinhaltete. Das Bildmaterial wurde retrospektiv hinsichtlich differentialdiagnostischer Charakteristika analysiert. Bei idiopathischen und erregerbedingten Myositiden, primaeren Vaskulitiden und bei Rhabdomyolysen bestanden ohne Ausnahme oedematoese Veraenderungen der Muskulatur. Abszessformationen wurden nur bei erregerbedingten Myositiden vorgefunden. Bei Poly- und Dermatomyositiden sowie

  20. 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 ...

  1. The Virtual Flier: The Link Trainer, Flight Simulation, and Pilot Identity. (United States)

    Jeon, Chihyung


    The Link Trainer is often described as the first successful attempt at what we now recognize as flight simulation and even virtual reality. Instead of asking how well the device simulated flight conditions, this article shows that what the Link Trainer simulated was not the conditions of the air, but rather the conditions of the cockpit that was gradually filled with flight instruments. The article also considers the Link Trainer as a cultural space in which shifting ideas about what it meant to be a pilot were manifested. A pilot in the Link Trainer was trained into a new category of flier-the virtual flier-who was an avid reader of instruments and an attentive listener to signals. This article suggests that, by situating the pilot within new spaces, protocols, and relationships, technologies of simulation have constituted the identity of the modern pilot and other operators of machines.


    Directory of Open Access Journals (Sweden)

    Valentín Félix-Salazar


    Full Text Available This is a qualitative study on the perceptions of the students of the Escuela Normal de Sinaloa (ENS about the teacher trainers and their citizen teaching practices. The objectives are geared to see the description and qualitative interpretation of the role that the ENS has played in citizenship education, the development of the practices and teaching strategies of the teacher trainer in relation with its citizen formation; furthermore, to know in what sense the teacher trainer of the ENS is an exemplary reference of citizenship for the own student. The collection of empirical data was developed through a questionnaire with open questions and an interview. The results indicate negative perceptions of students toward ENS and their trainers, their practices, their strategies used in teaching for the development of citizenship, as well as been a reference model of citizen.

  3. A Hybrid Expert Systems for Scheduling the US Army Close Combat Tactical Trainer (CCTT)

    National Research Council Canada - National Science Library

    McGinnis, Michael


    .... The first of the CATT family to be developed will be the Close Combat Tactical Trainer facility featuring manned simulator modules for training armored and mechanized forces at battalion and below...


    Directory of Open Access Journals (Sweden)

    Oksana K. Kornosenko


    Full Text Available In the article the purpose, aim, features and capabilities of the stepper trainer simulator (STS in professional preparation of future physical culture teachers are highlighted. STS is marked as a modern educational trainer device, developed for the purpose of professional preparation process improvement of future physical education teachers and fitness trainers. The functions of stepper trainer simulator (STS are grounded: educational, developing, stimulant, upbringing, organizational, integrational. Attention is paid to educational function, which focuses on possibility to teach students to work with the modern technical means of information transfer, to form the ability for independent creative activity, to adapt to realization of distance education model; the possibility of theoretical and practical study of health-improving aerobics basic steps.

  5. MST-80 microprocessor trainer. [Uses INTEL 8080A CPU and support chips housed in attache case

    Energy Technology Data Exchange (ETDEWEB)

    Jones, G. D.


    This trainer is a complete, self-contained microcomputer system housed in a brief case for portability and convenience of use. It utilizes INTEL's 8080A microprocessor and associated support chips. The trainer is designed to allow the student to explore and learn the hardware and software capability of the 8080 microprocessor. It includes a breadboard socket so that experiments can be interfaced to the trainer. This option allows the student to learn both interfacing techniques and programing. A keyboard and numerical display are provided for the student to communicate with the trainer. The keyboard and numerical display can be used with either the octal number system or the hexadecimal number system. 8 figures. (RWR)

  6. The Commanders' Integrated Training Tool for the Close Combat Tactical Trainer 3: Final Prototype Development

    National Research Council Canada - National Science Library

    Flynn, Michael


    ...) 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...

  7. Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI; Funktionelle MRT bei Schizophreniepatienten. Diagnostik und Therapiemonitoring kognitiver Defizite schizophrener Patienten mittels funktioneller MRT

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Sachs, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Psychiatrie und Psychotherapie, Wien (Austria)


    Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [German] Kognitive Defizite sind ein zentraler Bestandteil der Symptomatik schizophrener Patienten. Diese Defizite betreffen v. a. die Aufmerksamkeit, exekutive Funktionen sowie das Gedaechtnis. Der vorliegende Beitrag zeigt den Stellenwert der funktionellen Magnetresonanztomographie (fMRT) in Hinblick auf Diagnostik und Therapiemonitoring der unterschiedlichen kognitiven Teilbereiche auf. Darueber hinaus werden die Unterschiede in Bezug auf die Aktivierung der einzelnen Gehirnareale zwischen schizophrenen Patienten und gesunden Kontrollpersonen dargestellt. Diese Informationen sollen helfen, in der Praxis ein Profil der kognitiven Leistungsreduktionen sowie ein darauf angepasstes Therapiekonzept zu erstellen. (orig.)

  8. 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)


    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

  9. Left-handed cardiac surgery: tips from set up to closure for trainees and their trainers. (United States)

    Burdett, Clare; Dunning, Joel; Goodwin, Andrew; Theakston, Maureen; Kendall, Simon


    There are certain obstacles which left-handed surgeons can face when training but these are not necessary and often perpetuated by a lack of knowledge. Most have been encountered and overcome at some point but unless recorded and disseminated they will have to be resolved repeatedly by each trainee and their trainers. This article highlights difficulties that the left-hander may encounter in cardiac surgery and gives practical operative advice for both trainees and their trainers to help overcome them.

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


    Cassie Maxwell; Kyle Ruth; Carol Friesen


    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...

  11. Training medical students in general practice: a qualitative study among general practitioner trainers in Sri Lanka

    Directory of Open Access Journals (Sweden)

    R.P.J.C. Ramanayake


    Full Text Available Introduction: Worldwide Family Medicine has gained an important place in the undergraduate medical curriculum over the last few decades and general practices have become training centers for students. Exposure to patients early in the disease process, out patient management of common problems, follow up of chronic diseases and psychosocial aspects of health and disease are educational advantages of community based training but such training could have varying impact on patients, students and trainers. This study explored the views of General Practitioner (GP trainers on their experience in training students. Methodology: This qualitative study was conducted among GP trainers of the faculty of medicine, University of Kelaniya, Sri Lanka, to explore their experience on wide range of issues related to their role as GP trainers. The interviews were recorded and transcribed verbatim. Themes expressed were identified. Results: Altruistic reasons, self-satisfaction, self-esteem and opportunity to improve their knowledge were the motivations for their involvement in teaching. Teachers were confident of their clinical and teaching skills. They perceived that patients were willing participants of the process and benefited from it. There was a positive impact on consultation dynamics. Time pressure was the major problem and ideal number of trainees per session was two. They were willing to attend teacher training workshops to update their knowledge. Conclusions: GP trainers driven by altruistic reasons were willing participants of student training process. The perceived advantages of involvement of teaching for trainers and patients were an encouragement for potential trainers. University should organize training sessions for trainers which will boost their knowledge, confidence and teaching skills which will eventually benefit students.

  12. Brain-actuated gait trainer with visual and proprioceptive feedback (United States)

    Liu, Dong; Chen, Weihai; Lee, Kyuhwa; Chavarriaga, Ricardo; Bouri, Mohamed; Pei, Zhongcai; Millán, José del R.


    Objective. Brain-machine interfaces (BMIs) have been proposed in closed-loop applications for neuromodulation and neurorehabilitation. This study describes the impact of different feedback modalities on the performance of an EEG-based BMI that decodes motor imagery (MI) of leg flexion and extension. Approach. We executed experiments in a lower-limb gait trainer (the legoPress) where nine able-bodied subjects participated in three consecutive sessions based on a crossover design. A random forest classifier was trained from the offline session and tested online with visual and proprioceptive feedback, respectively. Post-hoc classification was conducted to assess the impact of feedback modalities and learning effect (an improvement over time) on the simulated trial-based performance. Finally, we performed feature analysis to investigate the discriminant power and brain pattern modulations across the subjects. Main results. (i) For real-time classification, the average accuracy was 62.33 +/- 4.95 % and 63.89 +/- 6.41 % for the two online sessions. The results were significantly higher than chance level, demonstrating the feasibility to distinguish between MI of leg extension and flexion. (ii) For post-hoc classification, the performance with proprioceptive feedback (69.45 +/- 9.95 %) was significantly better than with visual feedback (62.89 +/- 9.20 %), while there was no significant learning effect. (iii) We reported individual discriminate features and brain patterns associated to each feedback modality, which exhibited differences between the two modalities although no general conclusion can be drawn. Significance. The study reported a closed-loop brain-controlled gait trainer, as a proof of concept for neurorehabilitation devices. We reported the feasibility of decoding lower-limb movement in an intuitive and natural way. As far as we know, this is the first online study discussing the role of feedback modalities in lower-limb MI decoding. Our results suggest that

  13. An International Comparison of Nutrition Education Standards, Occupational Standards and Scopes of Practice for Personal Trainers. (United States)

    Barnes, Katelyn; Ball, Lauren; Desbrow, Ben


    Personal trainers are well placed to provide nutrition care in line with their recommended scope of practice. However, providing nutrition care beyond their recommended scope of practice has been identified as an industry risk. The International Confederation of Registers for Exercise Professionals (ICREPs) have international standards for nutrition knowledge and skills that are recommended for all fitness professionals, including personal trainers. This study investigates whether the ICREPs standards align with i) national nutrition education standards and ii) national nutrition occupational standards and scopes of practice for personal trainers within ICREPs affiliated countries. Content analysis of each standard and/or scope of practice was undertaken to extract nutrition statements. Extracted statements were matched with nutrition components of the ICREPs standards to result in a score based on the number of aligned ICREPs knowledge and skills criteria. Ten countries, with 16 organizations, were identified as being involved in the development of national education standards, occupational standards, or scopes of practice for personal trainers. The educational and occupational standards varied widely among countries and had minimal alignment with the ICREPs standards. As such, the expected role of personal trainers in providing nutrition care appeared to differ between countries. Further work is required to support personal trainers to develop a level of knowledge and skills that enables the provision of safe, consistent, and effective nutrition care.

  14. Increasing the realism of a laparoscopic box trainer: a simple, inexpensive method. (United States)

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


    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.

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


    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.

  16. Resilient computer system design

    CERN Document Server

    Castano, Victor


    This book presents a paradigm for designing new generation resilient and evolving computer systems, including their key concepts, elements of supportive theory, methods of analysis and synthesis of ICT with new properties of evolving functioning, as well as implementation schemes and their prototyping. The book explains why new ICT applications require a complete redesign of computer systems to address challenges of extreme reliability, high performance, and power efficiency. The authors present a comprehensive treatment for designing the next generation of computers, especially addressing safety-critical, autonomous, real time, military, banking, and wearable health care systems.   §  Describes design solutions for new computer system - evolving reconfigurable architecture (ERA) that is free from drawbacks inherent in current ICT and related engineering models §  Pursues simplicity, reliability, scalability principles of design implemented through redundancy and re-configurability; targeted for energy-,...

  17. Development of Microcontroller-Based Ball and Beam Trainer Kit

    Directory of Open Access Journals (Sweden)

    Gunawan Dewantoro


    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE A ball and beam trainer kit based on microcontroller was developed for teaching control system course for the sophomore students. This specially-purposed kit consists of a ball located on a beam with a fixed axle at one of its end. At the other end, a servomotor was employed to control the position of the ball by adjusting the rotation angle of the servomotor. Seven predetermined positions were set to 10, 20, 30, 40, 50, 60, and 70 cm relative to the fixed axle of the beam. The Proportional-Integral-Derivative (PID scheme was then used to compensate the error. This kit is equipped with a user interface to configure controller coefficients, select the set points, plot the actual ball position, and display parameter values. The user interface program runs on PC or notebook connected to microcontroller via serial communications. A questionnaire-based assessment about the use of this kit was conducted by 17 students taking the course, giving a rating value of 94.12%.

  18. Resilient communities: implications for professionals

    NARCIS (Netherlands)

    Duijnhoven, Hanneke; Neef, Martijn; Davis, Scott; Dinesen, Cecilie; Kerstholt, Johanna Helena


    As a result of societal changes like citizen empowerment and increasing attention for strengthening community resilience, relationships between citizens and professional responders in crisis management are changing. Citizens actively deal with crises themselves, implying adjustments to professional

  19. Assessment instruments of urban resilience

    Directory of Open Access Journals (Sweden)

    Giovanna Saporiti


    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.  

  20. Sociotechnical Resilience: A Preliminary Concept. (United States)

    Amir, Sulfikar; Kant, Vivek


    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.

  1. Imaging cervical myelo- and radiculopathy; Stellenwert von Myelographie, Myelo-CT und MRT in der Diagnostik der zervikalen Radikulo- und Myelopathie

    Energy Technology Data Exchange (ETDEWEB)

    Roth, C.; Papanagiotou, P.; Krick, C.; Reith, W.; Grunwald, I.Q. [Universitaetsklinikum des Saarlandes, Homburg (Germany). Abt. Neuroradiologie


    This article gives an overview of the diagnostic possibilities available in the diagnosis of cervical myelo- and radiculopathy. We compared conventional myelography, CTM, and MRI. Twenty-five patients with clinical evidence of cervical myelo- or radiculopathy were included. Sagittal and transverse T1-weighted (T1w) TSE and T2-weighted (T2w) TSE sequences were compared with myelography and CTM. Statistical analysis was performed using Wilcoxon's -test. Disc herniation could be depicted in CTM as well as in MRI. The extent of herniation did not differ between CTM and T1w. The extent of herniation seemed higher on T2w than on T1w (p <0.001). Foraminal encroachment was easier to diagnose in CTM. When regarding transverse T1w and T2w images simultaneously, a missing root in MRI corresponded to a missing root in CTM and conventional myelography and vice versa. Our data demonstrated the relative inability of MRI to determine whether the compression is by soft tissue or bony structures. The present study proposes that MRI, when available, should be the imaging method of first choice in patients with suspected radiculo- and myelopathy. (orig.) [German] Diese Arbeit zieht einen Vergleich zwischen zervikaler Myelographie, CT-Myelographie (CTM) und MRT. Es gilt herauszufinden, welchen Stellenwert jede der oben genannten Methoden in Bezug auf Diagnostik und nachfolgende Therapie hat. Bei insgesamt 25 Patienten mit klinischem Verdacht auf eine zervikale Myelo- oder Radikulopathie wurden sowohl eine MRT-Untersuchung der Halswirbelsaeule als auch eine Myelographie durchgefuehrt. Eine Einengung des Spinalkanals liess sich sowohl in der CTM als auch MRT darstellen. Bezueglich des Ausmasses der Spinalkanaleinengung bestand zwischen den T1w-axialen Bildern und den Postmyelo-CT-Bildern kein signifikanter Unterschied. Die MRT ist in der Diagnostik von Myelo- und Radikulopathien der CTM ebenbuertig. Die CT ist zwar in der Differenzierung von weicher und knoecherner Protrusion besser

  2. MRI in definition of bleeding source, lesion pattern and therapy in haemarthros of the knee; Die MRT beim Haemarthros des Kniegelenks: Bestimmung von Blutungsursachen, Verletzungsmustern und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Bachmann, G. [Abt. Diagnostische Radiologie, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Juergensen, I. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Leier, S. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Rauber, K. [Abt. Diagnostische Radiologie, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany)


    Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland lesions were accurately diagnosed in MRI which permitted a correct prediction of surgical and conservative therapy in 96% and 80%. Morphological criteria in MRI permit identification of bleeding sources in haemarthros of the knee. Different lesion patterns can be separated for the planning of therapy. (orig.) [Deutsch] Bei gesichertem Haemarthros des Knies wurde geprueft, ob mit der MRT Angaben zur Blutungsursache moeglich sind und die relevanten Verletzungsmuster fuer die folgende konservative oder operative Therapie exakt beschrieben werden koennen. In einer prospektiven Studie wurden 120 Patienten mit akutem Haemarthros des Knies nacheinander mit der MRT und der Arthroskopie untersucht. Alle Laesionen und Blutungsquellen wurden getrennt fuer beide Methoden auf standardisierten Erhebungsboegen fuer die Arthroskopie registriert. Arthroskopisch wurden Rupturen der vorderen Kreuzbaender in 86%, Meniskusrisse in 55%, Rupturen der Kollateralbaender in 17%, subchondrale Laesionen in 5% und Kapsel- bzw

  3. Resilient retfærdighed?

    DEFF Research Database (Denmark)

    Jacobsen, Stefan Gaarsmand


    This article uses the idea of resilience as a point of departure for analysing some contemporary challenges to the climate justice movement posed by social-ecological sciences. Climate justice activists are increasingly rallying for a system-change, demanding fundamental changes to political bure...... is that the scientific framework behind resilience is not politically neutral and that this framework tends to weaken the activist’s demands for a just transition and place more emphasis on technical and bureaucratic processes....

  4. Construction and validation of a low-cost surgical trainer based on iPhone technology for training laparoscopic skills. (United States)

    Pérez Escamirosa, Fernando; Ordorica Flores, Ricardo; Minor Martínez, Arturo


    In this article, we describe the construction and validation of a laparoscopic trainer using an iPhone 5 and a plastic document holder case. The abdominal cavity was simulated with a clear plastic document holder case. On 1 side of the case, 2 holes for entry of laparoscopic instruments were drilled. We added a window to place the camera of the iPhone, which works as our camera of the trainer. Twenty residents carried out 4 tasks using the iPhone Trainer and a physical laparoscopic trainer. The time of all tasks were analyzed with a simple paired t test. The construction of the trainer took 1 hour, with a cost of iPhone Trainer is a reusable and fully functional device that allows surgeons to practice their skills anywhere and at their own pace.


    Directory of Open Access Journals (Sweden)

    Kendra L. Smith


    Full Text Available The increased interdependence and complexity of modern societies have increased the need to involve all members of a community into solving problems. In times of great uncertainty, when communities face threats of different kinds and magnitudes, the traditional top-down approach where government provides solely for community wellbeing is no longer plausible. Crowdsourcing has emerged as an effective means of empowering communities with the potential to engage individuals in innovation, self-organization activities, informal learning, mutual support, and political action that can all lead to resilience. However, there remains limited resource on the topic. In this paper, we outline the various forms of crowdsourcing, economic and community resilience, crowdsourcing and economic resilience, and a case study of the Nepal earthquake. his article presents an exploratory perspective on the link can be found between crowdsourcing and economic resilience. It introduces and describes a framework that can be used to study the impact of crowdsourcing initiatives for economic resilience by future research. An initial a set of indicators to be used to measure the change in the level of resilience is presented.

  6. Resilience | Science Inventory | US EPA (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

  7. MRI in preoperative evaluation of chronic paranasal sinusitis - a comparison with CT; MRT in der praeoperativen Diagnostik der chronischen Sinusitis im Vergleich mit der CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, F.; Habermann, C.R.; Welger, J.; Steiner, P.; Rozeh, B.; Buecheler, E. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Radiologie; Knaape, A.; Metternich, F. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde; Schoder, V. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Inst. fuer Mathematik und Datenverarbeitung in der Medizin


    Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T{sub 2}-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal pathologies ({kappa}=0.46-0.87) and anatomic variants ({kappa}=0.55-0.86). All important anatomical structures could be evaluated sufficiently with MRI for preoperative management. Both diagnostic tools showed an unsatisfactory correlation with intraoperative findings in the ethmoidal complex and maxillary sinus ({tau}=-0.08-0.3). (orig.) [German] Zielsetzung: Einschaetzung des Stellenwertes der MRT in der Beurteilung der praeoperativen Diagnostik der chronischen Sinusitis und Vergleich mit koronarer CT und intraoperativem Befund. Material und Methodik: 42 Patientinnen mit klinischen Zeichen einer chronischen Sinusitis wurden jeweils innerhalb eines Tages mittels CT und MRT untersucht. Am Folgetag wurde eine transnasale endoskopische Operation an den Nasennebenhoehlen durchgefuehrt. Die CT erfolgte in Bauchlage und koronarer Schichtfuehrung (5 mm Schichtdicke und Tischvorschub). Die MRT wurde an einem 1,5 T-Geraet in Rueckenlage mittels Kopfspule durchgefuehrt. Eingesetzt wurden koronare Protonen-w-, T

  8. Development of a novel iPad-based laparoscopic trainer and comparison with a standard laparoscopic trainer for basic laparoscopic skills testing. (United States)

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


    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

  9. Aligning Organizational Pathologies and Organizational Resilience Indicators

    Directory of Open Access Journals (Sweden)

    Manuel Morales Allende


    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.

  10. Athletic Trainer Services in US Private Secondary Schools. (United States)

    Pike, Alicia; Pryor, Riana R; Mazerolle, Stephanie M; Stearns, Rebecca L; Casa, Douglas J


    Availability of athletic trainer (AT) services in US secondary schools has recently been reported to be as high as 70%, but this only describes the public sector. The extent of AT coverage in private secondary school settings has yet to be investigated and may differ from the public secondary school setting for several reasons, including differences in funding sources. To determine the level of AT services in US private secondary schools and identify the reasons why some schools did not employ ATs. Concurrent mixed-methods study. Private secondary schools in the United States. Of 5414 private secondary schools, 2044 (38%) responded to the survey. School administrators responded to the survey via telephone or e-mail. This instrument was previously used in a study examining AT services among public secondary schools. Descriptive statistics provided national data. Open-ended questions were evaluated through content analysis. Of the 2044 schools that responded, 58% (1176/2044) offered AT services, including 28% (574/2040) full time, 25% (501/2042) part time, 4% (78/1918) per diem, and 20% (409/2042) from a hospital or clinic. A total of 84% (281 285/336 165) of athletes had access to AT services. Larger private secondary schools were more likely to have AT services available. Barriers to providing AT services in the private sector were budgetary constraints, school size and sports, and lack of awareness of the role of an AT. More than half of the surveyed private secondary schools in the United States had AT services available; however, only 28% had a full-time AT. This demonstrates the need for increased medical coverage to provide athletes in this setting the appropriate level of care. Budgetary concerns, size of the school and sport offerings, and lack of awareness of the role of the AT continued to be barriers in the secondary school setting.

  11. Athletic Trainer Services in Public and Private Secondary Schools. (United States)

    Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J


     The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

  12. Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools (United States)

    Mazerolle, Stephanie M.; Raso, Samantha R.; Pagnotta, Kelly D.; Stearns, Rebecca L.; Casa, Douglas J.


    Context In its best-practices recommendation, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have a certified athletic trainer (AT) on staff. Despite the recommendation, many high schools lack the medical services of an AT. Objective To examine the barriers that athletic directors (ADs) face in hiring ATs in public high schools and in providing medical coverage for their student-athletes. Design Qualitative study. Setting Semistructured telephone interviews. Patients or Other Participants Twenty full-time public high school ADs (17 men, 3 women) from various geographical regions of the United States (6 North, 4 South, 4 Midwest, 6 West) participated. Data saturation guided the total number of participants. Data Collection and Analysis We completed telephone interviews guided by a semistructured questionnaire with all participants. Interviews were recorded and transcribed verbatim. Multiple-analyst triangulation and peer review were included as steps to establish data credibility. We analyzed the data using the principles of the general inductive approach. Results We identified 3 themes. Lack of power represented the inability of an AD to hire an AT, which was perceived to be a responsibility of the superintendent and school board. Budget concerns pertained to the funding allocated to specific resources within a school, which often did not include an AT. Nonbudget concerns represented rural locations without clinics or hospitals nearby; misconceptions about the role of an AT, which led to the belief that first-aid–trained coaches are appropriate medical providers; and community support from local clinics, hospitals, and volunteers. Conclusions Many ADs would prefer to employ ATs in their schools; however, they perceive that they are bound by the hiring and budgeting decisions of superintendents and school boards. Public school systems are experiencing the consequences of national budget

  13. Athletic Trainers' Facilitators of Professional Commitment in the Collegiate Setting (United States)

    Eason, Christianne M.; Mazerolle, Stephanie M.; Pitney, William A.


    Context: Professional responsibility, rewards and respect, and time for rejuvenation are factors supporting professional commitment for athletic trainers (ATs) in the high school setting. The inherent complexities of an occupational setting can mitigate perceptions of professional commitment. Thus far, evidence is lacking regarding professional commitment for ATs in other occupational settings. Objective: To extend the literature on professional commitment of the AT to the collegiate setting. Design: Qualitative study. Setting: Collegiate. Patients or Other Participants: Thirty-three Board of Certification-certified ATs employed in the collegiate setting (National Collegiate Athletic Association Division I = 11, Division II = 9, Division III = 13) with an average of 10 ± 8 years of clinical experience volunteered. Data saturation guided the total number of participants. Data Collection and Analysis: Online journaling via QuestionPro was used to collect data from all participants. Two strategies, multiple-analyst triangulation and peer review, were completed to satisfy data credibility. Data were evaluated using a general inductive approach. Results: Likert-scale data revealed no differences regarding levels of professional commitment across divisions. Two themes emerged from the inductive-content analysis: (1) professional responsibility and (2) coworker support. The emergent theme of professional responsibility contained 4 subthemes: (1) dedication to advancing the athletic training profession, (2) ardor for job responsibilities, (3) dedication to the student-athlete, and (4) commitment to education. Our participants were able to better maintain their own professional commitment when they felt their coworkers were also committed to the profession. Conclusions: The collegiate ATs investigated in this study, regardless of division, demonstrated professional commitment propelled by their aspiration to advance the profession, as well as their dedication to student

  14. Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools. (United States)

    Mazerolle, Stephanie M; Raso, Samantha R; Pagnotta, Kelly D; Stearns, Rebecca L; Casa, Douglas J


    In its best-practices recommendation, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have a certified athletic trainer (AT) on staff. Despite the recommendation, many high schools lack the medical services of an AT. To examine the barriers that athletic directors (ADs) face in hiring ATs in public high schools and in providing medical coverage for their student-athletes. Qualitative study. Semistructured telephone interviews. Twenty full-time public high school ADs (17 men, 3 women) from various geographical regions of the United States (6 North, 4 South, 4 Midwest, 6 West) participated. Data saturation guided the total number of participants. We completed telephone interviews guided by a semistructured questionnaire with all participants. Interviews were recorded and transcribed verbatim. Multiple-analyst triangulation and peer review were included as steps to establish data credibility. We analyzed the data using the principles of the general inductive approach. We identified 3 themes. Lack of power represented the inability of an AD to hire an AT, which was perceived to be a responsibility of the superintendent and school board. Budget concerns pertained to the funding allocated to specific resources within a school, which often did not include an AT. Nonbudget concerns represented rural locations without clinics or hospitals nearby; misconceptions about the role of an AT, which led to the belief that first-aid-trained coaches are appropriate medical providers; and community support from local clinics, hospitals, and volunteers. Many ADs would prefer to employ ATs in their schools; however, they perceive that they are bound by the hiring and budgeting decisions of superintendents and school boards. Public school systems are experiencing the consequences of national budget cuts and often do not have the freedom to hire ATs when other school staff are being laid off.

  15. The professional socialization of the graduate assistant athletic trainer. (United States)

    Mazerolle, Stephanie M; Eason, Christianne M; Clines, Stephanie; Pitney, William A


    The graduate assistant athletic trainer (AT) position often serves as one's first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored. To understand the socialization process for graduate assistant ATs during their graduate experience. Qualitative study. We conducted phone interviews with all participants. A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years. We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment. The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice. Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

  16. Flood Resilient Systems and their Application for Flood Resilient Planning (United States)

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


    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, 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

  17. New aspects from legislation, guidelines and safety standards for MRI; Neues aus Gesetzen, Richtlinien und Sicherheitsstandards fuer die MRT

    Energy Technology Data Exchange (ETDEWEB)

    Muehlenweg, M. [Krankenhaus Martha-Maria Halle-Doelau, Institut fuer Radiologie, Halle (Saale) (Germany); Schaefers, G. [MR:comp GmbH, Gelsenkirchen (Germany); Trattnig, S. [Exzellenzzentrum Hochfeld-Magnetresonanz, Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)


    Betriebsanleitung der MR-Scanner. Die verpflichtenden Inhalte der Betriebsanleitung werden in einer zentralen Norm der International Electrotechnical Commission (IEC) 60601-2-33 geregelt. In dieser Norm wurde juengst die Anwendung statischer Magnetfelder in der MRT bis zu 8 Tesla (T) in der klinischen Routine (kontrollierte Betriebsart 1. Stufe) zugelassen. Die ebenfalls notwendige CE-Zertifizierung der Ultrahochfeldscanner (7-8 T) in Europa ist fuer zukuenftige Geraete zu erwarten. Bestehende Installationen werden nicht automatisch zertifiziert, sondern behalten ihren experimentellen Status. Die aktuelle Erweiterung der IEC 60601-2-33 fuehrt eine neue Zusatzoption, die sog. ''fixed parameter option'' (FPO) ein. Diese Option kann zusaetzlich zu den etablierten Betriebsarten geschaltet werden und definiert eine fixe Geraetekonstellation und bestimmte Parameter des Energieoutputs von MR-Scannern, die zukuenftig die Untersuchungen von Implantatpatienten vereinfachen soll. Die Beschaeftigung schwangerer Mitarbeiterinnen in einer MRT-Einrichtung ist nach wie vor nicht allgemein in Europa geregelt. In Deutschland und Oesterreich wurden 2014 in Teilregionen Beschaeftigungsverbote fuer Schwangere und Stillende im der MR-Kontrollzone (0,5 mT) erteilt. Zugrunde liegt die meist ungeklaerte Frage der Anwendbarkeit von Grenzwerten fuer Beschaeftigte (Extremitaetenexposition fuer statische Magnetfelder bis 8 T erlaubt) oder der Grenzwerte fuer die Allgemeinbevoelkerung (maximal bis 400 mT). Das Verwerfen von Muttermilch nach i.v.-Gabe von gadoliniumhaltigen Kontrastmitteln bei einer stillenden Frau wird laut Gesellschaft fuer urogenitale Radiologie (ESUR) nur noch bei Gabe von Kontrastmitteln der Nephrogenic-systemic-fibrosis(NSF)-Hochrisikoklasse empfohlen. (orig.)

  18. Healthy ageing, resilience and wellbeing. (United States)

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


    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.

  19. An analysis of equine round pen training videos posted online: Differences between amateur and professional trainers. (United States)

    Kydd, Erin; Padalino, Barbara; Henshall, Cathrynne; McGreevy, Paul


    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 (pamateurs did (pamateurs Overall, these findings highlight the need for selectivity when using the internet as an educational source and the importance of trainer skill and excellent timing when using negative reinforcement in horse training.

  20. Towards resilient cities. Comparing approaches/strategies

    Directory of Open Access Journals (Sweden)

    Angela Colucci


    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

  1. Resilience and Higher Order Thinking

    Directory of Open Access Journals (Sweden)

    Ioan Fazey


    Full Text Available To appreciate, understand, and tackle chronic global social and environmental problems, greater appreciation of the importance of higher order thinking is required. Such thinking includes personal epistemological beliefs (PEBs, i.e., the beliefs people hold about the nature of knowledge and how something is known. These beliefs have profound implications for the way individuals relate to each other and the world, such as how people understand complex social-ecological systems. Resilience thinking is an approach to environmental stewardship that includes a number of interrelated concepts and has strong foundations in systemic ways of thinking. This paper (1 summarizes a review of educational psychology literature on PEBs, (2 explains why resilience thinking has potential to facilitate development of more sophisticated PEBs, (3 describes an example of a module designed to teach resilience thinking to undergraduate students in ways conducive to influencing PEBs, and (4 discusses a pilot study that evaluates the module's impact. Theoretical and preliminary evidence from the pilot evaluation suggests that resilience thinking which is underpinned by systems thinking has considerable potential to influence the development of more sophisticated PEBs. To be effective, however, careful consideration of how resilience thinking is taught is required. Finding ways to encourage students to take greater responsibility for their own learning and ensuring close alignment between assessment and desired learning outcomes are particularly important.

  2. Rethinking resilience from indigenous perspectives. (United States)

    Kirmayer, Laurence J; Dandeneau, Stéphane; Marshall, Elizabeth; Phillips, Morgan Kahentonni; Williamson, Karla Jessen


    The notions of resilience that have emerged in developmental psychology and psychiatry in recent years require systematic rethinking to address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples. In Canada, the overriding social realities of indigenous peoples include their historical rootedness to a specific place (with traditional lands, communities, and transactions with the environment) and the profound displacements caused by colonization and subsequent loss of autonomy, political oppression, and bureaucratic control. We report observations from an ongoing collaborative project on resilience in Inuit, Métis, Mi'kmaq, and Mohawk communities that suggests the value of incorporating indigenous constructs in resilience research. These constructs are expressed through specific stories and metaphors grounded in local culture and language; however, they can be framed more generally in terms of processes that include: regulating emotion and supporting adaptation through relational, ecocentric, and cosmocentric concepts of self and personhood; revisioning collective history in ways that valorize collective identity; revitalizing language and culture as resources for narrative self-fashioning, social positioning, and healing; and renewing individual and collective agency through political activism, empowerment, and reconciliation. Each of these sources of resilience can be understood in dynamic terms as emerging from interactions between individuals, their communities, and the larger regional, national, and global systems that locate and sustain indigenous agency and identity. This social-ecological view of resilience has important implications for mental health promotion, policy, and clinical practice.

  3. Military Climate Resilience Planning and Contemporary Urban Systems Thinking (United States)


    3 2.3 Psychological resilience...use of the term resilience must begin by asking core-level questions. A further overview of resilience in the areas of psychology , organizations, and...use of resilience during planning and design. 2.3 Psychological resilience While resilience is solidly rooted and established in the engineering

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

    Directory of Open Access Journals (Sweden)



    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.

  5. Water Infrastructure and Resiliency Finance Center (United States)

    The Water Infrastructure and Resiliency Finance Center serves as a resource to communities to improve their wastewater, drinking water and stormwater systems, particularly through innovative financing and increased resiliency to climate change.

  6. National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma (United States)

    Beam, Joel W.; Buckley, Bernadette; Holcomb, William R.; Ciocca, Mario


    Objective: To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. Background: Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications. Recommendations: These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma. PMID:28092169

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

    Directory of Open Access Journals (Sweden)

    Maurício Leite da Silva


    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.

  8. Concepts of Resilience for Coastal Systems (United States)


    Resilience Study Definition American Society of Civil Engineers (2006) “Resilience refers to the capability to...AR5/images/uploads/WGIIAR5-Glossary_FGD.pdf “The capacity of a social- ecological system to cope with a hazardous event or disturbance, responding or...dunes, wetlands Ecological Resilience The capacity of a system to absorb disturbance and reorganize while undergoing change Ecological Resilience

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

    Directory of Open Access Journals (Sweden)

    A Obarisiagbon


    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.

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

    Directory of Open Access Journals (Sweden)

    Stephanie M. Mazerolle


    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.

  11. Functional cine-MRI of the pelvic floor - normal anatomy and pathologic findings; Funktionelle MRT des Beckenbodens: normale Anatomie und pathologische Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Sprenger, D.; Lienemann, A.; Reiser, M. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Radiologische Diagnostik; Anthuber, C. [Klinikum Grosshadern, Muenchen (Germany). Frauenklinik


    Purpose. Functional MRI of the pelvic floor allows mapping and definition of different forms of pelvic floor dysfunction. Methods. We performed functional MRT of the pelvic floor in 39 healthy nulliparas and 324 patients. The diagnosis of a pathological organ descent was made if certain landmarks of the pelvic floor compartments descended below the pubococcygeal reference-line (PC-line). Results. If there was no organ descent below the PC-line on straining and if the pelvic floor muscles hardly changed position, a normal finding was diagnosed. 70% of organ prolapses came in the combined form. The generally gradual development of an organ descent led to a change of the main finding in 21,6%. The masking of a cystocele (48,6%) or of an enterocele (34,3%) by a rectocele was most frequent in these cases. Discussion. The use of functional MRI of the pelvic floor appears to be especially useful in young patients, in cases of divergent clinical and sonographic or radiological findings and if the presence of a predominant hernial sac with or without enterocele/rectocele is supposed. (orig.) [German] Ziel. Die funktionelle MRT des Beckenbodens ermoeglicht die Dokumentation und Definition der verschiedenen Manifestationsformen einer Beckenbodeninsuffizienz. Methodik. Es wurde bei 39 gesunden Nulliparen und 324 Patientinnen eine funktionelle MRT des Beckenbodens durchgefuehrt. Ein pathologischer Organdeszensus wurde dokumentiert, wenn bestimmte Kennstrukturen der Beckenbodenkompartimente unterhalb der pubokokygealen Referenzlinie (PC-Linie) zu liegen kamen. Ergebnisse. Beim Normalbefund zeigt sich unter Pressen kein Deszensus der Kennstrukturen unterhalb der PC-Linie und die Beckenbodenmuskulatur veraendert ihre Position kaum. In 70% fand sich die kombinierte Form eines Organdeszensus. Die meist stufenweise Entwicklung eines Organvorfalles fuehrte bei 21.6% zu einem Wechsel des Hauptbefundes. Am haeufigsten war hierbei die Maskierung einer Zystozele (48,6%) oder einer

  12. Depression and Resilience in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Gordana Ristevska-Dimitrоvska


    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.

  13. Providing resilience for carrier ethernet multicast traffic

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Wessing, Henrik; Zhang, Jiang


    This paper presents an overview of the Carrier Ethernet technology with specific focus on resilience. In particular, we detail how multicast traffic, which is essential for e.g. IPTV can be protected. We present Carrier Ethernet resilience methods for linear and ring networks and show by simulation...... that the availability of a multicast connection can be significantly increased by applying relevant resilience techniques....

  14. Resilience in nursing students: An integrative review. (United States)

    Thomas, Lisa Jean; Revell, Susan Hunter


    The aim of this integrative review was to investigate the state of knowledge on resilience in nursing students. Specifically the authors sought to define and describe the concept, and identify factors that affect and evaluate strategies to promote resilience in nursing students. Integrative literature review. Cumulative Index to Nursing and Allied Health (CINHAL), Education Resources Information Center (ERIC) and PsychINFO electronic databases were searched for publications between 1990 and 2014. Search terms included resilience, student, nurse, nursing student, hardiness, emotional resilience, research, resili*, and nurse*. Whittemore and Knafl's integrative approach was utilized to conduct the methodological review. Each article was assessed with an appraisal tool. The search resulted in the inclusion of nine articles. The majority of the literature utilized definitions of resilience from the discipline of psychology. One exception was a definition developed within nursing specific to nursing students. Factors that affect resilience were grouped into three themes: support, time, and empowerment. Strategies to promote resilience in nursing students were found in three of the nine articles, but their methods and findings were disparate. This review provides information about the concept of resilience in nursing students. Faculty awareness of the importance of resilience in nursing students can better prepare students for the role of the professional nurse. Support from family, friends and faculty impact a student's resilience. Through closely working with students in advisement, the clinical arena and the classroom faculty can promote resilience. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Risk Behavior and Personal Resiliency in Adolescents (United States)

    Prince-Embury, Sandra


    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"…

  16. The importance of being resilient (United States)

    Mysiak, J.


    Despite many efforts to pin down resilience in terms of measurable indicators and indices, there is little agreement about what is the most appropriate scale, level of (dis)integration, functional relationship and trade-off between the various constituents of resilience. More than anything else, resilience is knowledge. Knowing how to prepare, respond and recover from hazard strikes. More than that, resilience is a capacity to deploy that knowledge. To help oneself to get back on feet after having sustained a blow. To learn how to. Resilience has many forms and manifestations. People convalescing after having lost what was dear to them. Communities recovering from shattering blows. Economies getting back on track after having sustained major shocks and losses. However, resilience has also negative connotation: the persistent overlooking of the threat and perceived powerlessness of individuals, in front of unacquainted community or nonsensical institutions, to make any difference. During the flood emergency situations, the community resilience is determined at individual level by the willpower and readiness of community members to help others in need ('we don't step away') and themselves, and the degree to which they know how to. In this sense, the preparedness comprises capability and experience that can be acquired or trained, and commitment which is transmitted by moral obligation and community membership. In the most cases it is not the professional staff trained for emergency situation which arrives as first at the place of disaster, however well the emergency response is organised. Before the professional rescue teams, the ordinary people intervene, or can do so, with positive or negative outcomes. The articles revisits recent flood events and identify factors and measures that boost community resilience to flood (REF). In Italy, the analysed events included 2000 Soverato, 2006 Vibo Valentia floods, both places situated in Calabria on Ionian and Tyrrhenian

  17. Two-Way Communication between Scientists and the Public: A View from Science Communication Trainers in North America (United States)

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


    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…

  18. 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


    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

  19. A train-the-trainer approach to a shared pharmacogenomics curriculum for US colleges and schools of pharmacy. (United States)

    Lee, Kelly C; Ma, Joseph D; Hudmon, Karen Suchanek; Kuo, Grace M


    To assess pharmacy faculty trainers' perceptions of a Web-based train-the-trainer program for PharmGenEd, a shared pharmacogenomics curriculum for health professional students and licensed clinicians. Pharmacy faculty trainers (n=58, representing 39 colleges and schools of pharmacy in the United States and 1 school from Canada) participated in a train-the-trainer program consisting of up to 9 pharmacogenomics topics. Posttraining survey instruments assessed faculty trainers' perceptions toward the training program and the likelihood of their adopting the educational materials as part of their institution's curriculum. Fifty-five percent of faculty trainers reported no prior formal training in pharmacogenomics. There was a significant increase (ptrain licensed health professionals, and 95% indicated that they would recommend the program to other pharmacy faculty members. As a result of participating in the train-the-trainer program in pharmacogenomics, faculty member participants gained confidence in teaching pharmacogenomics to their students, and the majority of participants indicated a high likelihood of adopting the program at their institution. A Web-based train-the-trainer model appears to be a feasible strategy for training pharmacy faculty in pharmacogenomics.

  20. Fostering resilience through changing realities. Introduction to operational resilience capabilities

    NARCIS (Netherlands)

    Zuiderwijk, D.; Vorm, J. van der; Beek, F.A. van der; Veldhuis, G.J.


    The reality of operations does not always follow the book. Operational circumstances may develop into surprising situations that procedures have not accounted for. Still, we make things work. Resilient performance recognizes surprise early and acts upon it through adaptation, which is critical for

  1. MRI for therapy control in patients with tetralogy of Fallot; MRT zur Therapiekontrolle bei Patienten mit Fallot-Tetralogie

    Energy Technology Data Exchange (ETDEWEB)

    Theisen, D.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Dalla Pozza, R.D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Abteilung fuer Kinderkardiologie und Paediatrische Intensivmedizin, Kinderherzzentrum, Muenchen (Germany); Malec, E. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Herzchirurgische Klinik, Kinderherzzentrum, Muenchen (Germany)


    With prevalences ranging from 0.26 to 0.8 permille of all live births tetralogy of Fallot (TOF) is the most common congenital heart disease with primary cyanosis. Due to improvements in surgical techniques, nearly all patients can nowadays expect to reach adulthood. After surgical repair, pulmonary regurgitation (PR) occurs in almost every child and is an important contributing factor in long-term morbidity and mortality. Cardiac magnetic resonance imaging is well established for functional assessment and flow measurements and is an ideal tool for serial post-surgical follow-up examinations, as it is non-invasive and does not expose patients to ionizing radiation. The timing of pulmonary valve replacement is crucial as right ventricular (RV) volumes have only proven to normalize when preoperative end-diastolic volumes are <170 ml/m{sup 2} and end-systolic volumes are <85 ml/m{sup 2}. After surgical repair up to 15% of patients have residual or recurrent pulmonary artery stenosis. Distal pulmonary branch stenosis can aggravate PR and lead to right heart failure due to combined pressure and volume overload. Therefore, it has to be diagnosed in time and treated by angioplasty with or without stenting. (orig.) [German] Die Fallot-Tetralogie (TOF) ist mit einer Praevalenz zwischen 0,26 und 0,8 permille aller Lebendgeburten der haeufigste Herzfehler mit primaerer Zyanose. Durch verbesserte Operationstechniken erreichen heute nahezu alle Patienten das Erwachsenenalter. Bei fast allen Patienten tritt eine postoperative Pulmonalinsuffizienz (PI) auf, die entscheidenden Einfluss auf die langfristige Morbiditaet und Mortalitaet hat. Die kardiale Magnetresonanztomographie (MRT) ist fuer Quantifizierung von Ventrikelfunktion und Klappeninsuffizienzen etabliert und aufgrund ihrer fehlenden Invasivitaet und Strahlenexposition sehr gut fuer regelmaessige Verlaufskontrollen der heranwachsenden Patienten geeignet. Insbesondere der Zeitpunkt fuer einen Pulmonalklappenersatz darf

  2. 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)


    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.

  3. Seeding Stress Resilience through Inoculation

    Directory of Open Access Journals (Sweden)

    Archana Ashokan


    Full Text Available Stress is a generalized set of physiological and psychological responses observed when an organism is placed under challenging circumstances. The stress response allows organisms to reattain the equilibrium in face of perturbations. Unfortunately, chronic and/or traumatic exposure to stress frequently overwhelms coping ability of an individual. This is manifested as symptoms affecting emotions and cognition in stress-related mental disorders. Thus environmental interventions that promote resilience in face of stress have much clinical relevance. Focus of the bulk of relevant neurobiological research at present remains on negative aspects of health and psychological outcomes of stress exposure. Yet exposure to the stress itself can promote resilience to subsequent stressful episodes later in the life. This is especially true if the prior stress occurs early in life, is mild in its magnitude, and is controllable by the individual. This articulation has been referred to as “stress inoculation,” reminiscent of resilience to the pathology generated through vaccination by attenuated pathogen itself. Using experimental evidence from animal models, this review explores relationship between nature of the “inoculum” stress and subsequent psychological resilience.

  4. Cyber Resilience in de Boardroom

    NARCIS (Netherlands)

    Klaver, M.H.A.; Zielstra, A.


    The Grand Conference - Building a Resilient Digital Society - took place in Amsterdam on October 16, 2012. The international conference aimed for top decision-makers of industry government and other organisations. Two hundred participants from twenty-two nations participated. Three Dutch

  5. MSY from catch and resilience

    DEFF Research Database (Denmark)

    Jørgensen, Ole A; Chrysafi, Anna

    A simple Schaefer model was tested on the Greenland halibut stock offshore in NAFO SA 0 and 1. The minimum data required for this model is a catch time series and a measure of the resilience of the species. Other input parameters that had to be guessed were the carrying capacity, the biomass...

  6. Strengthening community resilience: a toolkit

    NARCIS (Netherlands)

    Davis, Scott; Duijnhoven, Hanneke; Dinesen, Cecilie; Kerstholt, Johanna Helena


    While community resilience is said to have gained a lot of traction politically and given credence by disaster management professionals, this perception is not always shared by the individual members of communities. One solution to addressing the difficulty of individuals ‘conceptualising’ the

  7. Coral reef resilience through biodiversity (United States)

    Rogers, Caroline S.


    Irrefutable evidence of coral reef degradation worldwide and increasing pressure from rising seawater temperatures and ocean acidification associated with climate change have led to a focus on reef resilience and a call to “manage” coral reefs for resilience. Ideally, global action to reduce emission of carbon dioxide and other greenhouse gases will be accompanied by local action. Effective management requires reduction of local stressors, identification of the characteristics of resilient reefs, and design of marine protected area networks that include potentially resilient reefs. Future research is needed on how stressors interact, on how climate change will affect corals, fish, and other reef organisms as well as overall biodiversity, and on basic ecological processes such as connectivity. Not all reef species and reefs will respond similarly to local and global stressors. Because reef-building corals and other organisms have some potential to adapt to environmental changes, coral reefs will likely persist in spite of the unprecedented combination of stressors currently affecting them. The biodiversity of coral reefs is the basis for their remarkable beauty and for the benefits they provide to society. The extraordinary complexity of these ecosystems makes it both more difficult to predict their future and more likely they will have a future.

  8. Integrative approaches: promoting socioecological resilience (United States)

    J.W. Long; Carl Skinner; M. North; C.T. Hunsaker; L. Quinn-Davidson


    This chapter begins by discussing current challenges for ecosystem management that emerged from multiple chapters of the full synthesis. It then considers integrative approaches to promote resilience, including general strategies that recognize the integrated nature of socioecological systems, the importance of promoting disturbance regimes upon which these systems...

  9. Fetal MRI; Fetales MRT

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D. [Inst. fuer Diagn. Radiologie, Uniklinikum Duesseldorf (Germany); Turowski, B. [Inst. fuer Diagn. Radiologie, Neuroradiologie, Uniklinikum Duesseldorf (Germany); Schaper, J. [Inst. fuer Diagn. Radiologie, Kinderradiologie, Uniklinikum Duesseldorf (Germany)


    Ultrasonography is the method of choice for prenatal malformation screening, but it does not always provide sufficient information for correct diagnosis or adequate abnormality evaluation. Fetal MRI is increasingly being used to complete sonographic findings. It was initially used for evaluation of cerebral abnormalities but is increasingly being applied to other fetal areas. In vivo investigation of fetal brain maturation has been enhanced by MRI. An adequate analysis of fetal chest and abdomen can be achieved with fast T2-, T1-weighted and diffusion-weighted imaging (DWI). The advantages include the great field of view and the excellent soft tissue contrast. This allows correct diagnosis of congenital diaphragmatic hernia and evaluation of the consequences on pulmonary growth. Other pulmonary malformations, such as cystic adenomatoid malformation, sequestration and brochogenic cysts, can also be easily identified. Renal position can be quickly determined using DWI sequences and renal agenesia can be easily diagnosed with only one sequence. Prenatal MRI is virtually as effective as postnatal examination, dispenses with transport of a potentially very ill newborn, and provides logistic advantages. Therefore, prenatal MRI is useful for adequate postnatal treatment of newborns with malformations. (orig.)

  10. Resilience definitions, theory, and challenges: interdisciplinary perspectives

    Directory of Open Access Journals (Sweden)

    Steven M. Southwick


    Full Text Available 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.

  11. Transdisciplinary Application of Cross-Scale Resilience

    Directory of Open Access Journals (Sweden)

    Shana M. Sundstrom


    Full Text Available 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.

  12. What do you mean, 'resilient geomorphic systems'? (United States)

    Thoms, M. C.; Piégay, H.; Parsons, M.


    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.

  13. Depression and Resilience in Breast Cancer Patients. (United States)

    Ristevska-Dimitrovska, Gordana; Stefanovski, Petar; Smichkoska, Snezhana; Raleva, Marija; Dejanova, Beti


    A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. Two hundred eighteen (218) women, treated for early breast cancer responded to Connor - Davidson Resilience Scale and Hospital Depression and Anxiety Scale, in order to assess the level of psychological resilience and the level of depression. There is a significant negative correlation between depression and resilience in our sample (r = - 0.562, p resilience. There is no statistically significant correlation between the ages of the participants; time passed since diagnosis, cancer stage and resilience levels. 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.

  14. Resilience definitions, theory, and challenges: interdisciplinary perspectives (United States)

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


    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

  15. Multidimensional approach to complex system resilience analysis

    International Nuclear Information System (INIS)

    Gama Dessavre, Dante; Ramirez-Marquez, Jose E.; Barker, Kash


    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.

  16. 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.


    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

  17. The Modified Readiness for Interprofessional Learning Scale in Currently Practicing Athletic Trainers (United States)

    Welsch, Lauren A.; Rutledge, Carolyn; Hoch, Johanna M.


    Context: Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for…

  18. The Teacher Trainer: A Practical Journal for Those Who Train, Mentor and Educate TESOL Teachers, 2002. (United States)

    Woodward, Tessa, Ed.


    These three journal issues include the following articles: "Competence in Facilitation" (Graham O'Connel); "Is My Map to Scale?" (Mark Wilson); "A Trainer's Dozen" (Barbara Thornton and Mary Lou McCloskey); "Carrot Ice Cream: Reactions to the New or Different" (Tessa Woodward); "Feeding (back to) the…

  19. Injured Athletes' Perceived Loss of Identity: Educational Implications for Athletic Trainers (United States)

    Lockhart, Barbara D.


    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…

  20. Women's Human Rights Education Trainers in Turkey: Situated Empowerment for Social Change (United States)

    Tibbitts, Felisa L.


    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…

  1. 77 FR 39741 - Solicitation for a Cooperative Agreement-Curricula Review and Revision: NIC Trainer Development... (United States)


    ... the knowledge, skills, and abilities needed to train and develop their staff. DATES: Application must... ``Training Design and Development,'' ``Foundation Skills for Trainers,'' ``Building Agency Success... throughout the country. Staff development divisions have been hit particularly hard by budget cuts, and...

  2. Cross-cultural communication capabilities of U.S. military trainers: host nation perspective. (United States)

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


    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.

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

    NARCIS (Netherlands)

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


    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

  4. Current Evaluation Practices of Diversity Trainers in German-Speaking Countries (United States)

    Rohmann, Anette; Froncek, Benjamin; Mazziotta, Agostino; Piper, Verena


    Diversity training has been greatly expanded in recent years in order to help people deal with the challenges of increased social diversity. However, little is known about the systematic evaluation of diversity training. The present research surveyed 172 diversity trainers concerning their evaluation practices with regard to diversity training.…

  5. Exploring Trainer and Trainee Emotional Talk in Narratives about Workplace-Based Feedback Processes (United States)

    Dennis, A. A.; Foy, M. J.; Monrouxe, L. V.; Rees, C. E.


    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…

  6. Model Curriculum And Trainer's Guide for Programs to Combat White-Collar Crime. (United States)

    Karchmer, Clifford L.

    This model curriculum is addressed to the training needs of personnel working in general white-collar crime assignments located in state and local police or prosecutors' offices. It is designed intentionally to orient personnel to the requirements of building a case as it moves along the enforcement process. Materials on trainer use and…

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

    Directory of Open Access Journals (Sweden)

    Bahtiyar Heru Susanto


    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.

  8. 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.


    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

  9. Comparison of muscle activation during elliptical trainer, treadmill and bike exercise

    Directory of Open Access Journals (Sweden)

    H Sözen


    Full Text Available The purpose of this study is to compare muscle activation during elliptical trainer (ET, treadmill (TM and bike (B exercise. Twenty three voluntary and healthy male athletes (age, 20.65±1.65 years; weight, 74.21±7.21 kg; height, 180.69±5.31 cm; Body Mass Index, 22.4±1.5 participated in our study. Study protocol was decided for three days. Measures were taken by using elliptical trainer on the first day, treadmill on the second day and bicycle device on the third. Exercise devices were run with 65�0metabolic pulse for six minutes and at the end of the sixth minute, surface electrodes were placed on Biceps Brachii, Triceps Brachii, Pectoralis Major and Trapezius of upper extremity muscle and on Gastrocnemius, Vastus Lateralis, Rectus Femoris and Gluteus Maximus of lower extremity muscles and Electromyography (EMG activities were measured. According to the finding of the study, it has been found out that all of the measured upper extremity muscle were more activated by elliptical trainer compared to treadmill and bike exercise (p0.05. In conclusion, due to the advantage of more upper extremity muscle activation, it has been thought that elliptical trainer is a device to be able to be used in rehabilitation and exercise science.

  10. Insect Identification Educational Volunteers Created in Train-the-Trainer Workshops in Oregon and Washington (United States)

    Corp, Mary K.; Rondon, Silivia I.; Van Vleet, Stephen M.


    The "train-the-trainer" model successfully created volunteer educators in insect identification. Intensive training programs prepared 71 individuals during 2 1/2-day (20 hour) training sessions. Trainees included university Extension faculty (13), agricultural professionals (13), and certified Master Gardeners (45). The sessions were…

  11. 24 CFR 3286.309 - Continuing education-trainers and curriculum. (United States)


    ... curriculum. 3286.309 Section 3286.309 Housing and Urban Development Regulations Relating to Housing and Urban...-Administered States § 3286.309 Continuing education-trainers and curriculum. (a) HUD-mandated elements. Only... number of hours and the required curriculum for such subject areas, according to experience with the...

  12. Learning results of GP trainers in a blended learning course on EBM: a cohort study

    NARCIS (Netherlands)

    te Pas, Ellen; Wieringa-de Waard, Margreet; de Ruijter, Wouter; van Dijk, Nynke


    General practitioners (GPs) experience barriers to the use of evidence-based medicine (EBM) related to a negative attitude and to insufficient knowledge and skills. We therefore designed a blended learning intervention to develop the competence of GP trainers in EBM. This study investigated the

  13. Trainers Attitudes towards the Teaching of AIDS Education in a Kenyan Teachers' College (United States)

    Nzau, K. A.; Ondimu, K. A.; Gikuhi, C. W.


    The purpose of this study was to examine the teaching of AIDS education. The study was mainly concerned with the implementation of the AIDS education curriculum. In particular the study sought to investigate the attitudes held by trainers and trainees towards the subject and make suggestions to improve its teaching. The study was conducted in a…

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

    Directory of Open Access Journals (Sweden)

    Adamchhuk Ja.


    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.

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

    Directory of Open Access Journals (Sweden)

    Allan Shefrin


    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.

  16. Core characteristics of the competent general practice trainer, a Delphi study

    NARCIS (Netherlands)

    Boendermaker, P.M.; Schuling, J.; Meyboom-de Jong, B.; Zwierstra, R.P.; Metz, J.C.; Conradi, Mark


    Introduction: The specific skills, attitude, knowledge, and personality characteristics, which should define the competent GP-trainer have been subject of research for many years. What are the most important of these characteristics have yet to be delineated. Aim: The aim of this study is to

  17. A Statewide Train-the-Trainer Model for Effective Entrepreneurship and Workforce Readiness Programming (United States)

    Fields, Nia Imani; Brown, Mananmi; Piechocinski, Alganesh; Wells, Kendra


    A statewide youth and adult train-the-trainer model that integrates workforce readiness and entrepreneurship can have a profound effect on young people's academic performance, interest in college, and overall youth development. Participants in workforce and entrepreneurship programs develop personal resources that have value in school, in the…

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


    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.

  19. Comparison of noninvasive MRT-procedures for the temperature measurement for the application during medical thermal therapies; Vergleich nichtinvasiver MRT-Verfahren zur Temperaturmessung fuer den Einsatz bei medizinischen Thermotherapien

    Energy Technology Data Exchange (ETDEWEB)

    Rademaker, G.; Jenne, J.W.; Rastert, R.; Roeder, D.; Schad, L.R. [Deutsches Krebsforschungszentrum (DKFZ), Abt. Biophysik und Medizinische Strahlenphysik, Heidelberg (Germany)


    Novel methods for hyperthermia tumor therapy, such as high-intensity focused ultrasound (HIFU) or laser-induced thermotherapy (LITT), require accurate non-invasive temperature monitoring. Non-invasive temperature measurement using magnetic resonance imaging (MRI) is based on the analysis of changes in longitudinal relaxation time (T1), diffusion coefficient (D), or water proton resonance frequency (PRF). The purpose of this study was the development and comparative analysis of the three different approaches of MRI temperature monitoring (T1, D, and PRF). Measurements in phantoms (e.g., ultrasound gel) resulted in the following percent changes: T1-relaxation time: 1.98%/ C; diffusion coefficient: 2.22%/ C; and PRF: -0,0101 ppm/ C. All measurements were in good agreement with the literature. Temperature resolutions could also be measured from the inverse correlation of the data over the whole calibration range: T1: 2.1{+-}0.6 C; D: 0.93{+-}0.2 C; and PRF: 1.4{+-}0.3 C. The diffusion and PRF methods were not applicable in fatty tissue. The use of the diffusion method was restricted due to prolonged echo time and anisotropic diffusion in tissue. Initial tests with rabbit muscle tissue in vivo indicated that MR thermometry via T1 and PRF procedures is feasible to monitor the local heating process induced by HIFU. The ultrasound applicators in the MR scanner did not substantially interfere with image quality. (orig.) [German] Neue Hyperthermieverfahren zur Tumortherapie basieren auf hochenergetischem fokussiertem ultraschall (HIFU) oder laserinduzierter thermotherapie (LITT). Fuer diese Verfahren ist eine genaue nichtinvasive Temperaturkontrolle erforderlich. Die nichtinvasiven Temperaturdarstellungen mit der magnetresonanztomographie (MRT) basieren auf Aenderung der longitudinalen Relaxationszeit (T{sub 1}), des diffusionskoeffizienten (D) oder der protonenresonanzfrequenz (PRF). Das Ziel waren die Entwicklung und der Vergleich der drei unterschiedlichen Methoden (T

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

    Directory of Open Access Journals (Sweden)

    Jason A. Bennie


    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

  1. Training the Trainers of Tomorrow Today - driving excellence in medical education. (United States)

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


    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 between the

  2. Variations in area-level disadvantage of Australian registered fitness trainers usual training locations. (United States)

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


    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

  3. Quantitative resilience analysis through control design.

    Energy Technology Data Exchange (ETDEWEB)

    Sunderland, Daniel; Vugrin, Eric D.; Camphouse, Russell Chris (Sandia National Laboratories, Carlsbad, NM)


    Critical infrastructure resilience has become a national priority for the U. S. Department of Homeland Security. System resilience has been studied for several decades in many different disciplines, but no standards or unifying methods exist for critical infrastructure resilience analysis. Few quantitative resilience methods exist, and those existing approaches tend to be rather simplistic and, hence, not capable of sufficiently assessing all aspects of critical infrastructure resilience. This report documents the results of a late-start Laboratory Directed Research and Development (LDRD) project that investigated the development of quantitative resilience through application of control design methods. Specifically, we conducted a survey of infrastructure models to assess what types of control design might be applicable for critical infrastructure resilience assessment. As a result of this survey, we developed a decision process that directs the resilience analyst to the control method that is most likely applicable to the system under consideration. Furthermore, we developed optimal control strategies for two sets of representative infrastructure systems to demonstrate how control methods could be used to assess the resilience of the systems to catastrophic disruptions. We present recommendations for future work to continue the development of quantitative resilience analysis methods.

  4. Resilience in women with autoimmune rheumatic diseases. (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


    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.

  5. Special Education Teacher Resilience: A Phenomenological Study of Factors Associated with Retention and Resilience of Highly Resilient Special Educators


    Downing, Brienne


    Abstract Of The DissertationSpecial Education Teacher Resilience: A Phenomenological Study of Factors Associated with Retention and Resilience of Highly Resilient Special EducatorsbyBrienne DowningDoctor of Education in Educational LeadershipUniversity of California, San Diego, 2017California State University, San Marcos, 2017Professor Jacqueline Thousand, ChairSpecial education teachers are in high demand and greatly needed to meet the needs of the growing population of students qualified fo...

  6. Building Resilient Communities Workshop Report (United States)


    University - Faculty of Liberal Arts Colleen Vaughan JIBC School of Public Safety Dan Sandink Institute for Catastrophic Loss Reduction Daniel...First Nations, Métis and Inuit people has been a very real positive outcome and the mini-poster carrying this focus will be an important step in...Executive Summary Promoting Canadian Aboriginal Disaster Resilience in First Nations, Métis and Inuit Communities Eric Bussey, Brenda L. Murphy

  7. The resilience of paradigm mixes

    DEFF Research Database (Denmark)

    Daugbjerg, Carsten; Farsund, Arild Aurvåg; Langhelle, Oluf


    This paper argues that a policy regime based on a paradigm mix may be resilient when challenged by changing power balances and new agendas. Controversies between the actors can be contained within the paradigm mix as it enables them to legitimize different ideational positions. Rather than engaging...... context changed. The paradigm mix proved sufficiently flexible to accommodate food security concerns and at the same time continue to take steps toward further liberalization. Indeed, the main players have not challenged the paradigm mix....

  8. Political Subculture: A Resilience Modifier (United States)


    A RESILIENCE MODIFIER by Gordon S. Hunter September 2011 Thesis Advisor: Samuel H. Clovis , Jr. Second Reader...Approved by: Samuel H. Clovis , Jr., DPA Thesis Advisor Lauren S. Fernandez, DSc Second Reader Harold A. Trinkunas, PhD Chair...addition, I must acknowledge the continued support, guidance, and encouragement of Dr. Sam Clovis and Dr. Lauren Fernandez who have led me on the path to

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

    Directory of Open Access Journals (Sweden)

    Fridolin Simon. Brand


    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.

  10. Cryotherapy of malignant tumors: MR imaging in comparison with pathological changes in mice; Kryotherapie maligner Tumoren: Untersuchungen mittels MRT im Tierexperiment und Vergleich mit morphologischen Veraenderungen

    Energy Technology Data Exchange (ETDEWEB)

    Romaneehsen, B.; Anders, M.; Roehrl, B.; Hast, H.J.; Schiffer, I.; Neugebauer, B.; Teichmann, E.; Schreiber, W.G.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Hengstler, J.G. [Mainz Univ. (Germany). Inst. fuer Toxikologie


    Aim of our study was to investigate the efficacy of 7 F cryoprobes for percutaneous use morpho- and histologically, to examine the role of apoptosis after cryotherapy, and to compare contrast-enhanced MRI with histopathological findings at different time intervals in a tumor-mouse model. Methods: Percutaneous cryotherapy was performed in 15 immunocompromised nude mice with subcutaneously implanted tumors using the non-small-cell lung cancer cell line Lu 1. In group a) 7 mice were sacrificed after definite time intervals and histological examinations were done for evaluation of necrosis and apoptosis (HE; TUNEL assay); 2 mice are in long-term follow-up. In group b) in 6 mice tumor destruction and perfusion before and after freezing were investigated with native and contrast-enhanced MR imaging (T{sub 1}- and T{sub 2}-weighted spin-echo) and compared with histopathological findings. Histological control were done in 2 untreated mice. Results: We observed fast tumor-reduction within two weeks (ca. 50%). On long-term follow-up (> 6 months) no recurrence has been noticed so far. Tumors were well vascularized prior to treatment and did not-show contrast enhancement an any time after cryotherapy. A narrow contrast-enhanced zone was seen on the tumor border subcutaneously as a sign of peripheral hyperemia and central vascular stasis after cryotherapy. On histology there was evidence of both apoptosis and necrosis. (orig.) [German] Evaluierung der Durchfuehrbarkeit und Effizienz einer perkutanen Kryotherapie mittels 7-F-Kryosonde in Nacktmaeusen. Erheben des histopathologischen Befundes der Kryolaesion nach definierten Zeitintervallen und Ueberpruefung einer moeglichen Rolle der Apoptose nach Kryotherapie. Darstellung morphologischer Veraenderungen des Tumors und des angrenzenden Gewebes im Anschluss an die Kryotherapie mittels kontrastmittelunterstuetzter MRT. Methodik: Zweiminuetige Kryotherapie subkutan implantierter Tumoren eines nicht-kleinzelligen Bronchialkarzinoms

  11. Functional MRI of the pelvic floor: postpartum changes of primiparous women after spontaneous vaginal delivery; Funktionelle Magnetresonanztomographie (MRT) des Beckenbodens: Postpartale Veraenderungen bei Erstgebaerenden nach vaginaler Spontangeburt

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, A.; Fischer, T.; Reiser, M. [Inst. fuer Klinische Radiologie, Klinikum der Univ. Muenchen (Germany); Anthuber, C. [Klinik und Poliklinik fuer Geburtshilfe und Frauenheilkunde, Klinikum der Univ. Muenchen/Grosshadern (Germany)


    Purpose: Detection of morphological and functional changes of the pelvic floor with functional MRI in primiparous women after spontaneous vaginal delivery. Methods and Materials: The study comprises 26 primiparous women after vaginal delivery and a control group of 41 healthy asymptomatic nulliparous volunteers. MRI was performed on a 1.5 T system in supine position with vagina and rectum opacified with Sonogel. The static images consisted of sagittal and axial T{sub 2}-weighted SE sequences and functional images of true FISP sequences in midsagittal and axial planes acquired with the patient at rest, straining and during defecation. Evaluation of morphometric parameters included pelvimetry, thickness of the puborectal muscle and width of the urogenital hiatus as well as position and movement of the pelvic organs relative to the pubococcygeal reference line. Results: The configuration of the bony pelvis did not differ for both groups. The puborectal muscle was significantly thinner in the study group (0.8 cm vs 0.6 cm). The functional images showed no significant differences between both groups at rest but a significantly increased incidence in the descent of the bladder neck, vaginal fornix and anorectal junction in the study group during straining. In addition, the primiparous women had more prominent rectoceles (0.6 cm vs 1.5 cm). Conclusion: Static imaging alone fails to demonstrate relevant pelvic floor changes and a functional method is necessary to evaluate the interactions of the pelvic organs regarding organ descent. Functional MRI of the pelvic floor is an excellent method to reveal the significant changes of the pelvic floor after vaginal birth without exposing the uterus to radiation. (orig.) [German] Ziel: Darstellung von morphologischen und funktionellen Veraenderungen am Beckenboden bei Erstgebaerenden nach spontanvaginaler Entbindung mittels funktioneller MRT. Methodik: Funktionelle MRT des Beckenbodens von 26 Erstgebaerenden nach vaginaler

  12. Identifying Resilient and Non-Resilient Middle-Adolescents in a Formerly Black-Only Urban School (United States)

    Mampane, Ruth; Bouwer, Cecilia


    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 and non-resilient…

  13. Migration, remittances, livelihood trajectories, and social resilience. (United States)

    Adger, W Neil; Kelly, P Mick; Winkels, Alexandra; Huy, Luong Quang; Locke, Catherine


    We argue that all aspects of demographic change, including migration, impact on the social resilience of individuals and communities, as well as on the sustainability of the underlying resource base. Social resilience is the ability to cope with and adapt to environmental and social change mediated through appropriate institutions. We investigate one aspect of the relationship between demographic change, social resilience, and sustainable development in contemporary coastal Vietnam: the effects of migration and remittances on resource-dependent communities in population source areas. We find, using longitudinal data on livelihood sources, that emigration and remittances have offsetting effects on resilience within an evolving social and political context. Emigration is occurring concurrently with, not driving, the expansion of unsustainable coastal aquaculture. Increasing economic inequality also undermines social resilience. At the same time diversification and increasing income levels are beneficial for resilience.

  14. Bridging Resilience Engineering and Human Reliability Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring


    There has been strong interest in the new and emerging field called resilience engineering. This field has been quick to align itself with many existing safety disciplines, but it has also distanced itself from the field of human reliability analysis. To date, the discussion has been somewhat one-sided, with much discussion about the new insights afforded by resilience engineering. This paper presents an attempt to address resilience engineering from the perspective of human reliability analysis (HRA). It is argued that HRA shares much in common with resilience engineering and that, in fact, it can help strengthen nascent ideas in resilience engineering. This paper seeks to clarify and ultimately refute the arguments that have served to divide HRA and resilience engineering.

  15. DDDAS-based Resilient Cyberspace (DRCS) (United States)


    using three Dell XPS 8700 towers with i7 4770 processors and 12GB memory, with Ubuntu 12.04 Server as a host operating system. We deployed OpenStack...resilient scientific and engineering applications. 15 . SUBJECT TERMS Dynamic Data-Driven Application Systems (DDDAS), resiliency, resilient DDDAS (rDDDAS...edition number, etc. 14. ABSTRACT. A brief (approximately 200 words) factual summary of the most significant information. 15 . SUBJECT TERMS. Key words

  16. Depression and Resilience in Breast Cancer Patients


    Ristevska-Dimitrovska, Gordana; Stefanovski, Petar; Smichkoska, Snezhana; Raleva, Marija; Dejanova, Beti


    OBJECTIVE: A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. MATERIAL AND METHODS: Two hundred eighteen (218) ...

  17. Evaluating multicast resilience in carrier ethernet

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Wessing, Henrik; Zhang, Jiang


    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....

  18. Incorporating Resilience into Dynamic Social Models (United States)


    AFRL-AFOSR-VA-TR-2016-0258 Incorporating Resilience into Dynamic Social Models Eunice Santos UNIVERSITY OF TEXAS AT EL PASO 500 UNIV ST ADMIN BLDG...REPORT TYPE Final Report 3. DATES COVERED (From - To) 3/1/13-12/31/14 4. TITLE AND SUBTITLE Incorporating Resilience into Dynamic Social Models 5a...AVAILABILITY STATEMENT 13. SUPPLEMENTARY NOTES 14. ABSTRACT We propose an overarching framework designed to incorporate various aspects of social resilience

  19. Emergency planning in school-based athletics: a national survey of athletic trainers. (United States)

    Olympia, Robert P; Dixon, Trevor; Brady, Jodi; Avner, Jeffrey R


    To use nationally published guidelines to examine the preparedness of schools in the United States to respond to emergencies associated with school-based athletics. A questionnaire, mailed to 1000 randomly selected members of the National Athletic Trainers' Association, included questions on the clinical background of the athletic trainer, the demographic features of their school, the preparedness of their school to manage life-threatening athletic emergencies, the presence of preventative measures to avoid potential sport-related emergencies, and the immediate availability of emergency equipment. Of the 944 questionnaires delivered, 643 (68%) were returned; of these, 521 (81%) were eligible for analysis (55% usable response rate). Seventy percent (95% confidence interval [CI], 66-74) of schools have a Written Emergency Plan (WEP), although 36% (95% CI, 30-40) of schools with a WEP do not practice the plan. Thirty-four percent (95% CI, 30-38) of schools have an athletic trainer present during all athletic events. Sports previously noted to have higher rates of fatalities/injuries based on published literature, such as ice hockey and gymnastics, had, according to our data, less coverage by athletic trainers compared with other sports with lower rates of fatalities/injuries. Athletic trainers reported the immediate availability of the following during athletic events: cervical spine collar (62%, 95% CI, 58-66), automatic electronic defibrillator (61%, 95% CI, 57-65), epinephrine autoinjector (37%, 95% CI, 33-41), bronchodilator metered-dose inhaler (36%, 95% CI, 32-40). Although schools are in compliance with many of the recommendations for school-based athletic emergency preparedness, specific areas for improvement include practicing the WEP several times a year, linking all areas of the school directly with emergency medical services, increasing the presence of athletic trainers at athletic events (especially sports with a higher rate of fatalities

  20. 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

  1. Laser-induced thermotherapy for liver metastases in an open 0.2 T MR system; Laserinduzierte Thermotherapie (LITT) von Lebermetastasen in einem offenen 0,2 T MRT

    Energy Technology Data Exchange (ETDEWEB)

    Reither, K.; Wacker, F.; Wolf, K.J. [Freie Univ. Berlin (Germany). Abt. fuer Radiologie und Nuklearmedizin; Ritz, J.P.; Isbert, C.; Germer, C.T. [Freie Univ. Berlin (Germany). Chirurgische Klinik 1 fuer Visceral-, Gefaess- und Thoraxchirurgie; Roggan, A. [Freie Univ. Berlin (Germany). Inst. fuer Medizinische Physik und Lasermedizin; Wendt, M. [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology


    Objective: To test the feasibility and safety of the laser-induced thermotherapy (LITT) for liver metastases in open MR imaging system operating at 0.2 Tesla. Method: Laser therapy using the Nd:YAG laser was performed on 25 patients with a total of 41 liver metastases. An open low-field MRI scanner was used for puncture, positioning of the laser applicator, and monitoring the therapy. A true FISP sequence was used to track the puncture in close to real-time. Localization diagnostics and temperature monitoring were aided by T{sub 1}-weighted gradient echo sequences in the breath-holding technique. In the first follow up after 24-48 hours, a contrast-enhanced T{sub 1}-weighted gradient-echo sequence was performed in an MRI scanner at 1.5 T. The pre-, intra- and post-interventional volumes of the liver metastases as well as the thermolesions and the thermonecroses were determined. Results: LITT in an open MRI system was technically feasible in all patients with no clinically relevant complications. The mean volumes of the thermolesions measured during intervention in low-field MRI were lower than the volumes of the thermonecroses measured after intervention in high-field MRI. Conclusion: The technique presented here of laser-induced thermotherapy for liver metastases in an open MRI system is technically feasible and safe. (orig.) [German] Ziel: Untersuchung der Praktikabilitaet und Sicherheit der laserinduzierten Thermotherapie (LITT) von Lebermetastasen in einem offenen 0,2 T MRT. Methode: Es wurde eine Lasertherapie mit einem Nd:YAG-Laser bei 25 Patienten mit insgesamt 41 Lebermetastasen durchgefuehrt. Punktion, Plazierung des Laserapplikators und Therapiekontrolle erfolgten in einem offenen Niederfeld-MRT. Zur echtzeitnahen Punktionskontrolle wurde eine True-FISP-Sequenz verwendet. Die Lokalisationsdiagnostik und das Thermomonitoring erfolgte mit Hilfe T{sub 1}-gewichteter Gradienten-Echo-Sequenzen in Atemanhaltetechnik. Zur ersten Verlaufskontrolle wurde nach 24

  2. Teaching Resilience: A Narrative Inquiry into the Importance of Teacher Resilience (United States)

    Vance, Angela; Pendergast, Donna; Garvis, Susanne


    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…

  3. Reframing Resilience: Pilot Evaluation of a Program to Promote Resilience in Marginalized Older Adults (United States)

    Fullen, Matthew C.; Gorby, Sean R.


    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…

  4. Degrees of Resilience: Profiling Psychological Resilience and Prospective Academic Achievement in University Inductees (United States)

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


    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…

  5. Priority Queues Resilient to Memory Faults

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Moruz, Gabriel; Mølhave, Thomas


    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....

  6. In-vitro examinations and patient examinations by MR: Significance of metal implants. In-vitro- und Patientenuntersuchungen mittels MRT: Bedeutung metallischer Implantate

    Energy Technology Data Exchange (ETDEWEB)

    Grebmeier, J.; Roedl, W. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Zentrum Innere Medizin); Weikl, A. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Medizinische Klinik 2 mit Poliklinik); Glueckert, K. (Waldkrankenhaus St. Marien, Erlangen (Germany, F.R.). Orthopaedische Klinik mit Poliklinik); Hofmann-Preiss, K. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Chirurgische Klinik mit Poliklinik); Huk, W.J. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Kopfklinikum); Wolf, F. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Inst. und Poliklinik fuer Nuklearmedizin)


    This study presents the results of in-vitro and clinical experiences with metallic implants during MRT investigations. In-vitro temperature measurements of various implants showed little temperature rise depending on the shape and the orientation in the static magnetic field (max. 0.3deg C). Ferromagnetic forces could not be detected with these implants. In contrast, severe temperature increase (9.3deg C) was observed with an intratracheal spiral tube. Tubes of this type should not be used in MR imaging to avoid the risk of burning. 105 MR examinations were performed in patients with metallic implants (CNS shunts, aortocoronary bypass grafts, aortic-, mitral-prothesis, orthopedic implants, skin staples, shrapnels). Patients with vascular clips were accepted for MR imaging when the clips were non-ferromagnetic only. No adverse effects were observed in these patients. (orig.).

  7. How safe is magnetic resonance imaging in patients with contraceptive implants; Wie sicher ist die MRT bei Patientinnen mit kontrazeptiven Implantaten

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, M.; Taupitz, M. [Charite - Universitaetsmedizin Berlin (Germany). Institut fuer Radiologie


    When patients with an implanted contraceptive device undergo MRI, it must be ensured that the examination involves no risk to the patient (MR safety) and that the diagnosis is not affected by artifacts or the function of the device compromised (MR compatibility). Two basic types of intrauterine devices can be distinguished: the metal-containing/metal-free intrauterine device (IUD) and the hormone-containing implant, the fully metal-free intrauterine system (IUS), as well as the ESSURE insert made of stainless steel, which has been approved for use in Europe since February 2001. The metal-containing and metal-free IUDs and ESSURE are MRI compatible up to a magnetic field strength of 1.5 T. They do not interact in any relevant way with the external magnetic or high-frequency field and the temperature increase is within the physiologic range. The implants merely produce a local signal void with a shape that depends on their orientation relative to the magnetic field lines. At 3 T, only the metal-free IUD and the IUS are MRI safe in terms of the material used. In contrast, metal-containing IUDs and the ESSURE have not yet been fully evaluated in the 3 T field, which is why they represent a contraindication to MRI. No data are available on the MRI compatibility at 3 T for any of these devices. (orig.) [German] Bei der Untersuchung von Patientinnen mit kontrazeptiven Implantaten im MRT muss gewaehrleistet sein, dass es weder zu einer Gesundheitsgefaehrdung der Patientin (MR-Sicherheit) noch zu befundrelevanten Artefakten oder einer Funktionsbeeintraechtigung des Implantats (MR-Kompatibilitaet) kommt. Unterschieden werden im wesentlichen 2 Systeme kontrazeptiver Implantate: Das metallhaltige/-lose Intrauterinpessar (IUP; engl. intrauterine device, IUD) sowie das bauaehnliche, hormontragende, vollstaendig metallfreie intrauterine System (IUS; engl. intrauterine system) und das seit Februar 2001 auf dem europaeischen Markt zugelassene, aus Edelstahl gefertigte ESSURE. Die

  8. Influence of platform screen doors on energy consumption of the environment control system of a mass rapid transit system: case study of the Taipei MRT system

    International Nuclear Information System (INIS)

    Hu, S.-C.; Lee, J.-H.


    This investigation studies how platform screen doors (PSD) affect the energy consumption of the environmental control system of a mass rapid transit (MRT) system in Taipei. The environmental parameter simulation was conducted using the subway environmental simulation (SES) program, while the associated air conditioning (A/C) cooling load was predicted with the carrier E20-II program. Results show that PSD can significantly decrease average and peak cooling load, thus reducing the capacity/size of cooling equipment and allowing the chiller cooling load to be abridged. However, electricity consumption by ventilation equipment increases notably when PSD are used, particularly the electricity consumption by the under platform exhaust (UPE) fan, and thus, ultimately, little difference exists in the overall energy consumption with and without UPE

  9. Hydro-MRI in inflammatory bowel diseases: a comparison with colonoscopy and histopathology; Hydro-MRT bei entzuendlichen Darmerkrankungen - Eine koloskopisch-histologische Vergleichsstudie

    Energy Technology Data Exchange (ETDEWEB)

    Schunk, K.; Reiter, S.; Kern, A. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Orth, T.; Wanitschke, R. [Mainz Univ. (Germany). Medizinische Klinik und Poliklinik


    Purpose: To compare hydro-MRI with colonoscopy and biopsy specimen regarding the assessment of inflammatory activity and the differentiation of inflammatory bowel diseases. Material and methods: After an oral bowel opacification using 1000 ml of a 2.5% mannitol solution and a rectal bowel opacification using 250-500 ml of a 0.9% saline solution, axial and coronal breath-hold sequences {+-}Gd-DTPA (HASTE-['half-Fourier acquisition single-shot turbo spin echo'] and dynamic FLASH-['fast low angle shot']) were acquired in 27 patients with inflammatory bowel disease. The enhancement of the bowel wall as well as morphological MRI findings were correlated with colonoscopy and biopsy specimens. By means of the MRI findings, Crohn's disease (CD) and ulcerative colitis (UC) should be differentiated. Results: In CD, a significant correlation between the contrast enhancement of the inflamed bowel wall ({delta} SI) and the endoscopic/histopathologic indices could be established (r=0.52; p=0.02 and r=0.72; p=0.001). In UC, no correlations between {delta} SI and the endoscopic/histopathologic indices could be found. The correct diagnosis of CD and UC by MRI findings was possible in 22/27 patients (81%). Conclusion: Hydro-MRI with dynamic studies is suitable for the assessment of disease activity in CD, but unreliable in UC. Hydro-MRI provides useful information for the differentiation of CD and UC. (orig.) [German] Zielsetzung: Vergleich der Hydro-MRT mi Koloskopie und Histopathologie bezueglich der Beurteilung der entzuendlichen Aktivitaet und der Differenzierung entzuendlicher Darmerkrankungen. Patienten und Methodik: Bei 27 Patienten mit einer entzuendlichen Darmerkrankung wurden nach einer oralen Darmkontrastierung mit 1000 ml einer 2,5%igen Mannitolloesung und einer rektalen Darmkontrastierung mit 250-500 ml einer 0,9%igen NaCl-Loesung atemangehaltene transversale und koronare Sequenzen {+-} intravenoese Gd-DTPA-Applikation (HASTE

  10. Trainers' perception of the learning environment and student competency : A qualitative investigation of midwifery and anesthesia training programs in Ethiopia

    NARCIS (Netherlands)

    Kibwana, Sharon; Haws, Rachel; Kols, Adrienne; Ayalew, Firew; Kim, Young-Mi; van Roosmalen, Jos; Stekelenburg, Jelle

    Background: Ethiopia has successfully expanded training for midwives and anesthetists in public institutions. This study explored the perceptions of trainers (instructors, clinical lab assistants and preceptors) towards the adequacy of students' learning experience and implications for achieving

  11. Flood resilience urban territories. Flood resilience urban territories. (United States)

    Beraud, Hélène; Barroca, Bruno; Hubert, Gilles


    The flood's impact during the last twenty years on French territory reveals our lack of preparation towards large-extended floods which might cause the stopping of companies' activity, services, or lead to housing unavailability during several months. New Orleans' case has to exemplify us: four years after the disaster, the city still couldn't get back its dynamism. In France, more than 300 towns are flood-exposed. While these towns are the mainspring of territory's development, it is likely that the majority of them couldn't get up quickly after a large-extended flood. Therefore, to understand and improve the urban territory's resilience facing floods is a real stake for territory's development. Urban technical networks supply, unify and irrigate all urban territories' constituents. Characterizing their flood resilience can be interesting to understand better urban resilience. In this context, waste management during and after floods is completely crucial. During a flood, the waste management network can become dysfunctional (roads cut, waste storage installations or waste treatment flooded). How can the mayor respect his obligation to guarantee salubrity and security in his city? In post flood the question is even more problematic. The waste management network presents a real stake for territory's restart. After a flood, building materials, lopped-of branches, furniture, business stocks, farm stocks, mud, rubbles, animal cadavers are wet, mixed, even polluted by hydrocarbons or toxic substances. The waste's volume can be significant. Sanitary and environmental risks can be crucial. In view of this situation, waste's management in post crisis period raises a real problem. What to make of this waste? How to collect it? Where to stock it? How to process it? Who is responsible? Answering these questions is all the more strategic since this waste is the mark of disaster. Thus, cleaning will be the first population's and local actor's reflex in order to forget the

  12. Field Evaluation of Model II of the Computer-Based, Individual Trainer for the Radar Intercept Officer (United States)


    Inspection. Subsequent analyses were done manually , using appropriate categories oJ these data. This .eUu^do sundry and analysis is...spent on the trainers, as recorded manually in a log. Thus, these times are not as accurate as those in remainder of the table...tradition are without pretest. Randomization procedures were taught to the TD technicians who monitored the operaCion of clu trainer at the

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

    Directory of Open Access Journals (Sweden)

    Diego Quattrini


    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

  14. The essence of training trainers in the context of distance education

    Directory of Open Access Journals (Sweden)

    Yudy Alexandra Molina-Hurtado


    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.

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

    International Nuclear Information System (INIS)

    Croes, R.


    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

  16. Resiliency Evaluation, Assessment and Contingency Tools, Phase I (United States)

    National Aeronautics and Space Administration — Resiliency Evaluation, Assessment and Contingency Tools (REACT) Achieving resiliency in any system requires capabilities that are beyond the boundaries of currently...

  17. Sensitivity of MRI in detecting alveolar infiltrates. Experimental studies; Sensitivitaet der MRT fuer alveolaere Infiltrate. Experimentelle Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J.; Busse, I.; Grimm, J.; Reuter, M.; Heller, M. [Kiel Univ. (Germany). Klinikum fuer Diagnostische Radiologie; Muhle, C. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin; Freitag, S. [Kiel Univ. (Germany). Inst. fuer Medizinische Informatik und Statistik


    detect pneumonia in patients. (orig.) [German] Zielsetzung: Eine experimentelle Studie zur Untersuchung des Signalverhaltens artifizieller alveolaerer Infiltrate mit T{sub 1}- und T{sub 2}-gewichteten MR-Sequenzen. Material und Methoden: 10 Lungen-Explantate von Schweinen wurden tracheal intubiert, in der kuenstlichen Thoraxhoehle eines Phantoms durch Unterdruck entfaltet und an einem klinischen Magnetresonanztomographen bei 1,5 T untersucht. Mit gezielter Instillation von 100-200 ml Gelatineloesung wurden alveolaere Infiltrate erzeugt und mit Gradientenecho- (2D-, 3D-GRE) und schnellen Spinechosequenzen (T{sub 2}-TSE, T{sub 2}-HASTE) dargestellt. Die Signalintensitaet des Lungenparenchyms nativ und mit Infiltrat wurde an repraesentativen Querschnitten erfasst. Zum Vergleich erfolgten Kontrollen mit Spiral-CT. Ergebnisse: Die instillierte Fluessigkeit simulierte alveolaere Infiltrate mit typischem Milchglasmuster im CT, wie es an Patienten mit Pneumonie oder ARDS beobachtet wird. Vor dem Versuch zeigten nur T{sub 2}-HASTE und T{sub 2}-TSE ein Lungenparenchymsignal (Signal/Rausch-Verhaeltnis von 3,62 bzw. 1,39). Nach Instillation von Fluessigkeit fand sich in diesen Sequenzen ein Signalanstieg von ca. 30% bei 100 ml (p<0,01) bzw. 60% bei 200 ml (p<0,01). Bei 2D-GRE betrug die Signalintensitaetszunahme 0,74% (p=0,32) nach 100 ml und 5,6% (p<0,01) nach 200 ml (fuer 3D-GRE 2,2% [p=0,02] bzw. 4,4% [p<0,01]). Die CT-Kontrollen zeigten fuer 100 ml eine Dichtezunahme um durchschnittlich 17 H.E. (p=0,02) und fuer 200 ml um 75 H.E. (p<0,01). Schlussfolgerungen: Mit T{sub 2}-gewichteten Sequenzen ist die MRT zur Darstellung artifizieller alveolaerer Infiltrate geeignet. (orig.)

  18. National athletic trainers' association position statement: preventing sudden death in sports. (United States)

    Casa, Douglas J; Guskiewicz, Kevin M; Anderson, Scott A; Courson, Ronald W; Heck, Jonathan F; Jimenez, Carolyn C; McDermott, Brendon P; Miller, Michael G; Stearns, Rebecca L; Swartz, Erik E; Walsh, Katie M


    To present recommendations for the prevention and screening, recognition, and treatment of the most common conditions resulting in sudden death in organized sports. Cardiac conditions, head injuries, neck injuries, exertional heat stroke, exertional sickling, asthma, and other factors (eg, lightning, diabetes) are the most common causes of death in athletes. These guidelines are intended to provide relevant information on preventing sudden death in sports and to give specific recommendations for certified athletic trainers and others participating in athletic health care.

  19. Laparoscopic simulation for all: two affordable, upgradable, and easy-to-build laparoscopic trainers. (United States)

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


    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.

  20. Information Collection on the Situation of VET Teachers and Trainers in Candidate Countries


    Foundation VET reform in Estonia / Estonian National Observatory


    Currently there are two main categories of teachers in VET schools – VET teachers and teachers of general education subjects. The former status of two different kinds of VET teachers – the professional subject teacher, and the training master has been replaced by one VET teacher category by the Regulation No 18 of the Minister of Culture and Education the Statute of a VET Teacher/Trainer of 26 May 1995.VET teachers have to carry out workshop training and teach professional subj...

  1. Learning results of GP trainers in a blended learning course on EBM: a cohort study. (United States)

    te Pas, Ellen; Wieringa-de Waard, Margreet; de Ruijter, Wouter; van Dijk, Nynke


    General practitioners (GPs) experience barriers to the use of evidence-based medicine (EBM) related to a negative attitude and to insufficient knowledge and skills. We therefore designed a blended learning intervention to develop the competence of GP trainers in EBM. This study investigated the effectiveness of this intervention in increasing the trainers' EBM competencies (i.e. knowledge, skills, attitude and behaviour). In total 129 GP trainers participated in the blended learning course on EBM consisting of four 3-h face-to-face meetings and an intensive preparatory e-course before each meeting over a 12-month period. The primary outcomes were changes in knowledge and skills (Fresno test), changes in attitude (McColl test) and intentions to change behaviour. Secondary outcomes were changes in self-rated knowledge, skills and attitude, and the relation between personal characteristics and changes in knowledge, skills and attitude. Data were collected before the start of the intervention (T0), at the end of the last day of the intervention (T1) and four months after the end of the intervention (T2). The mean changes in scores on the Fresno test were ∆T1-T0 = 40.8 (SD ±36.7, p attitude. An intensive blended learning course on EBM for GP trainers induces an increase in knowledge and skills that, although decreased, remains after four months. Attitude and behaviour towards EBM show no differences before and after the intervention, although GPs' intention to use EBM more often in their practice is present.

  2. The essence of training trainers in the context of distance education


    Yudy Alexandra Molina-Hurtado; Claudia Patricia Moreno-Cely


    The training of trainers in the context of distance education becomes a challenge for teacher’s degree program in Basic Education with emphasis in Mathematics, Humanities and Spanish language, inviting them to structure learning environments conducive to strengthening the apprehension of powers conceptual, educational, technological, and social work to ensure the mobilization of knowledge in concrete situations and different scenarios. The objective of the article focuses on the importance...

  3. National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes (United States)

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


    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

  4. Promoting Healthy Lifestyles to Children at School: Using a Multidisciplinary Train-the-Trainer Approach. (United States)

    Sanders, Martha J; Reynolds, Jesse; Bagatell, Nancy; Treu, Judith A; OʼConnor, Edward; Katz, David L


    The purpose of the study was to examine the efficacy of a multidisciplinary train-the-trainer model for improving fitness and food label literacy in third-grade students. University student trainers taught ABC for Fitness and Nutrition Detectives, established programs to promote physical activity and nutrition knowledge, to 239 third-grade students in 2 communities over a 6-month period. A total of 110 children were in the intervention group and 129 children in the control group (2 schools each). Outcomes included the Food Label Literacy and Nutrition Knowledge test and the fitness measures of curl-ups, push-ups, 0.5-mile run, and sit and reach. Focus groups were conducted as process feedback. Four public schools in 2 different communities. A total of 200 third-grade students. ABC for Fitness and Nutrition Detectives. Food Label Literacy and Nutrition Knowledge test and the fitness measures of curl-ups, push-ups, 0.5-mile run, and sit and reach. Nutrition knowledge increased in the intervention group by 25.2% (P sit and reach left (P = .07), and 0.5-mile run (P = .06). Process feedback from 3 teachers and 60 students indicated satisfaction with the program. Adaptation of the train-the-trainer approach for Nutrition Detectives and ABC for Fitness was effective for delivering these health-related programs.

  5. Train-the-trainer program on cardiovascular health for community pharmacists in Malaysia. (United States)

    Lee, Shaun Wen Huey; Mak, Vivienne Sook Li


    Background Studies have highlighted the benefits of having community pharmacists to deliver cardiovascular screening to patients. However, only few of such trainings are provided in Malaysia. Objective To describe the implementation and evaluation of a cardiovascular train-the-trainer program for community pharmacists. Method Community pharmacists' attended a 5 h train-the-trainer program. A pre and post-training survey was administered to participants who attended the workshop to determine their requirements for education and effectiveness of the training provided. Results Forty community pharmacists participated and were trained with 35 of them completing both the pre and post training assessment. Participants self-reported confidence, knowledge and ability to conduct a workshop on cardiovascular health increased between 0.22 and 0.75 points post-training (p train another 114 participants on cardiovascular health. Conclusion Participation in a train-the-trainer program significantly increases community pharmacists' perceived ability and confidence in conducting a cardiovascular health workshop.

  6. Recruitment and Rotation of the Trainers in the Lifelong Learning Context (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.

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

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


    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.

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

    Directory of Open Access Journals (Sweden)

    John Maltby

    Full Text Available 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.

  9. Refining Trait Resilience: Identifying Engineering, Ecological, and Adaptive Facets from Extant Measures of Resilience (United States)

    Maltby, John; Day, Liz; Hall, Sophie


    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

  10. An overdue alignment of risk and resilience? A conceptual contribution to community resilience. (United States)

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


    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.

  11. Sustainable Resilient, Robust & Resplendent Enterprises

    DEFF Research Database (Denmark)

    Edgeman, Rick

    to their impact. Resplendent enterprises are introduced with resplendence referring not to some sort of public or private façade, but instead refers to organizations marked by dual brilliance and nobility of strategy, governance and comportment that yields superior and sustainable triple bottom line performance....... Herein resilience, robustness, and resplendence (R3) are integrated with sustainable enterprise excellence (Edgeman and Eskildsen, 2013) or SEE and social-ecological innovation (Eskildsen and Edgeman, 2012) to aid progress of a firm toward producing continuously relevant performance that proceed from...

  12. Social vulnerability, age and resilience

    Directory of Open Access Journals (Sweden)

    Wanda Pereira Patrocinio


    Full Text Available This article aims to present a conceptual exposition on social vulnerability and its implications for the aging process. We conducted a survey of theme in Latin American literature, considering the social reality of Latin America closer to the Brazilian social reality, with a higher probability of relationships and approaches to the issue at hand. The second part of the article discusses the situation of old age amid the existence of social vulnerability to, third party, presenting the importance of community resilience to overcome adversity in this way. With this, we hope that our reflections will contribute to the field of research and practice in the field of social gerontology.

  13. Adaptive, dynamic, and resilient systems

    CERN Document Server

    Suri, Niranjan


    As the complexity of today's networked computer systems grows, they become increasingly difficult to understand, predict, and control. Addressing these challenges requires new approaches to building these systems. Adaptive, Dynamic, and Resilient Systems supplies readers with various perspectives of the critical infrastructure that systems of networked computers rely on. It introduces the key issues, describes their interrelationships, and presents new research in support of these areas.The book presents the insights of a different group of international experts in each chapter. Reporting on r

  14. Coping and resilience resources in early adolescents

    Czech Academy of Sciences Publication Activity Database

    Karaffová, Eva


    Roč. 27, Sup. 1 (2012), s. 240-240 ISSN 0887-0446. [Conference of European Health Psychology Society: Resilience and Health /26./. 21.08.2012-25.08.2012, Praha] R&D Projects: GA ČR(CZ) GAP407/12/2325 Institutional support: RVO:68081740 Keywords : resilience * coping * adolescents Subject RIV: AN - Psychology

  15. Preparing to be unprepared : Training for resilience

    NARCIS (Netherlands)

    Passenier, D; Pool, D.M.; Rankin, A; Sharpans'kykh, Alexei


    Training methods for operators working under high pressure and in dynamic, unpredictable settings could benefit from a focus on resilience. In such settings, formal training often focuses on procedural conformity to train for particular scenarios, but resilient performance taps into a wider

  16. Building Resiliency in Youth: Imagine the Difference. (United States)

    Baxley, Gladys B.

    Research indicates that children possess four important personality characteristics and abilities which define them as resilient. These characteristics and abilities are social competence, problem solving skills, autonomy, and a sense of purpose and future. In addition, several qualities of the environment of resilient youth tend to predict…

  17. Helping Children Develop Resiliency: Providing Supportive Relationships (United States)

    Kersey, Katharine C.; Malley, Catherine Robertson


    Helping children develop resiliency begins with positive, meaningful connections between teachers and students. This article defines the importance of encouraging children to develop characteristics related to resiliency including confidence in their ability to bounce back from setbacks, overcome challenges and frustrations. Furthermore, critical…

  18. Community Resilience and Resistance in Regulated Rivers. (United States)

    Noel, L.; Culp, J. M.


    Across diverse ecosystems, environmental factors such as nutrient loading have been shown to induce changes in state and reduce ecosystem resilience. Riverine communities are under increasing pressures from nutrient loading and fragmentation and it is unknown how these pressures will affect community resistance and resilience. This study focuses on determining 1) if nutrient loading and regulation change the resilience and resistance of rivers to further disturbances (floods); and 2) how particular community features create resilience and resistance. Along nutrient and algal biomass gradients in regulated and unregulated reaches of the Saint John River, Canada, community resilience (system capacity to return to its original state post disturbance) is examined both temporally and spatially. Resistance (ability to resist change) is measured by the nutrient concentration at which a change in ecological state occurs. State includes both community structure (species abundance and diversity of benthic algae and invertebrates) and community function (photosynthesis to respiration ratio). To determine how community features create resilience, trophic decoupling and food web connectance are examined along nutrient and physical disturbance gradients by comparing food webs constructed from stable isotope and biomass information. Because decreased resilience is linked with state shifts, strategies for sustainable ecosystem management should focus on maintaining resilience.

  19. Social Work, Pastoral Care and Resilience (United States)

    Considine, Tom; Hollingdale, Paul; Neville, Ruth


    This paper briefly examines the growing interest in developing resilience in the social work curricula as it is seen as a crucial quality necessary to cope with the increasing demands of the profession. The recent research into developing resilience is dominated by a psychological model which emphasises personal qualities. It runs the risk of…

  20. Putting resilience and resistance concepts into practice (United States)

    Jeanne C. Chambers; Jeremy D. Maestas; Mike Pellant


    Land managers are increasingly interested in improving resilience to disturbances, such as wildfire, and resistance to invasive species, such as cheatgrass and medusahead. This factsheet is designed to assist land managers in using resilience and resistance concepts to assess risks, prioritize management activities, and select appropriate treatments.

  1. Enhancing Human Resilience : monitoring, sensing, and feedback

    NARCIS (Netherlands)

    Binsch, O.; Wabeke, T.R.; Koot, G.; Venrooij, W.; Valk, P.J.L.


    The development of miniaturized monitoring technology represents the greatest opportunity for advancing Resilience and Mental Health in over a century. All experts of the Resilience- and Mental Health domain are contending with a significant mental health burden, e.g. almost half of all work

  2. Climate leadership program: Building Africa's resilience through ...

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

    Building Africa's resilience to climate change will require designing and implementing effective climate adaptation strategies. Science-informed policy, planning, and practice will ensure that development is more resilient and less vulnerable to the negative impacts of climate change. However, the generation and use of ...

  3. Intelligence Preparation for Operational Resilience (IPOR) (United States)


    resilience, risk, and project management contain numerous touchpoints at which intelligence needs can be identified and products consumed in introducing touchpoints with the following resilience, risk, and project- management operational frameworks: • CERT-RMM • Operationally Critical

  4. Resilient Women Leaders: A Qualitative Investigation (United States)

    Baldwin, Julia; Maldonado, Nancy L.; Lacey, Candace H.; Efinger, Joan


    This qualitative study investigated perceptions of resilient, transformational, successful women leaders regarding their own resiliency and leadership. The ten participants provided information during semi-structured, open-ended, audio taped interviews which were transcribed, hand coded, and then analyzed with QSR N6 software. Findings indicated…

  5. 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)


    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

  6. Holocaust survivors: three waves of resilience research. (United States)

    Greene, Roberta R; Hantman, Shira; Sharabi, Adi; Cohen, Harriet


    Three waves of resilience research have resulted in resilience-enhancing educational and therapeutic interventions. In the first wave of inquiry, researchers explored the traits and environmental characteristics that enabled people to overcome adversity. In the second wave, researchers investigated the processes related to stress and coping. In the third wave, studies examined how people grow and are transformed following adverse events, often leading to self-actualize, client creativity and spirituality. In this article the authors examined data from a study, "Forgiveness, Resiliency, and Survivorship among Holocaust Survivors" funded by the John Templeton Foundation ( Greene, Armour, Hantman, Graham, & Sharabi, 2010 ). About 65% of the survivors scored on the high side for resilience traits. Of the survivors, 78% engaged in processes considered resilient and felt they were transcendent or had engaged in behaviors that help them grow and change over the years since the Holocaust, including leaving a legacy and contributing to the community.

  7. Resilience engineering and the built environment

    DEFF Research Database (Denmark)

    Hollnagel, Erik


    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...... 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....


    Directory of Open Access Journals (Sweden)

    Rui Gomes


    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.

  9. How Robust is Your System Resilience? (United States)

    Homayounfar, M.; Muneepeerakul, R.


    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.

  10. National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise. (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


    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

  11. Resilience and vision impairment in older people. (United States)

    Thetford, Clare; Bennett, Kate M; Hodge, Suzanne; Knox, Paul C; Robinson, Jude


    Some people fare better than others when faced with adversity; they appear to be more 'resilient'. This article explores the concept of resilience in the context of vision impairment using two linked sets of narrative interview data from 2007 to 2010. Three case studies were analysed in detail using a framework approach based upon a social-ecological model of resilience and vision impairment. Within the model a range of assets and resources are identified which influence an individual's capacity for resilience. A set of criteria were used to establish the extent to which each individual appeared to be resilient at each point in time. Analysis revealed that it is not merely the presence or absence of individual, social, and community resources - but how these resources interact with each other - that influences resilience and can create a risk to wellbeing. To possess only some of these resources is not sufficient; there is a co-dependency between these resources which requires the presence of other resources for resilience to be achieved. Resilience is not a fixed state; individuals can become more or less resilient as their circumstances and resources change over time. We suggest that the concept of resilience has much to offer the field of vision impairment as it allows the identification of enablers as well as areas of barriers to improving people's health and wellbeing and suggests further opportunities for service providers to engage with clients, even those who appear to be supported, as people's social, economic and emotional landscapes continue to change over time, rather than identifying deficit. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The Australian Natural Disaster Resilience Index (United States)

    Thoms, Martin


    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.

  13. Hydrologic resilience and Amazon productivity. (United States)

    Ahlström, Anders; Canadell, Josep G; Schurgers, Guy; Wu, Minchao; Berry, Joseph A; Guan, Kaiyu; Jackson, Robert B


    The Amazon rainforest is disproportionately important for global carbon storage and biodiversity. The system couples the atmosphere and land, with moist forest that depends on convection to sustain gross primary productivity and growth. Earth system models that estimate future climate and vegetation show little agreement in Amazon simulations. Here we show that biases in internally generated climate, primarily precipitation, explain most of the uncertainty in Earth system model results; models, empirical data and theory converge when precipitation biases are accounted for. Gross primary productivity, above-ground biomass and tree cover align on a hydrological relationship with a breakpoint at ~2000 mm annual precipitation, where the system transitions between water and radiation limitation of evapotranspiration. The breakpoint appears to be fairly stable in the future, suggesting resilience of the Amazon to climate change. Changes in precipitation and land use are therefore more likely to govern biomass and vegetation structure in Amazonia.Earth system model simulations of future climate in the Amazon show little agreement. Here, the authors show that biases in internally generated climate explain most of this uncertainty and that the balance between water-saturated and water-limited evapotranspiration controls the Amazon resilience to climate change.

  14. RNEDE: Resilient Network Design Environment

    Energy Technology Data Exchange (ETDEWEB)

    Venkat Venkatasubramanian, Tanu Malik, Arun Giridh; Craig Rieger; Keith Daum; Miles McQueen


    Modern living is more and more dependent on the intricate web of critical infrastructure systems. The failure or damage of such systems can cause huge disruptions. Traditional design of this web of critical infrastructure systems was based on the principles of functionality and reliability. However, it is increasingly being realized that such design objectives are not sufficient. Threats, disruptions and faults often compromise the network, taking away the benefits of an efficient and reliable design. Thus, traditional network design parameters must be combined with self-healing mechanisms to obtain a resilient design of the network. In this paper, we present RNEDEa resilient network design environment that that not only optimizes the network for performance but tolerates fluctuations in its structure that result from external threats and disruptions. The environment evaluates a set of remedial actions to bring a compromised network to an optimal level of functionality. The environment includes a visualizer that enables the network administrator to be aware of the current state of the network and the suggested remedial actions at all times.

  15. Evaluating Application Resilience with XRay

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Sui [Louisiana State Univ., Baton Rouge, LA (United States); Bronevetsky, Greg [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Li, Bin [Louisiana State Univ., Baton Rouge, LA (United States); Casas-Guix, Marc [Barcelona Supercomputing Center (Spain); Peng, Lu [Louisiana State Univ., Baton Rouge, LA (United States)


    The rising count and shrinking feature size of transistors within modern computers is making them increasingly vulnerable to various types of soft faults. This problem is especially acute in high-performance computing (HPC) systems used for scientific computing, because these systems include many thousands of compute cores and nodes, all of which may be utilized in a single large-scale run. The increasing vulnerability of HPC applications to errors induced by soft faults is motivating extensive work on techniques to make these applications more resiilent to such faults, ranging from generic techniques such as replication or checkpoint/restart to algorithmspecific error detection and tolerance techniques. Effective use of such techniques requires a detailed understanding of how a given application is affected by soft faults to ensure that (i) efforts to improve application resilience are spent in the code regions most vulnerable to faults and (ii) the appropriate resilience technique is applied to each code region. This paper presents XRay, a tool to view the application vulnerability to soft errors, and illustrates how XRay can be used in the context of a representative application. In addition to providing actionable insights into application behavior XRay automatically selects the number of fault injection experiments required to provide an informative view of application behavior, ensuring that the information is statistically well-grounded without performing unnecessary experiments.

  16. 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)


    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

  17. Functional MRI of the pharynx in obstructive sleep apnea (OSA) with rapid 2-D flash sequences; Funktionelle MRT des Pharynx bei obstruktiver Schlafapnoe (OSA) mit schnellen 2D-FLASH-Sequenzen

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, L. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Guenther, E. [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Gauger, J. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Nitz, W. [Siemens Medizintechnik, Erlangen (Germany); Kastenbauer, E. [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany); Reiser, M. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Muenchen (Germany)


    Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager (`Vision`, Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of 6 images/s and an in-plane resolution of 2.67x1.8 mm were achieved. The mobility of the tongue, soft palate and pharyngeal surface could be clearly delineated. The MRI findings correlated well with the clinical examinations. We propose ultrafast MRI as a reliable and non-invasive method of evaluating pharyngeal obstruction and their levels. (orig.) [Deutsch] Die funktionelle Bildgebung des Pharynx war bisher eine Domaene der Hochfrequenzroentgenkinematographie, der Computertomographie (CT) und der ultraschnellen Computertomographie. Die Entwicklung moderner Techniken in der Magnetresonanztomographie (MRT) fuehrte zu neuen Ansaetzen in der Diagnostik pharyngealer Dysfunktionen. Ziel der vorliegenden Studie war die Implementierung neuer schneller MR-Sequenzen, um Verschlussmechanismen entlang des Pharnyxschlauches bei Patienten mit obstruktiver Schlafapnoe (OSA) zu untersuchen. 16 Patienten mit OSA und 6 gesunde Probanden wurden an einem 1,5-T-Ganzkoerpermagnetresonanztomographen (`Vision`, Siemens Medizintechnik, Erlangen

  18. Resilience in patients with psychotic disorder. (United States)

    Bozikas, V; Parlapani, E


    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

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

    International Nuclear Information System (INIS)

    Woods, David D.


    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

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

    Directory of Open Access Journals (Sweden)

    Hynes Kevin


    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.

  1. Ulysses' Return: Resilient Male Leaders Still at the Helm (United States)

    McClellan, Rhonda; Christman, Dana; Fairbanks, Anthony


    This study examined resilient men in higher education administration, educational leadership programs to determine how they identified components of their resiliency, how they described events that demonstrated their resiliency, and how they prescribed ways in which preparation programs can foster resiliency in students. Using masculinity…

  2. Educational Psychology and Resilience: New Concept, New Opportunities (United States)

    Toland, John; Carrigan, Donna


    Despite a growing literature on resilience in mainstream psychology, so far there has been very little discussion of resilience within educational psychology or how it might relate to practice. This article aims to bring resilience into the educational psychology literature and to show its potential to enhance service delivery. Resilience is…

  3. Reliability and Validity Testing of the Physical Resilience Measure (United States)

    Resnick, Barbara; Galik, Elizabeth; Dorsey, Susan; Scheve, Ann; Gutkin, Susan


    Objective: The purpose of this study was to test reliability and validity of the Physical Resilience Scale. Methods: A single-group repeated measure design was used and 130 older adults from three different housing sites participated. Participants completed the Physical Resilience Scale, Hardy-Gill Resilience Scale, 14-item Resilience Scale,…

  4. Biological invasions, ecological resilience and adaptive governance (United States)

    Chaffin, Brian C.; Garmestani, Ahjond S.; Angeler, David G.; Herrmann, Dustin L.; Stow, Craig A.; Nystrom, Magnus; Sendzimir, Jan; Hopton, Matthew E.; Kolasa, Jurek; Allen, Craig R.


    In a world of increasing interconnections in global trade as well as rapid change in climate and land cover, the accelerating introduction and spread of invasive species is a critical concern due to associated negative social and ecological impacts, both real and perceived. Much of the societal response to invasive species to date has been associated with negative economic consequences of invasions. This response has shaped a war-like approach to addressing invasions, one with an agenda of eradications and intense ecological restoration efforts towards prior or more desirable ecological regimes. This trajectory often ignores the concept of ecological resilience and associated approaches of resilience-based governance. We argue that the relationship between ecological resilience and invasive species has been understudied to the detriment of attempts to govern invasions, and that most management actions fail, primarily because they do not incorporate adaptive, learning-based approaches. Invasive species can decrease resilience by reducing the biodiversity that underpins ecological functions and processes, making ecosystems more prone to regime shifts. However, invasions do not always result in a shift to an alternative regime; invasions can also increase resilience by introducing novelty, replacing lost ecological functions or adding redundancy that strengthens already existing structures and processes in an ecosystem. This paper examines the potential impacts of species invasions on the resilience of ecosystems and suggests that resilience-based approaches can inform policy by linking the governance of biological invasions to the negotiation of tradeoffs between ecosystem services.

  5. Resilience and Coping After Hospital Mergers. (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.

  6. New resilience instrument for patients with cancer. (United States)

    Ye, Zeng Jie; Liang, Mu Zi; Li, Peng Fei; Sun, Zhe; Chen, Peng; Hu, Guang Yun; Yu, Yuan Liang; Wang, Shu Ni; Qiu, Hong Zhong


    Resilience is an important concept in the cancer literature and is a salient indicator of cancer survivorship. The aim of this study is to develop and validate a new resilience instrument that is specific to patients with cancer diagnosis (RS-SC) in Mainland China. First, a resilience framework was constructed for patients with cancer diagnosis. Second, items were formulated based on the framework to reflect different aspects of resilience. Third, two rounds of expert panel discussion were performed to select important and relevant items. Finally, two cross-sectional studies were conducted to evaluate the psychometric properties of this instrument. Fifty-one items were generated based on the resilience framework and the final 25-item RS-SC resulted in a five-factor solution including Generic Elements, Benefit Finding, Support and Coping, Hope for the Future and Meaning for Existence, accounting for 64.72% of the variance. The Cronbach's α of the RS-SC was 0.825 and the test-retest reliability was 0.874. The RS-SC is a brief and specific self-report resilience instrument for Chinese patients with cancer and shows sound psychometric properties in this study. The RS-SC has potential applications in both clinical practice and research with strength-based resiliency interventions.

  7. [Perspectives on resilience : trait or aptitude ? (United States)

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


    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.

  8. Resilience: A psychobiological construct for psychiatric disorders (United States)

    Shrivastava, Amresh; Desousa, Avinash


    Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder. PMID:26985103

  9. A resilience markers framework for small teams

    International Nuclear Information System (INIS)

    Furniss, Dominic; Back, Jonathan; Blandford, Ann; Hildebrandt, Michael; Broberg, Helena


    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.

  10. Utility of coronal oblique slices in cervical spine MRI. Improved detection of the neuroforamina; Nutzen der halbkoronaren Schichtung im MRT der Halswirbelsaeule. Verbesserte Erkennbarkeit von Neuroforamina

    Energy Technology Data Exchange (ETDEWEB)

    Freund, W.; Hoepner, G. [Universitaetskliniken Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Klessinger, S. [Nova Clinic Biberach, Neurochirurgie, Biberach (Germany); Universitaetskliniken Ulm, Neurochirurgie, Ulm (Germany); Mueller, M. [Universitaetskliniken Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Universitaetskliniken Aachen, Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany); Halatsch, M.E. [Universitaetskliniken Ulm, Neurochirurgie, Ulm (Germany); Weber, F. [Bundeswehrkrankenhaus Ulm, Neurologie, Ulm (Germany); Schmitz, B. [Universitaetskliniken Ulm, Neuroradiologie, Ulm (Germany)


    Angulated projections are standard in conventional radiography of the cervical spine, but rarely used in magnetic resonance imaging (MRI). As neuroforaminal pathology plays an important role in the etiology of radicular syndromes and may influence an operative approach, the utility of coronal oblique slices in MRI is explored. In a retrospective setting, 25 consecutive patients with neurologically diagnosed cervical monoradiculopathy were identified. T2-weighted sagittal, coronal oblique, and transversal slice orientations were anonymized. Two radiologists and two neurosurgeons independently assessed the cases. Criteria were site, cause, and grading of the neuroforaminal stenosis and the level of confidence on a 100-point visual analog scale (VAS). We computed interrater agreement, sensitivity, and t tests. Using only one slice orientation, the sensitivity in detecting the relevant neuroforamen was 0.40 for transversal, 0.68 for sagittal, and 0.64 for coronal oblique scans. A combination of the different angulations increased sensitivity and in 4 cases only the coronal oblique scans proved diagnostic. The readers felt significantly more confident in attributing the cause of the pathology on coronal oblique planes (a mean of 72 VAS points, p = 0.0003 vs 58 (sagittal) vs 64 (transversal)). Interrater agreement was significantly better for experienced (kappa 0. 48) than for inexperienced readers (0.32, p = 0.02). Adding coronal oblique planes in cervical spine MRI increases sensitivity and confidence in attributing the cause of neuroforaminal pathology. They are regarded as useful by all the readers. (orig.) [German] Im Gegensatz zur Magnetresonanztomographie (MRT) sind in der konventionellen Roentgendiagnostik der Halswirbelsaeule (HWS) Schraegaufnahmen Standard. Da neuroforaminale Pathologien wichtige Ursachen von radikulaeren Syndromen sind und die Operationstechnik moeglicherweise beeinflussen, wird der Nutzen halbkoronarer Schichten in der MRT untersucht. In

  11. Regional Employment Growth, Shocks and Regional Industrial Resilience

    DEFF Research Database (Denmark)

    Holm, J.R.; Østergaard, Christian Richter


    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 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....

  12. Inferring the relative resilience of alternative states.

    Directory of Open Access Journals (Sweden)

    David G Angeler

    Full Text Available Ecological systems may occur in alternative states that differ in ecological structures, functions and processes. Resilience is the measure of disturbance an ecological system can absorb before changing states. However, how the intrinsic structures and processes of systems that characterize their states affects their resilience remains unclear. We analyzed time series of phytoplankton communities at three sites in a floodplain in central Spain to assess the dominant frequencies or "temporal scales" in community dynamics and compared the patterns between a wet and a dry alternative state. The identified frequencies and cross-scale structures are expected to arise from positive feedbacks that are thought to reinforce processes in alternative states of ecological systems and regulate emergent phenomena such as resilience. Our analyses show a higher species richness and diversity but lower evenness in the dry state. Time series modeling revealed a decrease in the importance of short-term variability in the communities, suggesting that community dynamics slowed down in the dry relative to the wet state. The number of temporal scales at which community dynamics manifested, and the explanatory power of time series models, was lower in the dry state. The higher diversity, reduced number of temporal scales and the lower explanatory power of time series models suggest that species dynamics tended to be more stochastic in the dry state. From a resilience perspective our results highlight a paradox: increasing species richness may not necessarily enhance resilience. The loss of cross-scale structure (i.e. the lower number of temporal scales in community dynamics across sites suggests that resilience erodes during drought. Phytoplankton communities in the dry state are therefore likely less resilient than in the wet state. Our case study demonstrates the potential of time series modeling to assess attributes that mediate resilience. The approach is useful

  13. Mental resilience, perceived immune functioning, and health

    Directory of Open Access Journals (Sweden)

    Van Schrojenstein Lantman M


    Full Text Available Marith Van Schrojenstein Lantman,1 Marlou Mackus,1 Leila S Otten,1 Deborah de Kruijff,1 Aurora JAE van de Loo,1,2 Aletta D Kraneveld,1,2 Johan Garssen,1,3 Joris C Verster1,2,4 1Division of Pharmacology, Utrecht University, Utrecht, the Netherlands; 2Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; 3Nutricia Research, Utrecht, the Netherlands; 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia Background: Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status. Methods: A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ, and questions regarding their perceived health and immune status. Results: When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health (r=0.233, p=0.0001, perceived immune functioning (r=0.124, p=0.002, and IFQ score (r=−0.185, p=0.0001. Conclusion: A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health. Keywords: mental resilience, immune functioning, health, vitality, quality of life

  14. Interrogating resilience in health systems development. (United States)

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


    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:

  15. A Measure of Team Resilience: Developing the Resilience at Work Team Scale. (United States)

    McEwen, Kathryn; Boyd, Carolyn M


    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.

  16. Long term results of mantle irradiation(MRT) alone in 261 patients with clinical stage I-II supradiaphragmatic Hodgkin's disease

    International Nuclear Information System (INIS)

    Wirth, A.; Byram, D.; Chao, M.; Corry, J.; Davis, S.; Kiffer, J.; Laidlaw, C.; Quong, G.; Ryan, G.; Liew, K.


    Purpose: We report our results using MRT for clinical stage I-II HD and assess the value of published prognostic criteria in our study population. Pts and Methods: Between 1969 and 1994, 261 pts were treated with MRT alone for clinical stage I-II supradiaphragmatic HD. Pt characteristics: median age-30; M-54%/F-46%; stage IA-52%, IB-2%, IIA-37%, IIB-8%; histology LP-21%, NS-51%, MC-23%, other 5%; median ESR 18. CT abdomen and LAG were performed in 61% and 60% respectively. No pt had prior staging laparotomy. No pt received infradiaphragmatic RT. Central axis dose was 32 Gy-36 Gy. Univariate analysis was performed for prognostic factors for progression-free (PFS) and overall survival(OS). Outcome was assessed in favourable subsets as defined by: EORTC (v. favourable: CSIA, LP or NS histology, age < 40, female, no bulk, ESR < 50; favourable: CSI-II, age < 50, < 4 sites, no bulky mediastinal mass, ESR < 50 with no B symptoms or ESR < 30 with B symptoms); Princess Margaret Hospital (PMH) (IA-IIA, LP or NS histology, ESR < 40, age < 50, no large mediastinal mass, no E lesion). Results: 261 pts completed RT, with 5% requiring treatment interruption for toxicity. Significant factors (P<0.05) for PFS were stage, performance status, histology, B symptoms, number of sites, ESR and bulk. Significant factors (P<0.05) for OS were age, performance status, histology and B symptoms. (The results of a multivariate analysis will be presented.) Results in our study population using published prognostic criteria (in %): Thirty-six percent progressed following RT: 8% in-field; 24% out of field only (including 10% in the paraaortic/splenic region alone); 4% marginal; Fifty-seven percent of relapsed pts remain progression free after subsequent salvage treatment. Two cases of acute leukaemia, 8 cases of non-Hodgkin's lymphoma and 14 (non-skin) carcinomas occurred, of which 11 were in-field. Seventy pts have died. The cause was: HD 41%; other malignancy 20%; cardiovascular 17%; other 15

  17. MRI of the cerebellopontine angle in patients with cleido-cranial dysostosis; MRT der Kleinhirnbrueckenwinkelregion bei Patienten mit Dysostosis cleido-cranialis

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, A.; Engelbrecht, V.; Nawatny, J.; Moedder, U. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische Radiologie; Messing-Juenger, M. [Duesseldorf Univ. (Germany). Neurochirurgische Klinik; Reifenberger, G. [Duesseldorf Univ. (Germany). Inst. fuer Neuropathologie


    Purpose: Cleidocranial dysostosis (CCD) is an autosomal dominant bone disorder in which deafness is common secondary to malformation of the middle ear structures. The study aimed at MRI evaluation of the cerebellopontine angle in 7 patients with a history of CCD - two generation spanned relatives. Material and methods: Cranial MRI in 7 patients with CCD (4 women/3 men aged between 8 and 46 years) was performed. In two patients hearing disorders were present. The examinations encompassed multi-planar spinecho sequences of the cerebellopontine angle in 3-mm slice thickness before and after administration of contrast medium. Results: The clinically most conspicuous female patient (hearing loss, ataxia, headache) showed a strongly contrast-enhancing tumor in MRI that was histologically proved to be an acoustic schwannoma. Concerning the other family members, no pathological findings were noted except for non-pneumatized mastoids. Conclusion: The first report of a patient with CCD and an acoustic schwannoma shows that in case of hearing loss in these patients also a retrocochlear cause must be considered. (orig.) [German] Ziel: Die Dysostosis cleido-cranialis (DCC) ist eine autosomal-dominant erbliche Knochenerkrankung, bei der aufgrund von Mittelohrmissbildungen gehaeuft Hoerstoerungen beobachtet werden. Wir ueberpruefen bei 7 von diesem Syndrom betroffenen Verwandten 1. und 2. Grades, ob sich kernspintomographisch Auffaelligkeiten der Kleinhirnbrueckenwinkelregion nachweisen lassen. Material und Methoden: MRT-Untersuchungen des Schaedels bei 7 Patienten mit DCC (4 Frauen, 3 Maenner im Alter zwischen 8 und 46 Jahren). Bei zwei Patienten lagen klinisch Hoerstoerungen vor. Die Bildgebung umfasste multiplanare Spin-Echo-Sequenzen und wurde im Bereich des Kleinhirnbrueckenwinkels in 3 mm Schichtdicke vor und nach Gadoliniumgabe durchgefuehrt. Ergebnisse: Die klinisch auffaelligste Patientin (progredienter Hoerverlust, Ataxie, Cephalgien) zeigte in der MRT einen kraeftig

  18. 3D MRI of the colon: methods and first results of 5 patients; 3D-MRT des Kolons: Methodik und erste Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Luboldt, W.; Bauerfeind, P.; Pelkonen, P.; Steiner, P.; Krestin, G.P.; Debatin, J.F. [MRI-Zentrum, Dept. Diagnostische Radiologie, Universitaetsspital, Zurich (Switzerland)


    Purpose: `Exoscopic` and endoscopic identification of colorectal pathologies via MRI. Methods: 5 patients (36-88 years), two normal and three with different colorectal pathologies (diverticular disease, polyps and carcinoma of the colon), were examined by MRI after colonoscopy. Subsequent to filling of the colon with a gadolinium-water mixture under MRI-monitoring, 3D-data sets of the colon were acquired in prone and supine positions over a 28 sec breathold interval. Subsequently multiplanar T{sub 1}-weighted 2D-sequences were acquired before and following i.v. administration of Gd-DTPA (0.1 mmol/kg BW). All imaging was performed in the coronal orientation. The 3D-data were interactively analysed based on various displays: Maximum intensity projection (MIP), surface shadowed display (SSD), multiplanar reconstruction (MPR), virtual colonoscopy (VC). Results: All of the colorectal pathologies could be interactively diagnosed by MPR. On MIP images some pathologies were missed. VC presented the morphology of colon haustra as well as of all endoluminally growing lesions in a manner similar to endoscopy. The colon masses showed uptake of contrast media and could thus be differentiated from air or faeces. (orig./AJ) [Deutsch] Ziel: Externe und endoskopische Identifizierung kolorektaler Pathologien mittels MRT. Material und Methoden: 5 Patienten (36-88 Jahre), zwei mit Normalbefund, drei mit verschiedenen kolorektalen pathologischen Befunden (Divertikulose, Polypen, Karzinom), wurden nach der Kolonoskopie mit der MRT untersucht. Dazu wurde das Kolon unter MR-Sichtkontrolle mit einer Gadolinium-Wasser-Mischung gefuellt und als 3D-Datensatz atemangehalten in Bauch- und Rueckenlage aufgenommen. Anschliessend wurden multiplanare, T{sub 1}-gewichtete 2D-Sequenzen vor und nach i.v. Gd-DTPA-Gabe akquiriert. Die 3D-Datensaetze wurden interaktiv unter Zuhilfenahme verschiedener Darstellungsformen analysiert: Maximale Intensitaetsprojektion (MIP), Oberflaechendarstellung

  19. Gaucher disease: MR evaluation of bone marrow features during treatment with enzyme replacement; Morbus Gaucher: Analyse der Knochenmarkveraenderungen in der MRT waehrend Enzymersatztherapie

    Energy Technology Data Exchange (ETDEWEB)

    Poll, L.W.; Koch, J.A.; Boerner, D.; Cohnen, M.; Jung, G.; Scherer, A.; Moedder, U. [Duesseldorf Univ. (DF). Inst. fuer Diagnostische Radiologie; Dahl, S. vom; Haeussinger, D. [Duesseldorf Univ. (Germany). Klinik fuer Gastroenterologie, Hepatologie und Infektiologie; Willers, R. [Rechenzentrum, Heinrich-Heine-Univ. Duesseldorf (Germany); Niederau, C. [Innere Abt., St. Josef-Hospital Oberhausen, Akademisches Lehrkrankenhaus der Univ. Essen (Germany)


    Purpose: Enzyme replacement therapy (ERT) arrests and reverses the hematological and visceral symptoms of adult Gaucher disease, the most frequent lysosomal storage disorder. There are only a few studies available evaluating bone disease during ERT. The aim of this study was to investigate the features of bone marrow (bm) by magnetic resonance imaging (MRI) in these patients during ERT. Materials and Methods: MRI was performed prospectively in thirty adult type I Gaucher patients before and during ERT with a mean follow-up of 3 years. Spin-echo sequences (T{sub 1}/T{sub 2}) of the lower extremities were obtained and the reconversion (response) or lack of reconversion (non-response) to fatty marrow during treatment was analyzed. The morphological features of bm involvement, a homogeneous or non-homogeneous distribution of bm changes and focal bone lesions surrounded by a rim of reduced signal intensity (SI), were analyzed. Results: Infiltration of bm by Gaucher cells is characterized by a reduction of Sl on both T{sub 1}- and T{sub 2}-weighted sequences. Bone marrow responses were seen in 19 patients (63%) during treatment. Focal bone lesions, surrounded by a rim of reduced Sl, did not respond to ERT and correlated with a non-homogenous distribution of bone involvement and splenectomy. (orig.) [German] Ziel: Unter Enzymersatztherapie (enzyme replacement therapy = ERT) zeigen Patienten mit adulter Form des Morbus Gaucher, der haeufigsten lysosomalen Speicherkrankheit, eine deutliche Besserung der haematologischen und visceralen Symptome. Bislang liegen nur wenige Untersuchungen zur Analyse der Knochenveraenderungen waehrend der ERT vor. Ziel war es, die Knochenmarkveraenderungen bei Gaucher-Patienten waehrend der Enzymersatztherapie mit Alglucerase/Imiglucerase in der Magnetresonanztomographie (MRT) zu evaluieren. Material und Methoden: In einer prospektiven Untersuchung wurden 30 adulte Patienten mit gesichertem Morbus Gaucher vor und waehrend der ERT in der MRT

  20. Peripheral and central mechanisms of stress resilience

    Directory of Open Access Journals (Sweden)

    Madeline L. Pfau


    Full Text Available Viable new treatments for depression and anxiety have been slow to emerge, likely owing to the complex and incompletely understood etiology of these disorders. A budding area of research with great therapeutic promise involves the study of resilience, the adaptive maintenance of normal physiology and behavior despite exposure to marked psychological stress. This phenomenon, documented in both humans and animal models, involves coordinated biological mechanisms in numerous bodily systems, both peripheral and central. In this review, we provide an overview of resilience mechanisms throughout the body, discussing current research in animal models investigating the roles of the neuroendocrine, immune, and central nervous systems in behavioral resilience to stress.