Inhaled Antibiotic Therapy in Chronic Respiratory Diseases

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Diego J. Maselli

2017-05-01

Full Text Available The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM. These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics. Subsequent research advances focused on the development of antibiotic agents able to achieve high tissue concentrations capable of reducing the bacterial load of difficult-to-treat organisms in hosts with chronic respiratory conditions. In this review, we focus on the evidence regarding the use of antibiotic therapies administered through the respiratory system via inhalation, nebulization or aerosolization, specifically in patients with chronic respiratory diseases that include CF, non-CF bronchiectasis and NTM. However, further research is required to address the potential benefits, mechanisms of action and applications of inhaled antibiotics for the management of difficult-to-treat infections in patients with chronic respiratory diseases.

Guidelines for respiratory motion management in radiation therapy

International Nuclear Information System (INIS)

Matsuo, Yukinori; Onishi, Hiroshi; Nakagawa, Keiichi

2013-01-01

Respiratory motion management (RMM) systems in external and stereotactic radiotherapies have been developed in the past two decades. Japanese medical service fee regulations introduced reimbursement for RMM from April 2012. Based on thorough discussions among the four academic societies concerned, these Guidelines have been developed to enable staff (radiation oncologists, radiological technologists, medical physicists, radiotherapy quality managers, radiation oncology nurses, and others) to apply RMM to radiation therapy for tumors subject to respiratory motion, safely and appropriately. (author)

Prolonged lateral steep position impairs respiratory mechanics during continuous lateral rotation therapy in respiratory failure.

Science.gov (United States)

Schellongowski, Peter; Losert, Heidrun; Locker, Gottfried J; Laczika, Klaus; Frass, Michael; Holzinger, Ulrike; Bojic, Andja; Staudinger, Thomas

2007-04-01

To establish whether prolonged lateral steep position during continuous rotation therapy leads to improvement on pulmonary gas exchange, respiratory mechanics and hemodynamics. Prospective observational study. Intensive care unit of a university hospital. Twelve consecutive patients suffering from acute lung injury or adult respiratory distress syndrome undergoing continuous rotation therapy. Blood gas analysis, static lung compliance, blood pressure, cardiac index and pulmonary shunt fraction were measured in supine as well as in left and right lateral steep position at 62 degrees during continuous rotation therapy (phase I). Rotation was then stopped for 30 min with the patients in supine position, left and right lateral steep position, and the same measurements were performed every 10 min (phase II). Phase I and II revealed no significant changes in PaO(2)/FiO(2) ratio, mean arterial blood pressure, pulmonary shunt fraction, or cardiac index. Significantly lower static compliance was observed in lateral steep position than in supine position (pposition than in left and right lateral steep position (ppositioning impairs the compliance of the respiratory system. Prolonged lateral steep position does not lead to benefits with respect to oxygenation or hemodynamics. Individual response to the different positions is unpredictable. The pauses in "extreme" positions should be as short as possible.

Interferon therapy of acute respiratory viral infections in children

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A.E. Abaturov

2017-04-01

within the age limit and corresponded to the temperature response. Analyzing the dynamics of clinical symptoms of acute respiratory viral infection in both groups, it should be noted that there was a persistent tendency to lower body temperature in patients, both in the main and control groups. However, in the group of patients receiving Laferobionum®, the decrease in the temperature curve occurred faster, its normalization was noted already on the 4th day of therapy in 100 % of patients, whereas in the control group on the 4th day of the disease the body temperature remained subfebrile in 12 (28.6 %, on the 5th day — in 2 (4.8 % children. Complete blood count in children of the main and control groups at the beginning of the disease showed leukopenia of varying severity, relative lymphocytosis, and accelerated erythrocyte sedimentation rate (ESR. On the 5th day of therapy in patients of the main group, the number of leukocytes was normalized, the relative lymphocytosis persisted against the background of a decrease in ESR. While in the control group, the number of leukocytes in peripheral blood remained lower with an elevated level of ESR. During the whole period of observation, the presence and nature of possible complications of acute respiratory viral infection was assessed. The total duration of the observation period was 14 days. During the observation period, no complications were detected in any of the patients in the main or control groups. During the time of the clinical trial, no adverse reactions were recorded that could be associated with the administration of Laferobionum®. There were no cases of exacerbation of existing chronic diseases in the children of the main group, while 1 (2.4 % person from the control group had exacerbation of chronic tonsillitis. Evaluation of the effectiveness of therapy with the drug was carried out on the 5th day of treatment. Since one of the effectiveness criteria was the absence of clinical signs of the disease at the

How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia.

Science.gov (United States)

Widjanarko, Bagoes; Widyastari, Dyah Anantalia; Martini, Martini; Ginandjar, Praba

2016-01-01

Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians. This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables. Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%-75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled. Most of the laboratory technicians believed that they have an important role in TB patients' treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program.

Forensic Science Technician

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Tech Directions, 2010

2010-01-01

Forensic science technicians, also called crime laboratory technicians or police science technicians, help solve crimes. They examine and identify physical evidence to reconstruct a crime scene. This article discusses everything students need to know about careers for forensic science technicians--wages, responsibilities, skills needed, career…

Data analyst technician: an innovative role for the pharmacy technician.

Science.gov (United States)

Ervin, K C; Skledar, S; Hess, M M; Ryan, M

2001-10-01

The development of an innovative role for the pharmacy technician is described. The role of the pharmacy technician was based on a needs assessment and the expertise of the pharmacy technician selected. Initial responsibilities of the technician included chart reviews, benchmarking surveys, monthly financial impact analysis, initiative assessment, and quality improvement reporting. As the drug-use and disease-state management (DUDSM) program expanded, pharmacist activities increased, requiring the expansion of data analyst technician (DAT) duties. These new responsibilities included participation in patient assessment, data collection and interpretation, and formulary enforcement. Most recently, technicians' expanded duties include maintenance of a physician compliance profiling database, quality improvement reporting and graphing, active role in patient risk assessment and database management for adult vaccination, and support of financial impact monitoring for other institutions within the health system. This pharmacist-technician collaboration resulted a threefold increase in patient assessments completed per day. In addition, as the DUDSM program continues to expand across the health system, an increase in DAT resources from 0.5 to 1.0 full-time equivalent was obtained. The role of the DAT has increased the efficiency of the DUDSM program and has provided an innovative role for the pharmacy technician.

How do laboratory technicians perceive their role in tuberculosis diagnostic process: a cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia

Directory of Open Access Journals (Sweden)

Widjanarko B

2016-09-01

Full Text Available Bagoes Widjanarko,1 Dyah Anantalia Widyastari,2 Martini Martini,3 Praba Ginandjar3 1Department of Health Education and Behavior Sciences, Faculty of Public Health, Diponegoro University, Semarang, Indonesia; 2Institute for Population and Social Research, Mahidol University, Salaya, Thailand; 3Department of Epidemiology, Faculty of Public Health, Diponegoro University, Semarang, Indonesia Purpose: Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians.Methods: This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables.Results: Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%–75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled.Conclusion: Most of the laboratory technicians believed that they have an important role in TB patients’ treatment and should display proper self-efficacy in performing laboratory activities. The

Rapid improvement of respiratory quality in asthmatic children after "assisted drainage" therapy

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Haryono Utomo

2010-08-01

Full Text Available Background  Whilst current asthma management is well-developed, there are still 5-10% uncontrolled asthma patients with unknown etiologies. However, its connection with oral focal infection is still uncertain. Therefore, a collaborated research for asthma management was conducted by pediatricians and dental practitioners. Within minutes after the "assisted drainage" therapy, a modification of healing root planning procedure, there is rapid improvement of respiratory function, ie., forced expiratory-volume one second (FEV1 in asthmatic children. This quick response usually achieved by oral inhalation. Objective To investigate the effectiveness of the assisted drainage therapy in the improvement of respiratory quality. Methods Fifteen asthmatic children were subjected to a longitudinal study for two weeks. In tbe first week they were instructed for al lergen avoidance only and the fOllowing one week was combined with tbe assisted drainage therapy, followed by  mental health education and dental plaque control therapy. Each s'ubject was af'sef'sed for respiratory quality with a computerized spirometer and blood sampling test. Paired t-test analysis was used for statistical analysis. Results Assisted drainage therapy was performed, within minutes FEV1 increased significantly (P= 0.001. Additionally, there were significant differences serum histamine (P= 0,001 pre and post treatment. Conclusions The assisted drainage therapy is effective as an adjuvant therapy for mild persistent asthma in children.

Radiological Control Technician: Phase 1, Site academic training study guides

International Nuclear Information System (INIS)

1992-10-01

This volume is a study guide for training Radiological Control Technicians. Provided herein are support materials for learning radiological documentation, communication systems, counting errors and statistics, dosimetry, contamination control, airborne sampling program methods, respiratory protection, radiological source control, environmental monitoring, access control and work area setup, radiological work coverage, shipment and receipt for radioactive material, radiological incidents and emergencies, personnel decontamination, first aid, radiation survey instrumentation, contamination monitoring, air sampling, and counting room equipment

Antitussive pharmaceutical drugs administration in complex therapy of acute respiratory infections in children

OpenAIRE

Lokshina, E.; Zajtseva, O.

2009-01-01

There is considered the problem of treatment of cough in children with acute respiratory infections in article. In particular, the data on an effective administration of the domestic combined medication framed on basis of medicinal grasses with codeine in complex therapy of acute respiratory infections is presented.

Respiratory guiding system for respiratory motion management in respiratory gated radiotherapy

International Nuclear Information System (INIS)

Kang, Seong Hee; Kim, Dong Su; Kim, Tae Ho; Suh, Tae Suk

2013-01-01

Respiratory guiding systems have been shown to improve the respiratory regularity. This, in turn, improves the efficiency of synchronized moving aperture radiation therapy, and it reduces the artifacts caused by irregular breathing in imaging techniques such as four-dimensional computed tomography (4D CT), which is used for treatment planning in RGRT. We have previously developed a respiratory guiding system that incorporates an individual-specific guiding waveform, which is easy to follow for each volunteer, to improve the respiratory regularity. The present study evaluates the application of this system to improve the respiratory regularity for respiratory-gated radiation therapy (RGRT). In this study, we evaluated the effectiveness of an in-house-developed respiratory guiding system incorporating an individual specific guiding waveform to improve the respiratory regularity for RGRT. Most volunteers showed significantly less residual motion at each phase during guided breathing owing to the improvement in respiratory regularity. Therefore, the respiratory guiding system can clearly reduce the residual, or respiratory, motion in each phase. From the result, the CTV and the PTV margins during RGRT can be reduced by using the respiratory guiding system, which reduces the residual motions, thus improving the accuracy of RGRT

Insight into team competence in medical, nursing and respiratory therapy students.

Science.gov (United States)

Sigalet, Elaine L; Donnon, Tyrone L; Grant, Vincent

2015-01-01

This study provides information for educators about levels of competence in teams comprised of medical, nursing and respiratory therapy students after receiving a simulation-based team-training (SBT) curriculum with and without an additional formalized 30-min team-training (TT) module. A two-group pre- and post-test research design was used to evaluate team competence with respect to leadership, roles and responsibilities, communication, situation awareness and resource utilization. All scenarios were digitally recorded and evaluated using the KidSIM Team Performance Scale by six experts from medicine, nursing and respiratory therapy. The lowest scores occurred for items that reflected situation awareness. All teams improved their aggregate scores from Time 1 to Time 2 (p performance scores at Time 1 (Cohen's d = 0.92, p performances at Time 1 and 2.

Current possibilities of anti-inflammatory therapy in children with acute respiratory diseases

OpenAIRE

E. E. Lokshina; O. V. Zaytseva

2017-01-01

The paper gives an update on the pathogenesis of acute respiratory diseases, the basis for which is inflammation of the airway mucosal lining. It reflects the results of a comparative clinical trial of the efficacy and safety of the anti-inflammatory drug fenspiride used in the combination therapy for respiratory diseases in children. The findings allow one to recommend the use of fenspiride to treat this condition in children.

Current possibilities of anti-inflammatory therapy in children with acute respiratory diseases

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E. E. Lokshina

2017-01-01

Full Text Available The paper gives an update on the pathogenesis of acute respiratory diseases, the basis for which is inflammation of the airway mucosal lining. It reflects the results of a comparative clinical trial of the efficacy and safety of the anti-inflammatory drug fenspiride used in the combination therapy for respiratory diseases in children. The findings allow one to recommend the use of fenspiride to treat this condition in children.

Oligonucleotide Therapy for Obstructive and Restrictive Respiratory Diseases

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Wupeng Liao

2017-01-01

Full Text Available Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF. The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology. Corticosteroids have been widely prescribed for the treatment of asthma, COPD, and IPF. However, the effectiveness of corticosteroids as an anti-inflammatory drug is limited by steroid resistance in severe asthma, the majority of COPD cases, and pulmonary fibrosis. There is an urgent medical need to develop target-specific drugs for the treatment of these respiratory conditions. Oligonucleotide therapies, including antisense oligonucleotide (ASO, small interfering RNA (siRNA, and microRNA (miRNA are now being evaluated both pre-clinically and clinically as potential therapeutics. The mechanisms of action of ASO and siRNA are highly target mRNA specific, ultimately leading to target protein knockdown. miRNA has both biomarker and therapeutic values, and its knockdown by a miRNA antagonist (antagomir has a broader but potentially more non-specific biological outcome. This review will compile the current findings of oligonucleotide therapeutic targets, verified in various respiratory disease models and in clinical trials, and evaluate different chemical modification approaches to improve the stability and potency of oligonucleotides for the treatment of respiratory diseases.

Recent advances in delivery mechanisms for aerosol therapy during pediatric respiratory diseases.

Science.gov (United States)

Wu, Yue'E; Zhang, Chonglin; Zhen, Qing

2018-04-01

The treatment of pediatric surgery diseases via utilization of aerosol delivery mechanisms is in progress for the betterment of pediatric care. Over the years, aerosol therapy has come to play an integral role in the treatment of pediatric respiratory diseases. Inhaled aerosol agents such as bronchodilators, corticosteroids, antibiotics, and mucolytics are commonly delivered to spontaneously breathing pediatric patients with a tracheostomy. Administering therapeutic inhaled aerosols to pediatric patients is challenging. The pediatric population ranges in age, which means patients with different airway sizes, breathing patterns, and cooperation levels. These patient-related factors impact the deposition of aerosol drugs in the lungs. The present review article will discuss the recent advancements in the delivery mechanisms for aerosol therapy in pediatric patients with respiratory diseases.

Partnering for optimal respiratory home care: physicians working with respiratory therapists to optimally meet respiratory home care needs.

Science.gov (United States)

Spratt, G; Petty, T L

2001-05-01

The need for respiratory care services continues to increase, reimbursement for those services has decreased, and cost-containment measures have increased the frequency of home health care. Respiratory therapists are well qualified to provide home respiratory care, reduce misallocation of respiratory services, assess patient respiratory status, identify problems and needs, evaluate the effect of the home setting, educate the patient on proper equipment use, monitor patient response to and complications of therapy, monitor equipment functioning, monitor for appropriate infection control procedures, make recommendations for changes to therapy regimen, and adjust therapy under the direction of the physician. Teamwork benefits all parties and offers cost and time savings, improved data collection and communication, higher job satisfaction, and better patient monitoring, education, and quality of life. Respiratory therapists are positioned to optimize treatment efficacy, maximize patient compliance, and minimize hospitalizations among patients receiving respiratory home care.

The feasibility evaluation of Respiratory Gated radiation therapy simulation according to the Respiratory Training with lung cancer

International Nuclear Information System (INIS)

Hong, Mi Ran; Kim, Cheol Jong; Park, Soo Yeon; Choi, Jae Won; Pyo, Hong Ryeol

2016-01-01

To evaluate the usefulness of the breathing exercise,we analyzed the change in the RPM signal and the diaphragm image before 4D respiratory gated radiation therapy planning of lung cancer patients. The breathing training was enforced on 11 patients getting the 4D respiratory gated radiation therapy from April, 2016 until August. At the same time, RPM signal and diaphragm image was obtained respiration training total three steps in step 1 signal acquisition of free-breathing state, 2 steps respiratory signal acquisition through the guide of the respiratory signal, 3 steps, won the regular respiration signal to the description and repeat training. And then, acquired the minimum value, maximum value, average value, and a standard deviation of the inspiration and expiration in RPM signal and diaphragm image in each steps. Were normalized by the value of the step 1, to convert the 2,3 steps to the other distribution ratio (%), by evaluating the change in the interior of the respiratory motion of the patient, it was evaluated breathing exercise usefulness of each patient. The mean value and the standard deviation of each step were obtained with the procedure 1 of the RPM signal and the diaphragm amplitude as a 100% reference. In the RPM signal, the amplitudes and standard deviations of four patients (36.4%, eleven) decreased by 18.1%, 27.6% on average in 3 steps, and 2 patients (18.2%, 11 people) had standard deviation, It decreased by an average of 36.5%. Meanwhile, the other four patients (36.4%, eleven) decreased by an average of only amplitude 13.1%. In Step 3, the amplitude of the diaphragm image decreased by 30% on average of 9 patients (81.8%, 11 people), and the average of 2 patients (18.2%, 11 people) increased by 7.3%. However, the amplitudes of RPM signals and diaphragm image in 3 steps were reduced by 52.6% and 42.1% on average from all patients, respectively, compared to the 2 steps. Relationship between RPM signal and diaphragm image amplitude difference

The feasibility evaluation of Respiratory Gated radiation therapy simulation according to the Respiratory Training with lung cancer

Energy Technology Data Exchange (ETDEWEB)

Hong, Mi Ran; Kim, Cheol Jong; Park, Soo Yeon; Choi, Jae Won; Pyo, Hong Ryeol [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

2016-12-15

To evaluate the usefulness of the breathing exercise,we analyzed the change in the RPM signal and the diaphragm image before 4D respiratory gated radiation therapy planning of lung cancer patients. The breathing training was enforced on 11 patients getting the 4D respiratory gated radiation therapy from April, 2016 until August. At the same time, RPM signal and diaphragm image was obtained respiration training total three steps in step 1 signal acquisition of free-breathing state, 2 steps respiratory signal acquisition through the guide of the respiratory signal, 3 steps, won the regular respiration signal to the description and repeat training. And then, acquired the minimum value, maximum value, average value, and a standard deviation of the inspiration and expiration in RPM signal and diaphragm image in each steps. Were normalized by the value of the step 1, to convert the 2,3 steps to the other distribution ratio (%), by evaluating the change in the interior of the respiratory motion of the patient, it was evaluated breathing exercise usefulness of each patient. The mean value and the standard deviation of each step were obtained with the procedure 1 of the RPM signal and the diaphragm amplitude as a 100% reference. In the RPM signal, the amplitudes and standard deviations of four patients (36.4%, eleven) decreased by 18.1%, 27.6% on average in 3 steps, and 2 patients (18.2%, 11 people) had standard deviation, It decreased by an average of 36.5%. Meanwhile, the other four patients (36.4%, eleven) decreased by an average of only amplitude 13.1%. In Step 3, the amplitude of the diaphragm image decreased by 30% on average of 9 patients (81.8%, 11 people), and the average of 2 patients (18.2%, 11 people) increased by 7.3%. However, the amplitudes of RPM signals and diaphragm image in 3 steps were reduced by 52.6% and 42.1% on average from all patients, respectively, compared to the 2 steps. Relationship between RPM signal and diaphragm image amplitude difference

Training pharmacy technicians to administer immunizations.

Science.gov (United States)

McKeirnan, Kimberly C; Frazier, Kyle R; Nguyen, Maryann; MacLean, Linda Garrelts

To evaluate the effectiveness of an immunization training program for pharmacy technicians on technicians' self-reported confidence, knowledge, and number of vaccines administered. A one-group pre- and posttest study was conducted with certified pharmacy technicians from Albertsons and Safeway community pharmacies in Idaho. Thirty pharmacy technicians were recruited to participate in an immunization administration training program comprising a 2-hour home study and a 2-hour live training. Pharmacy technician scores on a 10-question knowledge assessment, responses on a pre- and posttraining survey, and number of immunizations administered in the 6-month period following the training were collected. Twenty-five pharmacy technicians completed the home study and live portions of the immunization training program. All 29 pharmacy technicians who took the home study assessment passed with greater than 70% competency on the first attempt. Technicians self-reported increased confidence with immunization skills between the pretraining survey and the posttraining survey. From December 2016 to May 2017, the technicians administered 953 immunizations with 0 adverse events reported. For the first time, pharmacy technicians have legally administered immunizations in the United States. Trained pharmacy technicians demonstrated knowledge of vaccination procedures and self-reported improved confidence in immunization skills and administered immunizations after participating in a 4-hour training program. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Diesel Engine Technician

Science.gov (United States)

Tech Directions, 2010

2010-01-01

Diesel engine technicians maintain and repair the engines that power transportation equipment such as heavy trucks, trains, buses, and locomotives. Some technicians work mainly on farm machines, ships, compressors, and pumps. Others work mostly on construction equipment such as cranes, power shovels, bulldozers, and paving machines. This article…

Rotational bed therapy to prevent and treat respiratory complications: a review and meta-analysis.

Science.gov (United States)

Goldhill, David R; Imhoff, Michael; McLean, Barbara; Waldmann, Carl

2007-01-01

Immobility is associated with complications involving many body systems. To review the effect of rotational therapy (use of therapeutic surfaces that turn on their longitudinal axes) on prevention and/or treatment of respiratory complications in critically ill patients. Published articles evaluating prophylaxis and/or treatment were reviewed. Prospective randomized controlled trials were assessed for quality and included in meta-analyses. A literature search yielded 15 nonrandomized, uncontrolled, or retrospective studies. Twenty prospective randomized controlled trials on rotational therapy were published between 1987 and 2004. Various types of beds were studied, but few details on the rotational parameters were reported. The usual control was manual turning of patients by nurses every 2 hours. One animal investigation and 12 clinical trials addressed the effectiveness of rotational therapy in preventing respiratory complications. Significant benefits were reported in the animal study and 4 of the trials. Significant benefits to patients were reported in 2 of another 4 studies focused on treatment of established complications. Researchers have examined the effects of rotational therapy on mucus transport, intrapulmonary shunt, hemodynamic effects, urine output, and intracranial pressure. Little convincing evidence is available, however, on the most effective rotation parameters (eg, degree, pause time, and amount of time per day). Meta-analysis suggests that rotational therapy decreases the incidence of pneumonia but has no effect on duration of mechanical ventilation, number of days in intensive care, or hospital mortality. Rotational therapy may be useful for preventing and treating respiratory complications in selected critically ill patients receiving mechanical ventilation.

Electric Vehicle Technician

Science.gov (United States)

Moore, Pam

2011-01-01

With President Obama's goal to have one million electric vehicles (EV) on the road by 2015, the electric vehicle technician should have a promising and busy future. "The job force in the car industry is ramping up for a revitalized green car industry," according to Greencareersguide.com. An electric vehicle technician will safely troubleshoot and…

Immunoadjuvant Therapy and Noninvasive Ventilation for Acute Respiratory Failure in Lung Tuberculosis: A Case Study

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René Agustín Flores-Franco

2015-01-01

Full Text Available Acute respiratory failure caused by pulmonary tuberculosis is a rare event but with a high mortality even while receiving mechanical ventilatory support. We report the case of a young man with severe pulmonary tuberculosis refractory to conventional therapy who successfully overcame the critical period of his condition using noninvasive ventilation and immunoadjuvant therapy that included three doses of etanercept 25 mg subcutaneously. We conclude that the use of etanercept along with antituberculosis treatment appears to be safe and effective in patients with pulmonary tuberculosis presenting with acute respiratory failure.

4D modeling and estimation of respiratory motion for radiation therapy

CERN Document Server

Lorenz, Cristian

2013-01-01

Respiratory motion causes an important uncertainty in radiotherapy planning of the thorax and upper abdomen. The main objective of radiation therapy is to eradicate or shrink tumor cells without damaging the surrounding tissue by delivering a high radiation dose to the tumor region and a dose as low as possible to healthy organ tissues. Meeting this demand remains a challenge especially in case of lung tumors due to breathing-induced tumor and organ motion where motion amplitudes can measure up to several centimeters. Therefore, modeling of respiratory motion has become increasingly important in radiation therapy. With 4D imaging techniques spatiotemporal image sequences can be acquired to investigate dynamic processes in the patient’s body. Furthermore, image registration enables the estimation of the breathing-induced motion and the description of the temporal change in position and shape of the structures of interest by establishing the correspondence between images acquired at different phases of the br...

Surfactant therapy for maternal blood aspiration: an unusual cause of neonatal respiratory distress syndrome.

Science.gov (United States)

Celik, Istemi Han; Demirel, Gamze; Canpolat, Fuat Emre; Erdeve, Omer; Dilmen, Ugur

2012-10-01

Surfactant replacement therapy is the main treatment of neonatal respiratory distress syndrome. However, surfactant therapy has been shown to be effective in the treatment of other diseases causing neonatal respiratory diseases such as pulmonary hemorrhage, meconium aspiration syndrome, pneumonia/sepsis, pulmonary edema or acute lung injury resulting a secondary surfactant deficiency (SSD). Rarely, as like as in the present patient, exogenous blood aspiration such as breast milk or formula aspiration may lead to SSD. Blood in alveolus leads to a significant biochemical and functional disturbance of the surfactant system and inhibits surfactant production. Here, the authors report a preterm infant of 33 wk gestational age with secondary surfactant deficiency due to maternal blood aspiration because of abruptio placentae. She was received two courses of beractant, a natural bovine surfactant, therapy in 24 h. She was extubated on second day and did not require oxygen on 4(th) day. To the authors' knowledge, this is the first reported case of SSD due to maternal blood aspiration treated with surfactant. In conditions such as abruptio placentae, infant should be protected from blood aspiration and if respiratory distress occurs, surfactant inhibition and need for surfactant administration should be considered.

Clinical education and clinical evaluation of respiratory therapy students.

Science.gov (United States)

Cullen, Deborah L

2005-09-01

Different blends of knowledge, decision making, problem solving,professional behaviors, values, and technical skills are necessary in the changing health care environments in which respiratory therapists practice. Frequently, novice students are expected to perform quickly and efficiently,and it may be forgotten that students are still learning and mastering the foundation pieces of practice. Clinical educators take on the responsibility of student development in addition to overseeing patient care. Normally,these volunteer instructors are role models for respiratory therapy students. The characteristic of initiative when demonstrated by a beginning student is attractive to the clinical instructor, promotes sharing of experiences, and may evolve into a mentor-protege relationship. Some clinical instructors may be underprepared to teach and are uncomfortable with student evaluation. Respiratory therapy facilities in conjunction with academic institutions may consider sponsoring ongoing programs for clinical teachers. Teaching and learning in the clinical environment is more than demonstration of skills and knowledge. Furthermore, it can be debated whether the memorization of facts or of the steps of a skill is more valuable than competency in problem solving, clinical reasoning, or information retrieval. New knowledge is built within a context and is further integrated when grounded by experience. Development of "prediction in practice" or the anticipation of the next necessary actions may be worth integrating into the instructional toolbox. Intuition has been defined as an "understanding without a rationale". This definition separates intuition from rational decision making and presents intuition as a type of innate ability. Reflection when guided by clinical instructors can help deepen critical thinking, as will Socratic questioning on a regular basis. Most clinical staff can agree on the performance of an incompetent student, but discrimination of the levels of

Dosimetric evaluation of the interplay effect in respiratory-gated RapidArc radiation therapy

International Nuclear Information System (INIS)

Riley, Craig; Yang, Yong; Li, Tianfang; Zhang, Yongqian; Heron, Dwight E.; Huq, M. Saiful

2014-01-01

Purpose: Volumetric modulated arc therapy (VMAT) with gating capability has had increasing adoption in many clinics in the United States. In this new technique, dose rate, gantry rotation speed, and the leaf motion speed of multileaf collimators (MLCs) are modulated dynamically during gated beam delivery to achieve highly conformal dose coverage of the target and normal tissue sparing. Compared with the traditional gated intensity-modulated radiation therapy technique, this complicated beam delivery technique may result in larger dose errors due to the intrafraction tumor motion. The purpose of this work is to evaluate the dosimetric influence of the interplay effect for the respiration-gated VMAT technique (RapidArc, Varian Medical Systems, Palo Alto, CA). Our work consisted of two parts: (1) Investigate the interplay effect for different target residual errors during gated RapidArc delivery using a one-dimensional moving phantom capable of producing stable sinusoidal movement; (2) Evaluate the dosimetric influence in ten clinical patients’ treatment plans using a moving phantom driven with a patient-specific respiratory curve. Methods: For the first part of this study, four plans were created with a spherical target for varying residual motion of 0.25, 0.5, 0.75, and 1.0 cm. Appropriate gating windows were applied for each. The dosimetric effect was evaluated using EDR2 film by comparing the gated delivery with static delivery. For the second part of the project, ten gated lung stereotactic body radiotherapy cases were selected and reoptimized to be delivered by the gated RapidArc technique. These plans were delivered to a phantom, and again the gated treatments were compared to static deliveries by the same methods. Results: For regular sinusoidal motion, the dose delivered to the target was not substantially affected by the gating windows when evaluated with the gamma statistics, suggesting the interplay effect has a small role in respiratory-gated Rapid

Dosimetric evaluation of the interplay effect in respiratory-gated RapidArc radiation therapy.

Science.gov (United States)

Riley, Craig; Yang, Yong; Li, Tianfang; Zhang, Yongqian; Heron, Dwight E; Huq, M Saiful

2014-01-01

Volumetric modulated arc therapy (VMAT) with gating capability has had increasing adoption in many clinics in the United States. In this new technique, dose rate, gantry rotation speed, and the leaf motion speed of multileaf collimators (MLCs) are modulated dynamically during gated beam delivery to achieve highly conformal dose coverage of the target and normal tissue sparing. Compared with the traditional gated intensity-modulated radiation therapy technique, this complicated beam delivery technique may result in larger dose errors due to the intrafraction tumor motion. The purpose of this work is to evaluate the dosimetric influence of the interplay effect for the respiration-gated VMAT technique (RapidArc, Varian Medical Systems, Palo Alto, CA). Our work consisted of two parts: (1) Investigate the interplay effect for different target residual errors during gated RapidArc delivery using a one-dimensional moving phantom capable of producing stable sinusoidal movement; (2) Evaluate the dosimetric influence in ten clinical patients' treatment plans using a moving phantom driven with a patient-specific respiratory curve. For the first part of this study, four plans were created with a spherical target for varying residual motion of 0.25, 0.5, 0.75, and 1.0 cm. Appropriate gating windows were applied for each. The dosimetric effect was evaluated using EDR2 film by comparing the gated delivery with static delivery. For the second part of the project, ten gated lung stereotactic body radiotherapy cases were selected and reoptimized to be delivered by the gated RapidArc technique. These plans were delivered to a phantom, and again the gated treatments were compared to static deliveries by the same methods. For regular sinusoidal motion, the dose delivered to the target was not substantially affected by the gating windows when evaluated with the gamma statistics, suggesting the interplay effect has a small role in respiratory-gated RapidArc therapy. Varied results were

Utility estimation of the application of auditory-visual-tactile sense feedback in respiratory gated radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Jo, Jung Hun; KIm, Byeong Jin; Roh, Shi Won; Lee, Hyeon Chan; Jang, Hyeong Jun; Kim, Hoi Nam [Dept. of Radiation Oncology, Biomedical Engineering, Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Song, Jae Hoon [Dept. of Biomedical Engineering, Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Kim, Young Jae [Dept. of Radiological Technology, Gwang Yang Health Collage, Gwangyang (Korea, Republic of)

2013-03-15

The purpose of this study was to evaluate the possibility to optimize the gated treatment delivery time and maintenance of stable respiratory by the introduction of breath with the assistance of auditory-visual-tactile sense. The experimenter's respiration were measured by ANZAI 4D system. We obtained natural breathing signal, monitor-induced breathing signal, monitor and ventilator-induced breathing signal, and breath-hold signal using real time monitor during 10 minutes beam-on-time. In order to check the stability of respiratory signals distributed in each group were compared with means, standard deviation, variation value, beam{sub t}ime of the respiratory signal. The stability of each respiratory was measured in consideration of deviation change studied in each respiratory time lapse. As a result of an analysis of respiratory signal, all experimenters has showed that breathing signal used both Real time monitor and Ventilator was the most stable and shortest time. In this study, it was evaluated that respiratory gated radiation therapy with auditory-visual-tactual sense and without auditory-visual-tactual sense feedback. The study showed that respiratory gated radiation therapy delivery time could significantly be improved by the application of video feedback when this is combined with audio-tactual sense assistance. This delivery technique did prove its feasibility to limit the tumor motion during treatment delivery for all patients to a defined value while maintaining the accuracy and proved the applicability of the technique in a conventional clinical schedule.

Utility estimation of the application of auditory-visual-tactile sense feedback in respiratory gated radiation therapy

International Nuclear Information System (INIS)

Jo, Jung Hun; KIm, Byeong Jin; Roh, Shi Won; Lee, Hyeon Chan; Jang, Hyeong Jun; Kim, Hoi Nam; Song, Jae Hoon; Kim, Young Jae

2013-01-01

The purpose of this study was to evaluate the possibility to optimize the gated treatment delivery time and maintenance of stable respiratory by the introduction of breath with the assistance of auditory-visual-tactile sense. The experimenter's respiration were measured by ANZAI 4D system. We obtained natural breathing signal, monitor-induced breathing signal, monitor and ventilator-induced breathing signal, and breath-hold signal using real time monitor during 10 minutes beam-on-time. In order to check the stability of respiratory signals distributed in each group were compared with means, standard deviation, variation value, beam t ime of the respiratory signal. The stability of each respiratory was measured in consideration of deviation change studied in each respiratory time lapse. As a result of an analysis of respiratory signal, all experimenters has showed that breathing signal used both Real time monitor and Ventilator was the most stable and shortest time. In this study, it was evaluated that respiratory gated radiation therapy with auditory-visual-tactual sense and without auditory-visual-tactual sense feedback. The study showed that respiratory gated radiation therapy delivery time could significantly be improved by the application of video feedback when this is combined with audio-tactual sense assistance. This delivery technique did prove its feasibility to limit the tumor motion during treatment delivery for all patients to a defined value while maintaining the accuracy and proved the applicability of the technique in a conventional clinical schedule

Current Issues of Antipyretic Therapy in Children with Acute Respiratory Infections

Directory of Open Access Journals (Sweden)

E. I. Novikova

2013-01-01

Full Text Available This article discusses the current issues in the pediatric practice of seasonal incidence of children with acute respiratory infections. The basic etiological aspects of this pathology, specific clinical symptoms typical for different pathogens, causes of bursts of disease in certain periods are described. Special attention is paid to the tactics of antipyretic therapy in different groups of children with fever and acute respiratory diseases, understand the typical errors in its appointment. The author discusses the domestic and foreign results of using ibuprofen to relieve fever in children with this pathology, comparative efficacy and safety data of ibuprofen with other analgesics-antipyretics.

Nanoparticle-based therapy for respiratory diseases

Directory of Open Access Journals (Sweden)

ADRIANA L. DA SILVA

2013-03-01

Full Text Available Nanotechnology is an emerging science with the potential to create new materials and strategies involving manipulation of matter at the nanometer scale (<100 nm. With size-dependent properties, nanoparticles have introduced a new paradigm in pharmacotherapy – the possibility of cell-targeted drug delivery with minimal systemic side effects and toxicity. The present review provides a summary of published findings, especially regarding to nanoparticle formulations for lung diseases. The available data have shown some benefits with nanoparticle-based therapy in the development of the disease and lung remodeling in respiratory diseases. However, there is a wide gap between the concepts of nanomedicine and the published experimental data and clinical reality. In addition, studies are still required to determine the potential of nanotherapy and the systemic toxicity of nanomaterials for future human use.

Career Directions: HVACR Technician

Science.gov (United States)

Moore, Pam

2005-01-01

Heating/ventilation/air conditioning/refrigeration (HVACR) technicians (also known as "heating and cooling technicians") are the people who install, maintain, test and repair the machines that control temperature, circulation, moisture and purity of air in residential, commercial and industrial buildings. These systems consist of a variety of…

Acute respiratory failure caused by organizing pneumonia secondary to antineoplastic therapy for non-Hodgkin's lymphoma

Science.gov (United States)

Santana, Adriell Ramalho; Amorim, Fábio Ferreira; Soares, Paulo Henrique Alves; de Moura, Edmilson Bastos; Maia, Marcelo de Oliveira

2012-01-01

Interstitial lung diseases belong to a group of diseases that typically exhibit a subacute or chronic progression but that may cause acute respiratory failure. The male patient, who was 37 years of age and undergoing therapy for non-Hodgkin's lymphoma, was admitted with cough, fever, dyspnea and acute hypoxemic respiratory failure. Mechanical ventilation and antibiotic therapy were initiated but were associated with unfavorable progression. Thoracic computed tomography showed bilateral pulmonary "ground glass" opacities. Methylprednisolone pulse therapy was initiated with satisfactory response because the patient had used three drugs related to organizing pneumonia (cyclophosphamide, doxorubicin and rituximab), and the clinical and radiological symptoms were suggestive. Organizing pneumonia may be idiopathic or linked to collagen diseases, drugs and cancer and usually responds to corticosteroid therapy. The diagnosis was anatomopathological, but the patient's clinical condition precluded performing a lung biopsy. Organizing pneumonia should be a differential diagnosis in patients with apparent pneumonia and a progression that is unfavorable to antimicrobial treatment. PMID:23917942

RCT: Module 2.07, Respiratory Protection, Course 8773

Energy Technology Data Exchange (ETDEWEB)

Hillmer, Kurt T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-08-10

Internal dosimetry controls require the use of engineering controls to prevent the internal deposition of radioactive and nonradiological contaminants. However, when engineering and administrative controls are not available or feasible, respiratory protection may be necessary. The radiation control technician (RCT) should know and apply the considerations used in determining the respiratory protection equipment that is most appropriate for the job. The inappropriate use of or the use of the wrong respiratory protection equipment may result in undesirable health effects. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

Science.gov (United States)

Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

2016-01-01

Background/Aims Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD). Although the role of multichannel intraluminal impedance–pH (MII-pH) monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes. Methods We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations. Results Of the 195 patients, 96 (49.2%) exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3) than patients without respiratory symptoms (64.7±24.4, p = 0.044) based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3) than the non-respiratory symptomatic group (28.3±17.9, p = 0.013). One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms) or LTF (n = 65, 35 with respiratory symptoms) completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05). However, LTF significantly reduced the recurrence (re-operation) rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006). Conclusions MII-pH monitoring effectively detected respiratory

Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring.

Directory of Open Access Journals (Sweden)

Chao Zhang

Full Text Available Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD. Although the role of multichannel intraluminal impedance-pH (MII-pH monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes.We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations.Of the 195 patients, 96 (49.2% exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3 than patients without respiratory symptoms (64.7±24.4, p = 0.044 based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3 than the non-respiratory symptomatic group (28.3±17.9, p = 0.013. One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms or LTF (n = 65, 35 with respiratory symptoms completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05. However, LTF significantly reduced the recurrence (re-operation rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006.MII-pH monitoring effectively detected respiratory-related predictive parameters, including total

Antiviral therapy and prophylaxis of acute respiratory infections

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L. V. Osidak

2012-01-01

Full Text Available Thearticle presents the results of years of studies (including biochemical and immunological of the effectiveness of application and prophylaxis (in relation to nosocomial infections and the safety of antiviral chemical preparation Arbidol in 694 children with influenza and influenza-like illness, including the coronavirus infection (43 children and combined lesions of respiratory tract (150, indicating the possible inclusion of the drug in the complex therapy for children with the listed diseases, regardless of the severity and nature of their course. The studies were conducted according to the regulated standard of test conditions and randomized clinical trials.

Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts.

Science.gov (United States)

Davis, Corey S; Ruiz, Sarah; Glynn, Patrick; Picariello, Gerald; Walley, Alexander Y

2014-08-01

Naloxone is a medication that reverses respiratory depression from opioid overdose if given in time. Paramedics routinely administer naloxone to opioid overdose victims in the prehospital setting, and many states are moving to increase access to the medication. Several jurisdictions have expanded naloxone administration authority to nonparamedic first responders, and others are considering that step. We report here on policy change in Massachusetts, where several communities have equipped emergency medical technicians, law enforcement officers, and firefighters with naloxone.

You're a What?: Tower Technician

Science.gov (United States)

Vilorio, Dennis

2012-01-01

In this article, the author talks about the role and functions of a tower technician. A tower technician climbs up the face of telecommunications towers to remove, install, test, maintain, and repair a variety of equipment--from antennas to light bulbs. Tower technicians also build shelters and radiofrequency shields for electronic equipment, lay…

The potential of methylxanthine-based therapies in pediatric respiratory tract diseases.

Science.gov (United States)

Oñatibia-Astibia, Ainhoa; Martínez-Pinilla, Eva; Franco, Rafael

2016-03-01

Caffeine, theophylline and theobromine are the most known methylxanthines as they are present in coffee, tea and/or chocolate. In the last decades, a huge experimental effort has been devoted to get insight into the variety of actions that these compounds exert in humans. From such knowledge it is known that methylxanthines have a great potential in prevention, therapy and/or management of a variety of diseases. The benefits of methylxanthine-based therapies in the apnea of prematurity and their translational potential in pediatric affections of the respiratory tract are here presented. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can they do it? Comparing the views of pharmacists and technicians to the introduction of an advanced technician role.

Science.gov (United States)

Napier, Patti; Norris, Pauline; Green, James; Braund, Rhiannon

2016-04-01

This study aimed to investigate the opinions of pharmacists and technicians regarding the ability of New Zealand technicians to take on an advanced checking technician role. A survey was developed to investigate the opinions regarding the introduction of this new role. The questions covered are: perceived ability to take on the role, training requirements and competence. Surveys were sent to pharmacists whose contact details are available for research purposes (n = 2095) and to all pharmacies in New Zealand (both community and hospital) for the attention of technicians (n = 858). The results were analysed using IBM SPSS and thematic analysis of comments was conducted. A total of 1221 surveys were returned (pharmacists = 736 and technicians = 485). The majority of the technicians (83%) believed that 'some' technicians could work in a CT role, compared with 73% of the pharmacists. Over two-thirds (69%) of the technicians felt comfortable checking a prescription at their current level of training compared with 53% of pharmacists. Both groups' comfort increased with further specific training for the technicians. The majority of both of these groups supported the change in roles. Pharmacists were less confident that technicians could take on this role now, but were more comfortable after extra training had been completed. The technicians, however, were confident they could take on this role now but would take on extra training if needed. © 2015 Royal Pharmaceutical Society.

The value of high-flow nasal cannula oxygen therapy after extubation in patients with acute respiratory failure

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Hong-Zhuan Song

Full Text Available OBJECTIVE: To investigate the value of high-flow nasal cannula oxygen therapy after extubation in patients with acute respiratory failure. METHODS: A single-center, prospective, randomized, controlled pilot trial was conducted between January 2013 and December 2014. Sixty enrolled patients were randomized immediately after extubation into either a high-flow nasal cannula group (n=30 or an air entrainment mask group (n=30 at a fixed inspired oxygen fraction (40%. The success rate of oxygen therapy, respiratory and hemodynamic parameters and subjective discomfort (using a visual analogue scale were assessed at 24h after extubation. RESULTS: The two groups were comparable at extubation. A total of 46 patients were successfully treated including 27 patients in the high-flow nasal cannula group and 19 patients in the air entrainment mask group. Compared to the air entrainment mask group, the success rate of oxygen therapy and the partial pressure of arterial oxygen were significantly higher and the respiratory rate was lower in the high-flow nasal cannula group. In addition, less discomfort related to interface displacement and airway dryness was observed in the high-flow nasal cannula group than in the air entrainment mask group. CONCLUSIONS: At a fixed inspired oxygen fraction, the application of a high-flow nasal cannula after extubation achieves a higher success rate of oxygen therapy and less discomfort at 24h than an air entrainment mask in patients with acute respiratory failure.

Technicians for the Brazilian nuclear power programme

International Nuclear Information System (INIS)

Martins Pinto, C.S.; Spitalnik, J.; Meakins, E.J.; Hurley, I.

1980-01-01

The technician has a responsible role to fulfil in nuclear industry, acting as a bridge between the engineer and the skilled worker. Technicians must have sufficient theoretical knowledge to communicate with engineers, and a thorough understanding of technological practice; the nuclear industry demands both theory and practice of a high standard. In Brazil the essential role of the technician in industry is in general recognized. However, the lack of a nationally recognized Nuclear Technician and Nuclear Technologist qualification, as well as a desire of the best technicians to quality as engineers and, in some areas, inadequate salaries has resulted in a shortage of well-trained technicians. A first step to ensure availability of these technicians is to improve their career prospects and status through definition of appropriate career standards and salaries. Practical training by the industry can only be given in factories, plants and construction sites where nuclear work is done. It is proposed to extend apprentice training centres at three sites, to give the most promising students after two years of apprentice training two further years of instruction and practice to qualify as Nuclear Technicians. The training centres are chosen to cover the three sectors of nuclear industry where special training of technicians is important: manufacture and construction; operation and maintenance; and testing and analysis for process control and safety. (author)

Non-vascular interventional therapy for respiratory diseases

International Nuclear Information System (INIS)

Ji Hongjian; Chen Liping; Wang Hui; Cheng Yongde

2009-01-01

To review the recent literature relating to non-vascular interventional therapy of respiratory diseases. Metal airway stent insertion can immediately relieve tracheobronchial obstruction and improve pulmonary function. However, as there is a high occurrence of the restenosis after stent insertion, it should be very careful to use metal stenting to treat the benign airway obstruction. Compared with traditional lung volume reduction surgery in treating severe emphysema, bronchoscopic lung volume reduction appears to be effective, safe and less invasive, although its clinical usefullness need to be further proved. Endoscopic occlusion of bronchial fistula represents an effective alternative to surgical treatment. Percutaneous lung biopsy under ultrasound or CT guidance has been applied successfully in the management of both benign and malignant lesions. (authors)

A computer-aided audit system for respiratory therapy consult evaluations: description of a method and early results.

Science.gov (United States)

Kester, Lucy; Stoller, James K

2013-05-01

Use of respiratory therapist (RT)-guided protocols enhances allocation of respiratory care. In the context that optimal protocol use requires a system for auditing respiratory care plans to assure adherence to protocols and expertise of the RTs generating the care plan, a live audit system has been in longstanding use in our Respiratory Therapy Consult Service. Growth in the number of RT positions and the need to audit more frequently has prompted development of a new, computer-aided audit system. The number and results of audits using the old and new systems were compared (for the periods May 30, 2009 through May 30, 2011 and January 1, 2012 through May 30, 2012, respectively). In contrast to the original, live system requiring a patient visit by the auditor, the new system involves completion of a respiratory therapy care plan using patient information in the electronic medical record, both by the RT generating the care plan and the auditor. Completing audits in the new system also uses an electronic respiratory therapy management system. The degrees of concordance between the audited RT's care plans and the "gold standard" care plans using the old and new audit systems were similar. Use of the new system was associated with an almost doubling of the rate of audits (ie, 11 per month vs 6.1 per month). The new, computer-aided audit system increased capacity to audit more RTs performing RT-guided consults while preserving accuracy as an audit tool. Ensuring that RTs adhere to the audit process remains the challenge for the new system, and is the rate-limiting step.

Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

Science.gov (United States)

Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

2010-06-08

Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Would guidance from a technician be as effective as guidance from a clinician? Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (ptechnician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Australian New

SU-G-JeP3-09: Tumor Location Prediction Using Natural Respiratory Volume for Respiratory Gated Radiation Therapy (RGRT): System Verification Study

Energy Technology Data Exchange (ETDEWEB)

Kim, M; Jung, J; Yoon, D; Shin, H; Kim, S; Suh, T [The catholic university of Korea, Seoul (Korea, Republic of)

2016-06-15

Purpose: Respiratory gated radiation therapy (RGRT) gives accurate results when a patient’s breathing is stable and regular. Thus, the patient should be fully aware during respiratory pattern training before undergoing the RGRT treatment. In order to bypass the process of respiratory pattern training, we propose a target location prediction system for RGRT that uses only natural respiratory volume, and confirm its application. Methods: In order to verify the proposed target location prediction system, an in-house phantom set was used. This set involves a chest phantom including target, external markers, and motion generator. Natural respiratory volume signals were generated using the random function in MATLAB code. In the chest phantom, the target takes a linear motion based on the respiratory signal. After a four-dimensional computed tomography (4DCT) scan of the in-house phantom, the motion trajectory was derived as a linear equation. The accuracy of the linear equation was compared with that of the motion algorithm used by the operating motion generator. In addition, we attempted target location prediction using random respiratory volume values. Results: The correspondence rate of the linear equation derived from the 4DCT images with the motion algorithm of the motion generator was 99.41%. In addition, the average error rate of target location prediction was 1.23% for 26 cases. Conclusion: We confirmed the applicability of our proposed target location prediction system for RGRT using natural respiratory volume. If additional clinical studies can be conducted, a more accurate prediction system can be realized without requiring respiratory pattern training.

Electronics for technicians

CERN Document Server

Crane, P W

2013-01-01

Electronics for Technicians covers the basic fundamentals of electronics, including the operation of devices and circuits. The book is meant to help the technician to obtain numerical answers to actual circuit problems. This volume consists of seven chapters, the first of which introduces the reader to the basic rules for circuits containing resistive and reactive elements. Charge and discharge of a capacitor through a resistor is discussed, along with charge and discharge of an inductance through a resistance, application of sinusoidal voltages to simple networks, and series and parallel LCR

Programmable segmented volumetric modulated arc therapy for respiratory coordination in pancreatic cancer

International Nuclear Information System (INIS)

Wu, Jian-Kuen; Wu, Chien-Jang; Cheng, Jason Chia-Hsien

2012-01-01

We programmably divided long-arc volumetric modulated arc therapy (VMAT) into split short arcs, each taking less than 30 s for respiratory coordination. The VMAT plans of five pancreatic cancer patients were modified; the short-arc plans had negligible dose differences and satisfied the 3%/3-mm gamma index on a MapCHECK-2 device.

Macrolide therapy is associated with reduced mortality in acute respiratory distress syndrome (ARDS) patients

NARCIS (Netherlands)

Simonis, Fabienne D.; de Iudicibus, Gianfranco; Cremer, Olaf L.; Ong, David S.Y.; van der Poll, Tom; Bos, Lieuwe D.; Schultz, Marcus J.

Background: Macrolides have been associated with favorable immunological effects in various inflammatory disease states. We investigated the association between macrolide therapy and mortality in patients with the acute respiratory distress syndrome (ARDS). Methods: This was an unplanned secondary

Snapshot of cobalt, chromium and nickel exposure in dental technicians.

Science.gov (United States)

Kettelarij, Jolinde; Nilsson, Sara; Midander, Klara; Lidén, Carola; Julander, Anneli

2016-12-01

It is not fully understood where and how people are exposed to sensitizing metals. Much can be learnt from studying occupational settings where metals are handled. To quantify cobalt (Co), chromium (Cr) and nickel (Ni) exposure on the skin and in the air, and urine levels, in dental technicians working with tools and alloys that may result in skin and respiratory exposure. The metal skin dose was quantified with acid wipe sampling in dental technicians (n = 13). Air exposure was monitored by personal air sampling. Spot urine samples were collected for 24 h. Metals were analysed with inductively coupled plasma mass spectrometry. Before work, Co was detected on the skin of 10 participants (0.00025-0.0039 µg/cm 2 ), and Cr (0.00051-0.011 µg/cm 2 ) and Ni (0.0062-0.15 µg/cm 2 ) on the skin of all participants. After a 2-h period without hand washing, CoCr-exposed participants had more Co on the skin (p = 0.004) than non-CoCr-exposed participants. Co was found in 10 air samples (0.22-155 µg/m 3 ), Cr in nine (0.43-71 µg/m 3 ), and Ni in four (0.48-3.7 µg/m 3 ). Metal urine concentrations were considered to be normal. Dental technicians were exposed to Co, Cr and Ni on the skin and through the air, which was not reflected in the urine concentrations in this study. Cobalt skin doses may potentially elicit allergic contact dermatitis and cause sensitization. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

5 CFR 842.210 - Military reserve technicians.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Military reserve technicians. 842.210 Section 842.210 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... reserve technicians. (a) A military reserve technician as defined in 5 U.S.C. 8401(30) who is separated...

[Clinical usefulness of the combined empirical therapy with flomoxef and fosfomycin for intractable respiratory tract infections. With a background of increasing MRSA incidence].

Science.gov (United States)

Shimada, K; Kudoh, S; Hayashi, I; Shishido, H; Fukuchi, Y; Suzuki, H; Oritsu, M; Nakada, K; Sano, Y; Goto, H

1994-10-01

We conducted a multicenter trial to determine the clinical usefulness of the combined therapy with flomoxef (FMOX) and fosfomycin (FOM) (FF therapy) as an empirical therapy in the treatment of intractable respiratory tract infections, because FF therapy has clinically been proved to be very useful for the treatment of severe infections including MRSA infections. The overall efficacy rate of FF therapy was 69.2%. The efficacy rate for "pneumonia/lung abscess," which occupy the largest portions of respiratory tract infections, was 70.0%, showing a statistically significant difference from the efficacy rate for FMOX alone (56.7%) found in a previous study (P = 0.09 by chi-squared test). Although MRSA was eradicated in only 3 cases (37.5%) including superinfection cases, of 8 patients, from whom MRSA had been isolated as causative organisms, none of our patients were superinfected with MRSA. Thus it has been concluded that FF therapy is clinically very useful when used as an empirical therapy in the treatment of respiratory tract infections.

Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

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Carlos Polanco

2013-01-01

Full Text Available A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010 taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts.

Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

Science.gov (United States)

Castañón-González, Jorge Alberto; Macías, Alejandro E.; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián

2013-01-01

A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts. PMID:24069063

24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

Science.gov (United States)

2010-04-01

... medical technicians. 291.530 Section 291.530 Housing and Urban Development Regulations Relating to Housing... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of... technician by a fire department or emergency medical services responder unit of the federal government, a...

Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

Directory of Open Access Journals (Sweden)

Anna Lucia Spear King

2011-01-01

Full Text Available Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive, especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

Training nuclear technicians in two-year, post-secondary educational programs

International Nuclear Information System (INIS)

Hull, D.M.; Roney, M.W.

1975-01-01

An available and economical supply to future manpower requirements for various types of nuclear technicians can be met by developing and/or restructuring two-year, post-secondary programs at local educational institutions. The Technical Education Research Centers program is under contract from the U.S. Office of Education to delineate the job requirements and develop curricula and instructional materials for two-year, post-secondary training of nuclear technicians. Six job categories have been identified along with corresponding tasks which the technician performs. These categories are: Reactor Operator, Nuclear Instrumentation Technician, Nuclear QA/QC Technician, Radiochemistry Technician, Radiation Protection Technician and Nuclear Medicine Technician. For the first five categories curricula have been established, courses have been described, and instructional materials are being written

Knowledge and attitudes about smoking cessation among pharmacy technicians.

Science.gov (United States)

Zillich, Alan J; Aquilino, Mary L; Farris, Karen B

2004-01-01

To evaluate the knowledge and attitudes of pharmacy technicians before and after attending a continuing education program about smoking cessation. A pre/post survey of a single group. Two statewide meetings of the Iowa Pharmacy Association. Pharmacy technicians. One 2-hour continuing education (CE) course about smoking cessation for pharmacy technicians. Changes in scores before and after the CE sessions among three domains (knowledge, efficacy, and outcome) of a validated survey instrument. Fifty-one technicians completed both the presession and postsession questionnaire. For the three survey domains, technicians' knowledge (P = .034), efficacy (P < .001), and outcome (P < .001) showed significant improvement between the presession and postsession surveys (Wilcoxon signed rank test). Pharmacy technicians who attended a CE program on smoking cessation improved their knowledge, attitudes, and self-confidence in helping smokers quit. Additional research should be conducted to test the role of pharmacy technicians in smoking cessation promotion.

Dose verification for respiratory-gated volumetric modulated arc therapy

Energy Technology Data Exchange (ETDEWEB)

Qian Jianguo; Xing Lei; Liu Wu; Luxton, Gary, E-mail: gluxton@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305 (United States)

2011-08-07

A novel commercial medical linac system (TrueBeam(TM), Varian Medical Systems, Palo Alto, CA) allows respiratory-gated volumetric modulated arc therapy (VMAT), a new modality for treating moving tumors with high precision and improved accuracy by allowing for regular motion associated with a patient's breathing during VMAT delivery. The purpose of this work is to adapt a previously-developed dose reconstruction technique to evaluate the fidelity of VMAT treatment during gated delivery under clinic-relevant periodic motion related to patient breathing. A Varian TrueBeam system was used in this study. VMAT plans were created for three patients with lung or pancreas tumors. Conventional 6 and 15 MV beams with flattening filter and high-dose-rate 10 MV beams with no flattening filter were used in these plans. Each patient plan was delivered to a phantom first without gating and then with gating for three simulated respiratory periods (3, 4.5 and 6 s). Using the adapted log-file-based dose reconstruction procedure supplemented with ion chamber array (Seven29(TM), PTW, Freiburg, Germany) measurements, the delivered dose was used to evaluate the fidelity of gated VMAT delivery. Comparison of Seven29 measurements with and without gating showed good agreement with gamma-index passing rates above 99% for 1%/1 mm dose accuracy/distance-to-agreement criteria. With original plans as reference, gamma-index passing rates were 100% for the reconstituted plans (1%/1 mm criteria) and 93.5-100% for gated Seven29 measurements (3%/3 mm criteria). In the presence of leaf error deliberately introduced into the gated delivery of a pancreas patient plan, both dose reconstruction and Seven29 measurement consistently indicated substantial dosimetric differences from the original plan. In summary, a dose reconstruction procedure was demonstrated for evaluating the accuracy of respiratory-gated VMAT delivery. This technique showed that under clinical operation, the TrueBeam system

Enactment of mandatory pharmacy technician certification in Kansas.

Science.gov (United States)

Lucas, Amber; Massey, Lindsay; Gill, Taylor; Burger, Gregory; Little, Jeff D

2016-02-01

The successful enactment of mandatory pharmacy technician certification in Kansas is described. In 2004, Kansas began requiring registration of all pharmacy technicians with the state board of pharmacy. Registration identified individuals working as pharmacy technicians but did not require any specific education or certification. In September 2012, the Kansas Board of Pharmacy created a task force of key stakeholders including pharmacists from multiple areas of practice, the University of Kansas School of Pharmacy, organizational leaders from the Kansas Council of Health-System Pharmacists (KCHP) and Kansas Pharmacists Association, and professional lobbyists. The goals of this task force were to research practices of technician certification in other states and to make recommendations to the state board of pharmacy on how Kansas could accomplish mandatory technician certification. The task force outlined the steps needed to achieve legislation that could be supported by the members. These topics included the creation of a technician trainee category, grandfathering certain technicians who had been practicing for a designated period of time, state board-approved exemptions, training requirements, age and education requirements, continuing-education requirements, and pharmacist:technician ratio. The recommendations were finalized at the August 2013 Kansas Pharmacy Summit, and the proposed legislation was introduced and passed during the 2014 legislative session. KCHP members learned many valuable lessons about advocacy and the legislative process with this initiative, including building relationships, working with legislators, and working with other professional organizations. The formation of a task force led to the successful passage of a bill granting the Kansas Board of Pharmacy the authority to issue regulations regarding mandatory pharmacy technician certification. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Improving job satisfaction and enlarging the role of technicians.

Science.gov (United States)

Spooner, S H; Britton, M E; Erskine, L M; Verschoor, B A; Williams, P A

1991-01-01

The process used in preparing this administrative report provided the means of documenting departmental support of technician task expansion, cost benefits, increased availability of professional time, and the need for a dynamic department. Some of the benefits to St. Luke's Regional Medical Center and its Pharmacy Department were an increase in technician job satisfaction, improved quality of patient care attributable to the increased scope of pharmacy service, and up to 8554 hours per year of professional time available for more clinically oriented responsibilities. If technician turnover were decreased by half, technician pricing errors eliminated, and technicians assumed the identified technical tasks, potential monetary benefits could be as much as +116,900 per year. The departmental cost of implementing these recommendations would be an additional 4.16 technician FTEs, and the professional time for training, supervising, and coordinating technicians and functions. These recommendations were well received by pharmacy administration, and the committee was asked to develop a list of priorities and an implementation plan for administrative approval.

Effects of Respiratory Motion on Passively Scattered Proton Therapy Versus Intensity Modulated Photon Therapy for Stage III Lung Cancer: Are Proton Plans More Sensitive to Breathing Motion?

International Nuclear Information System (INIS)

Matney, Jason; Park, Peter C.; Bluett, Jaques; Chen, Yi Pei; Liu, Wei; Court, Laurence E.; Liao, Zhongxing; Li, Heng; Mohan, Radhe

2013-01-01

Purpose: To quantify and compare the effects of respiratory motion on paired passively scattered proton therapy (PSPT) and intensity modulated photon therapy (IMRT) plans; and to establish the relationship between the magnitude of tumor motion and the respiratory-induced dose difference for both modalities. Methods and Materials: In a randomized clinical trial comparing PSPT and IMRT, radiation therapy plans have been designed according to common planning protocols. Four-dimensional (4D) dose was computed for PSPT and IMRT plans for a patient cohort with respiratory motion ranging from 3 to 17 mm. Image registration and dose accumulation were performed using grayscale-based deformable image registration algorithms. The dose–volume histogram (DVH) differences (4D-3D [3D = 3-dimensional]) were compared for PSPT and IMRT. Changes in 4D-3D dose were correlated to the magnitude of tumor respiratory motion. Results: The average 4D-3D dose to 95% of the internal target volume was close to zero, with 19 of 20 patients within 1% of prescribed dose for both modalities. The mean 4D-3D between the 2 modalities was not statistically significant (P<.05) for all dose–volume histogram indices (mean ± SD) except the lung V5 (PSPT: +1.1% ± 0.9%; IMRT: +0.4% ± 1.2%) and maximum cord dose (PSPT: +1.5 ± 2.9 Gy; IMRT: 0.0 ± 0.2 Gy). Changes in 4D-3D dose were correlated to tumor motion for only 2 indices: dose to 95% planning target volume, and heterogeneity index. Conclusions: With our current margin formalisms, target coverage was maintained in the presence of respiratory motion up to 17 mm for both PSPT and IMRT. Only 2 of 11 4D-3D indices (lung V5 and spinal cord maximum) were statistically distinguishable between PSPT and IMRT, contrary to the notion that proton therapy will be more susceptible to respiratory motion. Because of the lack of strong correlations with 4D-3D dose differences in PSPT and IMRT, the extent of tumor motion was not an adequate predictor of potential

Effects of Respiratory Motion on Passively Scattered Proton Therapy Versus Intensity Modulated Photon Therapy for Stage III Lung Cancer: Are Proton Plans More Sensitive to Breathing Motion?

Energy Technology Data Exchange (ETDEWEB)

Matney, Jason; Park, Peter C. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); The University of Texas Graduate School of Biomedical Sciences, Houston, Texas (United States); Bluett, Jaques [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chen, Yi Pei [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); The University of Texas Graduate School of Biomedical Sciences, Houston, Texas (United States); Liu, Wei; Court, Laurence E. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Li, Heng [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe, E-mail: rmohan@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2013-11-01

Purpose: To quantify and compare the effects of respiratory motion on paired passively scattered proton therapy (PSPT) and intensity modulated photon therapy (IMRT) plans; and to establish the relationship between the magnitude of tumor motion and the respiratory-induced dose difference for both modalities. Methods and Materials: In a randomized clinical trial comparing PSPT and IMRT, radiation therapy plans have been designed according to common planning protocols. Four-dimensional (4D) dose was computed for PSPT and IMRT plans for a patient cohort with respiratory motion ranging from 3 to 17 mm. Image registration and dose accumulation were performed using grayscale-based deformable image registration algorithms. The dose–volume histogram (DVH) differences (4D-3D [3D = 3-dimensional]) were compared for PSPT and IMRT. Changes in 4D-3D dose were correlated to the magnitude of tumor respiratory motion. Results: The average 4D-3D dose to 95% of the internal target volume was close to zero, with 19 of 20 patients within 1% of prescribed dose for both modalities. The mean 4D-3D between the 2 modalities was not statistically significant (P<.05) for all dose–volume histogram indices (mean ± SD) except the lung V5 (PSPT: +1.1% ± 0.9%; IMRT: +0.4% ± 1.2%) and maximum cord dose (PSPT: +1.5 ± 2.9 Gy; IMRT: 0.0 ± 0.2 Gy). Changes in 4D-3D dose were correlated to tumor motion for only 2 indices: dose to 95% planning target volume, and heterogeneity index. Conclusions: With our current margin formalisms, target coverage was maintained in the presence of respiratory motion up to 17 mm for both PSPT and IMRT. Only 2 of 11 4D-3D indices (lung V5 and spinal cord maximum) were statistically distinguishable between PSPT and IMRT, contrary to the notion that proton therapy will be more susceptible to respiratory motion. Because of the lack of strong correlations with 4D-3D dose differences in PSPT and IMRT, the extent of tumor motion was not an adequate predictor of potential

Aplastic anemia in Japanese radiological technicians

International Nuclear Information System (INIS)

Kitabatake, T.; Watanabe, T.; Saito, A.; Nakamura, M.; Shiohama Hospital, Mie

1976-01-01

Among the Japanese radiological technicians, four deaths from aplastic anemia have been reported after 1930. On the other hand, during the period from 1930 to 1960, the population of radiological technicians is estimated to be 74,400 man-years, in which 0.5 aplastic anemias are expected. However, actually three died from aplastic anemia. This difference is statistically significant at the 1% level. While, in the period from 1961 to 1973, the observed value is 1 against 0.7 expected. It is concluded that aplastic anemia had been induced frequently among the Japanese radiological technicians in the era when there was much exposure to occupational radiation. (orig.) [de

Welding Technician

Science.gov (United States)

Smith, Ken

2009-01-01

About 95% of all manufactured goods in this country are welded or joined in some way. These welded products range in nature from bicycle handlebars and skyscrapers to bridges and race cars. The author discusses what students need to know about careers for welding technicians--wages, responsibilities, skills needed, career advancement…

Experience with inhaled nitric oxide therapy in hypoxic respiratory failure of the newborn.

Science.gov (United States)

Sehgal, Arvind; Callander, Ian; Stack, Jacqueline; Momsen, Tracey; Sterling-Levis, Katy

2005-01-01

Respiratory diseases are the commonest cause of morbidity and mortality in newborns. Inhaled nitric oxide (iNO) has been shown to be effective in the management of persistent pulmonory hypertension of newborn (PPHN). To retrospectively analyse data to determine the effectiveness of inhaled nitric oxide (iNO) in the management of newborns with PPHN in terms of survival and changes in oxygenation status. Neo-natal data since inception of iNO therapy at the unit (past six years) was reviewed. Pertinent demographic and clinical information was collected from medical records of newborns that received inhaled nitric oxide therapy during their stay. Details of underlying illnesses, other therapeutic modalities, arterial blood gas, ventilatory and nitric oxide parameters were assessed and analysed to ascertain efficacy of iNO. A total of 36 babies (gestational age ranging from 24-41 weeks) received iNO during this period; two were excluded from final analysis. Overall survival rate was 80 percent. There was a statistically significant increase in systemic oxygenation (PaO2) from 41.1 +/- 2.1 mmHg to 128.5 +/- 13.2 mmHg and a decline in oxygenation index (OI) from 49.4 +/- 5.9 to 17.3 +/- 2.5, when assessed after four hours (P < 0.001). Mean duration of iNO therapy was 63 +/- 7.3 hours and the maximum methaemoglobin levels were noted to be 2.1 percent. Inhaled nitric oxide appears to be an effective rescue therapy for the management of PPHN associated with hypoxic respiratory failure. It is safe and well tolerated with no evidence of clinical or biochemical side effects.

SU-E-J-48: Development of An Abdominal Compression Device for Respiratory Correlated Radiation Therapy

International Nuclear Information System (INIS)

Kim, T; Kang, S; Kim, D; Suh, T; Kim, S

2014-01-01

therapy and respiratory training system will be investigated. This work was supported by Radiation Technology R and D program (No. 2013M2A2A7043498)and Basic Atomic Energy Research Institute (BAERI)(No. NRF-2009-0078390) through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning

[Role of the technician in a brachytherapy department].

Science.gov (United States)

Bélot-Cheval, V; Lemoine, L; Cuisinier, C; Gensse, M-C; Lasbareilles, O

2013-04-01

The role of the technician in a brachytherapy department is essential for the cohesion of the treatment team made up of the radiation oncologist, the physicist, and the technician. He/she collaborates in the different treatment steps such as taking care of the patients, training of the professionals and research studies in collaboration with the team. He participates in all steps of the treatment such as preparation, technician's consultation, catheters/templates and radioactives sources implant, dose distribution analysis and treatment. He looks after the management of planning, radioactive sources and chemist's equipments. He takes part in the training of the junior technician, and support doctors and physicists in different studies. The procedure writing and the presentation of professional practices are also part of the technician task. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Radiological control technician: Training program management manual

International Nuclear Information System (INIS)

1992-10-01

This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

46 CFR 160.151-39 - Training of servicing technicians.

Science.gov (United States)

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Training of servicing technicians. 160.151-39 Section...-39 Training of servicing technicians. (a) The training program for certification of servicing technicians must include— (1) Training and practice in packing an inflatable liferaft, repairing buoyancy...

Pressing Issues of Rational Antibiotic Therapy for Inflammatory Diseases of the Lower Respiratory Tract in Pediatric Practice

Directory of Open Access Journals (Sweden)

Ye.N. Okhotnikova

2015-03-01

Full Text Available Over the past 30 years, high incidence of acute lower respiratory tract infections of bacterial origin, primarily pneumonia and bronchitis, treatment of which under the spread of antibiotic resistance is often a difficult task, cause alarm. Bronchitis — one of the most common respiratory diseases in childhood after acute respiratory viral infections. Application of antibiotics for acute bronchitis in children is not recommended, but they are prescribed for severe intoxication and prolonged hyperthermia (over 3 days, especially in infants, children with poor premorbid background and high risk of pneumonia. Antibiotic therapy is considered as the only science-based treatment of pneumonia. Taking into account the broad spectrum of modern antibiotics, monotherapy is most suitable. If it is necessary to extend their effect, combination of amoxicillin/clavulanate with macrolides, to which all the major respiratory pathogens are sensitive, is preferred.

SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Wang, T; Zhu, L [Georgia Institute of Technology, Atlanta, GA (Georgia); Khan, M; Landry, J; Rajpara, R; Hawk, N [Emory University, Atlanta, GA (United States)

2014-06-01

Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

40 CFR 745.90 - Renovator certification and dust sampling technician certification.

Science.gov (United States)

2010-07-01

... sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION... technician certification. (a) Renovator certification and dust sampling technician certification. (1) To become a certified renovator or certified dust sampling technician, an individual must successfully...

Treatment of respiratory failure in COPD

Directory of Open Access Journals (Sweden)

Stephan Budweiser

2008-12-01

Full Text Available Stephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, GermanyAbstract: Patients with advanced COPD and acute or chronic respiratory failure are at high risk for death. Beyond pharmacological treatment, supplemental oxygen and mechanical ventilation are major treatment options. This review describes the physiological concepts underlying respiratory failure and its therapy, as well as important treatment outcomes. The rationale for the controlled supply of oxygen in acute hypoxic respiratory failure is undisputed. There is also a clear survival benefit from long-term oxygen therapy in patients with chronic hypoxia, while in mild, nocturnal, or exercise-induced hypoxemia such long-term benefits appear questionable. Furthermore, much evidence supports the use of non-invasive positive pressure ventilation in acute hypercapnic respiratory failure. It application reduces intubation and mortality rates, and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failure became a major indication for domiciliary mechanical ventilation, based on pathophysiological reasoning and on data regarding symptoms and quality of life. Still, however, its relevance for long-term survival has to be substantiated in prospective controlled studies. Such studies might preferentially recruit patients with repeated hypercapnic decompensation or a high risk for death, while ensuring effective ventilation and the patients’ adherence to therapy.Keywords: respiratory failure, COPD, mechanical ventilation, non-invasive ventilation long-term oxygen therapy, chronic

Radiological Control Technician: Standardized technician Qualification Standard

International Nuclear Information System (INIS)

1992-10-01

The Qualification Standard states and defines the knowledge and skill requirements necessary for successful completion of the Radiological Control Technician Training Program. The standard is divided into three phases: Phase I concerns RCT Academic training. There are 13 lessons associated with the core academics program and 19 lessons associated with the site academics program. The staff member should sign the appropriate blocks upon successful completion of the examination for that lesson or group of lessons. In addition, facility specific lesson plans may be added to meet the knowledge requirements in the Job Performance Measures (JPM) of the practical program. Phase II concerns RCT core/site practical (JPMs) training. There are thirteen generic tasks associated with the core practical program. Both the trainer/evaluator and student should sign the appropriate block upon successful completion of the JPM. In addition, facility specific tasks may be added or generic tasks deleted based on the results of the facility job evaluation. Phase III concerns the oral examination board successful completion of the oral examination board is documented by the signature of the chairperson of the board. Upon completion of all of the standardized technician qualification requirements, final qualification is verified by the student and the manager of the Radiological Control Department and acknowledged by signatures on the qualification standard. The completed Qualification Standard shall be maintained as an official training record

Practical analog electronics for technicians

CERN Document Server

Kimber, W A

2013-01-01

'Practical Analog Electronics for Technicians' not only provides an accessible introduction to electronics, but also supplies all the problems and practical activities needed to gain hands-on knowledge and experience. This emphasis on practice is surprisingly unusual in electronics texts, and has already gained Will Kimber popularity through the companion volume, 'Practical Digital Electronics for Technicians'. Written to cover the Advanced GNVQ optional unit in electronics, this book is also ideal for BTEC National, A-level electronics and City & Guilds courses. Together with 'Practical Digit

Hematological findings in male x-ray technicians

International Nuclear Information System (INIS)

Meo, Sultan A.

2004-01-01

In view of the known health hazards of x-ray radiation, this study focuses on the basic hematological parameters: red blood cells (RBCs), white blood cells (WBCs) and platelets count in x-ray technicians. The aim was to identify the affect of x-ray radiation on blood cell counts in x-ray technicians. The present study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the year 2002. In this study, a group of 40 apparently healthy male x-ray technicians with age ranging from 25-50-years were recruited. They were matched with another group of 40 apparently healthy control subjects in terms of age, sex and ethnic origin. Both groups met with exclusion criteria as per standard. Red blood cells, WBC and platelets count were performed by using a blood cell auto analyser. The mean value of platelet count was significantly decreased (p<0.01) in x-ray technicians when compared to controls. However, no significant difference was observed in RBC and WBC count between the groups. Radiation causes decreased platelet count. Further, studies are needed to study the long-term effects of x-ray radiation on blood cell count in x-ray technicians. (author)

Comparing Burnout Across Emergency Physicians, Nurses, Technicians, and Health Information Technicians Working for the Same Organization

OpenAIRE

Schooley, Benjamin; Hikmet, Neset; Tarcan, Menderes; Yorgancioglu, Gamze

2016-01-01

Abstract Studies on the topic of burnout measure the effects of emotional exhaustion (EE), depersonalization (DP) (negative or cynical attitudes toward work), and reduced sense of personal accomplishment (PA). While the prevalence of burnout in practicing emergency medicine (EM) professionals has been studied, little is known of the prevalence and factors across physicians, nurses, technicians, and health information technicians working for the same institution. The aim of this study was to a...

Section 608 Technician Certification

Science.gov (United States)

Certifications for technicians who maintain, service, repair, or dispose of equipment that could release ozone depleting refrigerants or, after January 1, 2018, substitute refrigerants into the atmosphere.

Technicians and Shop Owners

Science.gov (United States)

Overview page provides information for shops and technicians that repair or service motor vehicle air-conditioning systems, including information on proper training, approved equipment, and regulatory practices.

SPECIFIC DISORDERS OF THE RESPIRATORY SYSTEM IN CYSTIC FIBROSIS. CLINICAL EFFICACY OF THERAPY WITH DORNASE ALFA IN CHILDREN

Directory of Open Access Journals (Sweden)

T.V. Simanova

2010-01-01

Full Text Available The article is devoted to specific disorders of the respiratory system in cystic fibrosis. 64 patients with cystic fibrosis (CF aged 2 months to 32 years and residing in the Udmurtian Republic were studied. Epidemiological and genetic specifics of this disease in the mentioned region of the RF were examined. Clinical, X-ray, functional and microbiological studies of the CF patients’ respiratory system were conducted. It was found that genotype delF508 and chronic infection Pseudomonas aeruginosa, Staphylococcus aureus cause severe structural changes to the bronchopulmonary system more often. The obtained data suggest the advisability of identifying the groups of CF patients at the highest risk of severe respiratory system disorders in order to optimise therapeutic efforts. The article provides indicators of clinical efficacy of a dornase alfa therapy in CF children.Key words: cystic fibrosis, genotype, delF508 mutation, respiratory organs, pseudomonas aeruginosa infection, staphylococcal infection, respiratory function, mucolytic function, dornase alfa. (Pediatric Pharmacology. – 2010; 7(6:44-48

Preparing technicians for photonics industries and organizations

Science.gov (United States)

Souders, John; Hull, Dan

2012-10-01

U.S. photonics organizations need about 800 new photonics technicians each year. Thirty-one community and technical colleges have approximately 700 students enrolled in photonics related programs; about 275 of them complete their coursework and enter the workforce each year. A disparity exists between the demand and supply of qualified photonics technicians in the U.S. OP-TEC, the National Center for Optics and Photonics Education is a consortium of seven colleges, under the leadership of the University of Central Florida, and sponsored by NSF. OP-TEC's mission is to increase the quantity and quality of photonics technicians prepared at two-year colleges. OP-TEC maintains the National Photonics Skill Standards for Technicians, provides curriculum models, teaching materials, faculty training/professional development and planning services to strengthen existing college photonics programs and to attract and support new ones. OP-TEC is converting its text materials to E-Books to support students in technical programs. Through OP-TEC's recruitment efforts 84 additional colleges are interested in initiating new photonics programs. The OP-TEC Photonics College Network (OPCN) consists of 28 colleges that are currently providing photonics education. This fall OPCN will lead an additional national effort to further educate employed photonics technicians through on-line courses, complemented by lab experiences at nearby colleges. OP-TEC is expanding its outreach to photonics employers and colleges by regionalizing its approach to offering its services. OP-TEC is also planning to develop new curricula and instructional materials for AAS programs to prepare Precision Optics Technicians. This paper will detail OP-TEC's work with particular emphases on its materials and services.

[Emergency Medical Technician profile in Spain].

Science.gov (United States)

Martínez-Isasi, Santiago; Rodríguez-Lorenzo, María José; Vázquez-Santamariña, David; Abella-Lorenzo, Javier; Castro Dios, Diana Josefa; Fernández García, Daniel

2017-12-11

The emergency medical technician plays a fundamental role and is the most important figure quantitatively in pre-hospital emergencies. The aim was to asses the socio-demographic, work-related, health characteristics and technical skills of an Emergency Medical Technician in Spain. Cross-sectional descriptive study. An ad hoc questionnaire was managed using Google Docs® that was delivered between April-June 2014 via email and social networks. A total of 705 questionnaires were collected. Statistical analysis was performed with SPSS ® 20.0 Windows version. A significance level p≤0.05 was used for all analyzes. The data analyzed show that the profile of the Emergency Medical Technician in Spain is an 39 year-old man, married or living as a couple and has a child. The average BMI is 27 kg/m2, does regular exercise, does not smoke. His seniority in the company is 10 years and has the Medium Cycle of Emergency Medical Technician. The analysis for gender shows that men have an average of 40, an average BMI of 27, 5 kg/m2 and work in an advanced life support unit; while women have an average of 36,5 years, an average BMI of 24,7 kg/m2, mainly work in Basic Life Support Unit and her seniority in the company is 6,76 years. Emergency Medical Technician profile is a overweight men, who refer to practise regular exercise, his seniority in the company is 10 years and is in possession of CMTES; differences were observed according to gender in BMI, resource where they perform their work, seniority and age.

Evaluation of respiratory pattern during respiratory-gated radiotherapy

International Nuclear Information System (INIS)

Dobashi, Suguru; Mori, Shinichiro

2014-01-01

The respiratory cycle is not strictly regular, and generally varies in amplitude and period from one cycle to the next. We evaluated the characteristics of respiratory patterns acquired during respiratory gating treatment in more than 300 patients. A total 331 patients treated with respiratory-gated carbon-ion beam therapy were selected from a group of patients with thoracic and abdominal conditions. Respiratory data were acquired for a total of 3,171 fractions using an external respiratory sensing monitor and evaluated for respiratory cycle, duty cycle, magnitude of baseline drift, and intrafractional/interfractional peak inhalation/exhalation positional variation. Results for the treated anatomical sites and patient positioning were compared. Mean ± SD respiratory cycle averaged over all patients was 4.1 ± 1.3 s. Mean ± SD duty cycle averaged over all patients was 36.5 ± 7.3 %. Two types of baseline drift were seen, the first decremental and the second incremental. For respiratory peak variation, the mean intrafractional variation in peak-inhalation position relative to the amplitude in the first respiratory cycle (15.5 ± 9.3 %) was significantly larger than that in exhalation (7.5 ± 4.6 %). Interfractional variations in inhalation (17.2 ± 18.5 %) were also significantly greater than those in exhalation (9.4 ± 10.0 %). Statistically significant differences were observed between patients in the supine position and those in the prone position in mean respiratory cycle, duty cycle, and intra-/interfractional variations. We quantified the characteristics of the respiratory curve based on a large number of respiratory data obtained during treatment. These results might be useful in improving the accuracy of respiratory-gated treatment.

Advancing the role of the pharmacy technician: A systematic review.

Science.gov (United States)

Mattingly, Ashlee N; Mattingly, T Joseph

To summarize the findings of a literature search on advancing the role of pharmacy technicians, including the types of training identified and the potential costs and benefits to both the technician and the pharmacy. A literature search of Scopus, Embase, and Medline was conducted on January 11, 2017. Original research, research reports, case studies, or association reports were included for review. Articles were considered to be relevant based on identification of an advanced pharmacy technician role or addressing additional training/education for technician functions. A standard data extraction form was used to collect study authors, article title, year published, journal title, study design, brief description of methods, primary outcome measures, advanced technician roles identified, additional education or training addressed, and additional costs and benefits identified in each article. A total of 33 articles were included for full review and data extraction. Study design varied, with 17 (52%) quantitative, 1 (3%) qualitative, 5 (15%) mixed-method, and 10 (30%) case study designs. Seventeen (52%) of the studies included were published after 2006. The mechanism of training was primarily through supervised on-the-job training, allowing technicians to assume administrative-based positions that facilitated a pharmacist-led clinical service, with either the pharmacist or the pharmacy receiving the greatest benefits. Although the literature supports technicians performing advanced roles in the pharmacy, resulting in either improved patient outcomes or opportunities for pharmacists to engage in additional clinical services, the benefits to the technician were primarily indirect, such as an increase in job satisfaction or a more desirable work schedule. If a technician is to take on additional roles that require completion of a formalized training or educational program, benefits that are more tangible may help to inspire technicians to pursue these roles. Copyright �

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 5. CPR, Oxygen Therapy. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the fifth in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains two sections covering the following course content; cardiopulmonary resuscitation (CPR) (including artificial ventilation, foreign body obstructions, adjunctive equipment and special techniques, artificial…

[Respiratory hypercapnic-hypoxic training is an effective component of complex therapy of polyneuropathy in children with diabetes type 1].

Science.gov (United States)

Smirnov, K V; Smirnova, Yu V; Kulikov, V P; Nazarkina, O M

2018-01-01

To study the effectiveness of respiratory hypercapnic-hypoxic training in complex treatment of neuropathy due to diabetes type 1. Fifty children, 31 girls and 19 boys, were examined. The inclusion criteria were the presence of polyneuropathy, verified on the basis of clinical data and electromyographic changes. The patients were divided into 2 groups: the main group (n=25, 15 girls and 10 boys, mean age 12.9±1.8 years (M±SD) and the comparison group (n=25, 16 girls and 9 boys, mean age 13.2±2.0 years). Patients of the main group, along with standard therapy received respiratory hypercapnic-hypoxic training. The positive clinical and neurophysiological dynamics was noted in both groups, with more significant changes in children after respiratory training. Hypercapnic exercises significantly contribute to the pathogenetic therapy of diabetes mellitus and polyneuropathy in this disease, have a significant clinical effects reducing serum concentrations of fasting glucose and severity of neurological deficit scores on the NIS-LL, increasing the speed of conduction of excitation through the nerves, reducing the residual latency of EMG activity.

ROLE OF ENTEROSORPTION IN COMPREHENSIVE THERAPY FOR ACUTE RESPIRATORY DISEASES COMBINED DAMAGE TO WITH GASTROINTESTINAL TRACT DISEASE

Directory of Open Access Journals (Sweden)

Yu.B. Belan

2010-01-01

Full Text Available The frequency of acute respiratory infections remains high in childhood. It is impossible to identify etiology most accurately in each particular case. However, according to multiple studies, viruses, their associations with each other and bacteria prevail as causative agents. In addition, it is quite often that a respiratory infection, especially in minor children, is combined with a condition of the gastrointestinal tract. Apart from symptomatic and antiviral therapies in these cases, as the authors of this article demonstrated, it is advisable to use enterosorbents. This tactics results in a decreased level of intoxication, lower intensity and duration of diarrheal syndrome, i.e. more speedy recovery.Key words: acute respiratory infections, condition of gastro tract, intoxication, diarrheal syndrome, treatment, enterosorbents, children. (Pediatric Pharmacology. – 2010; 7(3:88-90

Inhaled phage therapy: a promising and challenging approach to treat bacterial respiratory infections.

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Bodier-Montagutelli, Elsa; Morello, Eric; L'Hostis, Guillaume; Guillon, Antoine; Dalloneau, Emilie; Respaud, Renaud; Pallaoro, Nikita; Blois, Hélène; Vecellio, Laurent; Gabard, Jérôme; Heuzé-Vourc'h, Nathalie

2017-08-01

Bacterial respiratory tract infections (RTIs) are increasingly difficult to treat due to evolving antibiotic resistance. In this context, bacteriophages (or phages) are part of the foreseen alternatives or combination therapies. Delivering phages through the airways seems more relevant to accumulate these natural antibacterial viruses in proximity to their bacterial host, within the infectious site. Areas covered: This review addresses the potential of phage therapy to treat RTIs and discusses preclinical and clinical results of phages administration in this context. Recent phage formulation and aerosolization attempts are also reviewed, raising technical challenges to achieve efficient pulmonary deposition via inhalation. Expert opinion: Overall, the inhalation of phages as antibacterial treatment seems both clinically relevant and technically feasible. Several crucial points still need to be investigated, such as phage product pharmacokinetics and immunogenicity. Furthermore, given phage-specific features, appropriate regulatory and manufacturing guidelines will need to be defined. Finally, randomized controlled clinical trials should be carried out to establish phage therapy's clinical positioning in the antimicrobial arsenal against RTIs.

Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.

Science.gov (United States)

Robinson, Emma; Titov, Nickolai; Andrews, Gavin; McIntyre, Karen; Schwencke, Genevieve; Solley, Karen

2010-06-03

Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (ptechnician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the

Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD

Directory of Open Access Journals (Sweden)

Yilmaz Yelvar GD

2016-06-01

Full Text Available Gul Deniz Yilmaz Yelvar,1 Yasemin Çirak,2 Yasemin Parlak Demir,3 Murat Dalkilinç,1 Bülent Bozkurt4 1Department of Musculoskeletal Physiotherapy, 2Department of Cardiopulmonary Physiotherapy, 3Department of Neurological Rehabilitation, School of Physiotherapy and Rehabilitation, 4Department of Respiratory Medicine, Faculty of Medicine, Turgut Özal University, Ankara, Turkey Objective: The objective of this study was to investigate the immediate effect of manual therapy (MT on respiratory functions and inspiratory muscle strength in patients with COPD.Participants and methods: Thirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients’ symptoms subjectively during the MT session.Results: There was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05. The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05. There was a significant decrease in heart rate, respiratory rate (P<0.05, and dyspnea and fatigue perception (P<0.05.Conclusion: A single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with

Comparing Burnout Across Emergency Physicians, Nurses, Technicians, and Health Information Technicians Working for the Same Organization.

Science.gov (United States)

Schooley, Benjamin; Hikmet, Neset; Tarcan, Menderes; Yorgancioglu, Gamze

2016-03-01

Studies on the topic of burnout measure the effects of emotional exhaustion (EE), depersonalization (DP) (negative or cynical attitudes toward work), and reduced sense of personal accomplishment (PA). While the prevalence of burnout in practicing emergency medicine (EM) professionals has been studied, little is known of the prevalence and factors across physicians, nurses, technicians, and health information technicians working for the same institution. The aim of this study was to assess burnout differences across EM professional types.The total population of 250 EM professionals at 2 public urban hospitals in Turkey were surveyed using the Maslach Burnout Inventory and basic social- and work-related demographics. Descriptive statistics, ANOVA, and additional post hoc tests were computed.Findings show that EE and DP scores were high across all occupational groups, while scores on PA were low. There was a statistically significant difference between nurses and medical technicians (P nurses and medical technicians (P Burnout can be high across occupational groups in the emergency department. Burnout is important for EM administrators to assess across human resources. Statistically significant differences across socio-demographic groups vary across occupational groups. However, differences between occupational groups may not be explained effectively by the demographic factors assessed in this or other prior studies. Rather, the factors associated with burnout are incomplete and require further institutional, cultural, and organizational analyses including differentiating between job tasks carried out by each EM job type.

Regulation on the training-schools and institutions for radiation-technicians and x-ray technicians

International Nuclear Information System (INIS)

1977-01-01

The regulation, in accordance with the Law on X-ray technicians (Law No. 227, 1951), controls and makes rules of the establishment and activities of schools and institutions for those technicians as above mentioned, with intent to secure prescribed qualifications and capabilities of said technicians. Such schools and institutions shall get the designation by relevant ministers of the government who have the power to supervise them, namely the Education Minister and the Minister for Health and Welfare (Article 2). Articles 4 and 4(2) prescribe the standards for the relevant ministers to make the designation of those schools and institutions, in relation to the school years, curriculums, teachers, equipments, etc. According to the standards, those schools and institutions may be of 3-year, 2-year on one-year course according to the required attainment level of students who enters them. The minimum requirement of the attainment is the secondary-school certificates for the 3-year course. The relevant ministers may require such reports from, and give such instructions to those schools and institutions as they consider necessary, and may revoke their designation when such a school on institution has become incompliant with above mentioned standards (Articles 6 and 7). (Matsushima, A.)

Advancing technician practice: Deliberations of a regulatory board.

Science.gov (United States)

Adams, Alex J

2018-01-01

In 2016, the Idaho State Board of Pharmacy (U.S.) undertook a major rulemaking initiative to advance pharmacy practice by broadening the ability of pharmacists to delegate tasks to pharmacy technicians. The new rules of the Board thus moved the locus of control in technician scope of practice from law to pharmacist delegation. Pharmacist delegation is individualistic and takes into account the individual technician's capabilities, the pharmacist's comfort level, facility policies, and the risk mitigation strategies present at the facility, among other factors. State law limits, by contrast, are rigid and can mean that pharmacists are unable to delegate tasks that are or could otherwise be within the abilities of their technicians. The expanded technician duties are in two domains: 1) medication dispensing support (e.g., tech-check-tech, accepting verbal prescriptions, transferring prescriptions, and performing remote data entry); and 2) technical support for pharmacist clinical services (e.g., administering immunizations). This commentary reviews the evidence behind these expanded duties, as well as the key regulatory decision points for each task. The Board's rules and approach may prove useful to other states and even other governing bodies outside the U.S. as they consider similar issues. Copyright © 2017 Elsevier Inc. All rights reserved.

Science and engineering technicians in the United States: characteristics of a redefined population, 1972

International Nuclear Information System (INIS)

Finn, M.G.

1978-02-01

The 1972 redefined population was distributed among 10 technician fields. Approximately 75% of the total were concentrated in four relatively large fields: computer programmers; draftsmen; electrical and electronic technicians; and technicians, other fields. Women accounted for 11% of all technicians. The average age of technicians in 1972 was 37. Whites comprised 94.8% of all technicians, while 3.0% were black. More technicians resided in the middle Atlantic region than in any other region. As a percentage of the civilian labor force, however, technicians were most heavily concentrated in the New England and mountain regions. The educational level of technicians was quite diverse: about one-third had no postsecondary education, about one-sixth had at least a bachelor's degree. About one-half fell somewhere between these extremes. Approximately 68% of all technicians reported some form of supplemental training outside formal educational institutions. This training was quite diverse. In 1972, unemployed technicians totaled 3.2% of the technician labor force. Fourteen percent of technicians reported employment outside their field, and 11% reported employment outside the 10 technician fields that constituted the focus of this report. The median annual earnings of technicians employed full-time in 1971 was approximately $10,400. Private companies employed 71% of the technicians; federal and state governments employed 12.4% and 7.4%, respectively. Most other technicians were employed by local government or nonprofit organizations. Implications for policy and planning are drawn. The statistics presented here indicate that the most commonly used assumptions about education--occupation linkages are grossly oversimplified. 5 figures, 44 tables

[Physical therapy performance in respiratory and motor involvement during postoperative in children submitted to abdominal surgeries].

Science.gov (United States)

Santo, Caroline C; Gonçalves, Marcela T; Piccolo, Mariana M; Lima, Simone; Rosa, George J da; Paulin, Elaine; Schivinski, Camila S

2011-01-01

to verify the physiotherapy performance in the respiratory and motor affections during postoperative period in pediatric patients undergoing abdominal surgery. was a literature review of articles published in the databases Lilacs, Medline and SciELO in the period 1983 to 2010 as well as books, papers presented at scientific meetings and journals of the area, who approached the post-therapy of abdominal surgery in children. The keywords used were: abdominal surgery, children and physiotherapy. 28 articles, one book chapter and one dissertation had been selected that examined the question and proposed that contained all, or at least two of the descriptors listed. Most of the material included covers the incidence of respiratory complications after surgery for pediatric abdominal surgery due to immaturity of the respiratory system of this population, abdominal manipulation of surgical period, the prolonged time in bed, pain at the incision site and waste anesthetic. Some authors also discuss the musculoskeletal and connective tissue arising from the inaction and delay of psychomotor development consequent to periods of hospitalization in early childhood, taking on the role of physiotherapy to prevent motor and respiratory involvement. there are few publications addressing this topic, but the positive aspects of physiotherapy have been described, especially in relation to the prevention of respiratory complications and motor, recognized the constraints and consequences of hospitalizations and surgeries cause in children.

A Novel Simulation Technician Laboratory Design: Results of a Survey-Based Study.

Science.gov (United States)

Ahmed, Rami; Hughes, Patrick G; Friedl, Ed; Ortiz Figueroa, Fabiana; Cepeda Brito, Jose R; Frey, Jennifer; Birmingham, Lauren E; Atkinson, Steven Scott

2016-03-16

OBJECTIVE : The purpose of this study was to elicit feedback from simulation technicians prior to developing the first simulation technician-specific simulation laboratory in Akron, OH. Simulation technicians serve a vital role in simulation centers within hospitals/health centers around the world. The first simulation technician degree program in the US has been approved in Akron, OH. To satisfy the requirements of this program and to meet the needs of this special audience of learners, a customized simulation lab is essential. A web-based survey was circulated to simulation technicians prior to completion of the lab for the new program. The survey consisted of questions aimed at identifying structural and functional design elements of a novel simulation center for the training of simulation technicians. Quantitative methods were utilized to analyze data. Over 90% of technicians (n=65) think that a lab designed explicitly for the training of technicians is novel and beneficial. Approximately 75% of respondents think that the space provided appropriate audiovisual (AV) infrastructure and space to evaluate the ability of technicians to be independent. The respondents think that the lab needed more storage space, visualization space for a large number of students, and more space in the technical/repair area. CONCLUSIONS : A space designed for the training of simulation technicians was considered to be beneficial. This laboratory requires distinct space for technical repair, adequate bench space for the maintenance and repair of simulators, an appropriate AV infrastructure, and space to evaluate the ability of technicians to be independent.

Epidemiology of aplastic anemia in Japanese radiological technicians

International Nuclear Information System (INIS)

Kitabatake, Takashi; Watanabe, Tsuyoshi; Saito, Akira; Nakamura, Minoru.

1976-01-01

Among Japanese radiological technicians, four deaths from aplastic anemia have been recorded. Based on this fact, some epidemiological considerations are tried. During the period from 1930 to 1960, the population of radiological technicians is estimated to be 74,400 man-years, in which 0.5 aplastic anemias are expected. However actually three died from aplastic anemia. This difference is statistically significant at the 1% level. On the other hand, in the period from 1961 to 1973, the observed value is 1 against 0.7 expected. It is concluded that aplastic anemia had been frequently induced among Japanese radiological technicians in the era when there was much exposure to occupational radiation. (auth.)

Defining the Simulation Technician Role: Results of a Survey-Based Study.

Science.gov (United States)

Bailey, Rachel; Taylor, Regina G; FitzGerald, Michael R; Kerrey, Benjamin T; LeMaster, Thomas; Geis, Gary L

2015-10-01

In health care simulation, simulation technicians perform multiple tasks to support various educational offerings. Technician responsibilities and the tasks that accompany them seem to vary between centers. The objectives were to identify the range and frequency of tasks that technicians perform and to determine if there is a correspondence between what technicians do and what they feel their responsibilities should be. We hypothesized that there is a core set of responsibilities and tasks for the technician position regardless of background, experience, and type of simulation center. We conducted a prospective, survey-based study of individuals currently functioning in a simulation technician role in a simulation center. This survey was designed internally and piloted within 3 academic simulation centers. Potential respondents were identified through a national mailing list, and the survey was distributed electronically during a 3-week period. A survey request was sent to 280 potential participants, 136 (49%) responded, and 73 met inclusion criteria. Five core tasks were identified as follows: equipment setup and breakdown, programming scenarios into software, operation of software during simulation, audiovisual support for courses, and on-site simulator maintenance. Independent of background before they were hired, technicians felt unprepared for their role once taking the position. Formal training was identified as a need; however, the majority of technicians felt experience over time was the main contributor toward developing knowledge and skills within their role. This study represents a first step in defining the technician role within simulation-based education and supports the need for the development of a formal job description to allow recruitment, development, and certification.

Radiologic Equipment and Technicians according to the Distribution of the Population

International Nuclear Information System (INIS)

Yoon, Chul Ho; Choi, Jun Gu

2009-01-01

The purpose of this paper is to provide basic data in order to systematize the management of demand and supply of radiologic technicians, to pursue a fair regional distribution of educational institutions, and furthermore to keep reasonable medical treatment and fee. This research was carried out through the investigation of radiologic equipment and technicians according to the distribution of the population. We compared and analyzed the correlation between regional population, the number of clinics and hospitals, the number of medical imaging devices, and the number of radiologists and radiologic technicians in 5 cities without 'Gu' administrative units in 2008. 27,317 radiologic technicians have been produced since the administration of the national qualifying exam for radiologic technicians. About 18,000 radiologic technicians are currently working. There are 39 colleges or universities with Departments of Radiology and the admission quota is 2,120 students excluding one college. The ratio of radiologic equipment to radiologic technicians is 2.6 to 1. There is a dilemma in which some radiologic technicians fail to find appropriate jobs while some clinics or hospitals are in need of radiologic technicians. This dilemma is due to unreasonable regional discrepancies in pay system and welfare situation, and excessive profit-oriented recruiting system of clinics and hospitals. The increase of students of Radiologic Departments and approval of additional departments will end up with producing superfluous high academic degree holders, which is on the contrary to the government policy to produce more job opportunities. So the policy of increasing Radiologic Departments should be reconsidered.

Fiber Optics Technician. Curriculum Research Project. Final Report.

Science.gov (United States)

Whittington, Herschel K.

A study examined the role of technicians in the fiber optics industry and determined those elements that should be included in a comprehensive curriculum to prepare fiber optics technicians for employment in the Texas labor market. First the current literature, including the ERIC database and equipment manufacturers' journals were reviewed. After…

A Grounded Theory Study of Aircraft Maintenance Technician Decision-Making

Science.gov (United States)

Norcross, Robert

Aircraft maintenance technician decision-making and actions have resulted in aircraft system errors causing aircraft incidents and accidents. Aircraft accident investigators and researchers examined the factors that influence aircraft maintenance technician errors and categorized the types of errors in an attempt to prevent similar occurrences. New aircraft technology introduced to improve aviation safety and efficiency incur failures that have no information contained in the aircraft maintenance manuals. According to the Federal Aviation Administration, aircraft maintenance technicians must use only approved aircraft maintenance documents to repair, modify, and service aircraft. This qualitative research used a grounded theory approach to explore the decision-making processes and actions taken by aircraft maintenance technicians when confronted with an aircraft problem not contained in the aircraft maintenance manuals. The target population for the research was Federal Aviation Administration licensed aircraft and power plant mechanics from across the United States. Nonprobability purposeful sampling was used to obtain aircraft maintenance technicians with the experience sought in the study problem. The sample population recruitment yielded 19 participants for eight focus group sessions to obtain opinions, perceptions, and experiences related to the study problem. All data collected was entered into the Atlas ti qualitative analysis software. The emergence of Aircraft Maintenance Technician decision-making themes regarding Aircraft Maintenance Manual content, Aircraft Maintenance Technician experience, and legal implications of not following Aircraft Maintenance Manuals surfaced. Conclusions from this study suggest Aircraft Maintenance Technician decision-making were influenced by experience, gaps in the Aircraft Maintenance Manuals, reliance on others, realizing the impact of decisions concerning aircraft airworthiness, management pressures, and legal concerns

How best to capture the respiratory consequences of prematurity?

Science.gov (United States)

Ciuffini, Francesca; Robertson, Colin F; Tingay, David G

2018-03-31

Chronic respiratory morbidity is a common complication of premature birth, generally defined by the presence of bronchopulmonary dysplasia, both clinically and in trials of respiratory therapies. However, recent data have highlighted that bronchopulmonary dysplasia does not correlate with chronic respiratory morbidity in older children born preterm. Longitudinally evaluating pulmonary morbidity from early life through to childhood provides a more rational method of defining the continuum of chronic respiratory morbidity of prematurity, and offers new insights into the efficacy of neonatal respiratory interventions. The changing nature of preterm lung disease suggests that a multimodal approach using dynamic lung function assessment will be needed to assess the efficacy of a neonatal respiratory therapy and predict the long-term respiratory consequences of premature birth. Our aim is to review the literature regarding the long-term respiratory outcomes of neonatal respiratory strategies, the difficulties of assessing dynamic lung function in infants, and potential new solutions. Copyright ©ERS 2018.

Qualitative risk analysis in the process of treatment in radiation oncology for the steps performed by the technician/technologist in intensity modulated radiotherapy (lMRT)

International Nuclear Information System (INIS)

Teixeira, Flavia C.S.; Faria, Alessandra L.; Pereira, Danielle P.S.; Silva, Fabiana M.I.

2013-01-01

The efficacy of radiation therapy is to eradicate the tumor while preserving the integrity of normal tissues. Technological advances have allowed to develop techniques capable of modulating doses delivered to the target volume, providing more effective treatments. However, the operational complexity of these techniques makes the benefits offered are directly proportional to the chances of occurrences of serious errors. The objective of this work is to analyze the steps performed by the technician/technologist in Intensity Modulated Radiotherapy (IMRT), to detect possible errors in order to determine ways to mitigate them. After literature regarding errors in the radiation therapy, a prospective analysis was performed in the first half of 2012 in a radiation clinic located in the city of Rio de Janeiro, in which 11 technicians/technologists contributed to the survey data analysis. The method of risk analysis Failure Mode and Effects Analysis was used for prospective analysis of accidents/incidents, with respect to a qualitative assessment . The method allowed mapping 16 steps performed by technicians/technologists in the treatments with IMRT, identifying possible failures and their causes allowing to find ways to avoid possible errors. This analysis helped to confirm that the qualification and continuing education of technicians/technologists, allied to implement quality assurance programs and a computerized management can make a tool capable of IMRT to achieve the greatest challenge of radiotherapy. (author)

A uniform approach for on-site training and qualification of health physics technicians

International Nuclear Information System (INIS)

Till, J.E.

1977-01-01

Estimates show that in the U.S. approx. 75% of the health physics technicians received their training through courses offered by their employer. The quality and the extent of this training vary considerably among nuclear facilities. This paper describes a uniform approach for on-site training and qualification of health physics technicians applicable to all nuclear facilities. The program consists of four levels of qualification: Health Physics Technician Trainee, Technician I, Technician II and Senior Technician. The training is divided into modules that are composed of formal lectures, practical factors, experience, and a comprehensive examination. The minimum time required from hiring of inexperienced trainees to qualification as Senior Technicians is approx. 24 months. A qualification guide lists each step a technician must complete in the training program and provides documentation which facilitates audits by internal and external groups. Although items in the program would differ between facilities, the program provides specific titles for technicians, based on their training and experience, which would be applicable throughout the nuclear industry. (author)

Oxygen therapy devices and portable ventilators for improved physical activity in daily life in patients with chronic respiratory disease.

Science.gov (United States)

Furlanetto, Karina Couto; Pitta, Fabio

2017-02-01

Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV). A literature review of these concepts was performed by using all related search terms. Expert commentary: Technological advances led to the development of light and small oxygen therapy devices and portable ventilators which aim to facilitate patients' mobility and ambulation. However, the day-by-day dependence of a device may reduce mobility and partially impair patients' PADL. Nocturnal NIV implementation in hypercapnic patients seems promising to improve PADL. The magnitude of their equipment-related physical inactivity is underexplored up to this moment and more long-term randomized clinical trials and meta-analysis examining the effects of ambulatory oxygen and NIV on PADL are required.

Respiratory problems in foals.

Science.gov (United States)

Beech, J

1985-04-01

Despite major advances in our knowledge and ability to treat respiratory diseases in neonatal foals, neonatal respiratory medicine is still in its infancy. It is hoped that this article may serve as a guideline for diagnosis and treatment. Specific antibiotic regimens and emergency procedures are covered in other articles in this symposium. Because management factors play a critical role in the pathogenesis of respiratory disease, education of clients as to their importance would help both prophylactically and therapeutically. The necessity of very careful monitoring of neonates, which is critical to early detection of disease, should be stressed. As respiratory diseases can be fulminant and rapidly fatal, it is imperative not to delay diagnosis and therapy. Thorough examination and implementation of appropriate diagnostic techniques, as well as prompt early referral to a more sophisticated facility when indicated, would prevent many deaths. Although sophisticated support systems are vital for survival of some of these foals, good basic intensive nursing care combined with selection of appropriate drug therapy very early in the course of the disease is all that many foals require and can significantly improve survival rates.

Guidebook on the education and training of technicians for nuclear power

International Nuclear Information System (INIS)

1989-01-01

The IAEA Guidebook on the Education and Training of Technicians for Nuclear Power aims to assist Member States, especially the developing countries which are in the process of implementing, or intending to implement, a nuclear power programme, to understand and meet their requirements for qualified technicians in the most effective and efficient manner. It specifically seeks to assist policy makers and planners, as well as those designing and implementing education and training programmes. In this Guidebook, technician level occupations include those filled by technicians and higher level technicians (techniciens superieurs or technologists) and also by non-graduate engineers. The Guidebook complements the IAEA Guidebook on Manpower Development for Nuclear Power, as well as the IAEA Guidebook on the Qualification of Nuclear Power Plant Operations Personnel. The key objectives of this Guidebook are to describe: (1) the level and content of conventional education and training which a technician must have before nuclear oriented education and training can begin; (2) the level and content of nuclear oriented education and training; (3) measures to bridge the gap between the education and training acquired by technicians in the national technical schools (i.e. the level attained before upgrading) and the level of education and training qualifications needed for technicians to work in the nuclear power programme (i.e. the level attained after completion of nuclear oriented education and training). Valuable information on the national experiences of IAEA Member States in the education and training of technicians for nuclear power, as well as examples of such education and training from various Member States, are included in IAEA-TECDOC-526, which should be read in conjunction with the present text. 3 refs, 13 figs, 3 tabs

Chemistry technician performance evaluation program Palo Verde Nuclear Generating Station

International Nuclear Information System (INIS)

Shawver, J.M.

1992-01-01

The Arizona Nuclear Power Project (ANPP), a three-reactor site located 50 miles west of Phoenix, Arizona, has developed and implemented a program for evaluating individual chemistry technician analytical performance on a routine basis. About 45 chemistry technicians are employed at the site, 15 at each operating unit. The technicians routinely perform trace level analyses for impurities of concern to PWRs. Each month a set of blind samples is provided by an outside vendor. The blind samples contain 16 parameters which are matrixed to approximate the PWR's primary and secondary cycles. Nine technicians receive the samples, three from each operating unit, and perform the required analyses. Acceptance criteria for successful performance on the blind parameters is based on the values found in the Institute of Nuclear Power Operations (INPO) Document 83-016, Revision 2, August 1989, Chemistry Quality Control Program. The goal of the program is to have each technician demonstrate acceptable performance on each of 16 analytical parameters. On completion of each monthly set, a summary report of all of the analytical results for the sample set is prepared. From the summary report, analytical bias can be detected, technician performance is documented, and overall laboratory performance can be evaluated. The program has been very successful at satisfying the INPO requirement that the analytical performance of each individual technician should be checked on at least a six-month frequency for all important parameters measured. This paper describes the program as implemented at the Palo Verde Nuclear Generating Station and provides a summary report and trend and bias graphs for illustrative purposes

The law for radiation and x-ray technicians engaging in medical treatment

International Nuclear Information System (INIS)

1977-01-01

The Law aims to define the qulifications of radiation and x-ray technicians engaging in medical treatment and to regulate so that the works are carried out properly for helping popularization and improvement of medicine and public hygiene. Persons who wish to be radiation or x-ray technicians engaging in medical treatment are required to pass the examinations for such technicians and obtain the licenes of the Minister of Health and Welfare for the former technicians and the license of a prefectural governor for the latter technicians. Mentally disordered, deaf, dumb or blind persons are excluded from licensees. Registration of such technicians, delivery of the license certificates and other related matters are provided for. The examinations are held concerning the knowledges and skills necessary for such technicians and carried out by the Minister of Health and Welfare. Persons except doctors, dentists and such technicians are prohibited to engage in the practices to apply radiation to human bodies. Restrictions on the intensity of radiation applied and the places of work are defined concerning such practices. Penal servitude of less than a year and fines less than yen 10,000 or yen 5,000 are imposed upon the violation of such prohibitions or restrictions. (Okada, K.)

Experimental verification of a two-dimensional respiratory motion compensation system with ultrasound tracking technique in radiation therapy.

Science.gov (United States)

Ting, Lai-Lei; Chuang, Ho-Chiao; Liao, Ai-Ho; Kuo, Chia-Chun; Yu, Hsiao-Wei; Zhou, Yi-Liang; Tien, Der-Chi; Jeng, Shiu-Chen; Chiou, Jeng-Fong

2018-05-01

This study proposed respiratory motion compensation system (RMCS) combined with an ultrasound image tracking algorithm (UITA) to compensate for respiration-induced tumor motion during radiotherapy, and to address the problem of inaccurate radiation dose delivery caused by respiratory movement. This study used an ultrasound imaging system to monitor respiratory movements combined with the proposed UITA and RMCS for tracking and compensation of the respiratory motion. Respiratory motion compensation was performed using prerecorded human respiratory motion signals and also sinusoidal signals. A linear accelerator was used to deliver radiation doses to GAFchromic EBT3 dosimetry film, and the conformity index (CI), root-mean-square error, compensation rate (CR), and planning target volume (PTV) were used to evaluate the tracking and compensation performance of the proposed system. Human respiratory pattern signals were captured using the UITA and compensated by the RMCS, which yielded CR values of 34-78%. In addition, the maximum coronal area of the PTV ranged from 85.53 mm 2 to 351.11 mm 2 (uncompensated), which reduced to from 17.72 mm 2 to 66.17 mm 2 after compensation, with an area reduction ratio of up to 90%. In real-time monitoring of the respiration compensation state, the CI values for 85% and 90% isodose areas increased to 0.7 and 0.68, respectively. The proposed UITA and RMCS can reduce the movement of the tracked target relative to the LINAC in radiation therapy, thereby reducing the required size of the PTV margin and increasing the effect of the radiation dose received by the treatment target. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Robotics/Automated Systems Technicians.

Science.gov (United States)

Doty, Charles R.

Major resources exist that can be used to develop or upgrade programs in community colleges and technical institutes that educate robotics/automated systems technicians. The first category of resources is Economic, Social, and Education Issues. The Office of Technology Assessment (OTA) report, "Automation and the Workplace," presents analyses of…

The Effects of Smartphone-based Nebulizer Therapy Education on Parents' Knowledge and Confidence of Performance in Caring for Children with Respiratory Disease.

Science.gov (United States)

Lee, Jung Min; Kim, Shin-Jeong; Min, Hae Young

This study aimed to identify the effects of smartphone-based nebulizer therapy education on the knowledge and confidence of parents while performing care for their children with respiratory disease. This quasi-experimental study employed a pretest-posttest design using a nonequivalent control group. Data were collected from children's parents who had not used nebulizer therapy for their children previously. Both the groups were given nebulizer therapy education using the same content but different learning methods. The experimental group (n=36) was taught using smartphones, while the control group (n=36) was taught using verbal and paper-based methods. The data were analyzed using the Chi Square test, repeated measures analysis of variance, and t-test. The mean scores on knowledge improvement (F=100.949, psmartphone-based education on nebulizer therapy might be effective in improving parents' knowledge and confidence in performing care for their children. This study suggests that smartphone-based education needs to be considered as an effective educational intervention in providing nursing support for parents of children with respiratory disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

Science.gov (United States)

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-09-01

Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

Directory of Open Access Journals (Sweden)

Henzen Christoph

2007-07-01

Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

Quality assurance for respiratory-gated stereotactic body radiation therapy in lung using real-time position management system

International Nuclear Information System (INIS)

Nakaguchi, Yuji; Maruyama, Masato; Araki, Fujio; Kouno, Tomohiro

2012-01-01

In this study, we investigated comprehensive quality assurance (QA) for respiratory-gated stereotactic body radiation therapy (SBRT) in the lungs using a real-time position management system (RPM). By using the phantom study, we evaluated dose liberality and reproducibility, and dose distributions for low monitor unite (MU), and also checked the absorbed dose at isocenter and dose profiles for the respiratory-gated exposure using RPM. Furthermore, we evaluated isocenter dose and dose distributions for respiratory-gated SBRT plans in the lungs using RPM. The maximum errors for the dose liberality were 4% for 2 MU, 1% for 4-10 MU, and 0.5% for 15 MU and 20 MU. The dose reproducibility was 2% for 1 MU and within 0.1% for 5 MU or greater. The accuracy for dose distributions was within 2% for 2 MU or greater. The dose error along a central axis for respiratory cycles of 2, 4, and 6 sec was within 1%. As for geometric accuracy, 90% and 50% isodose areas for the respiratory-gated exposure became almost 1 mm and 2 mm larger than without gating, respectively. For clinical lung-SBRT plans, the point dose at isocenter agreed within 2.1% with treatment planning system (TPS). And the pass rates of all plans for TPS were more than 96% in the gamma analysis (3 mm/3%). The geometrical accuracy and the dose accuracy of TPS calculation algorithm are more important for the dose evaluation at penumbra region for respiratory-gated SBRT in lung using RPM. (author)

Veterinary Technician Program Director Leadership Style and Program Success

Science.gov (United States)

Renda-Francis, Lori A.

2012-01-01

Program directors of American Veterinary Medical Association (AVMA) accredited veterinary technician programs may have little or no training in leadership. The need for program directors of AVMA-accredited veterinary technician programs to understand how leadership traits may have an impact on student success is often overlooked. The purpose of…

Description and comparison of pharmacy technician training programs in the United States.

Science.gov (United States)

Anderson, Douglas C; Draime, Juanita A; Anderson, Timothy S

2016-01-01

To describe pharmacy technician training programs in the United States and to compare pharmacy technician program characteristics between programs with and without a pharmacist on faculty and between programs with different accreditation status. Descriptive, cross-sectional study. Not applicable. United States pharmacy technician programs. Not applicable. Student class size, faculty credentials, coursework components, program length, tuition rates, and admission criteria. Currently, there are more than 698 pharmacy technician programs across 1114 campuses, with complete data available for 216 programs. Programs varied widely in terms of class sizes, faculty credentials, and admission criteria. Programs with pharmacists on faculty were significantly less expensive than were those without pharmacists (P = 0.009). Accreditation had no impact on tuition prices. This is the first study of its kind to describe and characterize pharmacy technician training programs. There is relatively little control of technician training by the profession of pharmacy. The quality of these programs in terms of student outcomes is unknown, and it should be explored. Rigorous debate and discussion is needed regarding the future of pharmacy technician roles and the training required for those roles. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

A reliability-based maintenance technicians' workloads optimisation model with stochastic consideration

Science.gov (United States)

Ighravwe, D. E.; Oke, S. A.; Adebiyi, K. A.

2016-06-01

The growing interest in technicians' workloads research is probably associated with the recent surge in competition. This was prompted by unprecedented technological development that triggers changes in customer tastes and preferences for industrial goods. In a quest for business improvement, this worldwide intense competition in industries has stimulated theories and practical frameworks that seek to optimise performance in workplaces. In line with this drive, the present paper proposes an optimisation model which considers technicians' reliability that complements factory information obtained. The information used emerged from technicians' productivity and earned-values using the concept of multi-objective modelling approach. Since technicians are expected to carry out routine and stochastic maintenance work, we consider these workloads as constraints. The influence of training, fatigue and experiential knowledge of technicians on workload management was considered. These workloads were combined with maintenance policy in optimising reliability, productivity and earned-values using the goal programming approach. Practical datasets were utilised in studying the applicability of the proposed model in practice. It was observed that our model was able to generate information that practicing maintenance engineers can apply in making more informed decisions on technicians' management.

RANDOMIZED EUROPEAN MULTICENTER TRIAL OF SURFACTANT REPLACEMENT THERAPY FOR SEVERE NEONATAL RESPIRATORY-DISTRESS SYNDROME - SINGLE VERSUS MULTIPLE DOSES OF CUROSURF

NARCIS (Netherlands)

SPEER, CP; ROBERTSON, B; CURSTEDT, T; HALLIDAY, HL; COMPAGNONE, D; GEFELLER, O; HARMS, K; HERTING, E; MCCLURE, G; REID, M; TUBMAN, R; HERIN, P; NOACK, G; KOK, J; KOPPE, J; VANSONDEREN, L; LAUFKOTTER, E; KOHLER, W; BOENISCH, H; ALBRECHT, K; HANSSLER, L; HAIM, M; OETOMO, SB; Okken, Albert; ALTFELD, PC; GRONECK, P; KACHEL, W; RELIER, JP; WALTI, H

There is now convincing evidence that the severity of neonatal respiratory distress syndrome can be reduced by surfactant replacement therapy; however, the optimal therapeutic regimen has not been defined. This randomized European multicenter trial was designed to determine whether the beneficial

Ask not what your technician can do for you-ask what you can do for your technician.

Science.gov (United States)

Ganderton, L

2018-04-27

Historically, the vital roles played by technicians in Higher Education have had little recognition. Job opportunities are often overlooked by those who have no working knowledge of such organisations and poorly defined career pathways mean that it may not be a first choice for well-qualified, ambitious individuals. With just over a third of all Higher Education technicians in the UK now due to retire in the next 10 to 15 years, fundamental changes are needed, both to attract large numbers of people into vacant roles and to retain current technical staff.National initiatives, founded and driven by charitable and professional bodies, are currently working to address the issues of technicians within Higher Education. Organisations have been urged to take action or face potential recruitment difficulties and skills gaps over the coming years. In light of these national campaigns, institutions across the UK are beginning to develop proper structured career pathways, provide professional development and improve recognition for the work of their technical workforce. Whilst these are encouraging signs, only time will tell if enough has been done to raise both the profile and appeal of a technical career in Higher Education.

Comparison of exercise blood pressure measured by technician and an automated system.

Science.gov (United States)

Garcia-Gregory, J A; Jackson, A S; Studeville, J; Squires, W G; Owen, C A

1984-05-01

We evaluated the automated system Blood Pressure Measuring System (BPMS) developed by NASA on 277 adult males who elected to have a treadmill test as part of their annual physical. The BPMS uses acoustic transduction with a computer-assisted ECG gating to detect nonsynchronous noise. The BPMS readings were compared to pressures simultaneously measured by trained technicians. For all stages of work, BPMS readings were higher for systolic and lower for diastolic than technician readings. At peak stages of work, BPMS systolic pressures were about 20 mmHg higher than technician readings. Within each 3-min workstage, BPMS readings were found to be more inconsistent than technician readings. The standard errors of measurement for BPMS were from two to three times higher than technician values. These data showed automated blood pressure readings were significantly different than technician values and subject to more random fluctuations. These findings demonstrate the need to view exercise blood pressure measured by automated systems with caution.

Inhaled β-agonist therapy and respiratory muscle fatigue as under-recognised causes of lactic acidosis.

Science.gov (United States)

Lau, Emily; Mazer, Jeffrey; Carino, Gerardo

2013-10-14

A 49-year-old man with chronic obstructive pulmonary disease (COPD) presented with significant tachypnoea, fevers, productive cough and increased work of breathing for the previous 4 days. Laboratory data showed elevated lactate of 3.2 mEq/L. Continuous inhaled ipratropium and albuterol nebuliser treatments were administered. Lactate levels increased to 5.5 and 3.9 mEq/L, at 6 and 12 h, respectively. No infectious source was found and the lactic acidosis cleared as the patient improved. The lactic acidosis was determined to be secondary to respiratory muscle fatigue and inhaled β-agonist therapy, two under-recognised causes of lactic acidosis in patients presenting with respiratory distress. Lactic acidosis is commonly used as a clinical marker for sepsis and shock, but in the absence of tissue hypoperfusion and severe hypoxia, alternative aetiologies for elevated levels should be sought to avoid unnecessary and potentially harmful medical interventions.

Clinical Experience and Learning Style of Flight Nurse and Aeromedical Evacuation Technician Students.

Science.gov (United States)

De Jong, Marla J; Dukes, Susan F; Dufour, Karey M; Mortimer, Darcy L

2017-01-01

The clinical experience and preferred learning style of U.S. Air Force flight nurses and aeromedical evacuation technicians are unknown. Using a cross-sectional survey design, we gathered data regarding the clinical experience, level of comfort providing clinical care, and preferred learning style of 77 active duty (AD), Air Force Reserve (AFR), and Air National Guard (ANG) nurses enrolled in the U.S. Air Force School of Aerospace Medicine Flight Nurse course, and 121 AD, AFR, and ANG medical technicians enrolled in the Aeromedical Evacuation Technician course. Nurses and medical technicians reported 7.6 ± 5.5 and 3.9 ± 4.5 yr of experience, respectively. AD, AFR, and ANG nurses had comparable years of experience: 5.8 ± 3.2, 8.3 ± 6.6, and 7.9 ± 4.2 yr, respectively; however, AD medical technicians had more years of experience (5.6 ± 4.4 yr) than AFR (3.1 ± 4.8 yr) and ANG (1.9 ± 2.8 yr) medical technicians. Both nurses and medical technicians reported infrequently caring for patients with various disease processes and managing equipment or devices that they will routinely encounter when transporting patients as an aeromedical evacuation clinician. Nurses and medical technicians preferred a kinesthetic learning style or a multimodal learning style that included kinesthetic learning. Nearly all (99%) nurses and 97% of medical technicians identified simulation as their preferred teaching method. These findings confirm faculty concerns regarding the clinical experience of flight nurse and aerospace evacuation technician students.De Jong MJ, Dukes SF, Dufour KM, Mortimer DL. Clinical experience and learning style of flight nurse and aeromedical evacuation technician students. Aerosp Med Hum Perform. 2017; 88(1):23-29.

Establishing a clinical pharmacy technician at a United States Army military treatment facility.

Science.gov (United States)

Evans, Jennifer L; Gladd, Ellen M; Gonzalez, Alicia C; Tranam, Salman; Larrabee, Joni M; Lipphardt, Sarah E; Chen, Tina T; Ronn, Michael D; Spain, John

2016-01-01

To describe the creation of a clinical pharmacy technician position within the U.S. Army and to identify the personal skills and characteristics required to meet the demands of this role. An outpatient military treatment facility located in Maryland. The clinical pharmacy technician position was designed to support clinical pharmacy services within a patient-centered medical home. Funding and a position description were established to hire a clinical pharmacy technician. Expected duties included administrative (45%), patient education (30%), and dispensing (25%). Local policy, in accordance with federal law and U.S. Army regulations, was developed to define the expanded technician responsibility to deliver patient medication education. In the initial 3 months, the clinical pharmacy technician spent 24 hours per week on clinical activities, affording an additional 10-15 hours per week for clinical pharmacists to provide patient care. Completed consults increased from 41% to 56%, and patient-pharmacist encounters increased from 240 to 290 per month. The technician, acting as a clinical pharmacist extender, also completed an average of 90 patient encounters independently each month. As a result of these improvements, the decision was made to hire a second technician. Currently, the technicians spend 28-40 hours per week on clinical activities, offsetting an average of 26 hours per week for the clinical pharmacists. A patient-centered medical home clinical pharmacy technician can reduce the administrative workload for clinical pharmacists, improve their efficiency, and enhance the use of clinical pharmacy services. Several characteristics, particularly medication knowledge, make pharmacy technicians particularly suited for this role. The results from the implementation of a clinical pharmacy technician at this military treatment facility resulted in an Army-wide expansion of the position and suggested applicability in other practice sites, particularly in federal

Management competencies required in the transition from a technician to a supervisor

Directory of Open Access Journals (Sweden)

Sibongile R. Mahlangu (Kubheka

2015-05-01

Full Text Available Orientation: Technicians are frequently promoted to supervisory positions based on their technical abilities, with scant attention focused on developing management competencies. This oversight often poses significant challenges. The effective transition from technician to supervisor is important in any organisation. Research objective: The primary objective is to identify and verify the competencies that are required for a technician and a supervisory position; the secondary objective is to identify the gap that must be filled with relevant training interventions to enable technicians to make an effective transition to a supervisory position. Motivation for this study: The identification of the management competencies required for a technician who makes a career change to a supervisor position. Research method: The sequential mixed method approach was used to enable the twophase data collection process: phase one was the quantitative phase and phase two was the qualitative phase. Main findings: The overall findings confirm that there are indeed management competencies that technicians require training and development on before being promoted to a supervisory position. Implication: Organisations need to identify the key competencies for a technician and a supervisor and implement development or training interventions that are essential to successfully transition an employee from the level of a technician to the level of a supervisor. Contribution: Organisations need to implement essential development or training interventions focused on developing management competencies and put in place support interventions such as coaching, job shadowing, mentoring and networking.

Job satisfaction and patient care practices of hemodialysis nurses and technicians.

Science.gov (United States)

Perumal, Seena; Sehgal, Ashwini R

2003-10-01

The quality of hemodialysis care has been the focus of intense scrutiny, yet little is known about the job satisfaction of the nurses and technicians providing this care. We identified 240 nurses and technicians from 307 randomly selected American facilities and asked them about (a) specific domains of job satisfaction, (b) overall job satisfaction, and (c) self-reported patient care practices. Fewer than half of nurses and technicians were satisfied with their pay or their opportunities for advancement. Almost all subjects were satisfied with their personal delivery of patient care, their chance to do things for others, and their job security. About three-fourths of nurses and technicians expressed overall satisfaction with their jobs. Higher job satisfaction was associated with increased attention to patient psychosocial and educational needs. We urge local and national associations of nurses and technicians to collaborate with dialysis facilities, chains, and regulatory agencies to address specific aspects of job satisfaction.

Career Directions--Electronics Technician

Science.gov (United States)

Tech Directions, 2012

2012-01-01

Electronics technicians (ETs) work with electronics engineers to set up and maintain complicated electronics equipment that many of today's businesses rely on. The field is varied. An ET might service the industrial controls on a factory floor. Or repair missile control systems for the government. Or an ET could specialize in cars and trucks,…

Distance learning and the internet in respiratory therapy education.

Science.gov (United States)

Varekojis, Sarah M; Sergakis, Georgianna G; Dunlevy, Crystal L; Foote, Elbie; Clutter, Jill

2011-11-01

The profession of respiratory therapy (RT) continues to grow both in number, due to population growth and an ever-increasing aging population, and scope of practice, due to both new and expanded roles and responsibilities in divergent areas of clinical practice. Instructional technology, including distance learning, will probably play a key role in training, educating, and assessing RT students to meet the increasing demand for practitioners. To assess current uses of distance learning and opinions concerning the appropriate use of distance education in RT education programs nationwide. A 13-item on-line survey was designed to collect information about the frequency of use of various types of distance education typically utilized in RT education programs. The survey was sent to directors of 343 Committee on Accreditation for Respiratory Care accredited programs of RT education that offer entry-level or advanced courses of study. The response rate was 50% (169 respondents). Fifty-two percent of the respondents indicated that their courses included some form of on-line learning component. Most directors anticipated that the distance composition of their course offerings will remain unchanged or increase in the near future. Our results indicate that, while distance education plays an important supportive role in RT education, there is still a preference for face-to-face instruction and Internet-facilitated courses among program directors. Program directors continue to view the laboratory and clinical settings as hands-on environments that require instructor supervision in order for students to demonstrate proficiency and critical thinking skills. When used appropriately, distance learning may be an efficient and effective approach to address the many barriers to education faced by the health workforce in general, including budget constraints, overloaded schedules, the need for on-the-job learning opportunities, and lack of access.

Experience with a pharmacy technician medication history program.

Science.gov (United States)

Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

2014-09-15

The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Impact of pharmacy technician-centered medication reconciliation on optimization of antiretroviral therapy and opportunistic infection prophylaxis in hospitalized patients with HIV/AIDS.

Science.gov (United States)

Siemianowski, Laura A; Sen, Sanchita; George, Jomy M

2013-08-01

This study aimed to examine the role of a pharmacy technician-centered medication reconciliation (PTMR) program in optimization of medication therapy in hospitalized patients with HIV/AIDS. A chart review was conducted for all inpatients that had a medication reconciliation performed by the PTMR program. Adult patients with HIV and antiretroviral therapy (ART) and/or the opportunistic infection (OI) prophylaxis listed on the medication reconciliation form were included. The primary objective is to describe the (1) number and types of medication errors and (2) the percentage of patients who received appropriate ART. The secondary objective is a comparison of the number of medication errors between standard mediation reconciliation and a pharmacy-led program. In the PTMR period, 55 admissions were evaluated. In all, 50% of the patients received appropriate ART. In 27of the 55 admissions, there were 49 combined ART and OI-related errors. The most common ART-related errors were drug-drug interactions. The incidence of ART-related medication errors that included drug-drug interactions and renal dosing adjustments were similar between the pre-PTMR and PTMR groups (P = .0868). Of the 49 errors in the PTMR group, 18 were intervened by a medication reconciliation pharmacist. A PTMR program has a positive impact on optimizing ART and OI prophylaxis in patients with HIV/AIDS.

Stem cells and respiratory diseases

Energy Technology Data Exchange (ETDEWEB)

Abreu, Soraia Carvalho; Maron-Gutierrez, Tatiana; Garcia, Cristiane Sousa Nascimento Baez; Morales, Marcelo Marcos; Rocco, Patricia Rieken Macedo [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Biofisica Carlos Chagas Filho. Lab. de Investigacao]. E-mail: prmrocco@biof.ufrj.br

2008-12-15

Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions need to be answered to better understand the mechanisms that control cell division and differentiation, therefore enabling the use of cell therapy in human respiratory diseases. (author)

Stem cells and respiratory diseases

International Nuclear Information System (INIS)

Abreu, Soraia Carvalho; Maron-Gutierrez, Tatiana; Garcia, Cristiane Sousa Nascimento Baez; Morales, Marcelo Marcos; Rocco, Patricia Rieken Macedo

2008-01-01

Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions need to be answered to better understand the mechanisms that control cell division and differentiation, therefore enabling the use of cell therapy in human respiratory diseases. (author)

Solar Technician Program Blows Hot

Science.gov (United States)

Ziegler, Peg Moran

1977-01-01

A training program for solar heating technicians was initiated at Sonoma State College's School of Environmental Studies for CETA applicants. Among the projects designed and built were a solar alternative energy center, a solar hot water system, and a solar greenhouse. (MF)

Coordinating technician allocation and maintenance routing for offshore wind farms

NARCIS (Netherlands)

Schrotenboer, Albert H.; uit het Broek, Michiel A. J.; Jargalsaikhan, Bolor; Roodbergen, Kees Jan

2018-01-01

A maintenance activity at offshore wind farms requires a combination of technicians with different skills. At an operational level, it is important to fully utilize and coordinate technicians in order to increase efficiency of the short-term maintenance planning. In this paper, we investigate

14 CFR 65.80 - Certificated aviation maintenance technician school students.

Science.gov (United States)

2010-01-01

... students has made satisfactory progress at the school and is prepared to take the oral and practical tests... technician school students. 65.80 Section 65.80 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... § 65.80 Certificated aviation maintenance technician school students. Whenever an aviation maintenance...

SU-E-T-66: Characterization of Radiation Dose Associated with Dark Currents During Beam Hold for Respiratory-Gated Electron Therapy

International Nuclear Information System (INIS)

Hessler, J; Gupta, N; Rong, Y; Weldon, M

2014-01-01

Purpose: The main objective of this study was to estimate the radiation dose contributed by dark currents associated with the respiratory-gated electron therapy during beam hold. The secondary aim was to determine clinical benefits of using respiratory-gated electron therapy for left-sided breast cancer patients with positive internal mammary nodes (IMN). Methods: Measurements of the dark current-induced dose in all electron modes were performed on multiple Siemens and Varian linear accelerators by manually simulating beam-hold during respiratory gating. Dose was quantified at the machine isocenter by comparing the collected charge to the known output for all energies ranging from 6 to 18 MeV for a 10cm × 10cm field at 100 SSD with appropriate solid-water buildup. Using the Eclipse treatment planning system, we compared the additional dose associated with dark current using gated electron fields to the dose uncertainties associated with matching gated photon fields and ungated electron fields. Dose uncertainties were seen as hot and cold spots along the match line of the fields. Results: The magnitude of the dose associated with dark current is highly correlated to the energy of the beam and the amount of time the beam is on hold. For lower energies (6–12 MeV), there was minimal dark current dose (0.1–1.3 cGy/min). Higher energies (15–18 MeV) showed measurable amount of doses. The dark current associated with the electron beam-hold varied between linear accelerator vendors and depended on dark current suppression and the age of the linear accelerator. Conclusion: For energies up to 12 MeV, the dose associated with the dark current for respiratorygated electron therapy was shown to be negligible, and therefore should be considered an option for treating IMN positive left-sided breast cancer patients. However, at higher energies the benefit of respiratory gating may be outweighed by dose due to the dark current

Radiological Control Technician: Phase 4, Facility practical training attachment

International Nuclear Information System (INIS)

1992-10-01

At DOE sites with more than one facility, and where RCT tasks at each facility may differ, site and facility tasks should be separated. The tasks that are common to all the facilities on the site should be included in Phase II training with the core tasks. Tasks unique to a facility should be added to the training program qualification standard, as an attachment, as Phase IV training. Not all the DOE sites will include Phase IV training in their programs. Phase IV training allows each site to qualify technicians to a select facility. Since the core training for the technicians is standardized, the transfer of technicians between facilities requires that only facility tasks be taught, provided the core qualification is current

A review of palivizumab and emerging therapies for respiratory syncytial virus.

Science.gov (United States)

Shadman, Kristin A; Wald, Ellen R

2011-11-01

Respiratory syncytial virus (RSV) is an important pathogen in children and adults; however, current treatment options are primarily supportive. Palivizumab, the only approved specific monoclonal antibody for RSV is used prophylactically to reduce morbidity in a select population of high-risk children. The development and current use of palivizumab; the potential role of palivizumab as preventive therapy in patients with cystic fibrosis, asthma and compromised immune systems; and explores the limited research in which palivizumab has been used for treatment of RSV. The modified recommendations for the use of palivizumab espoused by the American Academy of Pediatrics and research on the cost-effectiveness of this product are presented. In addition, the authors discuss the development of enhanced monoclonal antibodies including motavizumab, which was recently denied FDA approval for preventative therapy. The authors explore the historical and current efforts to develop a vaccine targeting RSV. The current status of antiviral drug development is also reviewed. The literature search included RSV-Ig, palivizumab, and emerging drugs and vaccines for the treatment of RSV as keywords and titles from 1997 to 2011. Although there are potential drugs and vaccines in development to prevent or reduce the effects of RSV infection, palivizumab remains the only licensed product to reduce the severity of disease in high-risk pediatric patients.

Section 608 Technician Certification Test Topics

Science.gov (United States)

Identifies some of the topics covered on Section 608 Technician Certification tests such as ozone depletion, the Clean Air Act and Montreal Protocol, Substitute Refrigerants and oils, Refrigeration and Recovery Techniques.

The acute effects of body position strategies and respiratory therapy in paralyzed patients with acute lung injury

OpenAIRE

Davis, Kenneth; Johannigman, Jay A; Campbell, Robert S; Marraccini, Ann; Luchette, Fred A; Frame, Scott B; Branson, Richard D

2001-01-01

Background: Routine turning of critically ill patients is a standard of care. In recent years, specialized beds that provide automated turning have been introduced. These beds have been reported to improve lung function, reduce hospital-acquired pneumonia, and facilitate secretion removal. This trial was designed to measure the physiological effects of routine turning and respiratory therapy in comparison with continuous lateral rotation (CLR). Methods: The study was a prospective, quasi-expe...

The Library Technician Programme in Lebanon

Science.gov (United States)

Rafidi, Samia

1973-01-01

A description of the library technician program established by the Beirut College for Women in February 1970: its curriculum, professional staff, students, and reactions produced by the program is presented. (Author/SJ)

Bovine respiratory syncytial virus (BRSV): A review

DEFF Research Database (Denmark)

Larsen, Lars Erik

2000-01-01

Bovine respiratory syncytial virus (BRSV) infection is the major cause of respiratory disease in calves during the first year of life. The study of the virus has been difficult because of its lability and very poor growth in cell culture. However, during the last decade, the introduction of new...... complex and unpredictable which makes the diagnosis and subsequent therapy very difficult. BRSV is closely related to human respiratory syncytial virus (HRSV) which is an important cause of respiratory disease in young children. In contrast to BRSV, the recent knowledge of HRSV is regularly extensively...

Respiratory muscle training with enzyme replacement therapy improves muscle strength in late - onset Pompe disease.

Science.gov (United States)

Jevnikar, Mitja; Kodric, Metka; Cantarutti, Fabiana; Cifaldi, Rossella; Longo, Cinzia; Della Porta, Rossana; Bembi, Bruno; Confalonieri, Marco

2015-12-01

Pompe disease is an autosomal recessive metabolic disorder caused by the deficiency of the lysosomal enzyme acid α-glucosidase. This deficiency leads to glycogen accumulation in the lysosomes of muscle tissue causing progressive muscular weakness particularly of the respiratory system. Enzyme replacement therapy (ERT) has demonstrated efficacy in slowing down disease progression in infants. Despite the large number of studies describing the effects of physical training in juvenile and adult late onset Pompe disease (LOPD). There are very few reports that analyze the benefits of respiratory muscle rehabilitation or training. The effectiveness of respiratory muscle training was investigated using a specific appliance with adjustable resistance (Threshold). The primary endpoint was effect on respiratory muscular strength by measurements of MIP and MEP. Eight late-onset Pompe patients (aged 13 to 58 years; 4 female, 4 male) with respiratory muscle deficiency on functional respiratory tests were studied. All patients received ERT at the dosage of 20 mg/kg/every 2 weeks and underwent training with Threshold at specified pressures for 24 months. A significant increase in MIP was observed during the follow-up of 24 month: 39.6 cm H 2 O (+ 25.0%) at month 3; 39.5 cm H 2 O (+ 24.9%) at month 6; 39.1 cm H 2 O (+ 23.7%) at month 9; 37.3 cm H 2 O (+ 18.2%) at month 12; and 37.3 cm H 2 O (+ 17.8%) at month 24. Median MEP values also showed a significant increase during the first 9 months: 29.8 cm H 2 O, (+ 14.3%) at month 3; 31.0 cm H 2 O (+ 18.6) at month 6; and 29.5 cm H 2 O (+ 12.9) at month 9. MEP was then shown to be decreased at months 12 and 24; median MEP was 27.2 cm H 2 O (+ 4.3%) at 12 months and 26.6 cm H 2 O (+ 1.9%) at 24 months. The FVC remain stable throughout the study. An increase in respiratory muscular strength was demonstrated with Threshold training when used in combination with ERT.

Surfactant nebulisation prevents the adverse effects of surfactant therapy on blood pressure and cerebral blood flow in rabbits with severe respiratory failure

NARCIS (Netherlands)

Dijk, Peter H.; Heikamp, A; Bambang Oetomo, Sidarto

1997-01-01

Objective: Surfactant replacement therapy for the neonatal respiratory distress syndrome has shown beneficial effects on lung function and survival. Recently, rapid fluctuations of haemodynamics and cerebral perfusion following surfactant instillation have beer, described and an association with the

Personalizing mechanical ventilation for acute respiratory distress syndrome.

Science.gov (United States)

Berngard, S Clark; Beitler, Jeremy R; Malhotra, Atul

2016-03-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response to therapy (recruitability). This summary will emphasize the potential role of personalized therapy in mechanical ventilation.

Technician Career Opportunities in Engineering Technology.

Science.gov (United States)

Engineers' Council for Professional Development, New York, NY.

Career opportunities for engineering technicians are available in the technologies relating to air conditioning, heating, and refrigeration, aviation and aerospace, building construction, chemical engineering, civil engineering, electrical engineering, electronics, industrial engineering, instrumentation, internal combustion engines, mechanical…

Alternative and Natural Therapies for Acute Lung Injury and Acute Respiratory Distress Syndrome

Directory of Open Access Journals (Sweden)

Vipul J. Patel

2018-01-01

Full Text Available Introduction. Acute respiratory distress syndrome (ARDS is a complex clinical syndrome characterized by acute inflammation, microvascular damage, and increased pulmonary vascular and epithelial permeability, frequently resulting in acute respiratory failure and death. Current best practice for ARDS involves “lung-protective ventilation,” which entails low tidal volumes and limiting the plateau pressures in mechanically ventilated patients. Although considerable progress has been made in understanding the pathogenesis of ARDS, little progress has been made in the development of specific therapies to combat injury and inflammation. Areas Covered. In recent years, several natural products have been studied in experimental models and have been shown to inhibit multiple inflammatory pathways associated with acute lung injury and ARDS at a molecular level. Because of the pleiotropic effects of these agents, many of them also activate antioxidant pathways through nuclear factor erythroid-related factor 2, thereby targeting multiple pathways. Several of these agents are prescribed for treatment of inflammatory conditions in the Asian subcontinent and have shown to be relatively safe. Expert Commentary. Here we review natural remedies shown to attenuate lung injury and inflammation in experimental models. Translational human studies in patients with ARDS may facilitate treatment of this devastating disease.

Prevention and treatment of respiratory syncytial virus bronchiolitis and postbronchiolitic wheezing

Directory of Open Access Journals (Sweden)

Kimpen Jan LL

2002-06-01

Full Text Available Abstract Respiratory syncytial virus (RSV is the primary cause of hospitalization for acute respiratory tract illness in general and specifically for bronchiolitis in young children. The link between RSV bronchiolitis and reactive airway disease is not completely understood, even though RSV bronchiolitis is frequently followed by recurrent episodes of wheezing. Therapy with ribavirin does not appear to significantly reduce long-term respiratory outcome of RSV lower respiratory tract infection, and corticosteroid or bronchodilator therapy may possibly improve outcomes only on a short-term basis. No vaccine against RSV is yet available. It is not known whether prophylaxis with RSV intravenous immune globulin or palivizumab can reduce postbronchiolitic wheezing.

Hydraulics and pneumatics a technician's and engineer's guide

CERN Document Server

Parr, Andrew

2011-01-01

Nearly all industrial processes require objects to be moved, manipulated or subjected to some sort of force. Such movements and manipulations are frequently accomplished by means of devices driven by liquids (hydraulics) or air (pneumatics), the subject of this book. Hydraulics and Pneumatics is written by a practicing process control engineer as a guide to the successful operation of hydraulic and pneumatic systems for all engineers and technicians working with them. Keeping mathematics and theory to a minimum, this practical guide is thorough but accessible to technicians without a

ASHP statement on the pharmacy technician's role in pharmacy informatics.

Science.gov (United States)

2014-02-01

The American Society of Health- System Pharmacists (ASHP) believes that specially trained pharmacy technicians can assume important supportive roles in pharmacy informatics. These roles include automation and technology systems management, management of projects, training and education, policy and governance, customer service, charge integrity, and reporting. Such roles require pharmacy technicians to gain expertise in information technology (IT) systems, including knowledge of interfaces, computer management techniques, problem resolution, and database maintenance. This knowledge could be acquired through specialized training or experience in a health science or allied scientific field (e.g., health informatics). With appropriate safeguards and supervision, pharmacy technician informaticists (PTIs) will manage IT processes in health-system pharmacy services, ensuring a safe and efficient medication-use process.

The role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections

Directory of Open Access Journals (Sweden)

Amal Abd El-Azeem

2013-10-01

Conclusion: Serum PCT level could be used as a novel marker of lower respiratory tract bacterial infections for diagnosis, prognosis and follow up of therapy. This reduces side-effects of an unnecessary antibiotic use, lowers costs, and in the long-term, leads to diminishing drug resistance.

Principles of etiopathogenetic therapy for acute respiratory viral infections in frequently ill children

Directory of Open Access Journals (Sweden)

L. A. Kharitonova

2015-01-01

Full Text Available Objective: to investigate the impact of incorporation of cycloferon into a therapy regimen on the efficiency of treatment for acute respiratory viral infections (ARVI in frequently ill children. Subjects and methods. The results of treatment were analyzed in 117 children divided into three groups according to the therapy regimen. Thus, symptomatic and local antiviral therapies (interferon nasal ointment and viferon suppositories were prescribed to all the children; furthermore, Group 1 (control used antibiotic therapy; Group 2 (Comparison Group 1 took antibiotics and cycloferon (tablets, and Group 3 (Comparison Group 2 had Cycloferon. Results: At the beginning of treatment, there was a reduction in interferon-a and interferon-y values with preserved serum interferon levels, suggesting the diminished compensatory responses ensuring antiviral protection. Analysis of the immune status revealed that virtually half of the children exhibited activation of compensatory mechanisms (stimulation of CD4+ and CD8+ production and an increase in NST test activity, one third displayed a disturbance (decreases in CD4+, CDlfrf, IgA, and NST test activity. After treatment, interferonogenesis was recovered in the majority (86,7% of the patients taking Cycloferon, in 74,1% of those who had a treatment regimen containing cycloferon and antibiotics, and only in 47,1 % of those who received antibiotics. Comparison of the immunological indicators during therapy with antibiotics alone or in combination with cycloferon demonstrated a more noticeable and balanced response to the latter: the normalized CD4+ and CD8+ values in the patients on antibiotic therapy was 8,9 and 5,8%, respectively, and 11,1 % in those who received antibiotics and cycloferon. Conclusion. Incorporation of cycloferon into ARVI treatment regimens for frequently ill patients has the positive effect on immunological indicators, which shows itself as recovery of initially diminished interferonogenesis

Use of a pharmacy technician to facilitate postfracture care provided by clinical pharmacy specialists.

Science.gov (United States)

Irwin, Adriane N; Heilmann, Rachel M F; Gerrity, Theresa M; Kroner, Beverly A; Olson, Kari L

2014-12-01

The ability of a pharmacy technician to support the patient screening and documentation-related functions of a pharmacist-driven osteoporosis management service was evaluated. A two-phase prospective study was conducted within a large integrated health system to assess a pharmacy technician's performance in supporting a multisite team of clinical pharmacy specialists providing postfracture care. In phase I of the study, a specially trained pharmacy technician provided support to pharmacists at five participating medical offices, helping to identify patients requiring pharmacist intervention and, when applicable, collecting patient-specific clinical information from the electronic health record. In phase II of the study, the amount of pharmacist time saved through the use of technician support versus usual care was evaluated. The records of 127 patient cases were reviewed by the pharmacy technician during phase I of the study, and a pharmacist agreed with the technician's determination of the need for intervention in the majority of instances (92.9%). An additional 91 patient cases were reviewed by the technician in phase II of the research. With technician support, pharmacists spent less time reviewing cases subsequently determined as not requiring intervention (mean ± S.D., 5.0 ± 3.8 minutes per case compared with 5.2 ± 4.5 minutes under the usual care model; p = 0.78). In cases requiring intervention, technician support was associated with a reduction in the average pharmacist time spent on care plan development (13.5 ± 7.1 minutes versus 18.2 ± 16.6 minutes with usual care, p = 0.34). The study results suggest that a pharmacy technician can accurately determine if a patient is a candidate for pharmacist intervention and collect clinical information to facilitate care plan development. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Pharmacy technician self-efficacies: Insight to aid future education, staff development, and workforce planning.

Science.gov (United States)

Desselle, Shane P; Hoh, Ryan; Holmes, Erin R; Gill, Amanpreet; Zamora, Lemuel

2017-07-15

The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles. A total of 5000 pharmacy technicians from 8 U.S. states were sent an electronic survey eliciting data on current involvement, self-efficacies, and attitudes for practicing in an expansive list of practice activities. The 8 states from which the sample was drawn were selected from a stratified randomized procedure using U.S. Census Bureau geographically defined regions. Pre-notification and response reminders were employed. Data were analyzed descriptively and with univariate, inferential tests, as appropriate, to determine associations with commitment, practice environment, experience level, and other variables. Of the 612 participants who responded, 494 were currently working as a technician and not enrolled in a PharmD program of study. Participants reported various activities in which they were highly engaged. Overall, attitudes toward performing most of the activities and self-efficacies were quite favorable, even for those activities in which technicians were currently less involved. There were some notable differences between technicians practicing in community versus hospital settings. Years of experience, profession commitment, and advanced employee ranking were associated with higher levels of self-efficacy, overall. This initial examination of pharmacy technician self-efficacies identified areas that along with other factors could help employers with further expanding technician practice activities and vocational institutions with considerations for education and development of these key members

Patient- and Technician-Oriented Attitudes Toward Transcranial Magnetic Stimulation Devices.

Science.gov (United States)

Lonergan, Brady; Nguyen, Eliza; Lembo, Cara; Hinchman, Carrie; Morales, Oscar G; Press, Daniel Z; Pascual-Leone, Alvaro; Stern, Adam P

2018-01-25

Four transcranial magnetic stimulation (TMS) devices are currently approved for use in treatment-resistant depression. The authors present the first data-driven study examining the patient- and technician-experience using three of these distinct devices. A retrospective survey design with both patient and technician arms was utilized. The study population included patients who received TMS for treatment-resistant depression at the Berenson Allen Center for Noninvasive Brain Stimulation for the first time between 2013 and 2016 and technicians who worked in the program from 2009 to 2017. Statistical analysis included t tests and analyses of variance to assess differences between and across the multiple groups, respectively. Patients treated with the NeuroStar device reported greater confidence that the treatment was being performed correctly compared with those treated with the Magstim device. Conversely, with regard to tolerability, patients treated with the Magstim device reported less pain in the last week and less pain on average compared with those treated with the NeuroStar device. On average, technicians reported feeling that both the Magstim and NeuroStar devices were significantly easier to use than the Brainsway Deep TMS H-Coil device. Additionally, they found the former two devices to be more reliable and better tolerated. Furthermore, the technicians reported greater confidence in the Magstim and NeuroStar devices compared with the Brainsway Deep TMS H-Coil device and indicated that they would be more likely to recommend the two former devices to other treatment centers.

Pharmacy technician-to-pharmacist ratios: a state-driven safety and quality decision.

Science.gov (United States)

Bess, D Todd; Carter, Jason; DeLoach, Lindsey; White, Carol L

2014-01-01

To discuss the policy of pharmacy technician-to-pharmacist ratios by comparing Florida as an example of legislative-led authority versus Tennessee as an example of board of pharmacy-led ruling. Over the past 2 years, the Florida legislature has debated the issue of pharmacy staffing ratios, initially leaving the Florida Board of Pharmacy with little authority to advocate for and enact safe technician staffing ratios. Anticipating this situation, the Tennessee Board of Pharmacy created rules to meet pharmacy staffing needs while protecting the authority of the pharmacist-in-charge and promoting patient safety. Before enacting rules, members of the board toured the state and talked about proposed rule changes with pharmacists. The final rule sets the pharmacy technician-to-pharmacist ratio at 2:1 but permits a 4:1 ratio based on public safety considerations and availability of at least two Certified Pharmacy Technicians. Pharmacists and leaders within the profession should conduct further research on appropriate and safe ratios of pharmacy technicians to pharmacists, with a focus on safety and quality of care.

FEVER AS KEY SYMPTOM OF ACUTE RESPIRATORY INFECTIONS AND MODERN METHODS OF THERAPY FOR HIGH TEMPERATURE IN CHILDREN

Directory of Open Access Journals (Sweden)

O.A. Solntseva

2010-01-01

Full Text Available Hyperthermia is the key symptom of acute respiratory infections (ARI. An increase in the body temperature is accompanied with phagocytosis activation, increased interferon synthesis, antibody genesis stimulation, lymphocytes activation and differentiation. Nevertheless, significant hyperthermia may result in my unfavourable consequences. It may particularly cause an exacerbation of chronic diseases. Modern therapy for hyperthermia is, therefore, an important aspect of treating children with ARI. The article outlines the modern approach to treating fever in children, identifies key criteria for selecting a medication. It also contains a case study of applying ibuprofen and data from various trials which verify the rationale for applying ibuprofen in children with hyperthermia that developed in conjunction with ARI.Key words: children, acute respiratory infections, hyperthermia, ibuprofen.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:80-84

The Clinical Utilisation of Respiratory Elastance Software (CURE Soft): a bedside software for real-time respiratory mechanics monitoring and mechanical ventilation management.

Science.gov (United States)

Szlavecz, Akos; Chiew, Yeong Shiong; Redmond, Daniel; Beatson, Alex; Glassenbury, Daniel; Corbett, Simon; Major, Vincent; Pretty, Christopher; Shaw, Geoffrey M; Benyo, Balazs; Desaive, Thomas; Chase, J Geoffrey

2014-09-30

Real-time patient respiratory mechanics estimation can be used to guide mechanical ventilation settings, particularly, positive end-expiratory pressure (PEEP). This work presents a software, Clinical Utilisation of Respiratory Elastance (CURE Soft), using a time-varying respiratory elastance model to offer this ability to aid in mechanical ventilation treatment. CURE Soft is a desktop application developed in JAVA. It has two modes of operation, 1) Online real-time monitoring decision support and, 2) Offline for user education purposes, auditing, or reviewing patient care. The CURE Soft has been tested in mechanically ventilated patients with respiratory failure. The clinical protocol, software testing and use of the data were approved by the New Zealand Southern Regional Ethics Committee. Using CURE Soft, patient's respiratory mechanics response to treatment and clinical protocol were monitored. Results showed that the patient's respiratory elastance (Stiffness) changed with the use of muscle relaxants, and responded differently to ventilator settings. This information can be used to guide mechanical ventilation therapy and titrate optimal ventilator PEEP. CURE Soft enables real-time calculation of model-based respiratory mechanics for mechanically ventilated patients. Results showed that the system is able to provide detailed, previously unavailable information on patient-specific respiratory mechanics and response to therapy in real-time. The additional insight available to clinicians provides the potential for improved decision-making, and thus improved patient care and outcomes.

New Zealand dental technicians and continuing education: findings from a qualitative survey.

Science.gov (United States)

Anderson, Vivienne R; Pang, Lilian C Y; Aarts, John M

2012-06-01

Under the 2003 Health Practitioners Competence Assurance (HPCA) Act, New Zealand registered dental technicians are subject to mandatory Continuing Professional Development (CPD) requirements. Internationally, little published literature has examined dental technicians' perspectives of CPD and CPD needs, and there is no published literature relating to the New Zealand context. Available research highlights the importance of CPD for maintaining high professional standards, ensuring patient safety, allowing dental technicians to keep abreast of current research and technological advances, fostering peer networks, and promoting job satisfaction. In 2009, an online open-ended questionnaire was developed to examine New Zealand dental and clinical dental technicians' perspectives of CPD and their perceived CPD needs. In total, 45 New Zealand registered dental technicians responded. Questionnaire responses provided rich qualitative insights into dental technicians' wide-ranging perceptions of CPD, factors that make CPD involvement more or less difficult and more or less desirable, and ways in which CPD access and relevance might be improved. This paper discusses the survey findings in the light of the existing literature on CPD and in relation to the unique New Zealand regulatory environment. It highlights the factors which respondents identified as shaping their CPD decisions, barriers to CPD engagement, perceived CPD needs, suggestions as to how the current CPD system could be improved, and areas for future research.

Intraoperative monitoring technician: a new member of the surgical team.

Science.gov (United States)

Brown, Molly S; Brown, Debra S

2011-02-01

As surgery needs have increased, the traditional surgical team has expanded to include personnel from radiology and perfusion services. A new surgical team member, the intraoperative monitoring technician, is needed to perform intraoperative monitoring during procedures that carry a higher risk of central and peripheral nerve injury. Including the intraoperative monitoring technician on the surgical team can create challenges, including surgical delays and anesthesia care considerations. When the surgical team members, including the surgeon, anesthesia care provider, and circulating nurse, understand and facilitate this new staff member's responsibilities, the technician is able to perform monitoring functions that promote the smooth flow of the surgical procedure and positive patient outcomes. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

A new standard for multidisciplinary health and safety technicians

International Nuclear Information System (INIS)

Trinoskey, P.A.; Fry, L.A.; Egbert, W.F.

2000-01-01

Over the last two decades, a significant trend in health and safety has been toward greater specialization. However, compartmentalization of health and safety disciplines often leads to an inequity in resources, especially when appropriations overemphasize one risk to the detriment of others. For example, overemphasis on radiological safety can create an imbalance in overall worker protection. A multidisciplinary technical can help restore the balance and provide for a healthier and safer work environment. The key advantages of a multidisciplinary health and safety technician include: Broad coverage of the work area by one technician, More diverse use of the technician pool, Better coverage for off-shift or nonstandard hours, Balance of risks because all hazards are considered, Integrated emergency response, Ownership, Less time of identify the correct person with the requisite skills. We have developed a new standard that establishes the training and related qualifications for a multidisciplinary health and safety technician. The areas of training and qualification that are addressed include elements of industrial hygiene, industrial safety, fire protection, electrical safety, construction safety, and radiation safety. The initial core training program ensures that individuals are trained to the performance of requirements of the job. Initial training is in five areas: Fundamentals, Hazard recognition, Hazard assessment, Hazards controls, Hazards minimization. Core training is followed by formal qualification on specific tasks, including ventilation surveys, air monitoring, noise assessments, radiological monitoring, area inspections, work-area setups, and work coverage. The new standard addresses not only training topics and requirements, but also guidance to ensure that performance objectives are met. The standard applies to technicians, supervisors, technologists, and six specialty areas, including academic institutions and decontamination and decommissioning

A new standard for multidisciplinary health and safety technicians

Energy Technology Data Exchange (ETDEWEB)

Trinoskey, P.A.; Fry, L.A. [Lawrence Livermore National Laboratory, Univ. of California, CA (United States); Egbert, W.F. [Lawrence Livermore National Laboratory, Allied Signal Technical Corporation (United States)

2000-05-01

Over the last two decades, a significant trend in health and safety has been toward greater specialization. However, compartmentalization of health and safety disciplines often leads to an inequity in resources, especially when appropriations overemphasize one risk to the detriment of others. For example, overemphasis on radiological safety can create an imbalance in overall worker protection. A multidisciplinary technical can help restore the balance and provide for a healthier and safer work environment. The key advantages of a multidisciplinary health and safety technician include: Broad coverage of the work area by one technician, More diverse use of the technician pool, Better coverage for off-shift or nonstandard hours, Balance of risks because all hazards are considered, Integrated emergency response, Ownership, Less time of identify the correct person with the requisite skills. We have developed a new standard that establishes the training and related qualifications for a multidisciplinary health and safety technician. The areas of training and qualification that are addressed include elements of industrial hygiene, industrial safety, fire protection, electrical safety, construction safety, and radiation safety. The initial core training program ensures that individuals are trained to the performance of requirements of the job. Initial training is in five areas: Fundamentals, Hazard recognition, Hazard assessment, Hazards controls, Hazards minimization. Core training is followed by formal qualification on specific tasks, including ventilation surveys, air monitoring, noise assessments, radiological monitoring, area inspections, work-area setups, and work coverage. The new standard addresses not only training topics and requirements, but also guidance to ensure that performance objectives are met. The standard applies to technicians, supervisors, technologists, and six specialty areas, including academic institutions and decontamination and decommissioning

Hypersensitivity Reaction and Acute Respiratory Distress Syndrome in Pyrethroid Poisoning and Role of Steroid Therapy

Directory of Open Access Journals (Sweden)

Jisa George

2015-06-01

Full Text Available Background: Pyrethroids are generally of low toxicity to humans, but in suicidal poisonings which are usually associated with ingestion of high doses, they lead to severe systemic effects. Case Report: A 30-year old woman presented to emergency department with a history of intentional ingestion of about 15 mL of prallethrin around 3 days earlier. She complained of shortness of breath along with chest pain for the last 2 days. She reported no vomiting or stomach pain prior to presentation to hospital. On chest auscultation, breath sounds were mildly decreased in bilateral infrascapular areas with generalized crepitation. Arterial blood gas analysis revealed respiratory alkalosis. Chest X ray and computed tomography of thorax revealed widespread confluent areas of consolidation with interlobular septal thickening involving bilateral parahilar regions suggestive of acute respiratory distress syndrome (ARDS. The patient did not respond to broad spectrum antibiotic coverage, diuretics and oxygen inhalation. Intravenous methylprednisolone (2 mg/kg/day divided 6 hourly was started and slowly tapered off during the next days. The patient discharged after 3 weeks in good health. Discussion: As pyrethroids can affect sodium channels, the osmotic gradient of alveolar epithelium probably disrupts and therefore, alveolar infiltrations gradually spread over lungs. In addition, there is a possibility of hypersensitivity reactions to pyrethroids, which can cause progressive inflammation and involve respiratory tract in severe cases. Conclusion: Pyrethroid poisoning can lead to ARDS. Steroid therapy may help such patients tide over the pulmonary crisis.

Filgrastim as a Rescue Therapy for Persistent Neutropenia in a Case of Dengue Hemorrhagic Fever with Acute Respiratory Distress Syndrome and Myocarditis

Directory of Open Access Journals (Sweden)

Desh Deepak

2011-01-01

Full Text Available Pathogenesis of dengue involves suppression of immune system leading to development of characteristic presentation of haematological picture of thrombocytopenia and leucopenia. Sometimes, this suppression in immune response is responsible for deterioration in clinical status of the patient in spite of all specific and supportive therapy. Certain drugs like steroids are used for rescue therapy in conditions like sepsis. We present a novel use of filgrastim as a rescue therapy in a patient with dengue hemorrhagic fever (DHF with acute respiratory distress syndrome (ARDS, myocarditis, and febrile neutropenia and not responding to standard management.

5 CFR 831.306 - Service as a National Guard technician before January 1, 1969.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Service as a National Guard technician... National Guard technician before January 1, 1969. (a) Definitions. In this section—(1) Service as a National Guard technician is service performed under section 709 of title 32, United States Code (or under...

Consideration of the accuracy by variation of respiration in real-time position management respiratory gating system

International Nuclear Information System (INIS)

Na, Jun Young; Kang, Tae Young; Beak, Geum Mun; Kwon, Gyeong Tae

2013-01-01

Respiratory Gated Radiation Therapy (RGRT) has been carried out using RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, varian, USA) in Asan Medical Center. This study was to analyze and evaluate the accuracy of Respiratory Gated Radiation Therapy (RGRT) according to variation of respiration. Making variation of respiration using Motion Phantom:QUASAR Programmable Respiratory Motion Phantom (Moudus Medical Device Inc. CANADA) able to adjust respiration pattern randomly was varying period, amplitude and baseline by analyze 50 patient's respiration of lung and liver cancer. One of the variations of respiration is baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. The other variation of respiration is baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm. Experiments were performed in the same way that is used RPM Respiratory Gating System (phase gating, usually 30-70% gating) in Asan Medical Center. It was all exposed radiation under one of the conditions of baseline shift gradually downward per 0.01 cm, 0.03 cm, 0.05 cm. Under the other condition of baseline shift accidently downward per 0.2 cm, 0.4 cm, 0.6 cm, 0.8 cm equally radiation was exposed. The variations of baseline shifts didn't accurately reflect on phase gating in RPM Respiratory Gating System. This inexactitude makes serious uncertainty in Respiratory Gated Radiation Therapy. So, Must be stabilized breathing of patient before conducting Respiratory Gated Radiation Therapy. also must be monitored breathing of patient in the middle of treatment. If you observe considerable changes of breathing when conducting Respiratory Gated Radiation Therapy. Stopping treatment immediately and then must be need to recheck treatment site using fluoroscopy. If patient's respiration rechecked using fluoroscopy restabilize, it is possible to restart Respiratory Gated Radiation Therapy

Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

Science.gov (United States)

Wang, Shouyi; Bowen, Stephen R.; Chaovalitwongse, W. Art; Sandison, George A.; Grabowski, Thomas J.; Kinahan, Paul E.

2014-02-01

The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUVpeak) over lesions of interest. Relative differences in SUVpeak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUVpeak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion compensation

Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

International Nuclear Information System (INIS)

Wang, Shouyi; Chaovalitwongse, W Art; Bowen, Stephen R; Kinahan, Paul E; Sandison, George A; Grabowski, Thomas J

2014-01-01

The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUV peak ) over lesions of interest. Relative differences in SUV peak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUV peak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion

House Dust Mite Respiratory Allergy

DEFF Research Database (Denmark)

Calderón, Moisés A; Kleine-Tebbe, Jörg; Linneberg, Allan

2015-01-01

Although house dust mite (HDM) allergy is a major cause of respiratory allergic disease, specific diagnosis and effective treatment both present unresolved challenges. Guidelines for the treatment of allergic rhinitis and asthma are well supported in the literature, but specific evidence on the e......Although house dust mite (HDM) allergy is a major cause of respiratory allergic disease, specific diagnosis and effective treatment both present unresolved challenges. Guidelines for the treatment of allergic rhinitis and asthma are well supported in the literature, but specific evidence...... not extend beyond the end of treatment. Finally, allergen immunotherapy has a poor but improving evidence base (notably on sublingual tablets) and its benefits last after treatment ends. This review identifies needs for deeper physician knowledge on the extent and impact of HDM allergy in respiratory disease...... and therapy of HDM respiratory allergy in practice....

Training and qualification of health and safety technicians at a national laboratory

International Nuclear Information System (INIS)

Egbert, W.F.; Trinoskey, P.A.

1994-10-01

Over the last 30 years, Lawrence Livermore National Laboratory (LLNL) has successfully implemented the concept of a multi-disciplined technician. LLNL Health and Safety Technicians have responsibilities in industrial hygiene, industrial safety, health physics, as well as fire, explosive, and criticality safety. One of the major benefits to this approach is the cost-effective use of workers who display an ownership of health and safety issues which is sometimes lacking when responsibilities are divided. Although LLNL has always promoted the concept of a multi-discipline technician, this concept is gaining interest within the Department of Energy (DOE) community. In November 1992, individuals from Oak Ridge Institute of Science and Education (ORISE) and RUST Geotech, joined by LLNL established a committee to address the issues of Health and Safety Technicians. In 1993, the DOE Office of Environmental, Safety and Health, in response to the Defense Nuclear Facility Safety Board Recommendation 91-6, stated DOE projects, particularly environmental restoration, typically present hazards other than radiation such as chemicals, explosives, complex construction activities, etc., which require additional expertise by Radiological Control Technicians. They followed with a commitment that a training guide would be issued. The trend in the last two decades has been toward greater specialization in the areas of health and safety. In contrast, the LLNL has moved toward a generalist approach integrating the once separate functions of the industrial hygiene and health physics technician into one function

Technicians under the Microscope: The Training and Skills of University Laboratory and Engineering Workshop Technicians

Science.gov (United States)

Lewis, Paul A.; Gospel, Howard

2015-01-01

The UK government aims to increase both the number, and also the status, of workers with intermediate-level skills, with a view to creating a "modern class of technicians" who can help to bolster economic growth and prosperity. This article considers the prospects for such a policy by focusing on one particular, but neglected, group of…

Technician Consistency in Specular Microscopy Measurements: A "Real-World" Retrospective Analysis of a United States Eye Bank.

Science.gov (United States)

Rand, Gabriel M; Kwon, Ji Won; Gore, Patrick K; McCartney, Mitchell D; Chuck, Roy S

2017-10-01

To quantify consistency of endothelial cell density (ECD) measurements among technicians in a single US eye bank operating under typical operating conditions. In this retrospective analysis of 51 microscopy technicians using a semiautomated counting method on 35,067 eyes from July 2007 to May 2015, technician- and date-related marginal ECD effects were calculated using linear regression models. ECD variance was correlated with the number of specular microscopy technicians. Technician mean ECDs ranged from 2386 ± 431 to 3005 ± 560 cells/mm. Nine technicians had statistically and clinically significant marginal effects. Annual mean ECDs adjusted for changes in technicians ranged from 2422 ± 433 to 2644 ± 430 cells/mm. The period of 2007 to 2009 had statistically and clinically significant marginal effects. There was a nonstatistically significant association between the number of technicians and ECD standard deviation. There was significant ECD variability associated with specular microscopy technicians and with the date of measurement. We recommend that eye banks collect data related to laboratory factors that have been shown to influence ECD variability.

Pharmacist and Technician Perceptions of Tech-Check-Tech in Community Pharmacy Practice Settings.

Science.gov (United States)

Frost, Timothy P; Adams, Alex J

2018-04-01

Tech-check-tech (TCT) is a practice model in which pharmacy technicians with advanced training can perform final verification of prescriptions that have been previously reviewed for appropriateness by a pharmacist. Few states have adopted TCT in part because of the common view that this model is controversial among members of the profession. This article aims to summarize the existing research on pharmacist and technician perceptions of community pharmacy-based TCT. A literature review was conducted using MEDLINE (January 1990 to August 2016) and Google Scholar (January 1990 to August 2016) using the terms "tech* and check," "tech-check-tech," "checking technician," and "accuracy checking tech*." Of the 7 studies identified we found general agreement among both pharmacists and technicians that TCT in community pharmacy settings can be safely performed. This agreement persisted in studies of theoretical TCT models and in studies assessing participants in actual community-based TCT models. Pharmacists who had previously worked with a checking technician were generally more favorable toward TCT. Both pharmacists and technicians in community pharmacy settings generally perceived TCT to be safe, in both theoretical surveys and in surveys following actual TCT demonstration projects. These perceptions of safety align well with the actual outcomes achieved from community pharmacy TCT studies.

Critical Thinking in Respiratory Therapy Students: Comparing Baccalaureate and Associate Degree Students

Science.gov (United States)

Clark, Myava C.

2012-01-01

Respiratory care is an allied health discipline that specializes in cardiopulmonary function and health. Respiratory therapists apply scientific principles to prevent, identify, and treat acute and chronic dysfunction of the cardiopulmonary system. Respiratory care specifically focuses on the assessment, treatment, management, control, diagnostic…

Clinical support role for a pharmacy technician within a primary care resource center.

Science.gov (United States)

Fera, Toni; Kanel, Keith T; Bolinger, Meghan L; Fink, Amber E; Iheasirim, Serah

2018-02-01

The creation of a clinical support role for a pharmacy technician within a primary care resource center is described. In the Primary Care Resource Center (PCRC) Project, hospital-based care transition coordination hubs staffed by nurses and pharmacist teams were created in 6 independent community hospitals. At the largest site, patient volume for targeted diseases challenged the ability of the PCRC pharmacist to provide expected elements of care to targeted patients. Creation of a new pharmacy technician clinical support role was implemented as a cost-effective option to increase the pharmacist's efficiency. The pharmacist's work processes were reviewed and technical functions identified that could be assigned to a specially trained pharmacy technician under the direction of the PCRC pharmacist. Daily tasks performed by the pharmacy technician included maintenance of the patient roster and pending discharges, retrieval and documentation of pertinent laboratory and diagnostic test information from the patient's medical record, assembly of patient medication education materials, and identification of discrepancies between disparate systems' medication records. In the 6 months after establishing the PCRC pharmacy technician role, the pharmacist's completion of comprehensive medication reviews (CMRs) for target patients increased by 40.5% ( p = 0.0223), driven largely by a 42.4% ( p technician to augment pharmacist care in a PCRC team extended the reach of the pharmacist and allowed more time for the pharmacist to engage patients. Technician support enabled the pharmacist to complete more CMRs and reduced the time required for chart reviews. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Expanded pharmacy technician roles: Accepting verbal prescriptions and communicating prescription transfers.

Science.gov (United States)

Frost, Timothy P; Adams, Alex J

2017-11-01

As the role of the clinical pharmacist continues to develop and advance, it is critical to ensure pharmacists can operate in a practice environment and workflow that supports the full deployment of their clinical skills. When pharmacy technician roles are optimized, patient safety can be enhanced and pharmacists may dedicate more time to advanced clinical services. Currently, 17 states allow technicians to accept verbal prescriptions called in by a prescriber or prescriber's agent, or transfer a prescription order from one pharmacy to another. States that allow these activities generally put few legal limitations on them, and instead defer to the professional judgment of the supervising pharmacist whether to delegate these tasks or not. These activities were more likely to be seen in states that require technicians to be registered and certified, and in states that have accountability mechanisms (e.g., discipline authority) in place for technicians. There is little evidence to suggest these tasks cannot be performed safely and accurately by appropriately trained technicians, and the track record of success with these tasks spans four decades in some states. Pharmacists can adopt strong practice policies and procedures to mitigate the risk of harm from verbal orders, such as instituting read-back/spell-back techniques, or requiring the indication for each phoned-in medication, among other strategies. Pharmacists may also exercise discretion in deciding to whom to delegate these tasks. As the legal environment becomes more permissive, we foresee investment in more robust education and training of technicians to cover these activities. Thus, with the adoption of robust practice policies and procedures, delegation of verbal orders and prescription transfers can be safe and effective, remove undue stress on pharmacists, and potentially free up pharmacist time for higher-order clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical Laboratory Technician--Microbiology (AFSC 90470).

Science.gov (United States)

Thompson, Joselyn H.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for medical laboratory technicians. Covered in the individual volumes are laboratory procedures in clinical bacteriology (the history of bacteriology; aseptic techniques and sterilization procedures; bacterial morphology and…

IMMUNOPATHOGENESIS OF ACUTE RESPIRATORY INFECTIONS AND TACTICS OF RATIONAL CHOICE OF ETIOTROPIC IMMUNOMODULATORY THERAPIES IN CHILDREN

Directory of Open Access Journals (Sweden)

V. V. Malinovskaya

2013-01-01

Full Text Available The article demonstrates that the basis for pathogenesis of acute respiratory infection (ARI is a deficiency in a number of factors of virus protection. This deficiency manifests itself through low concentration of interferon and secretory IgA in the nasal mucosa at higher levels of IL-8, alongside with low serum antiviral activity and significant inhibition of interferon production and reduction of the compensatory mechanisms of adaptive immunity. These disorders require prescription of alpha-interferon preparations. For infants and children with a burdened pre-morbid background, regardless of age, such preparations can be administered with all clinical forms of ARI; in older children — with severe forms, including complications. Alpha-interferon preparations can be introduced at in any stage of the disease. Combination therapy with alpha-interferon drugs (VIFERON® suppositories and VIFERON® ointment allows for enhanced clinical and immunological effects of therapy.

Respiratory disorders in patients with polymyositis/dermatomyositis

Directory of Open Access Journals (Sweden)

Olga Alekseyevna Antelava

2014-01-01

Full Text Available Idiopathic inflammatory myopathies (IIM are rare disorders characterized by inflammatory lesions in skeletal muscles. These diseases include polymyositis (PM, dermatomyositis (DM, and inclusion body myositis, which exhibit clinicoimmunological heterogeneity and give different response to therapy. The most frequent manifestation in PM/DM patients is respiratory system dysfunction. The developing respiratory disorders are varied and may outpace the presentation of muscle pathology.

SU-E-T-452: Impact of Respiratory Motion On Robustly-Optimized Intensity-Modulated Proton Therapy to Treat Lung Cancers

International Nuclear Information System (INIS)

Liu, W; Schild, S; Bues, M; Liao, Z; Sahoo, N; Park, P; Li, H; Li, Y; Li, X; Shen, J; Anand, A; Dong, L; Zhu, X; Mohan, R

2014-01-01

Purpose: We compared conventionally optimized intensity-modulated proton therapy (IMPT) treatment plans against the worst-case robustly optimized treatment plans for lung cancer. The comparison of the two IMPT optimization strategies focused on the resulting plans' ability to retain dose objectives under the influence of patient set-up, inherent proton range uncertainty, and dose perturbation caused by respiratory motion. Methods: For each of the 9 lung cancer cases two treatment plans were created accounting for treatment uncertainties in two different ways: the first used the conventional Method: delivery of prescribed dose to the planning target volume (PTV) that is geometrically expanded from the internal target volume (ITV). The second employed the worst-case robust optimization scheme that addressed set-up and range uncertainties through beamlet optimization. The plan optimality and plan robustness were calculated and compared. Furthermore, the effects on dose distributions of the changes in patient anatomy due to respiratory motion was investigated for both strategies by comparing the corresponding plan evaluation metrics at the end-inspiration and end-expiration phase and absolute differences between these phases. The mean plan evaluation metrics of the two groups were compared using two-sided paired t-tests. Results: Without respiratory motion considered, we affirmed that worst-case robust optimization is superior to PTV-based conventional optimization in terms of plan robustness and optimality. With respiratory motion considered, robust optimization still leads to more robust dose distributions to respiratory motion for targets and comparable or even better plan optimality [D95% ITV: 96.6% versus 96.1% (p=0.26), D5% - D95% ITV: 10.0% versus 12.3% (p=0.082), D1% spinal cord: 31.8% versus 36.5% (p =0.035)]. Conclusion: Worst-case robust optimization led to superior solutions for lung IMPT. Despite of the fact that robust optimization did not explicitly

Training needs analysis for engineering technicians in Oman

Science.gov (United States)

Al-Mughairi, Abdulkarim Sultan

This thesis examines the transition from the Omani Colleges of Technology (CT) to employment of its engineering graduates. It arises out of concerns that the transition to the labour market for engineering graduate is problematical. The research was carried out to identify the knowledge, skills, and abilities (KSA) of engineering technicians required in the Omani market place. The aim is to provide local curriculum designers in the Colleges of Technology with sufficient information about the required KSA in order to create and enhance the engineering curriculum so that it has greater capacity to meet the needs of a variety of stakeholders and of employers in particular. This in turn has the potential to bridge the gap between what is presently taught and what the workplace demands. Personnel psychologists identify views concerning the skills that are required for different jobs. One of these is based on the assumption that quite different skills are required in different jobs (SCANS, 1990). This view generates approaches within job analysis: the worker-oriented and the task-oriented approaches. This research uses Position Analysis Questionnaire (PAQ), which is a worker-oriented job analysis instrument, to investigate the KSA required to perform some of the engineering technician jobs in Omani industries. In addition, semi-structured interviews were used to investigate the factors that either hinder or entirely prevent the new graduates from Colleges of Technology from being accepted in the workforce pool. The major research findings concern the dimensions of knowledge, skills, and abilities of six engineering technician job titles and the major factors that hinder or (prevent) the technical college graduates from being accepted in the market place in Oman. These findings would definitely help design better transition route and bridge the gap between the CT technicians engineering programmes and the workplace demands.

Comparative impact of AAV and enzyme replacement therapy on respiratory and cardiac function in adult Pompe mice

Directory of Open Access Journals (Sweden)

Darin J Falk

Full Text Available Pompe disease is an autosomal recessive genetic disorder characterized by a deficiency of the enzyme responsible for degradation of lysosomal glycogen (acid α-glucosidase (GAA. Cardiac dysfunction and respiratory muscle weakness are primary features of this disorder. To attenuate the progressive and rapid accumulation of glycogen resulting in cardiorespiratory dysfunction, adult Gaa−/− mice were administered a single systemic injection of rAAV2/9-DES-hGAA (AAV9-DES or bimonthly injections of recombinant human GAA (enzyme replacement therapy (ERT. Assessment of cardiac function and morphology was measured 1 and 3 months after initiation of treatment while whole-body plethysmography and diaphragmatic contractile function was evaluated at 3 months post-treatment in all groups. Gaa−/− animals receiving either AAV9-DES or ERT demonstrated a significant improvement in cardiac function and diaphragmatic contractile function as compared to control animals. AAV9-DES treatment resulted in a significant reduction in cardiac dimension (end diastolic left ventricular mass/gram wet weight; EDMc at 3 months postinjection. Neither AAV nor ERT therapy altered minute ventilation during quiet breathing (eupnea. However, breathing frequency and expiratory time were significantly improved in AAV9-DES animals. These results indicate systemic delivery of either strategy improves cardiac function but AAV9-DES alone improves respiratory parameters at 3 months post-treatment in a murine model of Pompe disease.

Respiratory insufficiency with preserved diaphragmatic function in amyotrophic lateral sclerosis.

Science.gov (United States)

Yamauchi, Rika; Imai, Tomihiro; Tsuda, Emiko; Hozuki, Takayoshi; Yamamoto, Daisuke; Shimohama, Shun

2014-01-01

We performed a longitudinal study to elucidate the correlation between respiratory insufficiency and respiratory biomarkers, including diaphragmatic compound muscle action potential (DCMAP), at the initiation of noninvasive ventilation (NIV) in patients with amyotrophic lateral sclerosis (ALS). The patients were assessed at least every six months. Additional assessments were performed at the start of respiratory therapy when the patients met the criteria for the initiation of NIV. Each assessment consisted of a full neurological examination, a phrenic nerve conduction study, respiratory function tests, and nocturnal pulsed oximetry. We enrolled 43 patients with either definite or probable ALS as defined by the revised El Escorial criteria. The patients were divided into two groups according to the timing of the initiation of respiratory therapy. Seventeen patients (group A) met the criteria for NIV initiation when their DCMAP remained normal. Twenty-six patients (group B) met the criteria when their DCMAP decreased below normal limits. Although respiratory function parameters were significantly worse in group B compared with group A at NIV initiation, more than 80% of the patients in both groups developed nocturnal desaturation during sleep. DCMAP is not always a reliable indicator for determining the optimal timing for NIV initiation during the progression of respiratory insufficiency in ALS. Physicians should be aware of the risk of respiratory insufficiency during sleep in patients with ALS.

THE ROLE OF SCHOOL TECHNICIANS IN PROMOTING SCIENCE THROUGH PRACTICAL WORK

Directory of Open Access Journals (Sweden)

Anne T. Helliar

2011-11-01

Full Text Available This is a review of the role of practical work in UK’s secondary school science lessons, the impact that practical work has in the promotion of science, the challenges created through use of non-specialist science teachers and a possible additional role for science technicians. The paper considers how improved deployment of suitably experienced school science technicians and their recognition, by schools’ management, for their involvement in the delivery of training in the use of practical work, for less experienced teachers, could benefit schools and their students. This together with its companion paper endeavours to show how the more effective use of practical work and technicians can encourage more students to select science at higher, non-compulsory levels.

Metabolic syndrome and occupation: Any association? Prevalence among auto technicians and school teachers in South West Nigeria.

Science.gov (United States)

Akintunde, Adeseye A; Oloyede, Taiwo W

2017-11-01

To determine occupational association with metabolic syndrome among auto technicians and school teachers. One hundred and sixty six subjects were selected for this study. Clinical data was obtained while laboratory investigations including plasma glucose and lipid profile were performed. Statistical analysis was done with SPSS 20.0. Pauto technicians. Mean serum triglycerides was significantly higher among auto-technicians compared to school teachers in this study. The prevalence of some conventional cardiovascular risk factors was significantly higher among auto-technicians compared to school teachers: Impaired blood glucose (9.6% vs. 1.2%, pauto-technicians. Based on the WHO and the Harmonized criteria, metabolic syndrome was more frequent among auto-technicians compared to school teachers. (8.4% vs. 1.2% and 19.3% vs. 7.2% respectively, pauto technicians despite their high level of physical activity, exertion and education compared to teachers. This may be related to the increased occupational exposure to organic and inorganic materials from dust particles, oil and oil related matter and particulate matter among auto technicians. Prompt definitive evaluation of this concept and appropriate health education to encourage safety mechanism can reduce this burden of metabolic syndrome among auto technicians in Nigeria. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Survey on the use of CAD-CAM technology by UK and Irish dental technicians.

Science.gov (United States)

Blackwell, E; Nesbit, M; Petridis, H

2017-05-12

Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dental technicians' use and reporting of this technology.Purpose The aim of this cross sectional survey was to identify the extent digital technology has infiltrated the workplace and to investigate the factors affecting the use of CAD-CAM technology by dental laboratory technicians within Ireland and the UK.Materials and methods A web-based questionnaire was composed (Opinio, Object Planet Inc. Oslo, Norway) and distributed to UK and Irish dental technicians. Answers to all questions were anonymous and grouped such that general information was gathered initially, followed by branching of the survey into two sections depending on whether or not the respondent worked with CAD-CAM technology. Results were compiled and statistical analysis (Fisher's Exact test, SPSS, IBM, Armonk, New York, USA) was performed in order to investigate any correlation between various demographic variables and the answers provided.Results The survey was distributed to 760 UK technicians and 77 Irish technicians. The total number of completed surveys was 105, which yielded a total response rate of 14%. Most technicians reported using some form of CAD/CAM aspect in the workflow, and this was more significant for technicians working in large laboratories. Most training received was company-led. Large laboratories were also significantly correlated with less outsourcing of CAD/CAM work and a change in dental material use leading to the increase of zirconia and the decrease of noble alloys. Dental technicians did not report any significant change in working relationships and staffing as a result of CAD/CAM incorporation. High initial investment cost was the most common reason quoted from non-users, along with the lack of such technology in their working environment.

Recovery Act: Training Program Development for Commercial Building Equipment Technicians

Energy Technology Data Exchange (ETDEWEB)

Leah Glameyer

2012-07-12

The overall goal of this project has been to develop curricula, certification requirements, and accreditation standards for training on energy efficient practices and technologies for commercial building technicians. These training products will advance industry expertise towards net-zero energy commercial building goals and will result in a substantial reduction in energy use. The ultimate objective is to develop a workforce that can bring existing commercial buildings up to their energy performance potential and ensure that new commercial buildings do not fall below their expected optimal level of performance. Commercial building equipment technicians participating in this training program will learn how to best operate commercial buildings to ensure they reach their expected energy performance level. The training is a combination of classroom, online and on-site lessons. The Texas Engineering Extension Service (TEEX) developed curricula using subject matter and adult learning experts to ensure the training meets certification requirements and accreditation standards for training these technicians. The training targets a specific climate zone to meets the needs, specialized expertise, and perspectives of the commercial building equipment technicians in that zone. The combination of efficient operations and advanced design will improve the internal built environment of a commercial building by increasing comfort and safety, while reducing energy use and environmental impact. Properly trained technicians will ensure equipment operates at design specifications. A second impact is a more highly trained workforce that is better equipped to obtain employment. Organizations that contributed to the development of the training program include TEEX and the Texas Engineering Experiment Station (TEES) (both members of The Texas A&M University System). TEES is also a member of the Building Commissioning Association. This report includes a description of the project

Macrolide therapy is associated with reduced mortality in acute respiratory distress syndrome (ARDS) patients

Science.gov (United States)

de Iudicibus, Gianfranco; Cremer, Olaf L.; Ong, David S. Y.; van der Poll, Tom; Bos, Lieuwe D.; Schultz, Marcus J.

2018-01-01

Background Macrolides have been associated with favorable immunological effects in various inflammatory disease states. We investigated the association between macrolide therapy and mortality in patients with the acute respiratory distress syndrome (ARDS). Methods This was an unplanned secondary analysis of patients with ARDS within a large prospective observational study of critically ill patients in the intensive care units (ICUs) of two university-affiliated hospitals in the Netherlands. The exposure of interest was low-dose macrolide use prescribed for another reason than infection; we excluded patients who received high-dose macrolides for an infection. The primary endpoint was 30-day mortality. The association between macrolide therapy and mortality was determined in the whole cohort, as well as in a propensity score matched cohort; the association was compared between pulmonary versus non-pulmonary ARDS, and between two biological phenotypes based on plasma levels of 20 biomarkers. Results In total, 873 patients with ARDS were analyzed, of whom 158 patients (18%) received macrolide therapy during stay in ICU for a median duration of 3 (interquartile range, 1–4) days. Erythromycin was the most frequent prescribed macrolide (97%). Macrolide therapy was associated with reduced 30-day mortality in the whole cohort [22.8% vs. 31.6%; crude odds ratio (OR), 0.64 (interquartile range, 0.43–0.96), P=0.03]. The association in the propensity score matched cohort remained significant [22.8% vs. 32.9%; OR, 0.62 (interquartile range, 0.39–0.96), P=0.03]. Propensity matched associations with mortality were different in patients with non-pulmonary ARDS vs. pulmonary ARDS and also varied by biological phenotype. Conclusions These data together show that low-dose macrolide therapy prescribed for another reason than infection is associated with decreased mortality in patients with ARDS. PMID:29430441

Macrolide therapy is associated with reduced mortality in acute respiratory distress syndrome (ARDS) patients.

Science.gov (United States)

Simonis, Fabienne D; de Iudicibus, Gianfranco; Cremer, Olaf L; Ong, David S Y; van der Poll, Tom; Bos, Lieuwe D; Schultz, Marcus J

2018-01-01

Macrolides have been associated with favorable immunological effects in various inflammatory disease states. We investigated the association between macrolide therapy and mortality in patients with the acute respiratory distress syndrome (ARDS). This was an unplanned secondary analysis of patients with ARDS within a large prospective observational study of critically ill patients in the intensive care units (ICUs) of two university-affiliated hospitals in the Netherlands. The exposure of interest was low-dose macrolide use prescribed for another reason than infection; we excluded patients who received high-dose macrolides for an infection. The primary endpoint was 30-day mortality. The association between macrolide therapy and mortality was determined in the whole cohort, as well as in a propensity score matched cohort; the association was compared between pulmonary versus non-pulmonary ARDS, and between two biological phenotypes based on plasma levels of 20 biomarkers. In total, 873 patients with ARDS were analyzed, of whom 158 patients (18%) received macrolide therapy during stay in ICU for a median duration of 3 (interquartile range, 1-4) days. Erythromycin was the most frequent prescribed macrolide (97%). Macrolide therapy was associated with reduced 30-day mortality in the whole cohort [22.8% vs. 31.6%; crude odds ratio (OR), 0.64 (interquartile range, 0.43-0.96), P=0.03]. The association in the propensity score matched cohort remained significant [22.8% vs. 32.9%; OR, 0.62 (interquartile range, 0.39-0.96), P=0.03]. Propensity matched associations with mortality were different in patients with non-pulmonary ARDS vs. pulmonary ARDS and also varied by biological phenotype. These data together show that low-dose macrolide therapy prescribed for another reason than infection is associated with decreased mortality in patients with ARDS.

Respiratory gating based on internal electromagnetic motion monitoring during stereotactic liver radiation therapy: First results.

Science.gov (United States)

Poulsen, Per Rugaard; Worm, Esben Schjødt; Hansen, Rune; Larsen, Lars Peter; Grau, Cai; Høyer, Morten

2015-01-01

Intrafraction motion may compromise the target dose in stereotactic body radiation therapy (SBRT) of tumors in the liver. Respiratory gating can improve the treatment delivery, but gating based on an external surrogate signal may be inaccurate. This is the first paper reporting on respiratory gating based on internal electromagnetic monitoring during liver SBRT. Two patients with solitary liver metastases were treated with respiratory-gated SBRT guided by three implanted electromagnetic transponders. The treatment was delivered in end-exhale with beam-on when the centroid of the three transponders deviated less than 3 mm [left-right (LR) and anterior-posterior (AP) directions] and 4mm [cranio-caudal (CC)] from the planned position. For each treatment fraction, log files were used to determine the transponder motion during beam-on in the actual gated treatments and in simulated treatments without gating. The motion was used to reconstruct the dose to the clinical target volume (CTV) with and without gating. The reduction in D95 (minimum dose to 95% of the CTV) relative to the plan was calculated for both treatment courses. With gating the maximum course mean (standard deviation) geometrical error in any direction was 1.2 mm (1.8 mm). Without gating the course mean error would mainly increase for Patient 1 [to -2.8 mm (1.6 mm) (LR), 7.1 mm (5.8 mm) (CC), -2.6 mm (2.8mm) (AP)] due to a large systematic cranial baseline drift at each fraction. The errors without gating increased only slightly for Patient 2. The reduction in CTV D95 was 0.5% (gating) and 12.1% (non-gating) for Patient 1 and 0.3% (gating) and 1.7% (non-gating) for Patient 2. The mean duty cycle was 55%. Respiratory gating based on internal electromagnetic motion monitoring was performed for two liver SBRT patients. The gating added robustness to the dose delivery and ensured a high CTV dose even in the presence of large intrafraction motion.

An in-depth examination into pharmacy technician worklife through an organizational behavior framework.

Science.gov (United States)

Desselle, Shane P

2016-01-01

Pharmacy technicians are a vital part of the health care workforce. Little is known about perceptions of their own work environment that would engender more effective recruitment, retention, and management strategies by pharmacists and employers. The purpose of this study was to gain a greater understanding of certified pharmacy technician worklife. Specific objectives included the identification of themes of worklife phenomena to assist with the development of appropriate responses by other pharmacy stakeholders and to ascertain the contribution of various factors engendering or discouraging career commitment of pharmacy technicians. Semi-structured in-depth interviews were carried out with a convenience sample of pharmacy technicians in one U.S. state, who varied by their work settings and level of experience. The interview guide and corresponding participant responses were framed from around an organizational cultural basis rooted in organizational behavior theory. Notes from the interviews were analyzed thematically using directed content analysis. Four primary themes emerged, including: career impetus, job responsibilities, quality of work life, and equitable partnership. The data revealed pharmacy technicians' need for self-actualization and recognition of the value they bring to the organization. The participants identified primary responsibilities that contribute to their sense of worth and those that if not managed adequately potentially detract from their well-being and effectiveness. Findings in regard to rate of pay corroborate previous work on wages as both an intrinsic and extrinsic motivator. Pharmacy technicians seek equity among each other (their peers) and in a mutually beneficial relationship with their employing organization. This study provides the impetus for interventions and further study that should serve to enhance pharmacy technician effectiveness, quality of work life, and longevity in an emerging profession. Copyright © 2015 Elsevier

[Competencies in the education of nursing technicians to implement the nursing care systematization].

Science.gov (United States)

da Cruz, Andrea de Mello Pereira; Almeida, Miriam de Abreu

2010-12-01

This is a qualitative, exploratory and descriptive study whose general objective was to learn, considering the perspective of the nursing technician who works in school hospitals, the competencies developed during their educational process to implement the Nursing Care Systematization (NCS). Data collection and analysis were carried out through a focal group, with content analysis and nursing technicians. Two thematic categories emerged: The participation of the nursing technician in the NCS and The competencies in the education of the nursing technician. Each one received two subcategories: Conception of the NCS and (De)valuation of the NCS, Technical-scientific competency and Competency in the interpersonal relationship, respectively. It was observed that the NCS must be shared, discussed and made public among nursing professionals, so that they may acknowledge themselves as the leading actors of their methodology and be aware that their practices determine the results.

SMART phones and the acute respiratory patient.

LENUS (Irish Health Repository)

Gleeson, L

2012-05-01

Definition of Respiratory Failure using PaO2 alone is confounded when patients are commenced on oxygen therapy prior to arterial blood gas (ABG) measurement. Furthermore, classification of Respiratory Failure as Type 1 or Type 2 using PaCO2 alone can give an inaccurate account of events as both types can co-exist. 100 consecutive presentations of acute respiratory distress were assessed initially using PaO2, and subsequently PaO2\\/FiO2 ratio, to diagnose Respiratory Failure. Respiratory Failure cases were classified as Type 1 or Type 2 initially using PaCO2, and subsequently alveolar-arterial (A-a) gradient. Any resultant change in management was documented. Of 100 presentations, an additional 16 cases were diagnosed as Respiratory Failure using PaO2\\/FiO2 ratio in place of PaO2 alone (p = 0.0338). Of 57 cases of Respiratory Failure, 22 cases classified as Type 2 using PaCO2 alone were reclassified as Type 1 using A-a gradient (p < 0.001). Of these 22 cases, management changed in 18.

DNA damage and cytotoxicity in pathology laboratory technicians exposed to organic solvents

Directory of Open Access Journals (Sweden)

TATIANE DE AQUINO

2016-03-01

Full Text Available The aim of this study was to evaluate potential DNA damage and cytotoxicity in pathology laboratory technicians exposed to organic solvents, mainly xylene. Peripheral blood and buccal cells samples were collected from 18 technicians occupationally exposed to organic solvents and 11 non-exposed individuals. The technicians were sampled at two moments: Monday and Friday. DNA damage and cytotoxicity were evaluated using the Comet Assay and the Buccal Micronucleus Cytome assay. Fifteen subjects (83.5% of the exposed group to solvents complained about some symptom probably related to contact with vapours of organic solvents. DNA damage in the exposed group to solvents was nearly 2-fold higher on Friday than on Monday, and in both moments the individuals of this group showed higher levels of DNA damage in relation to controls. No statistical difference was detected in buccal cell micronucleus frequency between the laboratory technicians and the control group. However, in the analysis performed on Friday, technicians presented higher frequency (about 3-fold of karyolytic and apoptotic-like cells (karyorrhectic and pyknotic in relation to control group. Considering the damage frequency and the working time, a positive correlation was found in the exposed group to solvents (r=0.468; p=0.05. The results suggest that pathology laboratory workers inappropriately exposed to organic solvents have increased levels of DNA damage.

Section 609 Technician Training and Certification Programs

Science.gov (United States)

EPA-approved programs for technicians who service motor vehicle air conditioning (MVAC) systems. Any person who repairs or services a MVAC system for consideration must be certified under section 609 of the Clean Air Act by an EPA-approved program.

Changing Roles of Librarians and Library Technicians

Directory of Open Access Journals (Sweden)

Norene James

2015-10-01

Full Text Available What significant changes are librarians and library technicians experiencing in their roles? A survey put forward across Canada to librarians and library technicians addressing this question was conducted in February 2014. Eight hundred eighty-two responses were obtained from librarians, defined as MLIS graduates, and library technicians, defined as graduates from a two-year library diploma program. Respondents needed to have been employed in the last two years in these roles and students of either an MLIS or LIT program were also welcome to participate. The results suggest that both librarians and library technicians perceive their roles as growing in scope and complexity and that the lines of responsibility are blurring. A majority of respondents indicated that they perceive a change in their roles in the past five years and commented on what the perceived changes were. Librarian and library technician roles may be shifting away from what may be viewed as traditional or clearly defined responsibilities and both librarians and library technicians may be taking on new tasks as well as experiencing task overlap. All library staff will need to be fluid, adaptable, and open to change. Library school curricula and workplace training need to incorporate the development of these competencies. Quels sont les changements importants éprouvés par les bibliothécaires et les bibliotechniciens dans leurs rôles? Un sondage mené en février de 2014 a posé cette question aux bibliothécaires et aux bibliotechniciens dans tout le Canada. On a reçu huit-cent quatre-vingt-deux réponses des bibliothécaires, définis comme étant diplômés en MSIB, et les bibliotechniciens, définis comme étant diplômés d’un programme de deux ans en bibliotechnique. Les sondés devaient avoir travaillé au cours des deux dernières années dans ces fonctions et les étudiants d’un programme MSIB ou de bibliothéconomie/ sciences de l’information pouvaient aussi y

Management of the baseline shift using a new and simple method for respiratory-gated radiation therapy: Detectability and effectiveness of a flexible monitoring system

International Nuclear Information System (INIS)

Tachibana, Hidenobu; Kitamura, Nozomi; Ito, Yasushi; Kawai, Daisuke; Nakajima, Masaru; Tsuda, Akihisa; Shiizuka, Hisao

2011-01-01

Purpose: In respiratory-gated radiation therapy, a baseline shift decreases the accuracy of target coverage and organs at risk (OAR) sparing. The effectiveness of audio-feedback and audio-visual feedback in correcting the baseline shift in the breathing pattern of the patient has been demonstrated previously. However, the baseline shift derived from the intrafraction motion of the patient's body cannot be corrected by these methods. In the present study, the authors designed and developed a simple and flexible system. Methods: The system consisted of a web camera and a computer running our in-house software. The in-house software was adapted to template matching and also to no preimage processing. The system was capable of monitoring the baseline shift in the intrafraction motion of the patient's body. Another marker box was used to monitor the baseline shift due to the flexible setups required of a marker box for gated signals. The system accuracy was evaluated by employing a respiratory motion phantom and was found to be within AAPM Task Group 142 tolerance (positional accuracy <2 mm and temporal accuracy <100 ms) for respiratory-gated radiation therapy. Additionally, the effectiveness of this flexible and independent system in gated treatment was investigated in healthy volunteers, in terms of the results from the differences in the baseline shift detectable between the marker positions, which the authors evaluated statistically. Results: The movement of the marker on the sternum [1.599 ± 0.622 mm (1 SD)] was substantially decreased as compared with the abdomen [6.547 ± 0.962 mm (1 SD)]. Additionally, in all of the volunteers, the baseline shifts for the sternum [-0.136 ± 0.868 (2 SD)] were in better agreement with the nominal baseline shifts than was the case for the abdomen [-0.722 ± 1.56 mm (2 SD)]. The baseline shifts could be accurately measured and detected using the monitoring system, which could acquire the movement of the marker on the sternum. The

Factors affecting responses of infants with respiratory distress syndrome to exogenous surfactant therapy.

Science.gov (United States)

Ho, N K

1993-02-01

Approximately 20% to 30% of infants with respiratory distress syndrome (RDS) do not respond to surfactant replacement therapy. Unfortunately there is no uniform definition of 'response' or 'non-response' to surfactant therapy. Response was based on improvement in a/A PO2 and/or mean airway pressure (MAP) by some and on improvement in FIO2 and/or MAP by others. Even the point of time at which evaluation of response was done is different in various reports. There is an urgent need to adopt an uniform definition. Most premature babies are surfactant deficient which is the aetiological factor of RDS. Generally good antenatal care and perinatal management are essential in avoidance of premature birth. Babies with lung hypoplasia and who are extremely premature (less than 24 weeks of gestation) do not respond well to exogenous surfactant replacement because of structural immaturity. Prompt management of asphyxiated birth and shock are necessary as there may be negative response to surfactant replacement. Foetal exposure to glucocorticoids improves responsiveness to postnatal administration of surfactant. Antenatal steroid therapy has become an important part of management of RDS with surfactant replacement. The premature lungs with high alveolar permeability tend to develop pulmonary oedema. With the presence of plasma-derived surfactant inhibitors, the response to exogenous surfactant may be affected. These inhibitors may also be released following ventilator barotrauma. The standard of neonatal intensive care such as ventilatory techniques has an important bearing on the outcome of the RDS babies.(ABSTRACT TRUNCATED AT 250 WORDS)

High flow nasal cannula oxygen therapy, work in progress in respiratory critical care.

Science.gov (United States)

Schreiber, Annia; DI Marco, Fabiano; Braido, Fulvio; Solidoro, Paolo

2016-12-01

After a planned extubation, the re-occurrence of acute respiratory distress needing the restoration of invasive mechanical support is a severe phenomenon associated with several important consequences, including increased morbidity, Intensive Care Unit mortality, and an enormous financial burden. So far, the most commonly used techniques to ameliorate gas exchange in the postextubation period were low-flow oxygen therapy and non-invasive ventilation (NIV). High flows through nasal cannulae (HFNC) is a system which allows increased CO2 wash-out of anatomical dead space, positive nasopharyngeal pressure, a relatively constant FiO2, and an improvement of mucociliary function. In a recently published paper by Hernandez et al. HFNC therapy, compared in the postextubation period to standard oxygen in patients at low risk of re-intubation, was associated with a lower re-intubation rate within 72 hours of extubation, with no evidence of any delays in re-intubation which may prove fatal, as previously reported in the context of NIV. Despite yielding some useful starting points and positive results with HFNC, some discrepancies have emerged in the findings of the studies in this field. As we await further more homogeneous and enlightening studies, at present we can only affirm that HFNC seems to be a useful means to prevent and treat postextubation hypoxemia. In fact no harmful or adverse effects related to HFNC emerged in any of the studies and globally, it was associated with better comfort and tolerance compared with NIV, which justifies its use as a first alternative to standard oxygen therapy.

The relation between respiratory motion artifact correction and lung standardized uptake value

International Nuclear Information System (INIS)

Yin Lijie; Liu Xiaojian; Liu Jie; Xu Rui; Yan Jue

2014-01-01

PET/CT is playing an important role in disease diagnosis and therapeutic evaluation. But the respiratory motion artifact may bring trouble in diagnosis and therapy. There are many methods to correct the respiratory motion artifact. Respiratory gated PET/CT is applied most extensively of them. Using respiratory gated PET/CT to correct respiratory motion artifact can increase the maximum standardized uptake value of lung lesion obviously, thereby improving the quality of image and accuracy of diagnosis. (authors)

Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation.

Science.gov (United States)

Boughen, Melanie; Sutton, Jane; Fenn, Tess; Wright, David

2017-07-15

Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Following ethical approval and piloting, an online survey to ascertain pharmacy technicians' views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles.

Airway Reflux, Cough and Respiratory Disease

Science.gov (United States)

Molyneux, Ian D.; Morice, Alyn H.

2011-01-01

It is increasingly accepted that the effects of gastro-oesophageal reflux are not limited to the gastrointestinal tract. The adjacent respiratory structures are also at risk from material ejected from the proximal oesophagus as a result of the failure of anatomical and physiological barriers. There is evidence of the influence of reflux on several respiratory and otorhinological conditions and although in many cases the precise mechanism has yet to be elucidated, the association alone opens potential novel avenues of therapy to clinicians struggling to treat patients with apparently intractable respiratory complaints. This review provides a description of the airway reflux syndrome, its effects on the lung and current and future therapeutic options. PMID:23251752

A WIDER ROLE FOR TECHNICIANS IN SCIENCE PRACTICAL WORK WITH SCHOOL STUDENTS?

Directory of Open Access Journals (Sweden)

Timothy G. Harrison

2011-12-01

Full Text Available This paper reports the results of a study made on the impact of improved deployment of science technicians in the classroom could directly benefit students in practical science investigations. Science technicians are skilled individuals whose understanding of practical work is a valuable resource not being used of in support of students understanding of science. Aspects of practical work and technician support were scrutinised, through information attained from a post-16 student survey to improve understanding about this teaching tool, to establish if it was being used to its full potential within science lessons. Analysis was also made of students’ perceptions of school science. The main outcomes were that the majority of students enjoyed science practical work and felt that science could not be taught without it. Students studying science at pre-university level attained a greater understanding, through participating in relevant practical work, than students who had studied it at earlier, compulsory levels. Students reported that science technicians provide impact on student learning when contact time was the greatest.

Pulmonary Foreign Body Granulomatosis in Dental Technician.

Science.gov (United States)

Chung, Sung Jun; Koo, Gun Woo; Park, Dong Won; Kwak, Hyun Jung; Yhi, Ji Young; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Pyo, Ju Yeon; Oh, Young-Ha; Kim, Tae-Hyung

2015-10-01

Occupational lung diseases are caused by several toxic substances including heavy metals; however, the exact pathologic mechanisms remain unknown. In the workplace, dental technicians are often exposed to heavy metals such as cobalt, nickel, or beryllium and occasionally develop occupational lung diseases. We described a case of occupational lung disease in a patient who was employed as a dental technician for over a decade. A 31-year-old, non-smoking woman presented with productive cough and shortness of breath of several weeks duration. Chest computed tomography revealed a large number of scattered, bilateral small pulmonary nodules throughout the lung field, and multiple mediastinal lymph nodes enlargement. Percutaneous needle biopsy showed multifocal small granulomas with foreign body type giant cells suggestive of heavy metals inhalation. The patient's condition improved on simple avoidance strategy for several months. This case highlighted the importance of proper workplace safety.

Community Respiratory Viruses as a Cause of Lower Respiratory Tract Infections Following Suppressive Chemotherapy in Cancer Patients

International Nuclear Information System (INIS)

El-Mahallawy, H.A.; Ibrahim, M.H.; Shalaby, L.; Kandil

2005-01-01

Community respiratory viruses are an important cause of respiratory disease in the immunocompromised patients with cancer. To evaluate the occurrence and clinical significance of respiratory virus infections in hospitalized cancer patients at National Cancer Institute, Cairo University, during anticancer treatment, we studied cases that developed episodes of lower respiratory tract infections (LRTI). Patients and Methods: Thirty patients with LRTI were studied clinically, radiologically, and microbiologically. Sputum cultures were done and an immunofluorescence search for IgM antibodies of influenza A and B, parainfluenza serotypes 1,2 and 3, adenovirus, respiratory syncytial virus, Legionella pneumophila, Coxiella burnettii, Chlamydia pneumoniae, and Mycoplasma pneumoniae were performed on serum samples of patients. The main presenting symptom was cough and expectoration. Hematologic malignancy was the underlying disease in 86.6% of cases. Blood cultures were positive in II patients (36.6%) only. Sputum cultures revealed a bacterial pathogen in [3 cases and fungi in 3; whereas viral and atypical bacterial lgM antibodies were detected in 13 and 4 patients; respectively. Influenza virus was the commonest virus detected, being of type B in 4 cases, type A in one case and mixed A and B in another 5 cases; followed by RSV in 5 patients. Taken together, bacteria were identified as a single cause of LRTI in 10 cases, viruses in 6, fungi in 3 and mixed causes in 7. Still, there were 4 undiagnosed cases. This study showed that respiratory viruses are common in LRTI, either as a single cause or mixed with bacterial pathogens. in hospitalized cancer patients receiving chemotherapy. Diagnostic tests for respiratory viruses should be incorporated in the routine diagnostic study of patients with hematologic malignancies. Also, it must be emphasized that early CT chest is crucial as a base-line prior to initiation of anti-fungal or anti-viral therapy. In cancer patients with a

Investigating laparoscopic psychomotor skills in veterinarians and veterinary technicians.

Science.gov (United States)

Kilkenny, Jessica; Santarossa, Amanda; Mrotz, Victoria; Walker, Meagan; Monaghan, Dominique; Singh, Ameet

2017-04-01

To determine the influence of age, year of graduation, and video game experience on baseline laparoscopic psychomotor skills. Cross-sectional. Licensed veterinarians (n = 38) and registered veterinary technicians (VTs) (n = 49). A laparoscopic box trainer was set up at the 2016 Ontario Veterinary Medical Association (OVMA) and the 2016 Ontario Association of Veterinary Technicians (OAVT) conferences held in Toronto, Ontario, Canada. Participants volunteered to perform a single repetition of a peg transfer (PT) exercise. Participants were given a short demonstration of the PT task prior to testing. A Spearman's rank correlation (r s ) was used to identify associations between baseline psychomotor skills and self-reported surgical and non-surgical experiences collected via survey. Mann-Whitney U tests were used to compare PT scores in veterinarians and VTs. A P-value of  .05). Veterinary technicians that frequently used chopsticks scored higher than those without chopstick experience (P = .04). Age and year of graduation correlated inversely, while self-reported VG experience correlated positively with laparoscopic psychomotor skills of veterinarians, when assessed on a simulator. The use of chopsticks may contribute to the acquisition of psychomotor skills in VTs. © 2017 The American College of Veterinary Surgeons.

Staphylococcus aureus with Panton-Valentine toxin skin infection in a medical laboratory technician.

Science.gov (United States)

Pougnet, Richard; Pougnet, Laurence

2016-12-01

This report exposes the case of a Staphylococcus aureus infection occurring in a microbiology laboratory technician. He was a 52 year-old man without medical history. He presented an abscess on the anterior aspect of the left forearm. Analysis showed that it was a Staphylococcus aureus secreting the Panton-Valentine toxin. The study of the workplace found the frequency of exposure. The study of workstation showed the link between the technician position and the infection. Indeed, this man touched an area where the biocleaning was hard to do. This is the first case of infection with PVL described for a laboratory technician.

Role of the chemical engineering technician in applied research related to tritium separation from aqueous effluents

International Nuclear Information System (INIS)

Nelson, S.D.

1978-01-01

Applied research and development activities related to the removal of tritium from aqueous effluent streams have presented broad opportunities to the chemical engineering technician for professional growth. Technician job activities involve operating complex analytical instrumentation and constructing, maintaining, and operating experimental electrolysis apparatus. The technician is a member of a professional team including scientific, engineering, and other technical personnel and as such is expected to exercise creative thought. Proximity of a large university and availability of formalized ''in house'' training courses provide incentives for technicians to broaden their academic base concurrent with their work involvement

Fuzzy hybrid MCDM approach for selection of wind turbine service technicians

Directory of Open Access Journals (Sweden)

Goutam Kumar Bose

2016-01-01

Full Text Available This research paper is aimed to present a fuzzy Hybrid Multi-criteria decision making (MCDM methodology for selecting employees. The present study aspires to present the hybrid approach of Fuzzy multiple MCDM techniques with tactical viewpoint to support the recruitment process of wind turbine service technicians. The methodology is based on the application of Fuzzy ARAS (Additive Ratio Assessment and Fuzzy MOORA (Multi-Objective Optimization on basis of Ratio Analysis which are integrated through group decision making (GDM method in the model for selection of wind turbine service technicians’ ranking. Here a group of experts from different fields of expertise are engaged to finalize the decision. Series of tests are conducted regarding physical fitness, technical written test, practical test along with general interview and medical examination to facilitate the final selection using the above techniques. In contrast to single decision making approaches, the proposed group decision making model efficiently supports the wind turbine service technicians ranking process. The effectiveness of the proposed approach manifest from the case study of service technicians required for the maintenance department of wind power plant using Fuzzy ARAS and Fuzzy MOORA. This set of potential technicians is evaluated based on five main criteria.

The enforcement regulation for the law for radiation technicians engaging in medical treatment

International Nuclear Information System (INIS)

1985-01-01

The ordinance is set up under the provisions of the law concerning radiation and x-ray technicians engaging in medical treatment, to enforce it. An application for the license of such a technician shall be filed according to the form prescribed, attached with a copy or an abstract of the census register of the applicant and a medical certificate of a doctor concerning whether the applicant is an insane, deaf or blind person, or a case of epidemic. The membership registration of such a technician shall include the number and date of the registration, the prefecture of his legal domicile, name birth date and sex distinction, the year and month of his success in the examination for such technicains, the items concerning the cancellation of the license or the suspension of the business, etc. The subjects of the examination for such technicians are physics, radiological physics, electrical engineering, chemistry, general basic medical science, radiological biology, photographing technology, treatment technics and others. An application for the examination for such technicians shall be filed to the Minister of Health and Welfare, attached with a personal history, a study certificate or a diploma of graduation, a photograph of the applicant and other specified documents. (Kubozono, M.)

Hypoxemic Respiratory Failure from Acute Respiratory Distress Syndrome Secondary to Leptospirosis

Directory of Open Access Journals (Sweden)

Shannon M. Fernando

2017-01-01

Full Text Available Acute respiratory distress syndrome (ARDS, characterized by hypoxemic respiratory failure, is associated with a mortality of 30–50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU admission. The most common precipitant is community-acquired bacterial pneumonia, but other putative pathogens include viruses and fungi. On rare occasions, ARDS can be secondary to tropical disease. Accordingly, a history should include travel to endemic regions. Leptospirosis is a zoonotic disease most common in the tropics and typically associated with mild pulmonary complications. We describe a case of a 25-year-old male with undiagnosed leptospirosis, presenting with fever and severe hypoxemic respiratory failure, returning from a Costa Rican holiday. There was no other organ failure. He was intubated and received lung protective ventilation. His condition improved after ampicillin and penicillin G were added empirically. This case illustrates the rare complication of ARDS from leptospirosis, the importance of taking a travel history, and the need for empiric therapy because of diagnostic delay.

So You Want to Train Solar Technicians.

Science.gov (United States)

Ensign, M. Dale; Richins, Michael Paul

1978-01-01

Considers the role of solar energy in meeting the nation's energy requirements and the future needs for solar technicians and mechanics. Discusses the precautions community colleges must take in training these workers, to ensure that the demand be met without flooding the job market. (MB)

Hypnosis in paediatric respiratory medicine.

Science.gov (United States)

McBride, Joshua J; Vlieger, Arine M; Anbar, Ran D

2014-03-01

Hypnotherapy is an often misunderstood yet effective therapy. It has been reported to be useful within the field of paediatric respiratory medicine as both a primary and an adjunctive therapy. This article gives a brief overview of how hypnotherapy is performed followed by a review of its applications in paediatric patients with asthma, cystic fibrosis, dyspnea, habit cough, vocal cord dysfunction, and those requiring non-invasive positive pressure ventilation. As the available literature is comprised mostly of case series, retrospective studies, and only a single small randomized study, the field would be strengthened by additional randomized, controlled trials in order to better establish the effectiveness of hypnosis as a treatment, and to identify the processes leading to hypnosis-induced physiologic changes. As examples of the utility of hypnosis and how it can be taught to children with respiratory disease, the article includes videos that demonstrate its use for patients with cystic fibrosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Vitamin D and respiratory disorder

Directory of Open Access Journals (Sweden)

Mahnaz Hushmand

2015-09-01

Full Text Available The active form of vitamin D is synthesized in some body organs following sun exposure and dietary intake. Vitamin D exhibits its major and critical effects not only through regulation of calcium and phosphate metabolism but also by influencing on respiratory and immune system. Serum concentrations of 25-hydroxyvitamin D below the optimum limit lead to vitamin D insufficiency or maybe deficiency. These inappropriate concentrations of vitamin D lead to different types of pulmonary diseases such as viral and bacterial respiratory infection, asthma, chronic obstructive pulmonary disease, and cancer. In this review we described the association between vitamin D deficiency and severe therapy resistant asthma. We also reviewed the underlying molecular mechanism of vitamin D deficiency in children with severe- therapy resistant asthma. Based on current information, future clinical trial are needed to study the role of vitamin D supplementation on different groups of patients with severe asthma including infants, children of school age, and ethnic minorities.

Respiratory Therapy for Acute Lung Lesion, by Using Biphasic Positive Pressure Ventilation

Directory of Open Access Journals (Sweden)

Yu. V. Marchenkov

2005-01-01

Full Text Available Objective. To comparatively study the efficiency of respiratory support in patients with acute lung lesion, by applying BIPAP, SIMV, and aIPPV.Subjects. Twenty-six patients with acute lung lesion whose pattern included acute respiratory distress syndrome (n=16, pneumonia (и=6, and pneumonitis (n=4 were examined. The severity of disease was 18 to 21 APACHE II scale score.Results. The use of BIPAP leads to a better adaptation of a patient to respiratory support, to a reduction in the number of used myorelaxants and sedatives, and to improvement of gas exchange in the lung and diminishes the negative impact of artificial ventilation on hemodynamics. As compared with other types of assisted ventilation, BIPAP accelerates transfer from total respiratory support to spontaneous breathing.

Accuracy of densitometric vertebral fracture assessment when performed by DXA technicians-a cross-sectional, multiobserver study

DEFF Research Database (Denmark)

Rud, B; Vestergaard, A; Hyldstrup, L

2016-01-01

Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two radiolog......Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two...... radiologists. Three DXA technicians performed acceptable or better in identifying patients with fractured vertebrae. INTRODUCTION: This is the first study to evaluate the accuracy of vertebral fracture assessment (VFA) when used by DXA technicians as a triage test to select patients with deformed vertebrae...... for spinal radiographs. METHODS: Lateral single-energy scans and radiographs of the thoracolumbar spine (T4-L4) were acquired in 235 patients aged 65 years or more referred for osteoporosis assessment. Six DXA technicians evaluated lateral scans using dedicated software. The DXA technicians were trained...

Critically Ill Patients With the Middle East Respiratory Syndrome: A Multicenter Retrospective Cohort Study.

Science.gov (United States)

Arabi, Yaseen M; Al-Omari, Awad; Mandourah, Yasser; Al-Hameed, Fahad; Sindi, Anees A; Alraddadi, Basem; Shalhoub, Sarah; Almotairi, Abdullah; Al Khatib, Kasim; Abdulmomen, Ahmed; Qushmaq, Ismael; Mady, Ahmed; Solaiman, Othman; Al-Aithan, Abdulsalam M; Al-Raddadi, Rajaa; Ragab, Ahmed; Al Mekhlafi, Ghaleb A; Al Harthy, Abdulrahman; Kharaba, Ayman; Ahmadi, Mashael Al; Sadat, Musharaf; Mutairi, Hanan Al; Qasim, Eman Al; Jose, Jesna; Nasim, Maliha; Al-Dawood, Abdulaziz; Merson, Laura; Fowler, Robert; Hayden, Frederick G; Balkhy, Hanan H

2017-10-01

To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. Retrospective cohort study. Patients admitted to ICUs in 14 Saudi Arabian hospitals. Critically ill patients with laboratory-confirmed Middle East respiratory syndrome severe acute respiratory infection (n = 330) admitted between September 2012 and October 2015 were compared to consecutive critically ill patients with community-acquired severe acute respiratory infection of non-Middle East respiratory syndrome etiology (non-Middle East respiratory syndrome severe acute respiratory infection) (n = 222). None. Although Middle East respiratory syndrome severe acute respiratory infection patients were younger than those with non-Middle East respiratory syndrome severe acute respiratory infection (median [quartile 1, quartile 3] 58 yr [44, 69] vs 70 [52, 78]; p < 0.001), clinical presentations and comorbidities overlapped substantially. Patients with Middle East respiratory syndrome severe acute respiratory infection had more severe hypoxemic respiratory failure (PaO2/FIO2: 106 [66, 160] vs 176 [104, 252]; p < 0.001) and more frequent nonrespiratory organ failure (nonrespiratory Sequential Organ Failure Assessment score: 6 [4, 9] vs 5 [3, 7]; p = 0.002), thus required more frequently invasive mechanical ventilation (85.2% vs 73.0%; p < 0.001), oxygen rescue therapies (extracorporeal membrane oxygenation 5.8% vs 0.9%; p = 0.003), vasopressor support (79.4% vs 55.0%; p < 0.001), and renal replacement therapy (48.8% vs 22.1%; p < 0.001). After adjustment for potential confounding factors, Middle East respiratory syndrome was independently associated with death compared to non-Middle East respiratory syndrome severe acute respiratory

[EEG technician-nurse collaboration during stereo-electroencephalography].

Science.gov (United States)

Jomard, Caroline; Benghezal, Mouna; Cheramy, Isabelle; De Beaumont, Ségolène

2017-01-01

Drug-resistant epilepsy has significant repercussions on the daily life of children. Surgery may represent a hope. The nurse and the electroencephalogram technician carry out important teamwork during pre-surgical assessment tests and notably the stereo-electroencephalography. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Respiratory symptoms in people living with HIV and the effect of antiretroviral therapy: a systematic review and meta-analysis.

Science.gov (United States)

Brown, James; Roy, Anjana; Harris, Ross; Filson, Sarah; Johnson, Margaret; Abubakar, Ibrahim; Lipman, Marc

2017-04-01

Antiretroviral therapy (ART) has significantly altered the pattern of acute and chronic HIV-related disease. However, it is not clear what this means in terms of respiratory symptoms. We sought to investigate the association between HIV status and respiratory symptoms and how these have changed with the availability of ART. We searched Cochrane, Medline and Embase databases for studies published between 1946 and August 2015 comparing the prevalence of respiratory symptoms in populations with and without HIV infection. We undertook random effects meta-analysis of the main symptoms reported. We studied heterogeneity and completed sensitivity analyses and funnel plots. From 5788 unique references identified, 24 papers provided relevant data: 18 documented the prevalence of cough and 11 examined the prevalence of breathlessness among other symptoms reported. Compared with the HIV negative, people living with HIV (PLWH) were more likely to have respiratory symptoms with pooled ORs for the prevalence of cough of 3.05 (95% CI 2.24 to 4.16) in resource-limited populations without access to ART; 2.18 (1.56 to 3.18) in resource-rich populations without access to ART and 1.11 (0.99 to 1.24) in resource-rich populations with access to ART. In resource-rich settings, although the availability of ART was associated with a reduction in the difference between HIV-positive and HIV-negative individuals, PLWH were more likely to report breathlessness, OR 1.39 (95% CI 1.11 to 1.73). Respiratory symptoms are more common in PLWH than controls. This association persists although at a reduced level in populations with access to ART. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Job Satisfaction among Turkish Business Aviation Technicians

Directory of Open Access Journals (Sweden)

Tevfik Uyar

2013-09-01

Full Text Available The most applicable models in safety management put the human factors, employers’ attitudes and behaviors at the center. This study reports an investigation of job satisfaction among business aviation technicians. A demographic information form and Job Satisfaction Survey (JSS were used to collect data from 44 individuals. Data was analyzed using ANOVA and Student’s t-test. Our results show that there is significant difference in total job satisfaction levels with regard to marital status while other personal factors are not related to the total job satisfaction levels. However several sub dimensions of job satisfaction are affected by the workers’ military or civilian origin, their training background, types of companies they work in or their license category. No difference is found in age and position groups. Secondly, study shows that technicians are the most satisfied from the nature of their work, while they are the least satisfied by operational procedures.

40 CFR 745.92 - Fees for the accreditation of renovation and dust sampling technician training and the...

Science.gov (United States)

2010-07-01

... renovation and dust sampling technician training and the certification of renovation firms. 745.92 Section... Renovation § 745.92 Fees for the accreditation of renovation and dust sampling technician training and the... the following disciplines: Renovator, dust sampling technician. (ii) Exemption. No fee shall be...

Radiological Control Technician: Phase 2, Core/site practical training

International Nuclear Information System (INIS)

1992-10-01

This volume provides a description of the guidelines, qualification in radiological instrumentation, qualification in radiological protection, and qualification in emergency preparedness for radiological control technicians

Estimating actigraphy from motion artifacts in ECG and respiratory effort signals.

Science.gov (United States)

Fonseca, Pedro; Aarts, Ronald M; Long, Xi; Rolink, Jérôme; Leonhardt, Steffen

2016-01-01

Recent work in unobtrusive sleep/wake classification has shown that cardiac and respiratory features can help improve classification performance. Nevertheless, actigraphy remains the single most discriminative modality for this task. Unfortunately, it requires the use of dedicated devices in addition to the sensors used to measure electrocardiogram (ECG) or respiratory effort. This paper proposes a method to estimate actigraphy from the body movement artifacts present in the ECG and respiratory inductance plethysmography (RIP) based on the time-frequency analysis of those signals. Using a continuous wavelet transform to analyze RIP, and ECG and RIP combined, it provides a surrogate measure of actigraphy with moderate correlation (for ECG+RIP, ρ = 0.74, p  <  0.001) and agreement (mean bias ratio of 0.94 and 95% agreement ratios of 0.11 and 8.45) with reference actigraphy. More important, it can be used as a replacement of actigraphy in sleep/wake classification: after cross-validation with a data set comprising polysomnographic (PSG) recordings of 15 healthy subjects and 25 insomniacs annotated by an external sleep technician, it achieves a statistically non-inferior classification performance when used together with respiratory features (average κ of 0.64 for 15 healthy subjects, and 0.50 for a dataset with 40 healthy and insomniac subjects), and when used together with respiratory and cardiac features (average κ of 0.66 for 15 healthy subjects, and 0.56 for 40 healthy and insomniac subjects). Since this method eliminates the need for a dedicated actigraphy device, it reduces the number of sensors needed for sleep/wake classification to a single sensor when using respiratory features, and to two sensors when using respiratory and cardiac features without any loss in performance. It offers a major benefit in terms of comfort for long-term home monitoring and is immediately applicable for legacy ECG and RIP monitoring devices already used in clinical

[Undernutrition in chronic respiratory diseases].

Science.gov (United States)

Zielonka, Tadeusz M; Hadzik-Błaszczyk, Małgorzata

2015-01-01

Respiratory diseases such as asthma, COPD, lung cancer, infections, including also tuberculosis constitute the most frequent diseases in the word. Undernutrition frequently accompanies these diseases. Early diagnosis of malnutrition and implementation of appropriate treatment is very important. A nutritional interview and anthropometric examinations, such as body mass index, fat free mass and fat mass are used to diagnose it. Nutritional therapy affects the course and prognosis of these diseases. Diet should be individually adjusted to the calculated caloric intake that increases during exacerbation of disease, because of increased respiratory effort. Too large supply of energy can cause increase metabolism, higher oxygen consumption and PaCO2 increase each dangerous for patients with respiratory insufficiency. Main source of carbohydrates for these patients should be products with low glycemic index and with high dietary fiber contents. Large meals should be avoided since they cause rapid satiety, abdominal discomfort and have negative impact on the work of the respiratory muscles, especially of the diaphragm. Dietary supplements can be used in case of ineffectiveness of diet or for the patients with severe undernutrition.

Effects of occupational exposure of X-Ray on hematological parameters of diagnostic technicians

Science.gov (United States)

Taqi, Ali H.; Faraj, Kharman A.; Zaynal, Sarah A.; Hameed, Ahmed M.; Mahmood, Abd-Alkader A.

2018-06-01

The aim of this study was to identify the effects of long term exposure of X-ray on diagnostic technicians which they work at Kirkuk hospitals through examining some hematological parameters which are white blood cells (WBC), Neutrophils, Lymphocyte, Monocyte, Eosinophil, Basophil, Reactive Lymphocyte, red blood cells (RBC), hemoglobin (Hb), hematocrit (HCT), Mean Cell Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW), Platelet (PLT). The study included 54 male diagnostic technicians and 54 male healthy controls match with the first group to show any alteration of the hematological parameters. The diagnostic technicians divided into two groups depending on their work experience and hours working per day. The statistical analysis was performed using (Graph-pad) program. Our results showed that the Complete blood cells count (CBC) parameters (Neutrophil, Monocytes, Basophile, MCV, RDW and PLT) significantly (Pgroups of the diagnostic technicians compared with their controls. We concluded that chronic exposure of X-ray can significantly alter some hematological parameters and the number of hours working per day has observable effects on the some hematological parameters. We recommended training and courses about hazard of ionizing radiation should be organized for enhance the healthcare quality of the technicians and to improve their knowledge about benefit of radiation protection tools to protect themselves from any overexposure during the daily life.

Preparing technicians for engineering materials technology

Science.gov (United States)

Jacobs, James A.; Metzloff, Carlton H.

1990-01-01

A long held principle is that for every engineer and scientist there is a need for ten technicians to maximize the efficiency of the technology team for meeting needs of industry and government. Developing an adequate supply of technicians to meet the requirements of the materials related industry will be a challenge and difficult to accomplish. A variety of agencies feel the need and wish to support development of engineering materials technology programs. In a joint effort among Battelle Laboratories, the Department of Energy (DOE) and Northwest College and University Association for Science (NORCUS), the development of an engineering materials technology program for vocational programs and community colleges for the Pacific Northwest Region was recently completed. This effort has implications for a national model. The model Associate of Applied Science degree in Engineering Materials Technology shown provides a general structure. It purposely has course titles which need delimiting while also including a core of courses necessary to develop cognitive, affective and psychomotor skills with the underlining principles of math, science and technology so students have job entry skills, and so that students can learn about and adapt to evolving technology.

Work group design in pharmacy: the pharmacist-technician team.

Science.gov (United States)

Kershaw, B P; Solomon, D K; Zarowitz, B J

1987-05-01

The contemporary pharmacy practice manager faces the challenge of designing pharmacy service programs that not only satisfy the needs of the patient, but at the same time satisfy and motivate the pharmacists and technicians who sustain the programs. This research examined the team design, which has been recommended but not fully described in the literature. This application did not explore the full potential of the team design in the hospital pharmacy setting. More study is needed in this area to assess the impact of work group design on the expansion of clinical programs, employee turnover rates, quality and quantity of work produced, and, most important, the impact on job satisfaction enjoyed by pharmacists and technicians.

Monitoring of pulmonary mechanics in acute respiratory distress syndrome to titrate therapy.

Science.gov (United States)

Gattinoni, Luciano; Eleonora, Carlesso; Caironi, Pietro

2005-06-01

This paper reviews recent findings regarding the respiratory mechanics during acute respiratory distress syndrome as a tool for tailoring its ventilatory management. The pressure-volume curve has been used for many years as a descriptor of the respiratory mechanics in patients affected by acute respiratory distress syndrome. The use of the sigmoidal equation introduced by Venegas for the analysis of the pressure-volume curve seems to be the most rigorous mathematical approach to assessing lung mechanics. Increasing attention has been focused on the deflation limb for titration of positive end-expiratory pressure. Based on physiologic reasoning, a novel parameter, the stress index, has been proposed for tailoring a safe mechanical ventilation, although its clinical impact has still to be proved. Evidence has confirmed that a variety of underlying pathologies may lead to acute respiratory distress syndrome, making unrealistic any attempt to unify the ventilatory approach. Although extensively proposed to tailor mechanical ventilation during acute respiratory distress syndrome, there is no evidence that the pressure-volume curve may be useful in setting a lung-protective strategy in the presence of different potentials for recruitment. The Venegas approach should be the standard analysis of pressure-volume curves. In any patient, the potential for recruitment should be assessed, as a basis for tailoring the most effective mechanical ventilation. Further studies are needed to clarify the potential use of the pressure-volume curve to guide a lung-protective ventilatory strategy.

Practical digital electronics for technicians

CERN Document Server

Kimber, Will

2013-01-01

Practical Digital Electronics for Technicians covers topics on analog and digital signals, logic gates, combinational logic, and Karnaugh mapping. The book discusses the characteristics and types of logic families; sequential systems including latch, bistable circuits, counters and shift registers; Schmitt triggers and multivibrators; and MSI combinational logic systems. Display devices, including LED, LCD and dot matrix display; analog and digital conversion; and examples of and equipment for digital fault finding are also considered. The book concludes by providing answers to the questions

The enforcement regulation for the law for radiation and x-ray technicians engaging in medical treatment

International Nuclear Information System (INIS)

1978-01-01

These provisions are established on the basis of and to enforce the ''Law for radiation and X-ray technicians engaging in medical treatment''. Applications for the license of radiation and X-ray technicians engaging in medical treatment shall be filed, attached with a copy or an abstract of the census register of the applicant and a medical certificate by a doctor of whether the applicant is an insane, a deaf, a dumb or a blind person or a person caught by an infectious disease or not. In the register of such technicians, the number and the date of registration, the names of the prefectures where the technicians are legally domiciled, their names and the date of birth, the year and month of passing the examination, the matters concerning withdrawal of the license or suspension of the practice must be written. The date and the place of the examination for such technicians shall be published beforehand on the official gazette. The examinations for such radiation and X-ray technicians are made on the subjects, such as physics, electrical engineering, chemistry, elementary medical science, radiology, photographing technique, medical treatment technique and control technique. (Okada, K.)

Rapid methods for jugular bleeding of dogs requiring one technician.

Science.gov (United States)

Frisk, C S; Richardson, M R

1979-06-01

Two methods were used to collect blood from the jugular vein of dogs. In both techniques, only one technician was required. A rope with a slip knot was placed around the base of the neck to assist in restraint and act as a tourniquet for the vein. The technician used one hand to restrain the dog by the muzzle and position the head. The other hand was used for collecting the sample. One of the methods could be accomplished with the dog in its cage. The bleeding techniques were rapid, requiring approximately 1 minute per dog.

Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation

Science.gov (United States)

Boughen, Melanie; Sutton, Jane; Fenn, Tess

2017-01-01

Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. Aim: To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Methods: Following ethical approval and piloting, an online survey to ascertain pharmacy technicians’ views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Results: Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Conclusions: Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles. PMID:28970452

Oral health technicians in Brazilian primary health care: potentials and constraints.

Science.gov (United States)

Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo

2014-07-01

Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

Respiratory care management information systems.

Science.gov (United States)

Ford, Richard M

2004-04-01

Hospital-wide computerized information systems evolved from the need to capture patient information and perform billing and other financial functions. These systems, however, have fallen short of meeting the needs of respiratory care departments regarding work load assessment, productivity management, and the level of outcome reporting required to support programs such as patient-driven protocols. The respiratory care management information systems (RCMIS) of today offer many advantages over paper-based systems and hospital-wide computer systems. RCMIS are designed to facilitate functions specific to respiratory care, including assessing work demand, assigning and tracking resources, charting, billing, and reporting results. RCMIS incorporate mobile, point-of-care charting and are highly configurable to meet the specific needs of individual respiratory care departments. Important and substantial benefits can be realized with an RCMIS and mobile, wireless charting devices. The initial and ongoing costs of an RCMIS are justified by increased charge capture and reduced costs, by way of improved productivity and efficiency. It is not unusual to recover the total cost of an RCMIS within the first year of its operation. In addition, such systems can facilitate and monitor patient-care protocols and help to efficiently manage the vast amounts of information encountered during the practitioner's workday. Respiratory care departments that invest in RCMIS have an advantage in the provision of quality care and in reducing expenses. A centralized respiratory therapy department with an RCMIS is the most efficient and cost-effective way to monitor work demand and manage the hospital-wide allocation of respiratory care services.

The nuclear industry is looking for its technicians; Le nucleaire cherche ses techniciens

Energy Technology Data Exchange (ETDEWEB)

Dumas, A

2010-03-15

With massive retirements planned up to 2015, the French nuclear industry wishes to recruit technicians for the operation and maintenance of its power plants. The French nuclear park represents 19 power plants with 58 reactors. The nuclear industry personnel represents 19000 people at EdF and about 20000 people from about 600 different service provider companies. Technician's salary ranges from 1500 to 2800 euros for experienced people, bonus not included. Before being operational, the French nuclear technicians have to follow a long training period in one of the 20 specialized and certified training centres. However, the training demand is so important that the industry suffers from a lack of instructors as well. (J.S.)

The scientific basis for postoperative respiratory care.

Science.gov (United States)

Branson, Richard D

2013-11-01

Postoperative pulmonary complications (PPCs) are common and expensive. Costs, morbidity, and mortality are higher with PPCs than with cardiac or thromboembolic complications. Preventing and treating PPCs is a major focus of respiratory therapists, using a wide variety of techniques and devices, including incentive spirometry, CPAP, positive expiratory pressure, intrapulmonary percussive ventilation, and chest physical therapy. The scientific evidence for these techniques is lacking. CPAP has some evidence of benefit in high risk patients with hypoxemia. Incentive spirometry is used frequently, but the evidence suggests that incentive spirometry alone has no impact on PPC. Chest physical therapy, which includes mechanical clapping and postural drainage, appears to worsen atelectasis secondary to pain and splinting. As with many past respiratory therapy techniques, the profession needs to take a hard look at these techniques and work to provide only practices based on good evidence. The idea of a PPC bundle has merit and should be studied in larger, multicenter trials. Additionally, intraoperative ventilation may play a key role in the development of PPCs and should receive greater attention.

Does pneumoconiosis of dental technician cause to calcific pleural lesions? (Case report

Directory of Open Access Journals (Sweden)

Abdurrahman ŞENYİĞİT

2009-03-01

Full Text Available The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians.A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990.Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.

Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis.

Science.gov (United States)

Andréjak, Claire; Nielsen, Rikke; Thomsen, Vibeke Ø; Duhaut, Pierre; Sørensen, Henrik Toft; Thomsen, Reimar Wernich

2013-03-01

Chronic respiratory disease and inhaled corticosteroid (ICS) therapy for chronic obstructive pulmonary disease (COPD) increase the risk of pneumonia. Few data are available on the association of these risk factors with non-tuberculous mycobacterial (NTM) pulmonary disease. This study examined chronic respiratory diseases and ICS use as risk factors in a population-based case-control study encompassing all adults in Denmark with microbiologically confirmed NTM pulmonary disease between 1997 and 2008. The study included 10 matched population controls per case. Conditional logistic regression was used to compute adjusted ORs for NTM pulmonary disease with regard to chronic respiratory disease history. Overall, chronic respiratory disease was associated with a 16.5-fold (95% CI 12.2 to 22.2) increased risk of NTM pulmonary disease. The adjusted OR for NTM disease was 15.7 (95% CI 11.4 to 21.5) for COPD, 7.8 (95% CI 5.2 to 11.6) for asthma, 9.8 (95% CI 2.03 to 52.8) for pneumoconiosis, 187.5 (95% CI 24.8 to 1417.4) for bronchiectasis, and 178.3 (95% CI 55.4 to 574.3) for tuberculosis history. ORs were 29.1 (95% CI 13.3 to 63.8) for patients with COPD on current ICS therapy and 7.6 (95% CI 3.4 to 16.8) for patients with COPD who had never received ICS therapy. Among patients with COPD, ORs increased according to ICS dose, from 28.1 for low-dose intake to 47.5 for high-dose intake (more than 800 μg/day). The OR was higher for fluticasone than for budesonide. Chronic respiratory disease, particularly COPD treated with ICS therapy, is a strong risk factor for NTM pulmonary disease.

Nutrition: A Primary Therapy in Pediatric Acute Respiratory Distress Syndrome

Directory of Open Access Journals (Sweden)

Bryan Wilson

2016-10-01

Full Text Available Appropriate nutrition is an essential component of intensive care management of children with Acute Respiratory Distress Syndrome (ARDS and is linked to patient outcomes. One out of every two children in the PICU will develop malnutrition or have worsening of baseline malnutrition, and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN is associated with improved 60-day survival after pediatric critical illness and yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10. Inadequate delivery of EN is due to perceived feeding intolerance, reluctance to enterally feed children with hemodynamic instability, and fluid restriction. Underlying each of these factors is large practice variation between providers and across institutions for initiation, advancement and maintenance of EN. Strategies to improve early initiation, advancement, and to maintain delivery of EN are needed to improve morbidity and mortality from pediatric ARDS. Both over and underfeeding prolongs duration of mechanical ventilation in children and worsens other organ function such that precise calorie goals are needed. The gut is thought to act as a ‘motor’ of organ dysfunction and emerging data regarding the role of intestinal barrier functions and the intestinal microbiome on organ dysfunction and outcomes of critical illness present exciting opportunities to improve patient outcomes. Nutrition should be considered a primary rather than supportive therapy for pediatric ARDS. Precise nutritional therapies, which are titrated and targeted to preservation of intestinal barrier function, prevention of intestinal dysbiosis, preservation of lean body mass, and blunting of the systemic inflammatory response, offer great potential for improving outcomes of pediatric ARDS. In this review we examine the current evidence regarding dose, route, and timing of nutrition, current

Fulbright project focuses on rehabilitation technician education and ...

African Journals Online (AJOL)

Rehabilitation technician education and physiotherapy practice 272. Fulbright project focuses on ... particularly those qualified to mentor and teach entry-level learners, there are ... to reinforce classroom didactic knowledge as ongoing learning .... utilization of limited resources, and development of linkages with professional ...

Task Analysis and Job Descriptions for Robotics/Automated Systems Technicians. Final Report. Volume 1.

Science.gov (United States)

Hull, Daniel M.; Lovett, James E.

The Robotics/Automated Systems Technician (RAST) project developed a robotics technician model curriculum for the use of state directors of vocational education and two-year college vocational/technical educators. A baseline management plan was developed to guide the project. To provide awareness, project staff developed a dissemination plan…

Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project

Science.gov (United States)

Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger

2008-01-01

Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…

The practical training of students - x-ray technicians and requirements to mentors in clinical bases

International Nuclear Information System (INIS)

Gagova, P; Boninska, N.; Jovchev, D.

2012-01-01

Full text: Introduction: Training of X-ray technicians in Bulgaria takes place in the Medical Colleges to Medical Universities. It's purpose is providing professional training of students in the area of diagnostic imaging, nuclear medicine and radiotherapy. Practical training is based on the scientific and theoretical knowledge and skills and is organized in pedagogic environment, adequate to regularities for a gradual formation of practical skills and habits. The practical training and pre-graduation internship are performed in 1895 from total of 3810 hours, which represents about fifty percent of all training of X-ray technicians. Students are in groups of 2-4 students. Practical training is organized, accomplished and monitored by the teacher training practice with the help of a mentor in the clinical base. Purpose: To present the tasks of practical training of students - X-ray technicians and the requirements for the personal characteristics and activity of mentors. Materials and methods: Documentary method has been used. Literature and normative documents related to the practical training of students in 'X-ray technician' of Medical Colleges have been studied. The job descriptions of senior clinical X-ray technicians have been examined carefully. Results: By analyzing literature sources, we have structured the tasks of practical training and pre-graduation internship of students - X-ray technicians, also we have described the requirements for personal qualities of mentors and systematize the activities they perform. Conclusion: Practical training plays an important role in adaptation of young X-ray technicians to the conditions of medical work, improving their skills and habits, and to the development of specific practical skills for being able to respond to emergency conditions and to solve complicated practical situations. The mentor is the supervisor and the controller of interns who helps this happen through his own example, qualities and attitudes towards

IAEA Technical Co-operation activities: Asia and the Pacific. Workshop on training nuclear laboratory technicians

International Nuclear Information System (INIS)

Roeed, S.S.

1976-01-01

The workshop was held to exchange information on existing facilities and programmes in Asia and the Pacific for training nuclear laboratory technicians, to identify future training needs and to assess the need for IAEA's involvement in this field. As the participants outlined the requirements for nuclear laboratory technician training and the facilities available in their respective countries, it became evident that, in addition to the training of radioisotope laboratory technicians, they also wished to review the need for technician training for the operation of nuclear power plants and industrial application of atomic energy. The terms of reference of the workshop were extended accordingly. The opening address by Chang Suk Lee, the Korean Vice Minister of Science and Technology, noted the valuable contribution to quality control and other industrial uses that nuclear techniques have made in his country. He also reviewed the application of nuclear techniques in Korean agriculture and medicine. The participants explored various forms of co-operation that could be established between countries of the region. Exchange programmes, not only for students but also for expert teachers, and the exchange or loan of equipment were suggested. It was felt that some generalized training courses could be organized on a regional basis, and two countries advocated the setting up of a regional training centre. One suggestion was to arrange regional training courses in special fields that would move from one country to another. The need was felt for periodic regional meetings on training methods, course content and other questions relating to training of laboratory technicians. The IAEA was requested to act as a clearinghouse for information on available training facilities in the region and to advise on the curricula for technician training courses. The Agency was also asked to organize short courses for the training of instructors of technicians in the various fields of atomic

Rural emergency medical technician pre-hospital electrocardiogram transmission.

Science.gov (United States)

Powell, A M; Halon, J M; Nelson, J

2014-01-01

Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

Radon therapy; Radon in der Therapie

Energy Technology Data Exchange (ETDEWEB)

Spruck, Kaija [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz

2017-04-01

Radon therapies are used since more than 100 years in human medicine. Today this method is controversially discussed due to the possible increase of ionizing radiation induced tumor risk. Although the exact mode of biological radiation effect on the cell level is still not known new studies show the efficiency of the radon therapy without side effect for instance for rheumatic/inflammatory or respiratory disorders.

Respiratory care manpower issues.

Science.gov (United States)

Mathews, Paul; Drumheller, Lois; Carlow, John J

2006-03-01

Although respiratory care is a relatively new profession, its practitioners are deeply involved in providing patient care in the critical care. In preparation for writing this article, we sought to explore the respiratory therapy manpower needs and activities designed to fulfill those needs in critical care practice. We began by delineating the historical development of respiratory care as a profession, the development of its education, and the professional credentialing system. We then conducted several literature reviews with few articles generated. We requested and received data from the American Association for Respiratory Care (AARC), The National Board for Respiratory Care (NBRC), and the Committee on Accreditation of Respiratory Care education (CoARC) relative to their membership, number of credentialed individuals, and educational program student and graduate data for 2000 through 2004. We then conducted two electronic surveys. Survey 1 was a six-item survey that examined the use of mandatory overtime in respiratory care departments. We used a convenience sample of 30 hospitals stratified by size (or=500 beds). Survey 2 was a five-item instrument distributed by blast E-mail to the Society of Critical Care Medicine's Respiratory Care Section members and members of the RC_World list serve. This survey elicited 51 usable and non-duplicative responses from geographically and size-varied institutions. We analyzed these data in several ways from distribution analysis to one-way analysis of variance procedure and appropriate post hoc analysis techniques. Where appropriate, a matched-pairs analysis was performed and these were compared across the variables intensive care unit (ICU) beds per actual number of respiratory care practitioners (RCPs) and ICU beds per preferred number of RCPs. The data gathered from the professional organizations indicated a relatively stable attrition rate (35.2%+/-1.7-3.1%), even in the face of varying enrollments (6,231 in 2004 vs. 4

Bidirectional Cardio-Respiratory Interactions in Heart Failure.

Science.gov (United States)

Radovanović, Nikola N; Pavlović, Siniša U; Milašinović, Goran; Kirćanski, Bratislav; Platiša, Mirjana M

2018-01-01

We investigated cardio-respiratory coupling in patients with heart failure by quantification of bidirectional interactions between cardiac (RR intervals) and respiratory signals with complementary measures of time series analysis. Heart failure patients were divided into three groups of twenty, age and gender matched, subjects: with sinus rhythm (HF-Sin), with sinus rhythm and ventricular extrasystoles (HF-VES), and with permanent atrial fibrillation (HF-AF). We included patients with indication for implantation of implantable cardioverter defibrillator or cardiac resynchronization therapy device. ECG and respiratory signals were simultaneously acquired during 20 min in supine position at spontaneous breathing frequency in 20 healthy control subjects and in patients before device implantation. We used coherence, Granger causality and cross-sample entropy analysis as complementary measures of bidirectional interactions between RR intervals and respiratory rhythm. In heart failure patients with arrhythmias (HF-VES and HF-AF) there is no coherence between signals ( p respiratory signal in HF-VES. Cross-sample entropy analysis revealed the strongest synchrony between respiratory and RR signal in HF-VES group. Beside respiratory sinus arrhythmia there is another type of cardio-respiratory interaction based on the synchrony between cardiac and respiratory rhythm. Both of them are altered in heart failure patients. Respiratory sinus arrhythmia is reduced in HF-Sin patients and vanished in heart failure patients with arrhythmias. Contrary, in HF-Sin and HF-VES groups, synchrony increased, probably as consequence of some dominant neural compensatory mechanisms. The coupling of cardiac and respiratory rhythm in heart failure patients varies depending on the presence of atrial/ventricular arrhythmias and it could be revealed by complementary methods of time series analysis.

Scheduling technicians and tasks in a telecommunications company

DEFF Research Database (Denmark)

Cordeau, J. F.; Laporte, G.; Pasin, F.

2010-01-01

This paper proposes a construction heuristic and an adaptive large neighborhood search heuristic for the technician and task scheduling problem arising in a large telecommunications company. This problem was solved within the framework of the 2007 challenge set up by the French Operational Research...

Modelling of polysomnographic respiratory measurements for artefact detection and signal restoration

International Nuclear Information System (INIS)

Rathnayake, S I; Abeyratne, U R; Hukins, C; Duce, B

2008-01-01

Polysomnography (PSG), which incorporates measures of sleep with measures of EEG arousal, air flow, respiratory movement and oxygenation, is universally regarded as the reference standard in diagnosing sleep-related respiratory diseases such as obstructive sleep apnoea syndrome. Over 15 channels of physiological signals are measured from a subject undergoing a typical overnight PSG session. The signals often suffer from data losses, interferences and artefacts. In a typical sleep scoring session, artefact-corrupted signal segments are visually detected and removed from further consideration. This is a highly time-consuming process, and subjective judgement is required for the job. During typical sleep scoring sessions, the target is the detection of segments of diagnostic interest, and signal restoration is not utilized for distorted segments. In this paper, we propose a novel framework for artefact detection and signal restoration based on the redundancy among respiratory flow signals. We focus on the air flow (thermistor sensors) and nasal pressure signals which are clinically significant in detecting respiratory disturbances. The method treats the respiratory system and other organs that provide respiratory-related inputs/outputs to it (e.g., cardiovascular, brain) as a possibly nonlinear coupled-dynamical system, and uses the celebrated Takens embedding theorem as the theoretical basis for signal prediction. Nonlinear prediction across time (self-prediction) and signals (cross-prediction) provides us with a mechanism to detect artefacts as unexplained deviations. In addition to detection, the proposed method carries the potential to correct certain classes of artefacts and restore the signal. In this study, we categorize commonly occurring artefacts and distortions in air flow and nasal pressure measurements into several groups and explore the efficacy of the proposed technique in detecting/recovering them. The results we obtained from a database of clinical

Radiological Control Technician: Phase 1, Site academic training lesson plans

International Nuclear Information System (INIS)

1992-10-01

This volume provides lesson plans for training radiological control technicians. Covered here is basic radiological documentation, counting errors, dosimetry, environmental monitoring, and radiation instruments

Radiation Technician Scientist service

International Nuclear Information System (INIS)

Prieto Miranda, Enrique; Barrera Gonzalez, Gisela; Guerra Torres, Mercedes; Mora Lopez, Leonor; Altanes Valentin, Sonia; Rapado Paneque, Manuel; Plasencia Gutierrez, Manuel

2003-01-01

The irradiation service is part of the specialized technician scientist services of the Center of Technological Applications and Nuclear Development it belonging to the Radiobiological Department it provides a self shielded laboratory irradiator, PX y 30 type with Cobalt 60 sources, it destined for searches studies, so much basic as applying, in several branches of the science, like the radiobiology, the radiation chemistry, the solid state physics, the medicine, the agriculture and the Pharmaceutical- Medical Industry and besides offering the irradiation service properly with the which have been gotten significant economical outputs. The radiation processing is controlled by means of the dosimetric systems of Freckle, ceric cerous sulfate, Perspex (red, clear and Amber) and dose indicators

Respiratory muscle stretch gymnastics in patients with post coronary artery bypass grafting pain : Impact on respiratory muscle function, activity, mood and exercise capacity

OpenAIRE

會田, 信子; 渋谷, 優子; 吉野, 克樹; Komoda, Masaji; 井上, 智子

2002-01-01

A new rehabilitation (New-RH) program including respiratory muscle stretch gymnastics (RMSG) was developed to alleviate post-coronary artery bypass grafting pain (PCP). Effects on respiratory muscle function, pain, activities of daily living (ADL), mood and exercise capacity were investigated. Subjects were 16 consecutive patients undergoing median full sternotomy coronary artery bypass grafting (CABG), and were randomly divided into equal New-RH (S-group) and conventional therapy (C-group) g...

USE OF IMMUNOMODULATORS IN ACUTE RESPIRATORY INFECTION TREATMENT IN FREQUENTLY ILL CHILDREN

Directory of Open Access Journals (Sweden)

M.I. Ivardava

2011-01-01

Full Text Available Respiratory infections, relapses of ear, nose, throat infections, acute and chronic bronchial infections — these are the most common infantile infections. Regardless the wide range of medications, treatment of recurrent ENT and respiratory infections is not always effective especially in the group of frequently ill children. This article contains analysis of the necessity of immunomodulation therapy of recurrent respiratory infections as a part of complex prophylaxis and treatment of infants.Key words: children, acute respiratory infection, polyoxidonium, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 103–107

Highlights from the Electricity Sector Council's powerline technician project

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-05-15

The Electricity Sector Council completed a situational analysis of the powerline technician trade in Canada in April 2008. The purpose of the study was to provide industry partners with the opportunity to provide input into the development of the powerline trade; to assess the current workforce; to examine training and working conditions based on in-depth focus group interviews; and to demonstrate regional and provincial differences in apprenticeship development. This report presented highlights from the Electricity Sector Council's powerline technician project. Specifically, the report discussed the number of powerline apprentices entering the trade; regional differences in the powerline trade; and emerging practices for recruitment, retention, and training. Recommendations were also offered in order to address the challenges faced by the powerline trade. It was concluded that the best ways to recruit candidates in the powerline technician trade are to invest in a word-of mouth campaign, such as a coaching program; encourage early introduction to the trades through job sampling; offer financial incentives; and invest in outreach programs. 4 figs.

Technicians dismantle the inner section of L3

CERN Multimedia

Laurent Guiraud

2001-01-01

The technicians are dismantling the forward tracking chamber located at the heart of the L3 detector. This formed part of the hadronic calorimeter, which is used for measuring particle energies. L3 was an experiment at the LEP collider that ran from 1989 to 2000.

Computer Vision Tool and Technician as First Reader of Lung Cancer Screening CT Scans.

Science.gov (United States)

Ritchie, Alexander J; Sanghera, Calvin; Jacobs, Colin; Zhang, Wei; Mayo, John; Schmidt, Heidi; Gingras, Michel; Pasian, Sergio; Stewart, Lori; Tsai, Scott; Manos, Daria; Seely, Jean M; Burrowes, Paul; Bhatia, Rick; Atkar-Khattra, Sukhinder; van Ginneken, Bram; Tammemagi, Martin; Tsao, Ming Sound; Lam, Stephen

2016-05-01

To implement a cost-effective low-dose computed tomography (LDCT) lung cancer screening program at the population level, accurate and efficient interpretation of a large volume of LDCT scans is needed. The objective of this study was to evaluate a workflow strategy to identify abnormal LDCT scans in which a technician assisted by computer vision (CV) software acts as a first reader with the aim to improve speed, consistency, and quality of scan interpretation. Without knowledge of the diagnosis, a technician reviewed 828 randomly batched scans (136 with lung cancers, 556 with benign nodules, and 136 without nodules) from the baseline Pan-Canadian Early Detection of Lung Cancer Study that had been annotated by the CV software CIRRUS Lung Screening (Diagnostic Image Analysis Group, Nijmegen, The Netherlands). The scans were classified as either normal (no nodules ≥1 mm or benign nodules) or abnormal (nodules or other abnormality). The results were compared with the diagnostic interpretation by Pan-Canadian Early Detection of Lung Cancer Study radiologists. The overall sensitivity and specificity of the technician in identifying an abnormal scan were 97.8% (95% confidence interval: 96.4-98.8) and 98.0% (95% confidence interval: 89.5-99.7), respectively. Of the 112 prevalent nodules that were found to be malignant in follow-up, 92.9% were correctly identified by the technician plus CV compared with 84.8% by the study radiologists. The average time taken by the technician to review a scan after CV processing was 208 ± 120 seconds. Prescreening CV software and a technician as first reader is a promising strategy for improving the consistency and quality of screening interpretation of LDCT scans. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Maintaining Respiratory Health in Cystic Fibrosis Patients

Directory of Open Access Journals (Sweden)

MR Modaresi

2014-04-01

Full Text Available Cystic fibrosis (CF is an inherited disease that primarily affects the lungs and the digestive system, however, it also affects a number of other organs and systems. More than 90% of mortality of  CF patients is due to lung complications.  Healthy lungs are important for a long life for people with CF, We will discuss two important topics for maintaining respiratory health. Chronic use of drugs for maintaining respiratory health There are a number of drugs available to keep CF lungs healthy. We will discuss the science behind the recommendations for use of: Inhaled antibiotics Dornase alfa Azithromycin Hypertonic saline High-dose ibuprofen Ivacaftor CF Airway Clearance Therapies Airway Clearance therapy is very important to keeping CF lungs healthy. Our discussions cover the following topics such as the: Daily airway clearance Different techniques of airway clearance Effect of aerobic exercise on airway clearance  

Time to pregnancy among Danish laboratory technicians who were a part of the National Birth Cohort

DEFF Research Database (Denmark)

Zhu, Jin Liang; Knudsen, Lisbeth E; Andersen, Anne-Marie Nybo

2005-01-01

in 1997-2003. Altogether 6250 female teachers formed the reference group. A discrete-time survival analysis with a complementary log-log link was applied to estimate the fecundability ratio between the exposed and unexposed women, with adjustment for maternal age, gravidity, smoking, prepregnancy body......OBJECTIVES: The Danish National Birth Cohort was used to examine whether laboratory work was associated with reduced fecundity. METHODS: Self-reported data on laboratory work and waiting time to pregnancy (0-2, 3-5, 6-12 and > 12 months) were used for 829 female laboratory technicians interviewed...... mass index, and paternal job. RESULTS: No difference in time to pregnancy was found between the laboratory technicians and teachers or between the laboratory technicians with different exposures. The adjusted fecundability ratio for the laboratory technicians was 0.94 [95% confidence interval (95% CI...

Mutant frequency of radiotherapy technicians appears to be associated with recent dose of ionizing radiation

Energy Technology Data Exchange (ETDEWEB)

Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M. (Universite du Quebec a Montreal (Canada))

1989-10-01

The frequency of hypoxanthine phosphoribosyl transferase (HPRT) mutants among peripheral T-lymphocytes of radiotherapy technicians primarily exposed to 60Co was measured by the T-cell cloning method. Mutant frequencies of these technicians in 1984 and 1986 were significantly higher than those of physiotherapy technicians who worked in a neighboring service, and correlated significantly with thermoluminescence dosimeter readings recorded during the 6 mo preceding mutant frequency determination. Correlations decreased when related to dose recorded over longer time intervals. HPRT mutant frequency determination in peripheral lymphocytes is a good measure of recently received biologically effective radiation dose in an occupationally exposed population.

Mutant frequency of radiotherapy technicians appears to be associated with recent dose of ionizing radiation

International Nuclear Information System (INIS)

Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M.

1989-01-01

The frequency of hypoxanthine phosphoribosyl transferase (HPRT) mutants among peripheral T-lymphocytes of radiotherapy technicians primarily exposed to 60Co was measured by the T-cell cloning method. Mutant frequencies of these technicians in 1984 and 1986 were significantly higher than those of physiotherapy technicians who worked in a neighboring service, and correlated significantly with thermoluminescence dosimeter readings recorded during the 6 mo preceding mutant frequency determination. Correlations decreased when related to dose recorded over longer time intervals. HPRT mutant frequency determination in peripheral lymphocytes is a good measure of recently received biologically effective radiation dose in an occupationally exposed population

A finite state model for respiratory motion analysis in image guided radiation therapy

International Nuclear Information System (INIS)

Wu Huanmei; Sharp, Gregory C; Salzberg, Betty; Kaeli, David; Shirato, Hiroki; Jiang, Steve B

2004-01-01

Effective image guided radiation treatment of a moving tumour requires adequate information on respiratory motion characteristics. For margin expansion, beam tracking and respiratory gating, the tumour motion must be quantified for pretreatment planning and monitored on-line. We propose a finite state model for respiratory motion analysis that captures our natural understanding of breathing stages. In this model, a regular breathing cycle is represented by three line segments, exhale, end-of-exhale and inhale, while abnormal breathing is represented by an irregular breathing state. In addition, we describe an on-line implementation of this model in one dimension. We found this model can accurately characterize a wide variety of patient breathing patterns. This model was used to describe the respiratory motion for 23 patients with peak-to-peak motion greater than 7 mm. The average root mean square error over all patients was less than 1 mm and no patient has an error worse than 1.5 mm. Our model provides a convenient tool to quantify respiratory motion characteristics, such as patterns of frequency changes and amplitude changes, and can be applied to internal or external motion, including internal tumour position, abdominal surface, diaphragm, spirometry and other surrogates

A finite state model for respiratory motion analysis in image guided radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Wu Huanmei [College of Computer and Information Science, Northeastern University, Boston, MA 02115 (United States); Sharp, Gregory C [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114 (United States); Salzberg, Betty [College of Computer and Information Science, Northeastern University, Boston, MA 02115 (United States); Kaeli, David [Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115 (United States); Shirato, Hiroki [Department of Radiation Medicine, Hokkaido University School of Medicine, Sapporo (Japan); Jiang, Steve B [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114 (United States)

2004-12-07

Effective image guided radiation treatment of a moving tumour requires adequate information on respiratory motion characteristics. For margin expansion, beam tracking and respiratory gating, the tumour motion must be quantified for pretreatment planning and monitored on-line. We propose a finite state model for respiratory motion analysis that captures our natural understanding of breathing stages. In this model, a regular breathing cycle is represented by three line segments, exhale, end-of-exhale and inhale, while abnormal breathing is represented by an irregular breathing state. In addition, we describe an on-line implementation of this model in one dimension. We found this model can accurately characterize a wide variety of patient breathing patterns. This model was used to describe the respiratory motion for 23 patients with peak-to-peak motion greater than 7 mm. The average root mean square error over all patients was less than 1 mm and no patient has an error worse than 1.5 mm. Our model provides a convenient tool to quantify respiratory motion characteristics, such as patterns of frequency changes and amplitude changes, and can be applied to internal or external motion, including internal tumour position, abdominal surface, diaphragm, spirometry and other surrogates.

40 CFR 82.40 - Technician training and certification.

Science.gov (United States)

2010-07-01

... speaking technicians by providing tests in other languages or allowing the use of a translator when taking the test. If a translator is used, the certificate received must indicate that translator assistance.... Each program must provide adequate training, through one or more of the following means: on-the-job...

An Integration of Math with Auto Technician Courses

Science.gov (United States)

Valenzuela, Hector

2012-01-01

This article describes the development of the contextualized math, the course design, student teaching and daily interaction with the students, and the implementation aspects of the research project designed to develop contextualized mathematics and integrate it into the Auto Technician courses. The applied math curriculum was integrated into…

Medication reconciliation and prescribing reviews by pharmacy technicians in a geriatric ward

DEFF Research Database (Denmark)

Buck, Thomas Croft; Gronkjaer, Louise Smed; Duckert, Marie-Louise

2013-01-01

OBJECTIVE: Incomplete medication histories obtained on hospital admission are responsible for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy technicians can assist hospital physicians' in obtaining medication histories by performing medication reconciliation an...... reconciliation and focused medication reviews. Further randomized, controlled studies including a larger number of patients are required to elucidate whether these observations are of significance and of importance for securing patient safety....... and prescribing reviews. A secondary aim was to evaluate whether the interventions made by pharmacy technicians could reduce the time spent by the nurses on administration of medications to the patients. METHODS: This observational study was conducted over a 7 week period in the geriatric ward at Odense...... University Hospital, Denmark. Two pharmacy technicians conducted medication reconciliation and prescribing reviews at the time of patients' admission to the ward. The reviews were conducted according to standard operating procedures developed by a clinical pharmacist and approved by the Head of the Geriatric...

CURRENT STATUS OF PROBLEM: CHILDREN WITH RECURRENT RESPIRATORY INFECTIONS

Directory of Open Access Journals (Sweden)

V.A. Bulgakova

2007-01-01

Full Text Available The article deals with children suffered from recurrent respiraatory infections. The authors attempted to summarize the literature data on the research findings of inosine pranobex application (Isoa prinosine, Teva, Israel in complex therapy against virulent and inflammatory diseases. Within recent years, many experts emphaasize the persistence of viruses and other pathogenic microorganaisms in the human body, which leads to changes in reactivity and emergence of the chronic diseases. These disorders are especially urgent for sickly children, suffering from respiratory infections, what well justifies the application of bacteriogenic immunomodulaa tors, interferon synthesis inductors, expediency for incorporating immunomodulators with antiviral action into complex therapy along with special vaccination against flu, pneumococcus and etc.Key words: sickly children, acute respiratory infections, immunomodulators, inosine pranobex.

20 CFR 1002.306 - Is a National Guard civilian technician considered a State or Federal employee for purposes of...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Is a National Guard civilian technician... a National Guard civilian technician considered a State or Federal employee for purposes of USERRA? A National Guard civilian technician is considered a State employee for USERRA purposes, although he...

Bidirectional Cardio-Respiratory Interactions in Heart Failure

Directory of Open Access Journals (Sweden)

Nikola N. Radovanović

2018-03-01

Full Text Available We investigated cardio-respiratory coupling in patients with heart failure by quantification of bidirectional interactions between cardiac (RR intervals and respiratory signals with complementary measures of time series analysis. Heart failure patients were divided into three groups of twenty, age and gender matched, subjects: with sinus rhythm (HF-Sin, with sinus rhythm and ventricular extrasystoles (HF-VES, and with permanent atrial fibrillation (HF-AF. We included patients with indication for implantation of implantable cardioverter defibrillator or cardiac resynchronization therapy device. ECG and respiratory signals were simultaneously acquired during 20 min in supine position at spontaneous breathing frequency in 20 healthy control subjects and in patients before device implantation. We used coherence, Granger causality and cross-sample entropy analysis as complementary measures of bidirectional interactions between RR intervals and respiratory rhythm. In heart failure patients with arrhythmias (HF-VES and HF-AF there is no coherence between signals (p < 0.01, while in HF-Sin it is reduced (p < 0.05, compared with control subjects. In all heart failure groups causality between signals is diminished, but with significantly stronger causality of RR signal in respiratory signal in HF-VES. Cross-sample entropy analysis revealed the strongest synchrony between respiratory and RR signal in HF-VES group. Beside respiratory sinus arrhythmia there is another type of cardio-respiratory interaction based on the synchrony between cardiac and respiratory rhythm. Both of them are altered in heart failure patients. Respiratory sinus arrhythmia is reduced in HF-Sin patients and vanished in heart failure patients with arrhythmias. Contrary, in HF-Sin and HF-VES groups, synchrony increased, probably as consequence of some dominant neural compensatory mechanisms. The coupling of cardiac and respiratory rhythm in heart failure patients varies depending on the

Rehabilitation of patients admitted to a respiratory intensive care unit.

Science.gov (United States)

Nava, S

1998-07-01

Pulmonary rehabilitation has been shown to be of benefit to clinically stable patients with chronic obstructive pulmonary disease (COPD). This study examined the effect of pulmonary rehabilitation on some physiologic variables in COPD patients recovering from an episode of acute respiratory failure. A prospective, randomized study. A respiratory intensive care unit (RICU). Eighty COPD patients recovering from an episode of acute respiratory failure were randomized in a 3:1 fashion to receive stepwise pulmonary rehabilitation (group A, n=60 patients) or standard medical therapy (group B, n=20 patients). Improvements in exercise tolerance, sense of breathlessness, respiratory muscle function, and pulmonary function test values were measured, respectively, by exercise capacity (6-minute walking distance [6MWD]), dyspnea score (Visual Analog Scale [VAS]), maximal inspiratory pressure (MIP), forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). Group A received pulmonary rehabilitation that consisted of passive mobilization (step I), early deambulation (step II), respiratory and lower skeletal muscle training (step III), and if the patients were able, complete lower extremity training on a treadmill (step IV). Group B received standard medical therapy plus a basic deambulation program. Sixty-one of 80 patients were mechanically ventilated at admission to the unit and most of them were bedridden. Twelve of the 60 group A patients and 4 of the 20 group B patients died during their RICU stay, and 9 patients required invasive mechanical ventilation at home after their discharge. The total length of RICU stay was 38+/-14 days for patients in group A versus 33.2+/-11 days for those in group B. Most patients from both groups regained the ability to walk, either unaided or aided. At discharge, 6 MWD results were significantly improved (p respiratory failure and who, in most cases, required mechanical ventilation benefited from comprehensive early

Effect of dental technician disparities on the 3-dimensional accuracy of definitive casts.

Science.gov (United States)

Emir, Faruk; Piskin, Bulent; Sipahi, Cumhur

2017-03-01

Studies that evaluated the effect of dental technician disparities on the accuracy of presectioned and postsectioned definitive casts are lacking. The purpose of this in vitro study was to evaluate the accuracy of presectioned and postsectioned definitive casts fabricated by different dental technicians by using a 3-dimensional computer-aided measurement method. An arch-shaped metal master model consisting of 5 abutments resembling prepared mandibular incisors, canines, and first molars and with a 6-degree total angle of convergence was designed and fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) technology. Complete arch impressions were made (N=110) from the master model, using polyvinyl siloxane (PVS) and delivered to 11 dental technicians. Each technician fabricated 10 definitive casts with dental stone, and the obtained casts were numbered. All casts were sectioned, and removable dies were obtained. The master model and the presectioned and postsectioned definitive casts were digitized with an extraoral scanner, and the virtual master model and virtual presectioned and postsectioned definitive casts were obtained. All definitive casts were compared with the master model by using computer-aided measurements, and the 3-dimensional accuracy of the definitive casts was determined with best fit alignment and represented in color-coded maps. Differences were analyzed using univariate analyses of variance, and the Tukey honest significant differences post hoc tests were used for multiple comparisons (α=.05). The accuracy of presectioned and postsectioned definitive casts was significantly affected by dental technician disparities (Ptechnician differences. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics.

Science.gov (United States)

Studnek, Jonathan R

2016-12-01

The objective of this paper is to identify factors associated with compensation for Emergency Medical Technician (EMT)-Basics and Paramedics and assess whether these associations have changed over the period 1999-2008. Data obtained from the Longitudinal EMT Attributes and Demographic Study (LEADS) surveys, a mail survey of a random, stratified sample of nationally certified EMT-Basics and Paramedics, were analyzed. For the 1999-2003 period, analyses included all respondents providing Emergency Medical Services (EMS). With the addition of a survey in 2004 about volunteers, it was possible to exclude volunteers from these analyses. Over 60% of EMT-Basics reported being either compensated or noncompensated volunteers in the 2004-2008 period. This was substantially and significantly greater than the proportion of EMT-Paramedic volunteers (Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s87-s95.

Students as Technicians: Screening Newborns for Cystic Fibrosis

Science.gov (United States)

Gusky, Sharon

2014-01-01

In this activity, freshman college students learn biotechnology techniques while playing the role of a laboratory technician. They perform simulations of three diagnostic tests used to screen newborns for cystic fibrosis. By performing an ELISA, a PCR analysis, and a conductivity test, students learn how biotechnology techniques can be used to…

Are further education opportunities for emergency care technicians ...

African Journals Online (AJOL)

Background. A recent review of emergency care education and training in South Africa resulted in the creation of a new 2-year, 240-credit National Qualifications Framework (NQF) level 6 Emergency Care Technician (ECT) qualification. The National Department of Health (NDoH) view ECTs as 'mid-level workers' in the ...

Surfactant Protein D in Respiratory and Non-Respiratory Diseases

Science.gov (United States)

Sorensen, Grith L.

2018-01-01

Surfactant protein D (SP-D) is a multimeric collectin that is involved in innate immune defense and expressed in pulmonary, as well as non-pulmonary, epithelia. SP-D exerts antimicrobial effects and dampens inflammation through direct microbial interactions and modulation of host cell responses via a series of cellular receptors. However, low protein concentrations, genetic variation, biochemical modification, and proteolytic breakdown can induce decomposition of multimeric SP-D into low-molecular weight forms, which may induce pro-inflammatory SP-D signaling. Multimeric SP-D can decompose into trimeric SP-D, and this process, and total SP-D levels, are partly determined by variation within the SP-D gene, SFTPD. SP-D has been implicated in the development of respiratory diseases including respiratory distress syndrome, bronchopulmonary dysplasia, allergic asthma, and chronic obstructive pulmonary disease. Disease-induced breakdown or modifications of SP-D facilitate its systemic leakage from the lung, and circulatory SP-D is a promising biomarker for lung injury. Moreover, studies in preclinical animal models have demonstrated that local pulmonary treatment with recombinant SP-D is beneficial in these diseases. In recent years, SP-D has been shown to exert antimicrobial and anti-inflammatory effects in various non-pulmonary organs and to have effects on lipid metabolism and pro-inflammatory effects in vessel walls, which enhance the risk of atherosclerosis. A common SFTPD polymorphism is associated with atherosclerosis and diabetes, and SP-D has been associated with metabolic disorders because of its effects in the endothelium and adipocytes and its obesity-dampening properties. This review summarizes and discusses the reported genetic associations of SP-D with disease and the clinical utility of circulating SP-D for respiratory disease prognosis. Moreover, basic research on the mechanistic links between SP-D and respiratory, cardiovascular, and metabolic diseases

What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

Science.gov (United States)

Kim, Deog Kyeom; Lee, Jungsil; Park, Ju Hee; Yoo, Kwang Ha

2018-04-01

Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is

Carpal tunnel syndrome among laboratory technicians in relation to personal and ergonomic factors at work.

Science.gov (United States)

El-Helaly, Mohamed; Balkhy, Hanan H; Vallenius, Laura

2017-11-25

Work-related carpal tunnel syndrome (CTS) has been reported in different occupations, including laboratory technicians, so this study was carried out to determine the prevalence and the associated personal and ergonomic factors for CTS among laboratory technicians. A cross-sectional study was conducted among 279 laboratory technicians at King Fahd Hospital, Saudi Arabia, who filled in a self-administered questionnaire, including questions regarding their demographic criteria, occupational history, job tasks, workplace tools, ergonomic factors at work, and symptoms suggestive of CTS. Physical examinations and electrodiagnostic studies were carried out for those who had symptoms suggestive of CTS to confirm the diagnosis. Univariate and multivariate analysis were performed for both personal and physical factors in association with confirmed CTS among laboratory technicians. The prevalence of CTS among the laboratory technicians was 9.7% (27/279). The following were the statistically significant risk factors for CTS among them: gender (all cases of CTS were female, P=0.00), arm/hand exertion (OR: 7.96; 95% CI: 1.84-34.33), pipetting (OR: 7.27; 95% CI: 3.15-16.78), repetitive tasks (OR: 4.60; 95% CI: 1.39-15.70), using unadjustable chairs or desks (OR: 3.35; 95% CI: 1.23-9.15), and working with a biosafety cabinet (OR: 2.49; 95% CI: 1.11-5.59). CTS cases had significant longer work duration (17.9 ± 5.6 years) than CTS non-case (11.5 ± 7.4 yeas) with low OR (1.108). This study demonstrates some personal and ergonomic factors associated with CTS among the laboratory technicians, including female gender, arm/hand exertion, pipetting, repetitive tasks, working with a biosafety cabinet, and an unadjusted workstation.

Nuclear instrument technician training

International Nuclear Information System (INIS)

Wollesen, E.S.

1991-01-01

This paper reports on Nuclear Instrument Technician (NIT) training that has developed at an accelerated rate over the past three decades. During the 1960's commercial nuclear power plants were in their infancy. For that reason, there is little wonder that NIT training had little structure and little creditability. NIT training, in many early plants, was little more than On-The Job Training (OJT). The seventies brought changes in Instrumentation and Controls as well as emphasis on the requirements for more in depth training and documentation. As in the seventies, the eighties saw not only changes in technologies but tighter requirements, standardized training and the development of accredited Nuclear Instrument Training; thus the conclusion: Nuclear Instrument Training Isn't What It Used To Be

Targeting MicroRNA Function in Respiratory Diseases: Mini-review

Directory of Open Access Journals (Sweden)

Steven eMaltby

2016-02-01

Full Text Available MicroRNAs (miRNAs are small non-coding RNA molecules that modulate expression of the majority of genes by inhibiting protein translation. Growing literature has identified functional roles for miRNAs across a broad range of biological processes. As such, miRNAs are recognised as potential disease biomarkers and novel targets for therapies. While several miRNA-targeted therapies are currently in clinical trials (e.g. for the treatment of hepatitis C virus infection and cancer, no therapies have targeted miRNAs in respiratory diseases in the clinic. In this mini-review, we review the current knowledge on miRNA expression and function in respiratory diseases, intervention strategies to target miRNA function and considerations specific to respiratory diseases. Altered miRNA expression profiles have been reported in a number of respiratory diseases, including asthma, chronic obstructive pulmonary disease, cystic fibrosis and idiopathic pulmonary fibrosis. These include alterations in isolated lung tissue, as well as sputum, bronchoalveolar lavage fluids and peripheral blood or serum. The observed alterations in easily accessible body fluids (e.g. serum have been proposed as new biomarkers that may inform disease diagnosis and patient management. In a subset of studies, miRNA-targeted interventions also improved disease outcomes, indicating functional roles for altered miRNA expression in disease pathogenesis. In fact, direct administration of miRNA-targeting molecules to the lung has yielded promising results in a number of animal models. The ability to directly administer compounds to the lung holds considerable promise and may limit potential off-target effects and side effects caused by the systemic administration required to treat other diseases.

Nanotechnology in respiratory medicine.

Science.gov (United States)

Omlor, Albert Joachim; Nguyen, Juliane; Bals, Robert; Dinh, Quoc Thai

2015-05-29

Like two sides of the same coin, nanotechnology can be both boon and bane for respiratory medicine. Nanomaterials open new ways in diagnostics and treatment of lung diseases. Nanoparticle based drug delivery systems can help against diseases such as lung cancer, tuberculosis, and pulmonary fibrosis. Moreover, nanoparticles can be loaded with DNA and act as vectors for gene therapy in diseases like cystic fibrosis. Even lung diagnostics with computer tomography (CT) or magnetic resonance imaging (MRI) profits from new nanoparticle based contrast agents. However, the risks of nanotechnology also have to be taken into consideration as engineered nanomaterials resemble natural fine dusts and fibers, which are known to be harmful for the respiratory system in many cases. Recent studies have shown that nanoparticles in the respiratory tract can influence the immune system, can create oxidative stress and even cause genotoxicity. Another important aspect to assess the safety of nanotechnology based products is the absorption of nanoparticles. It was demonstrated that the amount of pulmonary nanoparticle uptake not only depends on physical and chemical nanoparticle characteristics but also on the health status of the organism. The huge diversity in nanotechnology could revolutionize medicine but makes safety assessment a challenging task.

Global Considerations in Human Immunodeficiency Virus-Associated Respiratory Disease.

Science.gov (United States)

Rylance, Jamie; Meghji, Jamilah; Miller, Robert F; Ferrand, Rashida A

2016-04-01

Respiratory tract infection, particularly tuberculosis, is a major cause of mortality among human immunodeficiency virus (HIV)-infected individuals. Antiretroviral therapy (ART) has resulted in a dramatic increase in survival, although coverage of HIV treatment remains low in many parts of the world. There is a concurrent growing burden of chronic noninfectious respiratory disease as a result of increased survival. Many risk factors associated with the development of respiratory disease, such as cigarette smoking and intravenous drug use, are overrepresented among people living with HIV. In addition, there is emerging evidence that HIV infection may directly cause or accelerate the course of chronic lung disease. This review summarizes the clinical spectrum and epidemiology of respiratory tract infections and noninfectious pulmonary pathologies, and factors that explain the global variation in HIV-associated respiratory disease. The potential for enhancing diagnoses of noninfective chronic conditions through the use of clinical algorithms is discussed. We also consider issues in assessment and management of HIV-related respiratory disease in view of the increasing global scale up of ART. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Efficacy and tolerance of fenspiride in adult patients with acute respiratory tract infections].

Science.gov (United States)

Płusa, T; Nawacka, D

1998-12-01

Fenspiride is an antiinflammatory drug targeted for the respiratory tract. In our study clinical efficacy and tolerance of drug were evaluated in 392 adult patients with acute respiratory tract infections. According to clinical criteria all observed symptoms were classified as mild, moderate and severe. The most of observed patients were included into moderate symptom score. Cough and nose obturation were dominant symptoms. All noticed changes in the upper respiratory tract were decreased after fenspiride therapy in 7 days trial. In 168 observed patients systemic and in 60 local acting antibiotics were successfully applied. Excellent tolerance of fenspiride was documented in 59% and good tolerance --in 34% of patients. Observed adverse reactions were classified as mild and in 20 patients fenspiride was rejected. Authors suggest that fenspiride therapy is save and successful in patient with acute respiratory tract infection. Good results in patients with bronchitis in decreasing of bronchospasm indicate fenspiride as a good tool in bronchial infection.

Differences in baseline factors and survival between normocapnia, compensated respiratory acidosis and decompensated respiratory acidosis in COPD exacerbation: A pilot study.

Science.gov (United States)

Lun, Chung-Tat; Tsui, Miranda S N; Cheng, Suet-Lai; Chan, Veronica L; Leung, Wah-Shing; Cheung, Alice P S; Chu, Chung-Ming

2016-01-01

Patients with chronic obstructive pulmonary disease (COPD) experiencing acute exacerbation (AE-COPD) with decompensated respiratory acidosis are known to have poor outcomes in terms of recurrent respiratory failure and death. However, the outcomes of AE-COPD patients with compensated respiratory acidosis are not known. We performed a 1-year prospective, single-centre, cohort study in patients surviving the index admission for AE-COPD to compare baseline factors between groups with normocapnia, compensated respiratory acidosis and decompensated respiratory acidosis. Survival analysis was done to examine time to readmissions, life-threatening events and death. A total of 250 patients fulfilling the inclusion and exclusion criteria were recruited and 245 patients were analysed. Compared with normocapnia, both compensated and decompensated respiratory acidosis are associated with lower FEV1 % (P respiratory acidosis, there was no difference in FEV1 (% predicted) (P = 0.15), GOLD stage (P = 0.091), BODE index (P = 0.158) or time to life-threatening events (P = 0.301). High PaCO2 level (P = 0.002) and previous use of non-invasive ventilation (NIV) in acute setting (P respiratory acidosis are associated with poorer lung function and higher risk of future life-threatening events. High PaCO2 level and past history of NIV use in acute settings were predictive factors for future life-threatening events. Compensated respiratory acidosis warrants special attention and optimization of medical therapy as it poses risk of life-threatening events. © 2015 Asian Pacific Society of Respirology.

Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy.

Science.gov (United States)

Kim, Jung-In; Lee, Hanyoung; Wu, Hong-Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

2017-09-01

The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system. The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy. The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding

Guidelines for training and qualification of radiological protection technicians

International Nuclear Information System (INIS)

1987-08-01

These guidelines, used in combination with plant-specific job analysis, provide the framework for a training and qualification program for radiological protection technicians at nuclear power plants. Radiological protection technicians are defined as those individuals, both plant and contractor, who will be engaged in the evaluation of radiological conditions in the nuclear plant and the implementation of the necessary radiological safety measures as they apply to nuclear plant workers and members of the general public. An important aspect of this work is recognizing and handling unusual situations involving radioactivity, including incidents related to degraded core conditions. These guidelines incorporate the results of an industry-wide job analysis and task analysis (JTA) combined with industry operating experience review. However, the industry-wide analyses did not identify all important academic and fundamental knowledge and skills. Further in-depth analysis by subject matter experts produced additional knowledge and skills that were added to these guidelines. All utilities should use these guidelines in conjunction with plant-specific and industry-wide JTA results to develop or validate their radiological protection technician training program. Plant-specific information should be used to establish appropriate training program content. This plant-specific information should reflect unique job duties, equipment, operating experience, and trainee entry-level qualifications. Revisions to these guidelines should be reviewed for applicability and incorporated into the training program using each utility's training system development (TSD) procedures. Plant-specific job analysis and task analysis data is essential to the development of performance-based training programs. These analyses are particularly useful in selecting tasks for training and in developing on-the-job training (OJT), laboratory training, and mock-up training. Qualification programs based on these

A method for the efficient and effective evaluation of contract health physics technicians

International Nuclear Information System (INIS)

Burkdoll, S.C.; Conley, T.A.

1992-01-01

This paper reports that Wolf Creek has developed a method for efficiently training contract health physics technicians. The time allotted for training contractors prior to a refueling and maintenance outage is normally limited to a few days. Therefore, it was necessary to develop a systematic method to evaluate prior experience as well as practical skills and knowledge. In addition, instruction in the particular methodologies used at Wolf Creek hadto be included with methods for evaluating technician comprehension

Characterization of Low Back Pain in Pilots and Maintenance Technicians on a Commercial Airline.

Science.gov (United States)

Fajardo Rodriguez, Hugo A; Ortiz Mayorga, Viviana A

2016-09-01

Lower back pain (LBP) is the most common complaint worldwide and the leading cause of disability in the workplace. In Colombia there are no epidemiological data on low back pain in aviation. This study aimed to characterize lower back pain in pilots and maintenance technicians in a Colombian commercial airline. Information was collected from the total population in a Colombian commercial airline in Bogota during the period from 2011 to 2013 using a voluntary survey which requested demographics, occupational (LEST survey) factors, back pain, and chronic pain (chronic pain grade scale). The prevalence rate of LBP in pilot respondents was 71% and the factors associated previously have belonged to the military forces: occupational exposure to physical load and work time. Chronic low back pain was at a prevalence of 49%. The prevalence of LBP in maintenance technicians was 65%. Associated factors were again similar to military forces and included mental workload. Chronic pain had a prevalence of 65%. Factors associated with chronic low back pain were the technicians' time in office and physical load. The prevalence of lower back pain in pilots is similar to that presented in the airline world population. In the case of maintenance technicians, the prevalence was higher than those found in other similar groups, but very similar to prevalences presented in different business industries, including the transport sector. Fajardo Rodriguez HA, Ortiz Mayorga VA. Characterization of low back pain in pilots and maintenance technicians on a commercial airline. Aerosp Med Hum Perform. 2016; 87(9):795-799.

Survey to assess the role of pharmacy technicians and nonpharmacist staff in the operation of research pharmacies.

Science.gov (United States)

Siden, Rivka; Tamer, Helen R; Skyles, Amy J; Dolan, Christopher S; Propes, Denise J; Redic, Kimberly

2014-11-01

Results of a survey assessing trends and innovations in the use of pharmacy technicians and other nonpharmacist staff in the research pharmacy setting are reported. A Web-based survey was distributed to Internet communities of members of the American Society of Health-System Pharmacists and the University Health-System Consortium involved in investigational drug research and related practice areas. The survey collected data on the characteristics of institutions with pharmacy department staff dedicated to such research activities and the participation of pharmacists, technicians, and other staff in key areas of research pharmacy operations. Survey responses from 51 institutions were included in the data analysis. Overall, the reported distribution of assigned responsibility for most evaluated research pharmacy tasks reflected traditional divisions of pharmacist and technician duties, with technicians performing tasks subject to a pharmacist check or pharmacists completing tasks alone. However, some institutions reported allowing technicians to perform a number of key tasks without direct pharmacist supervision, primarily in the areas of inventory management and sponsor monitoring and auditing; almost half of the surveyed institutions reported technician involvement in teaching activities. In general, the reported use of "tech-check-tech" arrangements in research pharmacies was very limited. Some responding institutions reported the innovative use of nonpharmacist staff (e.g., paid interns, students and residents on rotation). Although the majority of research pharmacy tasks related to direct patient care are performed by or under the direct supervision of pharmacists, a variety of other essential tasks are typically assigned to pharmacy technicians and other nonpharmacist staff. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Infectious respiratory disease outbreaks and pregnancy: occupational health and safety concerns of Canadian nurses.

Science.gov (United States)

Phillips, Karen P; O'Sullivan, Tracey L; Dow, Darcie; Amaratunga, Carol A

2011-04-01

This paper is a report of a qualitative study of emergency and critical care nurses' perceptions of occupational response and preparedness during infectious respiratory disease outbreaks including severe acute respiratory syndrome (SARS) and influenza. Healthcare workers, predominantly female, face occupational and personal challenges in their roles as first responders/first receivers. Exposure to SARS or other respiratory pathogens during pregnancy represents additional occupational risk for healthcare workers. Perceptions of occupational reproductive risk during response to infectious respiratory disease outbreaks were assessed qualitatively by five focus groups comprised of 100 Canadian nurses conducted between 2005 and 2006. Occupational health and safety issues anticipated by Canadian nurses for future infectious respiratory disease outbreaks were grouped into four major themes: (1) apprehension about occupational risks to pregnant nurses; (2) unknown pregnancy risks of anti-infective therapy/prophylaxis; (3) occupational risk communication for pregnant nurses; and (4) human resource strategies required for pregnant nurses during outbreaks. The reproductive risk perceptions voiced by Canadian nurses generally were consistent with reported case reports of pregnant women infected with SARS or emerging influenza strains. Nurses' fears of fertility risks posed by exposure to infectious agents or anti-infective therapy and prophylaxis are not well supported by the literature, with the former not biologically plausible and the latter lacking sufficient data. Reproductive risk assessments should be performed for each infectious respiratory disease outbreak to provide female healthcare workers and in particular pregnant women with guidelines regarding infection control and use of anti-infective therapy and prophylaxis.

Technician checks the mirrors of the Starshine-2 experiment

Science.gov (United States)

2001-01-01

Technician checks the mirrors of the Starshine-2 experiment KSC-01PD-1715 KENNEDY SPACE CENTER, Fla. -- A technician checks the mirrors on the Starshine-2 experiment inside a canister in the payload bay of Space Shuttle Endeavour. The deployable experiment is being carried on mission STS-108. Starshine-2's 800 aluminum mirrors were polished by more than 25,000 students from 26 countries. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of robotics tasks and a spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Liftoff of Endeavour on mission STS-108 is scheduled for 7:41 p.m. EST.

CERN's Technician Training Experience notches up another success!

CERN Multimedia

Stephanie Hills

2015-01-01

The programme was set up almost three years ago to help address a Europe-wide shortage of highly skilled technicians, with the participants gaining valuable skills and experience in an international environment. It’s clear that the programme works: some of the technician fellows who have taken part are being snapped up by major science projects and the high-tech industry.   Going underground: Fay Chicken at work in ATLAS. Fay Chicken (see UK news from CERN 59) has just accepted a job offer from the European Spallation Source in Sweden, where she will be working in the detector development team: “I’m also going to be setting up a new workshop where prototype detectors will be built. When I went to Lund, I was shown a big, empty room – it’s up to me to equip it!” This level of responsibility is a big step up for Fay, but there is no doubt that her time at CERN has both built her confidence to take on the role, and convinced ESS th...

Development of a Training Program for Commercial Building Technicians

Energy Technology Data Exchange (ETDEWEB)

Rinholm, Rod

2013-05-31

This project focused on developing and deploying a comprehensive program of 22 training modules, including certification requirements, and accreditation standards for commercial building technicians, to help achieve the full savings potential of energy efficient buildings, equipment, and systems. This curriculum extended the currently available commercial building technician programs -- training a labor force in a growing market area focused on energy efficiency. The program helps to remove a major market impediment to low energy/zero energy commercial building system acceptance, namely a lack of operating personnel capable of handling more complex high efficiency systems. The project developed a training curriculum for commercial building technicians, with particular focus on high-efficiency building technology, and systems. In Phase 1, the project team worked collaboratively in developing a draft training syllabus to address project objectives. The team identified energy efficiency knowledge gaps in existing programs and plans and plans to address the gaps with either modified or new curricula. In Phase 2, appropriate training materials were developed to meet project objectives. This material was developed for alternative modes of delivery, including classroom lecture materials, e-learning elements, video segments, exercises, and hands-on training elements. A Certification and Accreditation Plan and a Commercialization and Sustainability Plan were also investigated and developed. The Project Management Plan was updated quarterly and provided direction on the management approaches used to accomplish the expected project objectives. GTI project management practices tightly coordinate project activities using management controls to deliver optimal customer value. The project management practices include clear scope definition, schedule/budget tracking, risk/issue resolution and team coordination.

Respiratory Syncytial Virus Bronchiolitis in Children.

Science.gov (United States)

Smith, Dustin K; Seales, Sajeewane; Budzik, Carol

2017-01-15

Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or self-inoculation by contaminated secretions on surfaces. Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms such as increasing cough, wheezing, and increased respiratory effort. In 2014, the American Academy of Pediatrics updated its clinical practice guideline for diagnosis and management of RSV bronchiolitis to minimize unnecessary diagnostic testing and interventions. Bronchiolitis remains a clinical diagnosis, and diagnostic testing is not routinely recommended. Treatment of RSV infection is mainly supportive, and modalities such as bronchodilators, epinephrine, corticosteroids, hypertonic saline, and antibiotics are generally not useful. Evidence supports using supplemental oxygen to maintain adequate oxygen saturation; however, continuous pulse oximetry is no longer required. The other mainstay of therapy is intravenous or nasogastric administration of fluids for infants who cannot maintain their hydration status with oral fluid intake. Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. Children at risk of severe lower respiratory tract infection should receive immunoprophylaxis with palivizumab, a humanized monoclonal antibody, in up to five monthly doses. Prophylaxis guidelines are restricted to infants born before 29 weeks' gestation, infants with chronic lung disease of prematurity, and infants and children with hemodynamically significant heart disease.

The enforcement regulation for the law for radiation and x-ray technicians engaging in medical treatment

International Nuclear Information System (INIS)

1980-01-01

The ordinance is set up under the provisions of the law concerning radiation and X-ray technicians engaging in medical treatment, to enforce it. An application for the license of such a technician shall be filed according to the form prescribed, attached with a copy or an abstract of the census register of the applicant and a medical certificate of a doctor concerning whether the applicant is an insane, deaf or blind person, or a case of epidemic. The membership registration of such a technician shall include the number and date of the registration, the prefecture of his legal domicile, name, birth date and sex distinction, the year and month of his success in the examination for such technicains, the items concerning the cancellation of the license or the suspension of the business, etc. The subjects of the examination for such technicians are physics, radiological physics, electrical engineering, chemistry, general basic medical science, radiological biology, photographing technology, treatment technics and others. An application for the examination for such technicians shall be filed to the Minister of Health and Welfare, attached with a personal history, a study certificate or a diploma of graduation, a photograph of the applicant and other specified documents. (Okada, K.)

Results of the 2015 National Certified Pharmacy Technician Workforce Survey.

Science.gov (United States)

Desselle, Shane P; Holmes, Erin R

2017-07-01

The results of the 2015 National Certified Pharmacy Technician Workforce Survey are described. A survey was e-mailed to a randomized sample of 5,000 certified pharmacy technicians (CPhTs) throughout the United States, with response reminders employed. Survey items eliciting demographic and work characteristics and work life attitudes were generated from the literature and qualitative interviews. This study aimed to describe job satisfaction, sources of stress, profession and employer commitment, education and training, and reasons for entry into the profession among CPhTs and determine relationships between those variables and CPhTs' level of involvement in various work activities, with particular attention paid to differences in practice setting. Frequency statistics, correlation analysis, and means testing were used to meet study objectives and identify significant differences. A total of 516 CPhTs currently working as a pharmacy technician responded to the survey. The CPhTs reported high levels of involvement in more traditional activities but less involvement in those that involve greater cognitive load. Respondents reported moderate levels of job satisfaction and commitment and somewhat high levels of stress overall. Most CPhTs chose to be a pharmacy technician because they desired to enter a healthcare field and help people and were recruited. CPhTs derived benefit from all aspects of education and training evaluated and most from on-the-job training. Perceived value of education and training was associated with higher satisfaction and commitment and with lower stress. There were a number of differences in these work life attitudes across practice settings and by involvement in various job functions. The results of the survey indicated that job satisfaction and commitment were moderate and that stress levels were somewhat high among CPhTs. There were a number of differences in work life attitudes across practice settings and by involvement in various job

Neonatal varicella pneumonia, surfactant replacement therapy

Directory of Open Access Journals (Sweden)

Mousa Ahmadpour-kacho

2015-12-01

Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

Changes in the ocular surface: initial observations from a pilot study of diagnostic radiology technicians (radiographers)

International Nuclear Information System (INIS)

Guerdal, Canan; Aydin, Sevda; Sengoer, Tomris; Onmus, Hale; Oezarar, Muemtaz

2002-01-01

The purpose of this study was to evaluate the clinical and cytological changes in the ocular surface of radiology technicians (radiographers) exposed to diagnostic doses of radiation. The Schirmer, Rose Bengal staining and Tear-Break-Up-Time tear function tests were carried out following routine ophthalmic examination in 15 radiology technicians (group I) and 15 controls (group II). Impression cytology was performed by placing 5-mm-thick half-circular cellulose acetate filter paper in the upper and lower quadrants around the limbus. The cytological evaluation was made using the mapping technique. Significantly increased dry eye was detected in group I. In the impression cytology investigation, squamous metaplasia and intraepithelial lymphocytic infiltration was noted in all the group-I cases. A distinct change was observed between the regions showing squamous metaplasia and neigbouring normal epithelial cell structure. Dry eye and ocular surface cytological changes were observed in diagnostic radiology technicians. Routine ophthalmic evaluation of radiology technicians would be beneficial in detecting early cytological changes and dry eye. (orig.)

DOD Recovery personnel and NASA technicians inspect Friendship 7 spacecraft

Science.gov (United States)

1964-01-01

Department of Defense Recovery personnel and spacecraft technicians from NASA adn McDonnell Aircraft Corp., inspect Astronaut John Glenn's Mercury spacecraft, Friendship 7, following its return to Cape Canaveral after recovery in the Atlantic Ocean.

Technician Training for the Semiconductor Microdevices Industry. Final Report.

Science.gov (United States)

Center for Occupational Research and Development, Inc., Waco, TX.

The Center for Occupational Research and Development (CORD) carried out four activities to foster semiconductor manufacturing technician (SMT) training: (1) collaboration with industry experts and educators while developing a curriculum to train SMTs; (2) implementation and testing of the curriculum at a technical college; (3) dissemination of…

Dental technician pneumoconiosis mimicking lung cancer.

Science.gov (United States)

Uyar, Meral; Sokucu, Oral; Sanli, Maruf; Filiz, Ayten; Ali Ikidag, Mehmet; Feridun Isik, Ahmet; Bakir, Kemal

2015-09-01

A 47-year-old man was referred for assessment of bilateral lymph node enlargement identified on a routine chest radiograph. Positron emission tomography showed high standardized uptake values (SUVmax: 20.5) in right supraclavicular, right intercostal, and multiple mediastinal lymph nodes. Biopsy samples obtained from the right upper and left lower paratracheal nodes by mediastinoscopy revealed granulomatous inflammation. Clinical and laboratory findings indicated a diagnosis of dental technician pneumoconiosis. The patient is alive and well 3 years after diagnosis. This case highlights the importance of obtaining an occupational history.

Mechanical technology for higher engineering technicians

CERN Document Server

Black, Peter

1972-01-01

Mechanical Technology for Higher Engineering Technicians deals with the mechanics of machines, thermodynamics, and mechanics of fluids. This book presents discussions and examples that deal with the strength of materials, technology of machines, and techniques used by professional engineers. The book explains the strain energy of torsion, coil springs, and the effects of axial load. The author also discusses the forces that produce bending, shearing, and bending combined with direct stress, as well as beams subjected to a uniform bending moment or simply supported beams with concentrated non-c

Advances and results of the educative project: Implementation of the career of 'Technician in Radiological protection'

International Nuclear Information System (INIS)

Vizuet G, J.; Suarez, G.; Sanchez C, M.

2003-01-01

In this work the obtained advances and achievements during the impartment of the technician career in radiological protection are presented. This is carried out in the 'Justo Sierra' Technological High School Center of San Mateo Atenco, Estado de Mexico, and has for objective the formation of professional-technicians. (Author)

Respiratory mechanics to understand ARDS and guide mechanical ventilation.

Science.gov (United States)

Mauri, Tommaso; Lazzeri, Marta; Bellani, Giacomo; Zanella, Alberto; Grasselli, Giacomo

2017-11-30

As precision medicine is becoming a standard of care in selecting tailored rather than average treatments, physiological measurements might represent the first step in applying personalized therapy in the intensive care unit (ICU). A systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step in this direction, for two main reasons. Approach and Main results: On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient. Decreased respiratory system compliance, for example, is associated with low end expiratory lung volume and more severe lung injury. On the other hand, respiratory mechanics might guide protective mechanical ventilation settings. Improved gravitationally dependent regional lung compliance could support the selection of positive end-expiratory pressure and maximize alveolar recruitment. Moreover, the association between driving airway pressure and mortality in ARDS patients potentially underlines the importance of sizing tidal volume on respiratory system compliance rather than on predicted body weight. The present review article aims to describe the main alterations of respiratory mechanics in ARDS as a potent bedside tool to understand severity and guide mechanical ventilation settings, thus representing a readily available clinical resource for ICU physicians.

A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.

Science.gov (United States)

Kotecha, A; Brookes, J; Foster, P J

2017-06-01

PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.

Qualitative risk analysis in the process of treatment in radiation oncology for the steps performed by the technician/technologist in intensity modulated radiotherapy (lMRT); Analise qualitativa do risco no processo de tratamento em radioterapia para as etapas executadas pelo tecnico/tecnologo na radioterapia de intensidade modulada (lMRT)

Energy Technology Data Exchange (ETDEWEB)

Teixeira, Flavia C.S., E-mail: flavia@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Faria, Alessandra L.; Pereira, Danielle P.S.; Silva, Fabiana M.I. [Universidade UNIGRANRIO, Duque de Caxias, RJ (Brazil)

2013-10-01

The efficacy of radiation therapy is to eradicate the tumor while preserving the integrity of normal tissues. Technological advances have allowed to develop techniques capable of modulating doses delivered to the target volume, providing more effective treatments. However, the operational complexity of these techniques makes the benefits offered are directly proportional to the chances of occurrences of serious errors. The objective of this work is to analyze the steps performed by the technician/technologist in Intensity Modulated Radiotherapy (IMRT), to detect possible errors in order to determine ways to mitigate them. After literature regarding errors in the radiation therapy, a prospective analysis was performed in the first half of 2012 in a radiation clinic located in the city of Rio de Janeiro, in which 11 technicians/technologists contributed to the survey data analysis. The method of risk analysis Failure Mode and Effects Analysis was used for prospective analysis of accidents/incidents, with respect to a qualitative assessment . The method allowed mapping 16 steps performed by technicians/technologists in the treatments with IMRT, identifying possible failures and their causes allowing to find ways to avoid possible errors. This analysis helped to confirm that the qualification and continuing education of technicians/technologists, allied to implement quality assurance programs and a computerized management can make a tool capable of IMRT to achieve the greatest challenge of radiotherapy. (author)

New Form of Hypertonic Solution for Nebulization Therapy

Directory of Open Access Journals (Sweden)

Olga I. Simonova

2016-01-01

Full Text Available Mucolytic, expectorative and antitussive drugs are traditionally used in acute or chronic respiratory episodes affected by acute respiratory infections. Today, preference is given to drugs in a form of solutions for nebulization therapy. The article presents data on the new dosage form of 7% inhalation hypertonic solution in combination with hyaluronic acid used in mucostasis therapy for chronic respiratory diseases. The information on the properties and the favorable effect of hyaluronic acid is provided. We discuss the evidence base of inhalation of the hypertonic solution in combination with hyaluronic acid in cystic fibrosis.

The enforcement order for the law for radiation and x-ray technicians engaging in medical treatment

International Nuclear Information System (INIS)

1984-01-01

The enforcement order provides for the medical radiation technicians and medical X-ray technicians according to the established for them. The applicants for the license thereof must present their applications, together with the necessary documents, to the Government (or the prefectural government). The contents are as follows: application for license; to be entered in the register (with the items of the license); alteration of the registered items (the immediate corrective action, to the Government); elimination of the technicians from the register (to the Government); alteration of the license (the corrective action, to the Government); application for reissue of the license (to the Government); notification concerning the administrative measures. (Mori, K.)

Synchronized moving aperture radiation therapy (SMART): improvement of breathing pattern reproducibility using respiratory coaching

International Nuclear Information System (INIS)

Neicu, Toni; Berbeco, Ross; Wolfgang, John; Jiang, Steve B

2006-01-01

Recently, at Massachusetts General Hospital (MGH) we proposed a new treatment technique called synchronized moving aperture radiation therapy (SMART) to account for tumour motion during radiotherapy. The basic idea of SMART is to synchronize the moving radiation beam aperture formed by a dynamic multileaf collimator with the tumour motion induced by respiration. The two key requirements for being able to successfully use SMART in clinical practice are the precise and fast detection of tumour position during the simulation/treatment and the good reproducibility of the tumour motion pattern. To fulfil the first requirement, an integrated radiotherapy imaging system is currently being developed at MGH. The results of a previous study show that breath coaching techniques are required to make SMART an efficient technique in general. In this study, we investigate volunteer and patient respiratory coaching using a commercial respiratory gating system as a respiration coaching tool. Five healthy volunteers, observed during six sessions, and 33 lung cancer patients, observed during one session when undergoing 4D CT scans, were investigated with audio and visual promptings, with free breathing as a control. For all five volunteers, breath coaching was well tolerated and the intra- and inter-session reproducibility of the breathing pattern was greatly improved. Out of 33 patients, six exhibited a regular breathing pattern and needed no coaching, four could not be coached at all due to the patient's medical condition or had difficulty following the instructions, 13 could only be coached with audio instructions and 10 could follow the instructions of and benefit from audio-video coaching. We found that, for all volunteers and for those patients who could be properly coached, breath coaching improves the duty cycle of SMART treatment. However, about half of the patients could not follow both audio and video instructions simultaneously, suggesting that the current coaching

Synchronized moving aperture radiation therapy (SMART): improvement of breathing pattern reproducibility using respiratory coaching

Energy Technology Data Exchange (ETDEWEB)

Neicu, Toni; Berbeco, Ross; Wolfgang, John; Jiang, Steve B [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

2006-02-07

Recently, at Massachusetts General Hospital (MGH) we proposed a new treatment technique called synchronized moving aperture radiation therapy (SMART) to account for tumour motion during radiotherapy. The basic idea of SMART is to synchronize the moving radiation beam aperture formed by a dynamic multileaf collimator with the tumour motion induced by respiration. The two key requirements for being able to successfully use SMART in clinical practice are the precise and fast detection of tumour position during the simulation/treatment and the good reproducibility of the tumour motion pattern. To fulfil the first requirement, an integrated radiotherapy imaging system is currently being developed at MGH. The results of a previous study show that breath coaching techniques are required to make SMART an efficient technique in general. In this study, we investigate volunteer and patient respiratory coaching using a commercial respiratory gating system as a respiration coaching tool. Five healthy volunteers, observed during six sessions, and 33 lung cancer patients, observed during one session when undergoing 4D CT scans, were investigated with audio and visual promptings, with free breathing as a control. For all five volunteers, breath coaching was well tolerated and the intra- and inter-session reproducibility of the breathing pattern was greatly improved. Out of 33 patients, six exhibited a regular breathing pattern and needed no coaching, four could not be coached at all due to the patient's medical condition or had difficulty following the instructions, 13 could only be coached with audio instructions and 10 could follow the instructions of and benefit from audio-video coaching. We found that, for all volunteers and for those patients who could be properly coached, breath coaching improves the duty cycle of SMART treatment. However, about half of the patients could not follow both audio and video instructions simultaneously, suggesting that the current coaching

Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

DEFF Research Database (Denmark)

Andersen, Kenneth Jay; Brandt, Mikkel; Hansen, Klaus

2015-01-01

pain using individually tailored physical and cognitive elements. STUDY DESIGN: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial "Implementation of physical exercise at the Workplace (IRMA...... 2014 (follow-up). METHODS: Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain...... affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioral therapy/education. Participants of the REF group were encouraged to follow ongoing company health initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0 - 10) in average of the regions...

Regulation on measures in therapy by ionizing radiation of 24 September 1985

International Nuclear Information System (INIS)

1985-01-01

The regulation for the therapeutic application of ionizing radiation and radiopharmaceuticals applies to the relevant health service facilities. The tasks and responsibilities of specialists such as radiologists, physicists, engineers and technicians are specified. All forms of therapy by ionizing radiation must be planned and recorded

CERTAIN ASPECTS OF COUGH PATHOGENETIC THERAPY OF ACUTE CHILD RESPIRATORY INFECTIONS

Directory of Open Access Journals (Sweden)

S.I. Bardenikova

2008-01-01

Full Text Available An open controlled comparative research was conducted on 263 children with acute respiratory infection (ARI in order to evaluate the clinical effectiveness, acceptability and safety of plant based preparation that contains ivy leaf extract. It was established that prescribing the preparation during the first days of disease reduced the duration of dry and inefficient cough, improved sputum rheology and bronchial tree drainage function, reduced bronchial obstruction intensity, reduced the need for prescribing bronchial spasmolitics less necessary and decreased Staybin term. Compared to other antibcough medicines, plant based preparation with ivy leaf extract has quicker effect (effective on the 1st–3rd day.Key words: children, acute respiratory infections, cough, treatment.

Thomas L Petty's lessons for the respiratory care clinician of today.

Science.gov (United States)

Pierson, David J

2014-08-01

Because of the importance of his original contributions and their practical relevance today, Thomas L Petty (1932-2009) was arguably the most important physician in the history of respiratory care. As much as any single individual, he was responsible for the concept of intensive and multidisciplinary respiratory care. In the 1960s and 1970s, he made key observations and introduced pioneering therapies in the ICU and in the home. He was the first to describe and name ARDS and to show how to use PEEP to treat life-threatening hypoxemia. He was one of the first anywhere to organize a pulmonary rehabilitation program and to show the beneficial effects of long-term oxygen therapy in COPD. Dr Petty emphasized the importance of practical, hands-on respiratory care education for both physicians and non-physicians using a collaborative team approach. He targeted educational activities and practical resources specifically to patients, and he showed how researchers and clinicians could interact responsibly with innovators in industry to the benefit of both. His life and career provide 6 important lessons for respiratory clinicians today and in the future: (1) whatever their roles, RTs and other clinicians in this field need to be experts in its core areas, such as mechanical ventilation, ARDS, and COPD; (2) respiratory care is a team activity: every member is important, and all the members need to communicate well and work together; (3) education needs to be targeted to those in the best position to benefit the patient, including primary care providers and family members; (4) everyone in the field needs to understand the important role of the respiratory care industry and to deal with it responsibly; (5) it must never be forgotten that it is all about the patient; and (6) respiratory care should be exciting and fun. Copyright © 2014 by Daedalus Enterprises.

Effect of specific resistance training on forearm pain and work disability in industrial technicians: cluster randomised controlled trial

DEFF Research Database (Denmark)

Andersen, Lars Louis; Jakobsen, Markus D; Pedersen, Mogens Theisen

2012-01-01

To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians.......To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians....

Academy of Nutrition and Dietetics: Scope of Practice for the Dietetic Technician, Registered.

Science.gov (United States)

2013-06-01

The Scope of Practice for the Dietetic Technician, Registered provides standards and tools to guide competence in performing nutrition and dietetics practice. Composed of statutory and individual components, the DTR's scope of practice is determined by state statute and the DTR's education, training, credentialing, and demonstrated and documented competence in practice. The Scope of Practice for the Dietetic Technician, Registered reflects the Academy's position on the DTR scope of practice and the essential technical assistance role of the DTR in providing safe timely person-centered care for the delivery of quality food and nutrition services.

Hospital Costs Of Extracorporeal Life Support Therapy

NARCIS (Netherlands)

Oude Lansink-Hartgring, Annemieke; van den Hengel, Berber; van der Bij, Wim; Erasmus, Michiel E.; Mariani, Massimo A.; Rienstra, Michiel; Cernak, Vladimir; Vermeulen, Karin M.; van den Bergh, Walter M.

Objectives: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but

Numerical simulation of volume-controlled mechanical ventilated respiratory system with 2 different lungs.

Science.gov (United States)

Shi, Yan; Zhang, Bolun; Cai, Maolin; Zhang, Xiaohua Douglas

2017-09-01

Mechanical ventilation is a key therapy for patients who cannot breathe adequately by themselves, and dynamics of mechanical ventilation system is of great significance for life support of patients. Recently, models of mechanical ventilated respiratory system with 1 lung are used to simulate the respiratory system of patients. However, humans have 2 lungs. When the respiratory characteristics of 2 lungs are different, a single-lung model cannot reflect real respiratory system. In this paper, to illustrate dynamic characteristics of mechanical ventilated respiratory system with 2 different lungs, we propose a mathematical model of mechanical ventilated respiratory system with 2 different lungs and conduct experiments to verify the model. Furthermore, we study the dynamics of mechanical ventilated respiratory system with 2 different lungs. This research study can be used for improving the efficiency and safety of volume-controlled mechanical ventilation system. Copyright © 2016 John Wiley & Sons, Ltd.

Accuracy of vision technicians in screening ocular pathology at rural vision centres of southern India.

Science.gov (United States)

Suram, Vasantha; Addepalli, Uday Kumar; Krishnaiah, Sannapaneni; Kovai, Vilas; Khanna, Rohit C

2016-03-01

There is paucity of data on the inter-observer agreement and diagnostic accuracy between a primary-care technician (vision technician) and an ophthalmologist. Hence, the current study was conducted to assess the accuracy of vision technicians, to screen potentially sight-threatening ocular conditions at rural vision centres of southern India and their agreement with an ophthalmologist. In July to August 2010, patients presenting to seven vision centres in Adilabad district (Andhra Pradesh) were selected and screened in a masked manner by seven vision technicians followed by an examination by a consultant ophthalmologist. Agreement was assessed between vision technicians and the ophthalmologist for screening of potential sight-threatening ocular conditions and decisions for referral. The ophthalmologist's findings were considered as the reference standard. Two hundred and seventy-nine patients were enrolled at seven vision centres with a mean age of 32.9 ± 21.8 years. Agreement for screening of ocular pathology was 0.82 (95 per cent CI, 0.8-0.83). There was excellent agreement for cataract (0.97; 95 per cent CI, 0.93-1), refractive error (0.98; 95 per cent CI, 0.96-1), corneal pathology (1.0; 95 per cent CI, 1.0-1.0) and other anterior segment pathology (0.95; 95 per cent CI, 0.9-1); the agreement was moderate to fair for detection of glaucoma suspects (0.43; 95 per cent CI, 0.28-0.60) and retinal pathology (0.39; 95 per cent CI, 0.14-0.63). Sensitivity for screening of anterior segment pathology was 94.6-100 per cent. There was a fair to moderate sensitivity for glaucoma suspect; 35.6 per cent (95 per cent CI, 21.9-51.2) and retinal pathology 26.3 per cent (95 per cent CI, 9.2-51.2). Specificity for screening of ocular pathology was 98.2 to 100 per cent. The kappa (κ) agreement for referral for any pathology was 0.82 (0.8-0.83) CONCLUSION: As there is good agreement between the vision technicians and the ophthalmologist for screening and referral of

Respiratory Symptoms, Sleep, and Quality of Life in Patients With Advanced Lung Cancer.

Science.gov (United States)

Lou, Vivian W Q; Chen, Elaine J; Jian, Hong; Zhou, Zhen; Zhu, Jingfen; Li, Guohong; He, Yaping

2017-02-01

Maintenance of quality of life and symptom management are important in lung cancer therapy. To the author's knowledge, the interplay of respiratory symptoms and sleep disturbance in affecting quality of life in advanced lung cancer remains unexamined. The study was designed to examine the relationships among respiratory symptoms, sleep disturbance, and quality of life in patients with advanced lung cancer. A total of 128 patients with advanced lung cancer (from chest oncology inpatient-units in Shanghai, China) participated in the study. They completed two questionnaires: the Functional Assessment of Cancer Therapy-Lung and the Pittsburgh Sleep Quality Index. Symptomatic breathing difficulty, coughing, shortness of breath, and tightness in the chest were reported in 78.1%, 70.3%, 60.9%, and 60.2% of the patients, respectively. Sleep disturbance affected 62.5% of the patients. The patients with severe respiratory symptoms were more likely to be poor sleepers and to have a lower quality of life. After the covariates were controlled for, regression analysis showed that respiratory symptoms and sleep disturbance were significant indicators of quality of life. In addition, some of the effect of the respiratory symptoms on quality of life was mediated by sleep disturbance. Respiratory symptoms and sleep disturbance were common in the advanced lung cancer patients and had a negative impact on their quality of life; sleep disturbance may mediate the relationship between respiratory symptoms and quality of life. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Acute Respiratory Failure due to Neuromyelitis Optica Treated Successfully with Plasmapheresis

Directory of Open Access Journals (Sweden)

Massa Zantah

2016-01-01

Full Text Available Neuromyelitis Optica (NMO is a demyelinating autoimmune disease involving the central nervous system. Acute respiratory failure from cervical myelitis due to NMO is known to occur but is uncommon in monophasic disease and is treated with high dose steroids. We report a case of a patient with NMO who developed acute respiratory failure related to cervical spinal cord involvement, refractory to pulse dose steroid therapy, which resolved with plasmapheresis.

Considerations for services from dental technicians in fabrication of fixed prostheses: A survey of commercial dental laboratories in Thessaloniki, Greece.

Science.gov (United States)

Hatzikyriakos, Andreas; Petridis, Haralampos P; Tsiggos, Nikolaos; Sakelariou, Sotirios

2006-11-01

Effective communication and cooperation between dentists and dental technicians are essential in providing quality services. There has been a lack of information regarding dentist-dental technician communications and current methods and materials used for the fabrication of fixed partial dentures (FPDs). This cross-sectional study identified the materials and techniques used for fabrication of FPDs, as well as the status of communication between dentists and dental technicians in Thessaloniki, Greece. A questionnaire was developed with 7 sections pertaining to procedures and materials used for the fabrication of fixed prostheses: general questions, infection control, impressions/interocclusal records, die technique/mounting, information from final casts, prostheses design/materials, and communication/shade selection. The questionnaire was anonymous and distributed by the Association of Dental Technicians of Thessaloniki to all member laboratories (228) in the wider province of Thessaloniki, Greece. Due to the absence of normal distribution of the results, frequencies and medians were reported. Ninety-six of 228 dental laboratories responded (42.1% response rate). Twenty-six percent of dental laboratories did not routinely disinfect incoming items. The dental technicians considered 30% of incoming final impressions and 20% of interocclusal registrations as inadequate. Half of the time (55%) final casts were mounted by technicians on simple hinge articulators. Only 20% of tooth preparations had adequate finish lines. The majority (70%) of fixed restorations were metal-ceramic. Fifty-seven percent of dental technicians considered the delivery time requested by dentists as insufficient. The information provided in this study indicates areas of weakness in communication between dentists and dental technicians, along with areas where both parties should use greater care during clinical and laboratory procedures.

The Technician beneath Our Wings, or Is That Blades?

Science.gov (United States)

Colony, Lee; Foster, John

2011-01-01

Today's trained technicians in alternative energy fields are finding even more career opportunities open to them as the United States and the world turn to green technology to power their homes and businesses. Wisconsin's Gateway Technical College is training workers for green collar careers in geoexchange heating and cooling systems, wind power…

Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections

Directory of Open Access Journals (Sweden)

Werner C. Albrich

2013-01-01

Full Text Available Background: In 14 randomized controlled studies to date, a procalcitonin (PCT-based algorithm has been proven to markedly reduce the use of antibiotics along with an unimpaired high safety and low complication rates in patients with lower respiratory tract infections (LRTIs. However, compliance with the algorithm and safety out of controlled study conditions has not yet been sufficiently investigated. Methods: We performed a prospective international multicenter observational post-study surveillance of consecutive adults with community-acquired LRTI in 14 centers (Switzerland (n = 10, France (n = 3 and the United States (n = 1. Results: Between September 2009 and November 2010, 1,759 patients were enrolled (median age 71; female sex 44.4%. 1,520 (86.4% patients had a final diagnosis of LRTI (community-acquired pneumonia (CAP, 53.7%; acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 17.1%; and acute bronchitis, 14.4%. Compliance with the PCT-guided therapy (overall 68.2% was highest in patients with bronchitis (81.0% vs. AECOPD, 70.1%; CAP, 63.7%; p < 0.001, outpatients (86.1% vs. inpatients, 65.9%; p < 0.001 and algorithm-experienced centers (82.5% vs. algorithm-naive, 60.1%; p < 0.001 and showed significant geographical differences. The initial decision about the antibiotic therapy was based on PCT value in 72.4%. In another 8.6% of patients, antibiotics were administered despite low PCT values but according to predefined criteria. Thus, the algorithm was followed in 81.0% of patients. In a multivariable Cox hazard ratio model, longer antibiotic therapy duration was associated with algorithm-non-compliance, country, hospitalization, CAP vs. bronchitis, renal failure and algorithm-naïvety of the study center. In a multivariable logistic regression complications (death, empyema, ICU treatment, mechanical ventilation, relapse, and antibiotic-associated side effects were significantly associated with increasing CURB65-Score, CAP

Expectations and final evaluation of complete dentures by patients, dentist and dental technician.

Science.gov (United States)

Marachlioglou, C R M Z; Dos Santos, J F F; Cunha, V P P; Marchini, Leonardo

2010-07-01

There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207) and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.

Appendices to the guidebook on the education and training of technicians for nuclear power

International Nuclear Information System (INIS)

1989-10-01

The current publication, a supplement to the IAEA Guidebook on the Education and Training of Technicians for Nuclear Power, in conjunction with which it should be read, aims to assist Member States, especially the developing countries which are in the process of implementing, or intending to implement, a nuclear power programme, to understand and meet their requirements for qualified technicians in the most effective and efficient manner. It specifically seeks to assist policy makers and planners, as well as those designing and implementing education and training programmes. The Guidebook and this TECDOC complement the IAEA Guidebook on Manpower Development for Nuclear Power, as well as the IAEA Guidebook on the Qualification of Nuclear Power Plant Operations Personnel. This TECDOC supplements the Guidebook with valuable information on the national experience of IAEA Member States in the education and training of technicians for nuclear power, as well as examples of such education and training from various Member States. Figs and tabs

Two technicians apply insulation to S-II second stage

Science.gov (United States)

1964-01-01

Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Cooperative educational project for optical technicians utilizing amateur telescope making

Science.gov (United States)

Williamson, Ray

2004-01-01

In the modern optical shop, technicians are typically skilled machine operators who work on only one phase of the manufacture for each and every component. The product is designed, specified, methodized, scheduled and integrated by people off the shop floor. Even at the component level, the people inside the shop usually see only one stage of completion. In an effort to make the relevance of their work visible; to demonstrate competence to their peers; to gain appreciation for the work of others; and to give them a meaningful connection with the functions of optical systems, I created "The Telescope Project" for my former employer. I invited those interested to participate in an after-hours, partially subsidized project to build telescopes for themselves. The ground-rules included that we would all make the same design (thus practicing consensus and configuration management); that we would all work on every phase (thus learning from each other); and that we would obtain our parts by random lot at the end (thus making quality assurance a personal issue). In the process the participating technicians learned about optical theory, design, tolerancing, negotiation, scheduling, purchasing, fabrication, coating and assembly. They developed an appreciation for each other's contributions and a broader perspective on the consequences of their actions. In the end, each obtained a high-quality telescope for his or her personal use. Several developed an abiding love for astronomy. The project generated much interest from technicians who didn"t initially choose to participate. In this paper I describe the project in detail.

DEGREE OF AWARENESS OF SOFT RELINING MATERIALS BY DENTAL TECHNICIANS

Directory of Open Access Journals (Sweden)

Ilian Hristov

2017-10-01

Full Text Available The aim of the current investigation is to analyze the dental-technicians’ awareness of the soft relining materials, their characteristics, advantages, shortcomings and methods for relining. Materials and methods: For the purpose of this investigation a standard questionnaire has been presented. A direct survey method, documentary and statistical method, as well as graphical methods, including tables, charts, graphics and figures, were used. Data were analysed with the help of IBM SPSS Statistics (ver. 19. Results: One hundred and eight dental technicians were included in the survey, evenly distributed by gender. Removable and fixed prosthodontics is the most commonly mentioned spheres of dental activities. Almost all included in the investigation point out the laboratory relining method as the most frequently used. Acrylic and silicone SRM are the most used groups of relining materials. Change of colour and hardness are the most frequently noticed shortcomings of these materials. The majority of the dental technicians declare that they have never done replacement of SRM or the relining has lasted more than a year. Discussion: The correlation between the age and the years of labour service among the participants is quite obvious. Most of them start working soon after their graduation. Removable prosthodontics is among the priorities for the majority of the labs. Conclusion: Although their unambiguous advantages, the soft relining materials have lots of shortcomings as well. The major problems are connected with their change of colour and hardness. Nevertheless, the dental technicians find them useful and reliable in overcoming specific prosthetic problems.

Job analysis of nuclear power reactor health physics technicians

International Nuclear Information System (INIS)

Davis, L.T.; Mazour, T.J.; Clark, P.V.; Todd, R.C.; Marotta, F.J.

1984-06-01

This report describes a project, an industry-wide Job Analysis of Nuclear Power Reactor Health Physics Technicians (HPTs), conducted by Brookhaven National Laboratory and Analysis and Technology, Inc. to provide the industry with job-performance data that can be used in systematically defining training programs in terms of required job functions responsibilities, and performance standards. The job-analysis methodology is consistent with that used by the Institute of Nuclear Power Operations (INPO) in similar industry-wide projects and includes administration of over 850 job task questionnaires to utility and contractor Health Physics Technicians throughout the country. Data collected includes task performance (difficulty, importance, and frequency) and industry-wide demographics (job levels, experience, education, and training). The results of this project discussed herein include model job descriptions for HPT positions, summaries of HPT experience, education, and training, industry-wide task listings with task-performance characteristics, and recommendations of selected tasks as a basis for HPT training development. Finally, potential future applications of the data base by utility and contractor organizations in training program development and evaluation and personnel qualifications are discussed

Sleep technologists educational needs assessment: a survey of polysomnography, electroneurodiagnostic technology, and respiratory therapy education program directors.

Science.gov (United States)

Wells, Mary Ellen; Vaughn, Bradley V

2013-10-15

In this study, we assessed the community and educational needs for sleep technologists by surveying program directors of nationally accredited polysomnography, electroneurodiagnostic technology, and respiratory care educational programs. Currently, little is known about our educational capacity and the need for advanced degrees for sleep medicine technical support. A questionnaire was developed about current and future community and educational needs for sleep technologists. The questionnaire was sent to directors of CAAHEP-accredited polysomnography and electroneurodiagnostic technology programs (associate degree and certificate programs), and directors of CoARC-accredited respiratory therapy associate degree and bachelor degree programs (n = 358). Qualitative and quantitative data were collected via an internet survey tool. Data analysis was conducted with the IBM SPSS statistical package and included calculating means and standard deviations of the frequency of responses. Qualitative data was analyzed and classified based on emerging themes. One hundred seven of 408 program directors completed the survey. Seventy-four percent agreed that demand for qualified sleep technologists will increase, yet 50% of those surveyed believe there are not enough educational programs to meet the demand. Seventy-eight percent of those surveyed agreed that the educational requirements for sleep technologists will soon increase; 79% of those surveyed believe sleep centers have a need for technologists with advanced training or specialization. Our study shows educators of associate and certificate degree programs believe there is a need for a bachelor's degree in sleep science and technology.

Statistical Study on Respiratory Stability Through RPM Signal Analysis according to Patient Position Under Radiation Therapy and Device

International Nuclear Information System (INIS)

Park, Myung Hwan; Seo, Jeong Min; Choi, Byeong Gi; Shin, Eun Hyeok; Song, Gi Won

2011-01-01

This study statistically analyzed the difference of the stability of maintaining a respiratory period shown according to position and use of a device to search the tendency and usefulness of a device. The study obtained respiratory signals which maintained a respiratory period for 20 minutes each supine and prone position for 11 subjects. The study obtained respiratory signals in a state of using a belly board for 7 patients in a bad condition of a respiratory period in a prone position to analyze a change in respiration and the stability before and after the use of a device. The supine part showed 54.5%, better than the prone part of 36.4% in a case that the stability for maintaining a respiratory period was in a good condition as a fixed respiratory period was well maintained according to the position. 6 patients (85%) showed a maintenance pattern of a respiratory period significantly different before the use and 4 patients showed a significantly good change in the stability for maintaining a respiratory period as a result that belly boards were used for 7 patients that the maintenance of a respiratory period was not in a good condition on a prone position. It seemed that this study could contribute to the maintenance of respiratory period and of respiratory stability as the optimal position for maintenance of respiration and the use of a device such as a belly board were decided through statistic analysis of respiratory signals and its application even if patient position and use of device were decided by the beam arrangement a treatment part of a patient, location of a target, and an expected plan.

Cosmonaut Sergei Krikalev receives assistance from suit technician

Science.gov (United States)

1994-01-01

Sergei Krikalev, alternative mission specialist for STS-63, gets help from Dawn Mays, a Boeing suit technician. The cosmonaut was about to participate in a training session at JSC's Weightless Environment Training Facility (WETF). Wearing the training version of the extravehicular mobility unit (EMU) space suit, weighted to allow neutral buoyancy in the 25 feet deep WETF pool, Krikalev minutes later was underwater simulating a contingency spacewalk, or extravehicular activity (EVA).

Occupational contact dermatitis amongst dentists and dental technicians

OpenAIRE

Lugović-Mihić, Liborija; Ferček, Iva; Duvančić, Tomislav; Bulat, Vedrana; Ježovita, Josip; Novak-Bilić, Gaby; Šitum, Mirna

2016-01-01

Since the working medical personnel including dentists and dental technicians mainly use their hands, it is understandable that the most common occupational disease amongst medical personnel is contact dermatitis (CD) (80%-90% of cases). Development of occupational CD is caused by contact of the skin with various substances in occupational environment. Occupational etiologic factors for dental personnel are foremost reactions to gloves containing latex, followed by various dental materials...

CLINICAL EFFICACY OF IBUPROFEN IN THERAPY FOR VIRAL UPPER RESPIRATORY TRACT INFECTIONS IN INFANTS

Directory of Open Access Journals (Sweden)

I.O. Skugarevskaya

2006-01-01

Full Text Available A study of use of ibuprofen in cases of viral upper respiratory tract infections (Vuri in children of early childhood has proved its' safety and efficacy. This medical agent has not only terminate fever but also diminished some other symptoms of Vuri.Key words: ibuprofen, viral upper respiratory tract infections, children.

Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

NARCIS (Netherlands)

Kneyber, Martin C. J.; van Heerde, Marc; Twisk, Jos W. R.; Plotz, Frans B.; Markhors, Dick G.

2009-01-01

Introduction Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

NARCIS (Netherlands)

Kneijber, M.C.J.; van Heerde, M.; Twisk, J.W.R.; Plotz, F.; Markhorst, D.G.

2009-01-01

Introduction: Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

The relationship between managers' leadership styles and emergency medical technicians' job satisfaction.

Science.gov (United States)

Ghorbanian, Azimeh; Bahadori, Mohammadkarim; Nejati, Mostafa

2012-01-01

Leadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers' leadership styles and emergency medical technicians' job satisfaction. This is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction. Among both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (Pleadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction. Considering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

Radiation protection technician job task analysis manual

International Nuclear Information System (INIS)

1990-03-01

This manual was developed to assist all DOE contractors in the design and conduct of job task analysis (JTA) for the radiation protection technician. Experience throughout the nuclear industry and the DOE system has indicated that the quality and efficiency in conducting a JTA at most sites is greatly enhanced by using a generic task list for the position, and clearly written guidelines on the JTA process. This manual is designed to provide this information for personnel to use in developing and conducting site-specific JTAs. (VC)

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications.

Science.gov (United States)

Sardinha, Aline; Freire, Rafael Christophe da Rocha; Zin, Walter Araújo; Nardi, Antonio Egidio

2009-07-01

Multiple respiratory abnormalities can be found in anxiety disorders, especially in panic disorder (PD). Individuals with PD experience unexpected panic attacks, characterized by anxiety and fear, resulting in a number of autonomic and respiratory symptoms. Respiratory stimulation is a common event during panic attacks. The respiratory abnormality most often reported in PD patients is increased CO2 sensitivity, which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in PD. There is evidence that PD patients with dominant respiratory symptoms are more sensitive to respiratory tests than are those who do not manifest such symptoms, and that the former group constitutes a distinct subtype. Patients with PD tend to hyperventilate and to panic in response to respiratory stimulants such as CO2, triggering the activation of a hypersensitive fear network. Although respiratory physiology seems to remain normal in these subjects, recent evidence supports the idea that they present subclinical abnormalities in respiration and in other functions related to body homeostasis. The fear network, composed of the hippocampus, the medial prefrontal cortex, the amygdala and its brain stem projections, might be oversensitive in PD patients. This theory might explain why medication and cognitive-behavioral therapy are both clearly effective. Our aim was to review the relationship between respiration and PD, addressing the respiratory subtype of PD and the hyperventilation syndrome, with a focus on respiratory challenge tests, as well as on the current mechanistic concepts and the pharmacological implications of this relationship.

Performing Chest X-Rays at Inspiration in Uncooperative Children: The Effect of Exercises with a Training Program for Radiology Technicians

International Nuclear Information System (INIS)

Langen, H.J.; Sengenberger, C.; Bielmeier, J.; Jocher, R.; Kohlhauser-Vollmuth, Ch.; Eschmann, M.

2014-01-01

It is difficult to acquire a chest X-ray of a crying infant at maximum inspiration. A computer program was developed for technician training. Method. Video clips of 3 babies were used and the moment of deepest inspiration was determined in the single-frame view. 12 technicians simulated chest radiographs at normal video speed by pushing a button. The computer program stopped the video and calculated the period of time to the optimal instant for a chest X-ray. Demonstration software can be tested at website online. Every technician simulated 10 chest X-rays for each of the 3 video clips. The technicians then spent 40 minutes practicing performing chest X-rays at optimal inspiration. The test was repeated after 5, 20, and 40 minutes of practice. Results. 6 participants showed a significant improvement after exercises (collective 1). Deviation from the optimal instant for taking an X-ray at inspiration decreased from 0.39 to 0.22 s after 40 min of practice. 6 technicians showed no significant improvement (collective 2). Deviation decreased from a low starting value of 0.25 s to 0.21 s. Conclusion. The tested computer program improves the ability of radiology technicians to take a chest X-ray at optimal inspiration in a crying child

Impact of nasopharyngeal microbiota on the development of respiratory tract diseases.

Science.gov (United States)

Esposito, S; Principi, N

2018-01-01

Knowledge of whether and how respiratory microbiota composition can prime the immune system and provide colonisation resistance, limiting consecutive pathobiont overgrowth and infections, is essential to improving the prevention and therapy of respiratory disorders. Modulation of dysbiotic ecosystems or reconstitution of missing microbes might be a possible measure to reduce respiratory diseases. The aim of this review is to analyse the role of nasopharyngeal microbiota in the development of respiratory tract disease in paediatric-age subjects. PubMed was used to search for all studies published over the last 15 years using the following key words: "microbiota" or "microbioma" and "nasopharyngeal" or "respiratory" or "nasal" and "children" or "paediatric" or "infant". Analysis of the literature showed that respiratory microbiota can regulate health and disease development in the respiratory tract. Like the gut microbiota, the respiratory microbiota is established at birth, and early respiratory microbiota composition determines bacterial succession patterns and respiratory health in children. Protective and dangerous bacteria have been identified, and this can be considered the base for developing new approaches to diseases that respond poorly to traditional interventions. Reconstitution of missing microbes can be achieved by the administration of pre- and probiotics. Modulation of respiratory microbiota by favouring colonisation of the upper respiratory tract by beneficial commensals can interfere with the proliferation and activity of resident pathobionts and is a possible new measure to reduce the risk of disease. However, further studies are needed because a deeper understanding of these and related issues can be transferred to clinical practice.

[Position-checking by imaging embarked there tomotherapy and the delegation to the radiology technician].

Science.gov (United States)

Autret, A; Choupeaux, D; Le Mée, M

2016-10-01

Tomotherapy is a technique of IMRT and IGRT using a linear accelerator and a helical CT-scanner. To reach this targeting of precision, the repositioning of the patient is essential. The use of a contention adapted according to the location of the disease and the morphology of the patient is necessary for the safety of this one and the treatment. Once the patient positioned on the reference table, technicians of imager's team check by the acquisition of helical imagery with the reference CT-scanner the position of the patient, the zone of the PTV and healthy organs in the protected surroundings. At first, adjustment will be made automatically on three planes of the space (axial, sagittal, frontal) and three rotations (pitch, roll and yaw) by the device of treatment, then the technicians of imagery will bring a modification of these recalls manually. After validation, the processing will then be made in complete safety for the patient and the nursing. This check by MVCT is daily before every session of processing. It is made by the technicians of imagery. The radiation oncologist confirms the images at j0, then controls once a week MVCT. Traceability in the file of the patient of the various marks (osseous and\\or soft tissue) necessary for the daily gaps will be noted by this one to delegate to the technicians of imagery the validation of the MVCT before every session. Copyright © 2016. Published by Elsevier SAS.

Large Outbreak of Hepatitis C Virus Associated With Drug Diversion by a Healthcare Technician.

Science.gov (United States)

Alroy-Preis, Sharon; Daly, Elizabeth R; Adamski, Christine; Dionne-Odom, Jodie; Talbot, Elizabeth A; Gao, Fengxiang; Cavallo, Steffany J; Hansen, Katrina; Mahoney, Jennifer C; Metcalf, Erin; Loring, Carol; Bean, Christine; Drobeniuc, Jan; Xia, Guo-Liang; Kamili, Saleem; Montero, José T

2018-05-14

In May 2012, the New Hampshire (NH) Division of Public Health Services (DPHS) was notified of 4 persons with newly diagnosed hepatitis C virus (HCV) infection at hospital X. Initial investigation suggested a common link to the hospital cardiac catheterization laboratory (CCL) because the infected persons included 3 CCL patients and a CCL technician. NH DPHS initiated an investigation to determine the source and control the outbreak. NH DPHS conducted site visits, case patient and employee interviews, medical record and medication use review, and employee and patient HCV testing using enzyme immunoassay for anti-HCV, reverse-transcription polymerase chain reaction for HCV RNA, nonstructural 5B (NS5B) and hypervariable region 1 (HVR1) sequencing, and quasispecies analysis. HCV HVR1 analysis of the first 4 cases confirmed a common source of infection. HCV testing identified 32 of 1074 CCL patients infected with the outbreak strain, including 3 patients coinfected with >1 HCV strain. The epidemiologic investigation revealed evidence of drug diversion by the HCV-infected technician, evidenced by gaps in controlled medication control, higher fentanyl use during procedures for confirmed cases, and building card key access records documenting the presence of the technician during days when transmission occurred. The employee's status as a traveling technician led to a multistate investigation, which identified additional cases at prior employment sites. This is the largest laboratory-confirmed drug diversion-associated HCV outbreak published to date. Recommendations to reduce drug diversion risk and to conduct outbreak investigations are provided.

Requirements for, and training and certification of, quality assurance technicians for nuclear power plants

International Nuclear Information System (INIS)

Saiz, A.; Mir, A.; Serrano, J.

1982-01-01

The paper examines the requirements for, and training and certification of, technicians working in a quality assurance department at periods when the site, the main supplier and the engineering firm are being selected for construction, commissioning and operation of a light-water nuclear power plant with an output of approximately 1000 MW(e). In determining the system to be applied for the present work, account is taken of the special fields of engineering, supply, commissioning and operation. To this end, an analysis is made of the necessary organization, pointing out the number of technicians in each of the phases mentioned, and the necessary experience and knowledge required for discharging the functions indicated and for obtaining the appropriate certification. The second generation of Spanish nuclear power stations - about 7500MW(e) - demonstrated the need for quality assurance technicians. The Spanish Atomic Forum, a member of Foratom, is the first Spanish body to deal with the problem of training of such technicians at the national level through holding of seminars. This led to the appearance (in April 1974) of the first publication in Spanish on these techniques, a document which is still being used for teaching purposes. Later, it was the university and the professional associations which, with the support of the State Administration, undertook to provide this instruction. The paper also analyses Spanish experience in the teaching of quality assurance techniques during the period 1975-80, describing the programmes and contents of the courses

Dynamic gating window for compensation of baseline shift in respiratory-gated radiation therapy

International Nuclear Information System (INIS)

Pepin, Eric W.; Wu Huanmei; Shirato, Hiroki

2011-01-01

Purpose: To analyze and evaluate the necessity and use of dynamic gating techniques for compensation of baseline shift during respiratory-gated radiation therapy of lung tumors. Methods: Motion tracking data from 30 lung tumors over 592 treatment fractions were analyzed for baseline shift. The finite state model (FSM) was used to identify the end-of-exhale (EOE) breathing phase throughout each treatment fraction. Using duty cycle as an evaluation metric, several methods of end-of-exhale dynamic gating were compared: An a posteriori ideal gating window, a predictive trend-line-based gating window, and a predictive weighted point-based gating window. These methods were evaluated for each of several gating window types: Superior/inferior (SI) gating, anterior/posterior beam, lateral beam, and 3D gating. Results: In the absence of dynamic gating techniques, SI gating gave a 39.6% duty cycle. The ideal SI gating window yielded a 41.5% duty cycle. The weight-based method of dynamic SI gating yielded a duty cycle of 36.2%. The trend-line-based method yielded a duty cycle of 34.0%. Conclusions: Dynamic gating was not broadly beneficial due to a breakdown of the FSM's ability to identify the EOE phase. When the EOE phase was well defined, dynamic gating showed an improvement over static-window gating.

Maternal and neonatal outcomes of respiratory failure during pregnancy

Directory of Open Access Journals (Sweden)

Chen-Yiu Hung

2018-05-01

Full Text Available Background: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. Methods: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test. Results: The leading causes of respiratory failure were postpartum hemorrhage and severe preeclampsia in the obstetric causes group and pneumonia in the nonobstetric causes group during pregnancy and the peripartum period. The non-obstetric causes group exhibited a higher incidence of acute respiratory distress syndrome and renal replacement therapy as well as requiring more ventilator days. The patients in the obstetric causes group showed significant improvement after delivery in the partial pressure of arterial oxygen to the fraction of inspired oxygen and peak inspiratory pressure decrease. Both groups exhibited high incidences of neonatal respiratory distress syndrome. Neonatal complications resulting from meconium aspiration syndrome (MAS and sepsis were more common in the non-obstetric causes group; however, neurological development impairment was more common in the obstetric causes group. Conclusion: Obstetric cause was associated with longer ventilator free days and fewer episodes of ARDS after delivery. Neonatal complications resulting from different etiologies of respiratory failure were found to differ. Keywords: Acute respiratory distress syndrome, Neonatal, Obstetric, Outcome, Respiratory failure

Respiratory physiology during early life.

Science.gov (United States)

Stocks, J

1999-08-01

Despite the rapid adaptation to extrauterine life, the respiratory system of an infant is not simply a miniaturized version of that of an adult, since the rapid somatic growth that occurs during the first year of life is accompanied by major developmental changes in respiratory physiology. The highly compliant chest wall of the infant results in relatively low transpulmonary pressures at end expiration with increased tendency of the small peripheral airways to close during tidal breathing. This not only impairs gas exchange and ventilation-perfusion balance, particularly in dependent parts of the lung, but, together with the small absolute size of the airways, renders the infant and young child particularly susceptible to airway obstruction. Premature airways are highly compliant structures compared with those of mature newborns or adults. This increased compliance can cause airway collapse, resulting in increased airways resistance, flow limitation, poor gas exchange and increased work of breathing. Although there is clear evidence that airway reactivity is present from birth, its role in wheezing lower respiratory tract illnesses in young infants may be overshadowed by pre-existing abnormalities of airway geometry and lung mechanics, or by pathological changes such as airway oedema and mucus hypersecretion. Attempts to assess age-related changes in airway reactivity or response to aerosol therapy in the very young is confounded by changes in breathing patterns and the fact that infants are preferential nose breathers. There is increasing evidence that pre-existing abnormalities of respiratory function, associated with adverse events during foetal life (including maternal smoking during pregnancy), and familial predisposition to wheezing are important determinants of wheezing illnesses during the first years of life. This emphasizes the need to identify and minimize any factors that threaten the normal development of the lung during this critical period if

Communication Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 2209

Science.gov (United States)

Alberta Advanced Education and Technology, 2009

2009-01-01

The graduate of the Communication Technician apprenticeship program is a certified journeyperson who will be able to: (1) supervise, train and coach apprentices; (2) use a thorough knowledge of electrical and electronic theory and its application to communication and associated equipment used in the telecommunication industry; (3) understand…

Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet?

DEFF Research Database (Denmark)

Aabenhus, R.; Jensen, J.U.

2011-01-01

Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection, co...... are likely to benefit from antibiotic treatment and to rule out serious infections, and comments on further research to determine a future role for procalcitonin in primary care......Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection......, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

Science.gov (United States)

Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

Directory of Open Access Journals (Sweden)

Arne C Rodloff

1998-01-01

Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

Current resistance issues in antimicrobial therapy | Senekal ...

African Journals Online (AJOL)

The human gut contains 1013 - 1014 bacteria that are exposed to selection pressure whenever antibiotics are administered.1 The same selection pressure applies to respiratory flora, which is one of the reasons why antimicrobial therapy prescribed for the treatment of respiratory tract infection should aim to eradicate ...

Exploring the impact of an automated prescription-filling device on community pharmacy technician workflow

Science.gov (United States)

Walsh, Kristin E.; Chui, Michelle Anne; Kieser, Mara A.; Williams, Staci M.; Sutter, Susan L.; Sutter, John G.

2012-01-01

Objective To explore community pharmacy technician workflow change after implementation of an automated robotic prescription-filling device. Methods At an independent community pharmacy in rural Mayville, WI, pharmacy technicians were observed before and 3 months after installation of an automated robotic prescription-filling device. The main outcome measures were sequences and timing of technician workflow steps, workflow interruptions, automation surprises, and workarounds. Results Of the 77 and 80 observations made before and 3 months after robot installation, respectively, 17 different workflow sequences were observed before installation and 38 after installation. Average prescription filling time was reduced by 40 seconds per prescription with use of the robot. Workflow interruptions per observation increased from 1.49 to 1.79 (P = 0.11), and workarounds increased from 10% to 36% after robot use. Conclusion Although automated prescription-filling devices can increase efficiency, workflow interruptions and workarounds may negate that efficiency. Assessing changes in workflow and sequencing of tasks that may result from the use of automation can help uncover opportunities for workflow policy and procedure redesign. PMID:21896459

Verification and compensation of respiratory motion using an ultrasound imaging system

International Nuclear Information System (INIS)

Chuang, Ho-Chiao; Hsu, Hsiao-Yu; Chiu, Wei-Hung; Tien, Der-Chi; Wu, Ren-Hong; Hsu, Chung-Hsien

2015-01-01

Purpose: The purpose of this study was to determine if it is feasible to use ultrasound imaging as an aid for moving the treatment couch during diagnosis and treatment procedures associated with radiation therapy, in order to offset organ displacement caused by respiratory motion. A noninvasive ultrasound system was used to replace the C-arm device during diagnosis and treatment with the aims of reducing the x-ray radiation dose on the human body while simultaneously being able to monitor organ displacements. Methods: This study used a proposed respiratory compensating system combined with an ultrasound imaging system to monitor the compensation effect of respiratory motion. The accuracy of the compensation effect was verified by fluoroscopy, which means that fluoroscopy could be replaced so as to reduce unnecessary radiation dose on patients. A respiratory simulation system was used to simulate the respiratory motion of the human abdomen and a strain gauge (respiratory signal acquisition device) was used to capture the simulated respiratory signals. The target displacements could be detected by an ultrasound probe and used as a reference for adjusting the gain value of the respiratory signal used by the respiratory compensating system. This ensured that the amplitude of the respiratory compensation signal was a faithful representation of the target displacement. Results: The results show that performing respiratory compensation with the assistance of the ultrasound images reduced the compensation error of the respiratory compensating system to 0.81–2.92 mm, both for sine-wave input signals with amplitudes of 5, 10, and 15 mm, and human respiratory signals; this represented compensation of the respiratory motion by up to 92.48%. In addition, the respiratory signals of 10 patients were captured in clinical trials, while their diaphragm displacements were observed simultaneously using ultrasound. Using the respiratory compensating system to offset, the diaphragm

Negative-pressure in treatment of persistent post-traumatic subcutaneous emphysema with respiratory failure: Case report and literature review

Directory of Open Access Journals (Sweden)

Jakov Mihanović

2018-02-01

Full Text Available Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published. We report on patient injured in a motor vehicle accident who had serial rib fractures and bilateral pneumothorax managed initially in another hospital. Due to respiratory deterioration, haemodynamic instability and renal failure patient was transferred to our Intensive Care Unit. Massive and persistent subcutaneous emphysema despite adequate thoracic drainage with respiratory deterioration and potentially injurious mechanical ventilation with high airway pressures was the indication for active surgical treatment. Negative-pressure wound therapy dressing was applied on typical blowhole incisions which resulted in swift emphysema regression and respiratory improvement. Negative pressure wound therapy for decompression of severe subcutaneous emphysema represents simple, effective and relatively unknown technique that deserves wider attention.

State of the art. Neonatal respiratory failure.

Science.gov (United States)

Parker, L A

1999-12-01

Advances in ventilatory management of respiratory distress in the newborn have made dramatic strides during the last decade. Innovative treatments such as PTV, HFV, liquid ventilation, and NO therapy are just beginning to have an impact on the care of neonates in the NICU. These treatment modalities should continue to have an effect on the care of the newborn infant well into the future.

The impact of respiratory motion and treatment technique on stereotactic body radiation therapy for liver cancer

International Nuclear Information System (INIS)

Wu, Q. Jackie; Thongphiew, Danthai; Wang Zhiheng; Chankong, Vira; Yin Fangfang

2008-01-01

Stereotactic body radiation therapy (SBRT), which delivers a much higher fractional dose than conventional treatment in only a few fractions, is an effective treatment for liver metastases. For patients who are treated under free-breathing conditions, however, respiration-induced tumor motion in the liver is a concern. Limited clinical information is available related to the impact of tumor motion and treatment technique on the dosimetric consequences. This study evaluated the dosimetric deviations between planned and delivered SBRT dose in the presence of tumor motion for three delivery techniques: three-dimensional conformal static beams (3DCRT), dynamic conformal arc (DARC), and intensity-modulated radiation therapy (IMRT). Five cases treated with SBRT for liver metastases were included in the study, with tumor motions ranging from 0.5 to 1.75 cm. For each case, three different treatment plans were developed using 3DCRT, DARC, and IMRT. The gantry/multileaf collimator (MLC) motion in the DARC plans and the MLC motion in the IMRT plans were synchronized to the patient's respiratory motion. Retrospectively sorted four-dimensional computed tomography image sets were used to determine patient-organ motion and to calculate the dose delivered during each respiratory phase. Deformable registration, using thin-plate-spline models, was performed to encode the tumor motion and deformation and to register the dose-per-phase to the reference phase images. The different dose distributions resulting from the different delivery techniques and motion ranges were compared to assess the effect of organ motion on dose delivery. Voxel dose variations occurred mostly in the high gradient regions, typically between the target volume and normal tissues, with a maximum variation up to 20%. The greatest CTV variation of all the plans was seen in the IMRT technique with the largest motion range (D99: -8.9%, D95: -8.3%, and D90: -6.3%). The greatest variation for all 3DCRT plans was less

Gastroesophageal reflux and respiratory diseases in children

International Nuclear Information System (INIS)

Fatima, S.; Saeed, M.A.; Jafri, S.R.A.; Raza, M.; Kundi, Z.U.; Hyder, S.W.

2002-01-01

The association of gastroesophageal reflux disease and its pulmonary manifestation is well known however the exact underlying mechanism is unclear. The medical literature is deluged with studies on relationship between Gear and its pulmonary manifestations. The aim of this study was to 1) determine prevalence of GER in children with rLRTI, wheezing and asthma. 2) determine prevalence of asymptomatic respiratory anomalies in children with clinical reflux 3) determine effectiveness of anti-reflux therapy in clinical control of asthma, wheezing and rLRTI. Children were included in the study if they presented either with rLRTI, wheezing, Bronchial asthma or Clinical suspicion of GER without any respiratory symptoms. The GER study comprised esophageal transit, gastroesophageal reflux and lung aspiration studies. Acquisition and processing were according to predetermined protocol. Segmental and global esophageal transit times, GER according to duration of episode and volume of refluxed liquid, Reflux severity, Gastric retention at 30 minutes, Gastric emptying time, Presence of lung aspiration were calculated for each study. All children underwent Barium studies on a separate day. Clinical follow-up was done every 3 months and GER study was repeated every 6 months up to one year. The patient's therapy was determined by local protocols at discretion of clinicians. GER scintigraphy was performed in 43 patients (age range 5 months -12 years). Gastroesophageal reflux of varying degrees was observed in 10 children (23.25%) in all groups. The severity of clinical symptoms was directly related to severity of GER. The direct correlation was found between GER and reflux index. The results of GER scintigraphy were compared with Barium studies and results were found to be superior in terms of sensitivity, specificity and accuracy in detecting disease. It was possible to objectively evaluate and monitor response to therapy after medical treatment in few cases with help of follow

Myxedema coma leading to respiratory depression in a dog

OpenAIRE

Atkinson, Kathryn; Aubert, Isabelle

2004-01-01

A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma.

Myxedema coma leading to respiratory depression in a dog.

Science.gov (United States)

Atkinson, Kathryn; Aubert, Isabelle

2004-04-01

A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma.

Efficiency of respiratory-gated delivery of synchrotron-based pulsed proton irradiation

International Nuclear Information System (INIS)

Tsunashima, Yoshikazu; Vedam, Sastry; Dong, Lei; Bues, Martin; Balter, Peter; Smith, Alfred; Mohan, Radhe; Umezawa, Masumi; Sakae, Takeji

2008-01-01

Significant differences exist in respiratory-gated proton beam delivery with a synchrotron-based accelerator system when compared to photon therapy with a conventional linear accelerator. Delivery of protons with a synchrotron accelerator is governed by a magnet excitation cycle pattern. Optimal synchronization of the magnet excitation cycle pattern with the respiratory motion pattern is critical to the efficiency of respiratory-gated proton delivery. There has been little systematic analysis to optimize the accelerator's operational parameters to improve gated treatment efficiency. The goal of this study was to estimate the overall efficiency of respiratory-gated synchrotron-based proton irradiation through realistic simulation. Using 62 respiratory motion traces from 38 patients, we simulated respiratory gating for duty cycles of 30%, 20% and 10% around peak exhalation for various fixed and variable magnet excitation patterns. In each case, the time required to deliver 100 monitor units in both non-gated and gated irradiation scenarios was determined. Based on results from this study, the minimum time required to deliver 100 MU was 1.1 min for non-gated irradiation. For respiratory-gated delivery at a 30% duty cycle around peak exhalation, corresponding average delivery times were typically three times longer with a fixed magnet excitation cycle pattern. However, when a variable excitation cycle was allowed in synchrony with the patient's respiratory cycle, the treatment time only doubled. Thus, respiratory-gated delivery of synchrotron-based pulsed proton irradiation is feasible and more efficient when a variable magnet excitation cycle pattern is used

Does virus-bacteria coinfection increase the clinical severity of acute respiratory infection?

Science.gov (United States)

Damasio, Guilherme A C; Pereira, Luciane A; Moreira, Suzana D R; Duarte dos Santos, Claudia N; Dalla-Costa, Libera M; Raboni, Sonia M

2015-09-01

This retrospective cohort study investigated the presence of bacteria in respiratory secretions of patients hospitalized with acute respiratory infections and analyzed the impact of viral and bacterial coinfection on severity and the mortality rate. A total of 169 patients with acute respiratory infections were included, viruses and bacteria in respiratory samples were detected using molecular methods. Among all samples, 73.3% and 59.7% were positive for viruses and bacteria, respectively; 45% contained both virus and bacteria. Bacterial coinfection was more frequent in patients infected by community respiratory viruses than influenza A H1N1pdm (83.3% vs. 40.6%). The most frequently bacteria detected were Streptococcus pneumoniae and Haemophilus influenzae. Both species were co-detected in 54 patients and identified alone in 22 and 21 patients, respectively. Overall, there were no significant differences in the period of hospitalization, severity, or mortality rate between patients infected with respiratory viruses alone and those coinfected by viruses and bacteria. The detection of mixed respiratory pathogens is frequent in hospitalized patients with acute respiratory infections, but its impact on the clinical outcome does not appear substantial. However, it should be noted that most of the patients received broad-spectrum antibiotic therapy, which may have contributed to this favorable outcome. © 2015 Wiley Periodicals, Inc.

Mutations des roles techniques et formation. Etude documentaire (Changes in the Roles and Education of Technicians. Documentary Study).

Science.gov (United States)

Pinard, Helene

Drawing from research conducted in 1990-91, this report examines trends affecting the future work of technicians in Quebec, their pre-employment education, and the link between college and work. Part 1 focuses on aspects of the economic, technological, and social environment that will influence the future role of technicians. Economic concerns…

The validation of the Utrecht work engagement scale for emergency medical technicians in Gauteng

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JLP Naudé

2004-04-01

Full Text Available The objectives of this study were to validate the Utrecht Work Engagement Scale (UWES for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different language groups. A cross-sectional survey design was used with a convenient sample (N = 318 of emergency medical technicians in Gauteng. The UWES and a biographical questionnaire were administered. A two-factor model of work engagement, consisting of Vigour/Dedication and Absorption was found. Exploratory factor analysis with target rotations confirmed the construct equivalence of the work engagement construct for white and black employees.

The efficacy of the upright position on gastro-esophageal reflux and reflux-related respiratory symptoms in infants with chronic respiratory symptoms.

Science.gov (United States)

Jung, Woo Jin; Yang, Hyeon Jong; Min, Taek Ki; Jeon, You Hoon; Lee, Hae Won; Lee, Jun Sung; Pyun, Bok Yang

2012-01-01

Gastro-esophageal reflux (GER), particularly non-acid reflux, is common in infants and is a known cause of chronic respiratory symptoms in infancy. Recent guidelines recommended empirical acid suppression therapy and the head-up position in patients with suspected GER. However, the efficacy of the upright position in relieving GER and reflux-related respiratory symptoms in infants is unclear. We conducted this study to investigate the efficacy of the upright position on GER and reflux-related respiratory symptoms in infants with chronic respiratory symptoms. Thirty-two infants (21 male; median age, 5 months; range, 0 to 19 months) with unexplained chronic respiratory symptoms underwent multi-channel intraluminal esophageal impedance and pH monitoring. We retrospectively compared the frequencies of GER and reflux-related symptoms according to body position. A mean of 3.30 episodes of reflux per hour was detected. Overall, refluxes were more frequent during the postprandial period than the emptying period (3.77 vs. 2.79 episodes/hour, respectively; P=0.01). Although there was no significant difference in the total refluxes per hour between the upright and recumbent positions (6.12 vs. 3.77 episodes, P=0.10), reflux-related respiratory symptoms per reflux were significantly fewer in infants kept in an upright position than in a recumbent position during the postprandial period (3.07% vs. 14.75%, P=0.016). Non-acid reflux was the predominant type of reflux in infants, regardless of body position or meal time. The upright position may reduce reflux-related respiratory symptoms, rather than reflux frequency. Thus, it may be a useful non-pharmacological treatment for infantile GER disease resistant to acid suppressants.

Child Passenger Safety Technician Consultation in the Pediatric Primary Care Setting.

Science.gov (United States)

Burstein, Dina; Zonfrillo, Mark R; Baird, Janette; Mello, Michael J

2017-09-01

Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician. Follow-up was conducted 4 months post enrollment. Intervention group participants had a 21.3% reduction in critical misuse at follow-up, whereas control participants critical misuse rate at follow-up was identical to the intervention group at baseline. A consult with a certified CPS technician, at the time of a routine visit to the pediatrician, resulted in a reduction in CSS misuse rates.

Emerging indications for extracorporeal membrane oxygenation in adults with respiratory failure.

Science.gov (United States)

Abrams, Darryl; Brodie, Daniel

2013-08-01

Recent advances in technology have spurred the increasing use of extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure. However, this accounts for only a small percentage of patients with respiratory failure. We envision the application of ECMO in many other forms of respiratory failure in the coming years. Patients with less severe forms of acute respiratory distress syndrome, for instance, may benefit from enhanced lung-protective ventilation with the very low tidal volumes made possible by direct carbon dioxide removal from the blood. For those in whom hypercapnia predominates, extracorporeal support will allow for the elimination of invasive mechanical ventilation in some cases. The potential benefits of ECMO may be further enhanced by improved techniques, which facilitate active mobilization. Although ECMO for these and other expanded applications is under active investigation, it has yet to be proven beneficial in these settings in rigorous controlled trials. Ultimately, with upcoming and future technological advances, there is the promise of true destination therapy, which could lead to a major paradigm shift in the management of respiratory failure.

Pedagogical Strategy for the professional training of technicians in Accountability and Auditing

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Martha Ximena Jaramillo-Lema

2016-06-01

Full Text Available The professionals in the specialty of Accounting and Auditing have an important role in the founding of mid and small enterprises (PYMES, therefore, there is need of forming technicians of high quality. However, after the application of different methods of research, it has been proven that there are insufficiencies in their work, which has brought about that the hirers reject to employ them. They support their decision saying that these technicians lack professional preparation in the processes of accounting and auditing. The present article has as main purpose, to propose a pedagogical strategy for the development of updating and upbringing courses based on the development in the spheres of accounting and auditing , thus it has been designed a system of actions of marked pedagogical effect that allows the achievement of this objective.

Baseline job satisfaction and stress among pharmacists and pharmacy technicians participating in the Fleetwood Phase III Study.

Science.gov (United States)

Lapane, Kate L; Hughes, Carmel M

2004-11-01

To provide baseline levels of job satisfaction and stress among members of the long-term care pharmacy team participating in the Fleetwood Phase III evaluation. Cross-sectional design; long-term care pharmacy provider in North Carolina (the implementation site of the large-scale Fleetwood Phase III study). All current pharmacy employees as of May/June 2002. None. Health Professional Stress Inventory and job satisfaction. Ninety-four percent (16/17) of consultant pharmacists were satisfied with their job, with 89% reporting they would definitely choose to be a pharmacist again. Seventy-five percent both of dispensing pharmacists and pharmacy technicians reported overall job satisfaction. Forty-one reported that they would not choose to be a pharmacist (pharmacy technician) again. The most frequently reported sources of stress among the dispensing pharmacists and pharmacy technicians were conflicts with non-work obligations (i.e., family, personal life) and the ability to perform duties with short staffing. In addition, inadequate pay and few opportunities for job advancement were often/frequent sources of stress among pharmacy technicians. More than one third of dispensing pharmacists also reported stress frequently because of fears of mistakes in patient treatment. Overall, consultants are very satisfied with their positions, although dispensing pharmacists and pharmacy technicians are less satisfied with their work. The reasons may be because of the different nature of each job, as well as staffing shortages. The extent to which the Fleetwood Model can improve job satisfaction and impact on stress will be evaluated once we resurvey the pharmacy team after the intervention period of the Fleetwood Phase III study.

Office-based Management of Recurrent Respiratory Papilloma.

Science.gov (United States)

Motz, Kevin M; Hillel, Alexander T

2016-06-01

This review will highlight the indications and benefits of office-based therapy for recurrent respiratory papillomatosis (RRP) and discuss the utilization of photo-dynamic lasers and adjuvant medical therapy in office-based settings. Office-based management of RRP allows for more timely interventions, is preferred by the majority of patients, and negates the risk of general anesthesia. Current literature argues for the utilization of KTP laser over CO 2 laser for office-based treatment of RRP. Medical therapies for RRP are limited, but agents such as bevacizumab are promising and have been shown to reduce disease burden. Medical therapies that can induce disease remission are still needed. Office-based procedures save time and healthcare expenses compared to like procedures in the operating room. However, the increased frequency for office-based procedures predicts similar overall healthcare costs for office-based and OR laser excision of RRP. Office-based management of RRP is a feasible and well-tolerated strategy in appropriately selected patients with adequate local anesthesia.

August 2014 Phoenix pulmonary journal club: the use of macrolide antibiotics in chronic respiratory disease

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Robbins RA

2014-08-01

Full Text Available No abstract available. Article truncated after 150 words. This month's journal club reviewed the role of macrolide antibiotics in chronic respiratory disease. Macrolide usage was suggested from observational studies in Japan in diffuse panbroncholitis, a disorder associated with chronic respiratory infection, usually Pseudomonas aeruginosa (1. Clinical improvement was noted despite doses of antibiotics well below the minimal inhibitory concentration (MIC of the antibiotic. This suggested the antibiotic was likely working by an anti-inflammatory effect. These observations were extended to cystic fibrosis (CF where prophylactic macrolide therapy in CF patients infected with Pseudomonas has become standard therapy (2. More recently, low dose macrolide therapy has been applied to non-CF lung diseases such as chronic obstructive pulmonary disease (COPD, bronchiectasis and asthma. Time did not permit a review of all studies so a representative sample was discussed. In patients with COPD, the four randomized, placebo-controlled trials reviewed all suggested that chronic therapy with macrolide antibiotics reduced COPD exacerbations (3-5. This ...

Digitizing the Facebow: A Clinician/Technician Communication Tool.

Science.gov (United States)

Kalman, Les; Chrapka, Julia; Joseph, Yasmin

2016-01-01

Communication between the clinician and the technician has been an ongoing problem in dentistry. To improve the issue, a dental software application has been developed--the Virtual Facebow App. It is an alternative to the traditional analog facebow, used to orient the maxillary cast in mounting. Comparison data of the two methods indicated that the digitized virtual facebow provided increased efficiency in mounting, increased accuracy in occlusion, and lower cost. Occlusal accuracy, lab time, and total time were statistically significant (Ptechnician communication.

Microprocessor based systems for the higher technician

CERN Document Server

Vears, RE

2013-01-01

Microprocessor Based Systems for the Higher Technician provides coverage of the BTEC level 4 unit in Microprocessor Based Systems (syllabus U80/674). This book is composed of 10 chapters and concentrates on the development of 8-bit microcontrollers specifically constructed around the Z80 microprocessor. The design cycle for the development of such a microprocessor based system and the use of a disk-based development system (MDS) as an aid to design are both described in detail. The book deals with the Control Program Monitor (CP/M) operating system and gives background information on file hand

A case of hypersensitivity pneumonitis with giant cells in a female dental technician.

Science.gov (United States)

Kim, Yong-Hyun; Chung, Yun Kyung; Kim, Changhwan; Nam, Eun Suk; Kim, Hyun-Jun; Joo, Youngsu

2013-10-04

Dental technicians are exposed to methyl methacrylate(MMA) and hard metal dusts while working, and several cases of hypersensitivity pneumonitis caused by the exposure have been reported. The authors experienced a case of hypersensitivity pneumonitis in a female dental technician who had 10 years' work experience and report the case with clinical evidence. The patient's work, personal, social, and past and present medical histories were investigated based on patient questioning and medical records. Furthermore, the workplace conditions and tools and materials the patient worked with were also evaluated. Next, the pathophysiology and risk factors of pneumonitis were studied, and studies on the relationship between hypersensitivity pneumonitis and a dental technician's exposure to dust were reviewed. Any changes in the clinical course of her disease were noted for evaluation of the work-relatedness of the disease. The patient complained of cough and sputum for 1 year. In addition, while walking up the stairs, the patient was not able to ascend without resting due to dyspnea. She visited our emergency department due to epistaxis, and secondary hypertension was incidentally suspected. Laboratory tests including serologic, electrolyte, and endocrinologic tests and a simple chest radiograph showed no specific findings, but chest computed tomography revealed a centrilobular ground-glass pattern in both lung fields. A transbronchial biopsy was performed, and bronchoalveolar washing fluid was obtained. Among the findings of the laboratory tests, microcalcification, noncaseating granuloma containing foreign body-type giant cells, and metal particles within macrophages were identified histologically. Based on these results, hypersensitivity pneumonitis was diagnosed. The patient stopped working due to admission, and she completely quit her job within 2 months of restarting work due to reappearance of the symptoms. In this study, the patient did not have typical radiologic

Historical overview of the process of training of Senior Technician in Nursing in relation to research training

Directory of Open Access Journals (Sweden)

Lola Rosario Altamirano-Baquerizo

2016-07-01

Full Text Available The formation of the Senior Technician in Nursing has been studied by many researchers as a process that integrates knowledge, skills and attitudes for the development of techniques and nursing procedures to healthy individuals or patients, families and community in the various bodies of the Network Asistencial. This paper identifies the training needs of Technician in Nursing, as it has found some shortcomings that do not refer to little curricular and methodological intent of the research training of this professional in the Bolivarian Technological Institute of Ecuador. In addressing the characterization of the historical background of the formation of the Senior Technician in Nursing el-logical historical method to use as documentation reviewing educational programs and policies of vocational training the technical level in the Ecuadorian higher education was used.

Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

Science.gov (United States)

Napier, Patti; Norris, Pauline; Braund, Rhiannon

2018-04-01

Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Perflubron residua: 12 years following therapy

International Nuclear Information System (INIS)

Servaes, Sabah; Epelman, Monica

2009-01-01

Partial liquid ventilation therapy utilizing perfluorocarbons has been used for patients with severe respiratory distress. Perfluorocarbons such as perflubron have been demonstrated to clear from the lungs shortly after therapy. We present a 13-year-old boy with residual perflubron in his lungs, 12 years following therapy with perflubron. The imaging features are important to recognize as these patients return for additional care and imaging. (orig.)

Singing teaching as a therapy for chronic respiratory disease - a randomised controlled trial and qualitative evaluation

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Kelly Julia L

2010-08-01

Full Text Available Abstract Background Despite optimal pharmacological therapy and pulmonary rehabilitation, patients with COPD continue to be breathless. There is a need to develop additional strategies to alleviate symptoms. Learning to sing requires control of breathing and posture and might have benefits that translate into daily life. Methods To test this hypothesis we performed a randomised controlled trial, comparing a six week course of twice weekly singing classes to usual care, in 28 COPD patients. The experience of singing was assessed in a qualitative fashion, through interviews with a psychologist. In addition, we surveyed patients with chronic respiratory conditions who participated in a series of open singing workshops. Results In the RCT, the physical component score of the SF36 improved in the singers (n = 15 compared to the controls (n = 13; +7.5(14.6 vs. -3.8(8.4 p = 0.02. Singers also had a significant fall in HAD anxiety score; -1.1(2.7 vs. +0.8(1.7 p = 0.03. Singing did not improve single breath counting, breath hold time or shuttle walk distance. In the qualitative element, 8 patients from the singing group were interviewed. Positive effects on physical sensation, general well-being, community/social support and achievement/efficacy emerged as common themes. 150 participants in open workshops completed a questionnaire. 96% rated the workshops as "very enjoyable" and 98% thought the workshop had taught them something about breathing in a different way. 81% of attendees felt a "marked physical difference" after the workshop. Conclusion Singing classes can improve quality of life measures and anxiety and are viewed as a very positive experience by patients with respiratory disease; no adverse consequences of participation were observed. Trial Registration Current Controlled Trials - ISRCTN17544114.

Respiratory acidosis

Science.gov (United States)

Ventilatory failure; Respiratory failure; Acidosis - respiratory ... Causes of respiratory acidosis include: Diseases of the airways (such as asthma and COPD ) Diseases of the lung tissue (such as ...

Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

Science.gov (United States)

Bhattacharyya, D; Prasad, Bnbm; Tampi, P S; Ramprasad, R

2011-10-01

Non-invasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute hypercapnic respiratory failure. Patients with hypercapnic respiratory failure requiring ventilation therapy (respiratory rate [RR] of > 30 breaths per minutes, PaCO2 > 55 mmHg and arterial pH success group and these parameters continued to improve even after four and 24 hours of NIPPV treatment. Out of 24 (24%) patients who failed to respond, 13 (54%) needed endotracheal intubation within one hour. The failure group had higher baseline HR than the success group. Improvement in HR, RR, pH, and PCO2 one hour after putting the patient on NIPPV predicts success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

Science.gov (United States)

Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

2017-09-01

We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Pneumonia, Acute Respiratory Distress Syndrome, and Early Immune-Modulator Therapy

Directory of Open Access Journals (Sweden)

Kyung-Yil Lee

2017-02-01

Full Text Available Acute respiratory distress syndrome (ARDS is caused by infectious insults, such as pneumonia from various pathogens or related to other noninfectious events. Clinical and histopathologic characteristics are similar across severely affected patients, suggesting that a common mode of immune reaction may be involved in the immunopathogenesis of ARDS. There may be etiologic substances that have an affinity for respiratory cells and induce lung cell injury in cases of ARDS. These substances originate not only from pathogens, but also from injured host cells. At the molecular level, these substances have various sizes and biochemical characteristics, classifying them as protein substances and non-protein substances. Immune cells and immune proteins may recognize and act on these substances, including pathogenic proteins and peptides, depending upon the size and biochemical properties of the substances (this theory is known as the protein-homeostasis-system hypothesis. The severity or chronicity of ARDS depends on the amount of etiologic substances with corresponding immune reactions, the duration of the appearance of specific immune cells, or the repertoire of specific immune cells that control the substances. Therefore, treatment with early systemic immune modulators (corticosteroids and/or intravenous immunoglobulin as soon as possible may reduce aberrant immune responses in the potential stage of ARDS.

Doses to nuclear technicians in a dedicated PET/CT centre utilising 18F fluorodeoxyglucose (FDG)

International Nuclear Information System (INIS)

Seierstad, T.; Stranden, E.; Bjering, K.; Evensen, M.; Holt, A.; Michalsen, H. M.; Wetteland, O.

2007-01-01

The first dedicated PET/CT centre in Norway was established at the Norwegian Radiumhospital in Oslo in 2005. Knowing that the introductions of PET-isotopes in nuclear medicine give increased occupational radiation dose to the technicians, a study was carried out in order to map the doses to staff members during different working operations and to see if any dose reducing measures were needed. The results of the study are in good agreement with other studies, and a technician dose of 20-25 nSv per injected MBq of 18 F seems to be representative for such centres. For an average injected activity of 350 MBq per patient, the dose limit is reached after handling around 3000 patients annually. For an annual number of less than 500 patients at the centre and rotation of the staff, an annual individual dose for the technicians would realistically be less than 2-3 mSv. Even a major increase in the number of patients will not result in individual doses near the ICRP dose limit. (authors)

SU-E-J-169: The Dosimetric and Temporal Effects of Respiratory-Gated Radiation Therapy in Lung Cancer Patients

International Nuclear Information System (INIS)

Rouabhi, O; Gross, B; Xia, J; Bayouth, J

2015-01-01

Purpose: To evaluate the dosimetric and temporal effects of high dose rate treatment mode for respiratory-gated radiation therapy in lung cancer patients. Methods: Treatment plans from five lung cancer patients (3 nongated (Group 1), 2 gated at 80EX-80IN (Group 2)) were retrospectively evaluated. The maximum tumor motions range from 6–12 mm. Using the same planning criteria, four new treatment plans, corresponding to four gating windows (20EX–20IN, 40EX–40IN, 60EX–60IN, and 80EX–80IN), were generated for each patient. Mean tumor dose (MTD), mean lung dose (MLD), and lung V20 were used to assess the dosimetric effects. A MATLAB algorithm was developed to compute treatment time by considering gantry rotation time, time to position collimator leaves, dose delivery time (scaled relative to the gating window), and communication overhead. Treatment delivery time for each plan was estimated using a 500 MU/min dose rate for the original plans and a 1500 MU/min dose rate for the gated plans. Results: Differences in MTD were less than 1Gy across plans for all five patients. MLD and lung V20 were on average reduced between −16.1% to −6.0% and −20.0% to −7.2%, respectively for non-gated plans when compared with the corresponding gated plans, and between − 5.8% to −4.2% and −7.0% to −5.4%, respectively for plans originally gated at 80EX–80IN when compared with the corresponding 20EX-20IN to 60EX– 60IN gated plans. Treatment delivery times of gated plans using high dose rate were reduced on average between −19.7% (−1.9min) to −27.2% (−2.7min) for originally non-gated plans and −15.6% (−0.9min) to −20.3% (−1.2min) for originally 80EX-80IN gated plans. Conclusion: Respiratory-gated radiation therapy in lung cancer patients can reduce lung toxicity, while maintaining tumor dose. Using a gated high-dose-rate treatment, delivery time comparable to non-gated normal-dose-rate treatment can be achieved. This research is supported by Siemens

Patient training in respiratory-gated radiotherapy

International Nuclear Information System (INIS)

Kini, Vijay R.; Vedam, Subrahmanya S.; Keall, Paul J.; Patil, Sumukh; Chen, Clayton; Mohan, Radhe

2003-01-01

Respiratory gating is used to counter the effects of organ motion during radiotherapy for chest tumors. The effects of variations in patient breathing patterns during a single treatment and from day to day are unknown. We evaluated the feasibility of using patient training tools and their effect on the breathing cycle regularity and reproducibility during respiratory-gated radiotherapy. To monitor respiratory patterns, we used a component of a commercially available respiratory-gated radiotherapy system (Real Time Position Management (RPM) System, Varian Oncology Systems, Palo Alto, CA 94304). This passive marker video tracking system consists of reflective markers placed on the patient's chest or abdomen, which are detected by a wall-mounted video camera. Software installed on a PC interfaced to this camera detects the marker motion digitally and records it. The marker position as a function of time serves as the motion signal that may be used to trigger imaging or treatment. The training tools used were audio prompting and visual feedback, with free breathing as a control. The audio prompting method used instructions to 'breathe in' or 'breathe out' at periodic intervals deduced from patients' own breathing patterns. In the visual feedback method, patients were shown a real-time trace of their abdominal wall motion due to breathing. Using this, they were asked to maintain a constant amplitude of motion. Motion traces of the abdominal wall were recorded for each patient for various maneuvers. Free breathing showed a variable amplitude and frequency. Audio prompting resulted in a reproducible frequency; however, the variability and the magnitude of amplitude increased. Visual feedback gave a better control over the amplitude but showed minor variations in frequency. We concluded that training improves the reproducibility of amplitude and frequency of patient breathing cycles. This may increase the accuracy of respiratory-gated radiation therapy

Medical Laboratory Technician--Hematology, Serology, Blood Banking, and Immunohematology (AFSC 90470).

Science.gov (United States)

Thompson, Joselyn H.

This three-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for medical laboratory technicians. Covered in the individual volumes are hematology (the physiology of blood, complete blood counts and related studies, erythrocyte studies, leukocyte and thrombocyte maturation, and blood…

Respiratory motion prediction by using the adaptive neuro fuzzy inference system (ANFIS)

International Nuclear Information System (INIS)

Kakar, Manish; Nystroem, Haakan; Aarup, Lasse Rye; Noettrup, Trine Jakobi; Olsen, Dag Rune

2005-01-01

The quality of radiation therapy delivered for treating cancer patients is related to set-up errors and organ motion. Due to the margins needed to ensure adequate target coverage, many breast cancer patients have been shown to develop late side effects such as pneumonitis and cardiac damage. Breathing-adapted radiation therapy offers the potential for precise radiation dose delivery to a moving target and thereby reduces the side effects substantially. However, the basic requirement for breathing-adapted radiation therapy is to track and predict the target as precisely as possible. Recent studies have addressed the problem of organ motion prediction by using different methods including artificial neural network and model based approaches. In this study, we propose to use a hybrid intelligent system called ANFIS (the adaptive neuro fuzzy inference system) for predicting respiratory motion in breast cancer patients. In ANFIS, we combine both the learning capabilities of a neural network and reasoning capabilities of fuzzy logic in order to give enhanced prediction capabilities, as compared to using a single methodology alone. After training ANFIS and checking for prediction accuracy on 11 breast cancer patients, it was found that the RMSE (root-mean-square error) can be reduced to sub-millimetre accuracy over a period of 20 s provided the patient is assisted with coaching. The average RMSE for the un-coached patients was 35% of the respiratory amplitude and for the coached patients 6% of the respiratory amplitude

Respiratory motion prediction by using the adaptive neuro fuzzy inference system (ANFIS)

Energy Technology Data Exchange (ETDEWEB)

Kakar, Manish [Department of Radiation Biology, Norwegian Radium Hospital, Montebello, 0310 Oslo (Norway); Nystroem, Haakan [Department of Radiation Oncology, The Finsen Centre, Rigshospitalet, Copenhagen (Denmark); Aarup, Lasse Rye [Department of Radiation Oncology, The Finsen Centre, Rigshospitalet, Copenhagen (Denmark); Noettrup, Trine Jakobi [Department of Radiation Oncology, The Finsen Centre, Rigshospitalet, Copenhagen (Denmark); Olsen, Dag Rune [Department of Radiation Biology, Norwegian Radium Hospital, Montebello, 0310 Oslo (Norway); Department of Medical Physics and Technology, Norwegian Radium Hospital, Oslo (Norway); Department of Physics, University of Oslo (Norway)

2005-10-07

The quality of radiation therapy delivered for treating cancer patients is related to set-up errors and organ motion. Due to the margins needed to ensure adequate target coverage, many breast cancer patients have been shown to develop late side effects such as pneumonitis and cardiac damage. Breathing-adapted radiation therapy offers the potential for precise radiation dose delivery to a moving target and thereby reduces the side effects substantially. However, the basic requirement for breathing-adapted radiation therapy is to track and predict the target as precisely as possible. Recent studies have addressed the problem of organ motion prediction by using different methods including artificial neural network and model based approaches. In this study, we propose to use a hybrid intelligent system called ANFIS (the adaptive neuro fuzzy inference system) for predicting respiratory motion in breast cancer patients. In ANFIS, we combine both the learning capabilities of a neural network and reasoning capabilities of fuzzy logic in order to give enhanced prediction capabilities, as compared to using a single methodology alone. After training ANFIS and checking for prediction accuracy on 11 breast cancer patients, it was found that the RMSE (root-mean-square error) can be reduced to sub-millimetre accuracy over a period of 20 s provided the patient is assisted with coaching. The average RMSE for the un-coached patients was 35% of the respiratory amplitude and for the coached patients 6% of the respiratory amplitude.

The management of respiratory motion in radiation oncology report of AAPM Task Group 76

International Nuclear Information System (INIS)

Keall, Paul J.; Mageras, Gig S.; Balter, James M.

2006-01-01

This document is the report of a task group of the AAPM and has been prepared primarily to advise medical physicists involved in the external-beam radiation therapy of patients with thoracic, abdominal, and pelvic tumors affected by respiratory motion. This report describes the magnitude of respiratory motion, discusses radiotherapy specific problems caused by respiratory motion, explains techniques that explicitly manage respiratory motion during radiotherapy and gives recommendations in the application of these techniques for patient care, including quality assurance (QA) guidelines for these devices and their use with conformal and intensity modulated radiotherapy. The technologies covered by this report are motion-encompassing methods, respiratory gated techniques, breath-hold techniques, forced shallow-breathing methods, and respiration-synchronized techniques. The main outcome of this report is a clinical process guide for managing respiratory motion. Included in this guide is the recommendation that tumor motion should be measured (when possible) for each patient for whom respiratory motion is a concern. If target motion is greater than 5 mm, a method of respiratory motion management is available, and if the patient can tolerate the procedure, respiratory motion management technology is appropriate. Respiratory motion management is also appropriate when the procedure will increase normal tissue sparing. Respiratory motion management involves further resources, education and the development of and adherence to QA procedures

Integrated Technical Information for the Air Logistics Center: Enhancing Maintenance Technician Task Performance

National Research Council Canada - National Science Library

Mitta, Deborah

1998-01-01

This technical paper documents the final results of an analysis of the task environment under which depot maintenance technicians perform their jobs--specifically, programmed depot maintenance (PDM) for F-15 aircraft...

Proceedings of the bright futures in Canada conference : building talent for a powerful tomorrow : powerline technician symposium

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

This powerline technician symposium was held as part of the Electricity Sector Council (ESC) project conducted to report on emerging practices related to the recruitment, retention, and training of powerline technicians. Participants at the symposium were provided with an in-depth discussion of the ESC's situational analysis of the powerline technical trade in Canada. Electric power industry professionals from across Canada discussed regional practices related to the training and recruitment of new powerline technicians. Training programs discussed at the symposium included Cambrian College's powertechmodel; New Brunswick Power's mobile learning program; Hydro Ottawa's apprentice program; and Bright Futures BC's apprentice program. Career materials and methods of promoted the skilled labour market in Canada were also presented. The symposium featured a panel discussion as well as 4 panel PowerPoint presentations. tabs., figs.

Spacecraft and propulsion technician error

Science.gov (United States)

Schultz, Daniel Clyde

Commercial aviation and commercial space similarly launch, fly, and land passenger vehicles. Unlike aviation, the U.S. government has not established maintenance policies for commercial space. This study conducted a mixed methods review of 610 U.S. space launches from 1984 through 2011, which included 31 failures. An analysis of the failure causal factors showed that human error accounted for 76% of those failures, which included workmanship error accounting for 29% of the failures. With the imminent future of commercial space travel, the increased potential for the loss of human life demands that changes be made to the standardized procedures, training, and certification to reduce human error and failure rates. Several recommendations were made by this study to the FAA's Office of Commercial Space Transportation, space launch vehicle operators, and maintenance technician schools in an effort to increase the safety of the space transportation passengers.

Terapia com células-tronco na síndrome do desconforto respiratório agudo Stem cell therapy in acute respiratory distress syndrome

Directory of Open Access Journals (Sweden)

Tatiana Maron-Gutierrez

2009-03-01

. It is believed that an efficient therapy for the acute respiratory distress syndrome should attenuate inflammatory response and promote adequate repair of the lung injury. This article presents a brief review on the use of stem cells and their potential therapeutic effect on the acute respiratory distress syndrome. This systematic review was based upon clinical and experimental acute respiratory distress syndrome studies included in the MedLine and SciElO database during the last 10 years. Stem cell transplant lead to an improvement in lung injury and fibrotic process by inducing adequate tissue repair. This includes alveolar epithelial cell differentiation,and also reduces pulmonary and systemic inflammatory mediators and secretion of growth factors. Stem cells could be a potential therapy for acute respiratory distress syndrome promoting lung repair and attenuating the inflammatory response. However, mechanisms involving their anti-inflammatory and antifibrinogenic effects require better elucidation, limiting their immediate clinical use in acute respiratory distress syndrome.

Neuromuscular disease and respiratory physiology in children: putting lung function into perspective.

Science.gov (United States)

Fauroux, Brigitte; Khirani, Sonia

2014-08-01

Neuromuscular diseases represent a heterogeneous group of disorders of the muscle, nerve or neuromuscular junction. The respiratory muscles are rarely spared in neuromuscular diseases even if the type of muscle involvement, severity and time course greatly varies among the different diseases. Diagnosis of respiratory muscle weakness is crucial because of the importance of respiratory morbidity and mortality. Presently, routine respiratory evaluation is based on non-invasive volitional tests, such as the measurement of lung volumes, spirometry and the maximal static pressures, which may be difficult or impossible to obtain in some young children. Other tools or parameters are thus needed to assess the respiratory muscle weakness and its consequences in young children. The measurement of oesogastric pressures can be helpful as they allow the diagnosis and quantification of paradoxical breathing, as well as the assessment of the strength of the inspiratory and expiratory muscles by means of the oesophageal pressure during a maximal sniff and of the gastric pressure during a maximal cough. Sleep assessment should also be part of the respiratory evaluation of children with neuromuscular disease with at least the recording of nocturnal gas exchange if polysomnography is not possible or unavailable. This improvement in the assessment of respiratory muscle performance may increase our understanding of the respiratory pathophysiology of the different neuromuscular diseases, improve patient care, and guide research and innovative therapies by identifying and validating respiratory parameters. © 2014 Asian Pacific Society of Respirology.

Heuristic evaluation of online COPD respiratory therapy and education video resource center.

Science.gov (United States)

Stellefson, Michael; Chaney, Beth; Chaney, Don

2014-10-01

Abstract Purpose: Because of limited accessibility to pulmonary rehabilitation programs, patients with chronic obstructive pulmonary disease (COPD) are infrequently provided with patient education resources. To help educate patients with COPD on how to live a better life with diminished breathing capacity, we developed a novel social media resource center containing COPD respiratory therapy and education videos called "COPDFlix." A heuristic evaluation of COPDFlix was conducted as part of a larger study to determine whether the prototype was successful in adhering to formal Web site usability guidelines for older adults. A purposive sample of three experts, with expertise in Web design and health communications technology, was recruited (a) to identify usability violations and (b) to propose solutions to improve the functionality of the COPDFlix prototype. Each expert evaluated 18 heuristics in four categories of task-based criteria (i.e., interaction and navigation, information architecture, presentation design, and information design). Seventy-six subcriteria across these four categories were assessed. Quantitative ratings and qualitative comments from each expert were compiled into a single master list, noting the violated heuristic and type/location of problem(s). Sixty-one usability violations were identified across the 18 heuristics. Evaluators rated the majority of heuristic subcriteria as either a "minor hindrance" (n=32) or "no problem" (n=132). Moreover, only 2 of the 18 heuristic categories were noted as "major" violations, with mean severity scores of ≥3. Mixed-methods data analysis helped the multidisciplinary research team to categorize and prioritize usability problems and solutions, leading to 26 discrete design modifications within the COPDFlix prototype.

Royal Engineer Geographic Technicians: Exploring their attitudes to education and training

Science.gov (United States)

Knight, John Anthony

A creative approach is presented for understanding the attitudes of Royal Engineer (RE) Geographic Technicians (Geo Techs) to training and education. Through a grounded theory methodology, participants' experiences of learning and teaching are explored. These provide a greater awareness and perception of attitudes than have emerged through more established, formal methods of evaluating the effectiveness of training. Recent developments in technology, doctrine, requirements and operations have brought about significant changes to the range and complexity of subjects taught in the field of Geospatial Intelligence (GEOINT). This in turn has increased the challenges to RE staff and students, many of whom find themselves instructing on or undertaking demanding degree level courses without the requisite formal qualifications. Grounded theory, based on guidelines rather than rigid rules, is adopted to provide a study of RE Geographic Technicians' learning experiences from the perspective of those who live it and for an interpretive understanding of their meanings to emerge. The policies, culture and social processes in which the RE Geo training takes place are explored to appreciate the influence of the training environment on learning. Data obtained through focus groups held with students and instructors, and through in-depth interviews with individuals who hold key roles associated with the course, recognises the relativism of multiple social realities in developing a rich source of knowledge on attitudes to learning. The collection, synthesis and analysis of data led to the emergence of core categories: context, commitment, expectations, motivation, qualifications, relevance and respect. Through their engagement the research participants' awareness, in particular of instructors, of Geographic Technicians' attitudes to training and education has been raised. Using the theoretical framework of communities of practice, the challenges and effectiveness of the RSMS as a

Animal Health Technicians: A Survey of Program Graduates and of Veterinarians.

Science.gov (United States)

Barsaleau, Richard B.; Walters, Henry R.

This document compiles the reports of two surveys conducted by Cosumnes River College to determine the status of graduates of its Animal Health Technician program, and to assess the acceptance and use of such paraprofessionals by area veterinarians. Information concerning type of employment, state certification, salaries, types of duties, length…

Respiratory alkalosis

Science.gov (United States)

Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis (such as pulmonary embolism and asthma). ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

Directory of Open Access Journals (Sweden)

Seyed M Razavi

2013-01-01

Full Text Available Background: About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict (1980-88. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. Methods: For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. Results: There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Conclusions: Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

"Diagnosis of sleep apnea in network" respiratory polygraphy as a decentralization strategy.

Science.gov (United States)

Borsini, Eduardo; Blanco, Magali; Bosio, Martin; Fernando, Di Tullio; Ernst, Glenda; Salvado, Alejandro

2016-01-01

Obstructive sleep apnea syndrome (OSA) is diagnosed through polysomnography (PSG) or respiratory polygraphy (RP). Self-administered home-based RP using devices with data transmission could facilitate diagnosis in distant populations. The purpose of this work was to describe a telemedicine initiative using RP in four satellite outpatient care clinics (OCC) of Buenos Aires Hospital Británico Central (HBC). OCC technicians were trained both in the use of RP. Raw signals were sent to HBC via intranet software for scoring and final report. During a 24-month 499 RP were performed in 499 patients: 303 men (60.7%) with the following characteristics (mean and standard deviation): valid time for manual analysis: 392.8 min (±100.1), AHI: 17.05 (±16.49 and percentile 25-75 [Pt]: 5-23) ev/hour, ODI (criterion 3%): 18.05 (±16.48 and Pt 25-75: 6-25) ev/hour, and time below 90% (Ttransmission, and low rate of missing data.

Fifty Years of Research in ARDS. Cell-based Therapy for Acute Respiratory Distress Syndrome. Biology and Potential Therapeutic Value.

Science.gov (United States)

Laffey, John G; Matthay, Michael A

2017-08-01

On the basis of several preclinical studies, cell-based therapy has emerged as a potential new therapeutic for acute respiratory distress syndrome (ARDS). Of the various cell-based therapy options, mesenchymal stem/stromal cells (MSCs) from bone marrow, adipose tissue, and umbilical cord have the most experimental data to support their potential efficacy for lung injury from both infectious and noninfectious causes. Mechanistically, MSCs exert their beneficial effects by release of paracrine factors, microvesicles, and transfer of mitochondria, all of which have antiinflammatory and pro-resolving effects on injured lung endothelium and alveolar epithelium, including enhancing the resolution of pulmonary edema by up-regulating sodium-dependent alveolar fluid clearance. MSCs also have antimicrobial effects mediated by release of antimicrobial factors and by up-regulating monocyte/macrophage phagocytosis. Phase 2a clinical trials to establish safety in ARDS are in progress, and two phase 1 trials did not report any serious adverse events. Several issues need further study, including: determining the optimal methods for large-scale production, reconstitution of cryopreserved cells for clinical use, defining cell potency assays, and determining the therapeutic potential of conditioned media derived from MSCs. Because ARDS is a heterogeneous syndrome, targeting MSCs to patients with ARDS with a more hyperinflammatory endotype may further enhance their potential for efficacy.

Hydraulics and pneumatics a technician's and engineer's guide

CERN Document Server

Parr, Andrew

1991-01-01

Hydraulics and Pneumatics: A Technician's and Engineer's Guide provides an introduction to the components and operation of a hydraulic or pneumatic system. This book discusses the main advantages and disadvantages of pneumatic or hydraulic systems.Organized into eight chapters, this book begins with an overview of industrial prime movers. This text then examines the three different types of positive displacement pump used in hydraulic systems, namely, gear pumps, vane pumps, and piston pumps. Other chapters consider the pressure in a hydraulic system, which can be quickly and easily controlled

Changing patterns of inpatient respiratory care services over a decade at the Cleveland Clinic: challenges posed and proposed responses.

Science.gov (United States)

Orens, Douglas K; Kester, Lucy; Konrad, Dale J; Stoller, James K

2005-08-01

Changing characteristics of hospitalized patients over the last decade have created challenges for all health-care providers in delivering optimal care. In the specific case of respiratory care, trends that hospitalized patients have generally become sicker over time and that average lengths of stay have generally become shorter have posed the challenge of meeting demands for more services delivered with greater immediacy. We undertook the current analysis to assess how the delivery of respiratory care services at a tertiary-care academic medical center, the Cleveland Clinic Foundation Hospital, has evolved over the decade 1991 to 2001. In this observational study, we examined concurrent departmental trends and speculated that the capability to increase clinical activity with maintained or improved clinical outcomes, preserved costs, and a lower turnover rate among respiratory therapists reflects features of the professional environment within our Section of Respiratory Therapy. This analysis compares patterns of respiratory care service delivery in two 5-year intervals: from 1991 to 1996 and from 1996 to 2001. Data were collected using a respiratory care information-management system and an inpatient hospital information system, which track the volume and actual cost of services provided. These analyses accounted for the actual time-based cost of the services, including labor (with benefits), necessary equipment and supplies, medications, and equipment maintenance and depreciation. Hospital case-mix index values were determined according to guidelines from the Centers for Medicare and Medicaid Services, as the weighted average of resource allocation scores assigned to diagnosis-related-group categories of hospitalized patients. From 1991 to 2001, there were important expansions in the scope of respiratory care practice by our Section of Respiratory Care, while the volume of respiratory care services delivered per year increased 1.96-fold (from 339,600 to 665

Automotive Service Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 0912

Science.gov (United States)

Alberta Advanced Education and Technology, 2012

2012-01-01

The graduate of the Automotive Service Technician apprenticeship program is a certified journeyperson who will be able to: (1) repair, maintain and overhaul or modify a motor vehicle; (2) comprehend work orders, technical bulletins and estimates, and relate the information to the job at hand; (3) interpret warranty policy in terms of service…

The Hazardous Material Technician Apprenticeship Program at Lawrence Livermore National Laboratory

International Nuclear Information System (INIS)

Steiner, S.D.

1987-07-01

This document describes an apprenticeship training program for hazardous material technician. This entry-level category is achieved after approximately 216 hours of classroom and on-the-job training. Procedures for evaluating performance include in-class testing, use of on-the-job checks, and the assignment of an apprentice mentor for each trainee

Stem cells and respiratory diseases

Directory of Open Access Journals (Sweden)

Soraia Carvalho Abreu

2008-12-01

Full Text Available Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions need to be answered to better understand the mechanisms that control cell division and differentiation, therefore enabling the use of cell therapy in human respiratory diseases.As células-tronco têm uma infinidade de implicações clínicas no pulmão. Este artigo é uma revisão crítica que inclui estudos clínicos e experimentais advindos do banco de dados do MEDLINE e SciElo nos últimos 10 anos, onde foram destacados os efeitos da terapia celular na síndrome do desconforto respiratório agudo ou doenças mais crônicas, como fibrose pulmonar e enfisema. Apesar de muitos estudos demonstrarem os efeitos benéficos das células-tronco no desenvolvimento, reparo e remodelamento pulmonar; algumas questões ainda precisam ser respondidas para um melhor entendimento dos mecanismos que controlam a divisão celular e diferenciação, permitindo o uso da terapia celular nas doenças respiratórias.

Studies on the chronological alterations of blood counts on the radiological technicians at health centers in Japan (1957 - 1975)

International Nuclear Information System (INIS)

Endo, Kouichi; Ishizaka, Masatsuna

1977-01-01

From the nine health surveys made on clinical radiation technicians working at health centers during the 18 years from 1957 to 1975, 679 technicians on whom blood examinations were made for not less than ten consecutive years were sampled to investigate for chronological alterations in their blood parameters. The radiation protective means at the health centers have made rapid progress ever since the atomic bomb experiment in 1954, and the dose of exposure to radiation then began to decrease. On the other hand, it was in about 1960 that the measurement of individual exposure doses began to be made on 60% of all the technicians. Chronological alterations in the average blood counts of these technicians under the abovementioned situation were such that RBC and hemoglobin level continued to increase from 1963 until about 1967, but then began to decrease, and that WBC was as low as 5,883/mm 3 in 1957, but tended to increase though slightly at each of the subsequent surveys, and was increased to 6,570/mm 3 in 1975, that is, WBC has been approaching the normal count of 6,774/mm 3 in the Japanese, with a significant difference at a not more than 1% level of significance in each survey year. For the purpose of preventing radiation hazard, further efforts should be made to protect the technicians from exposure to radiation and to control their health. (auth.)

Maternal and neonatal outcomes of respiratory failure during pregnancy.

Science.gov (United States)

Hung, Chen-Yiu; Hu, Han-Chung; Chiu, Li-Chung; Chang, Chih-Hao; Li, Li-Fu; Huang, Chung-Chi; Kao, Chuan-Chi; Cheng, Po-Jen; Kao, Kuo-Chin

2018-05-01

Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test. The leading causes of respiratory failure were postpartum hemorrhage and severe preeclampsia in the obstetric causes group and pneumonia in the nonobstetric causes group during pregnancy and the peripartum period. The non-obstetric causes group exhibited a higher incidence of acute respiratory distress syndrome and renal replacement therapy as well as requiring more ventilator days. The patients in the obstetric causes group showed significant improvement after delivery in the partial pressure of arterial oxygen to the fraction of inspired oxygen and peak inspiratory pressure decrease. Both groups exhibited high incidences of neonatal respiratory distress syndrome. Neonatal complications resulting from meconium aspiration syndrome (MAS) and sepsis were more common in the non-obstetric causes group; however, neurological development impairment was more common in the obstetric causes group. Obstetric cause was associated with longer ventilator free days and fewer episodes of ARDS after delivery. Neonatal complications resulting from different etiologies of respiratory failure were found to differ. Copyright © 2017. Published by Elsevier B.V.

Integrating Safety in the Aviation System: Interdepartmental Training for Pilots and Maintenance Technicians

Science.gov (United States)

Mattson, Marifran; Petrin, Donald A.; Young, John P.

2001-01-01

The study of human factors has had a decisive impact on the aviation industry. However, the entire aviation system often is not considered in researching, training, and evaluating human factors issues especially with regard to safety. In both conceptual and practical terms, we argue for the proactive management of human error from both an individual and organizational systems perspective. The results of a multidisciplinary research project incorporating survey data from professional pilots and maintenance technicians and an exploratory study integrating students from relevant disciplines are reported. Survey findings suggest that latent safety errors may occur during the maintenance discrepancy reporting process because pilots and maintenance technicians do not effectively interact with one another. The importance of interdepartmental or cross-disciplinary training for decreasing these errors and increasing safety is discussed as a primary implication.

Institutional transparency improves public perception of lab animal technicians and support for animal research.

Science.gov (United States)

Mills, Katelyn E; Han, Zetta; Robbins, Jesse; Weary, Daniel M

2018-01-01

The use of animals in research is controversial and often takes place under a veil of secrecy. Lab animal technicians responsible for the care of animals at research institutions are sometimes described as performing 'dirty work' (i.e. professions that are viewed as morally tainted), and may be stigmatized by negative perceptions of their job. This study assessed if transparency affects public perceptions of lab animal technicians and support for animal research. Participants (n = 550) were randomly assigned to one of six scenarios (using a 3x2 design) that described identical research varying only the transparency of the facility (low, high) and the species used (mice, dogs, cows). Participants provided Likert-type and open-ended responses to questions about the personal characteristics (warmth, competence) of a hypothetical lab technician 'Cathy' and their support for the described research. Quantitative analysis showed participants in the low-transparency condition perceived Cathy to be less warm and were less supportive of the research regardless of animal species. Qualitative responses varied greatly, with some participants expressing support for both Cathy and the research. These results suggest that increasing transparency in lab animal institutions could result in a more positive perception of lab animal researchers and the work that they do.

Residual Motion and Duty Time in Respiratory Gating Radiotherapy Using Individualized or Population-Based Windows

International Nuclear Information System (INIS)

Fuji, Hiroshi; Asada, Yoshihiro; Numano, Masumi; Yamashita, Haruo; Nishimura, Tetsuo; Hashimoto, Takayuki; Harada, Hideyuki; Asakura, Hirofumi; Murayama, Shigeyuki

2009-01-01

Purpose: The efficiency and precision of respiratory gated radiation therapy for tumors is affected by variations in respiration-induced tumor motion. We evaluated the use of individualized and population-based parameters for such treatment. Methods and Materials: External respiratory signal records and images of respiration-induced tumor motion were obtained from 42 patients undergoing respiratory gated radiation therapy for liver tumors. Gating window widths were calculated for each patient, with 2, 4, and 10 mm of residual motion, and the mean was defined as the population-based window width. Residual motions based on population-based and predefined window widths were compared. Duty times based on whole treatment sessions, at various window levels, were calculated. The window level giving the longest duty time was defined as the individualized most efficient level (MEL). MELs were also calculated based on the first 10 breathing cycles. The duty times for population-based MELs (defined as mean MELs) and individualized MELs were compared. Results: Tracks of respiration-induced tumor motion ranged from 3 to 50 mm. Half of the patients had larger actual residual motions than the assigned residual motions. Duty times were greater when based on individualized, rather than population-based, window widths. The MELs established during whole treatment sessions for 2 mm and 4 mm of residual motion gave significantly increased duty times, whereas those calculated using the first 10 breathing cycles showed only marginal increases. Conclusions: Using individualized window widths and levels provided more precise and efficient respiratory gated radiation therapy. However, methods for predicting individualized window levels before treatment remain to be explored.

Large-area burns with pandrug-resistant Pseudomonas aeruginosa infection and respiratory failure.

Science.gov (United States)

Ning, Fang-Gang; Zhao, Xiao-Zhuo; Bian, Jing; Zhang, Guo-An

2011-02-01

Infection due to pandrug-resistant Pseudomonas aeruginosa (PDRPA) has become a challenge in clinical practice. The aim of this research was to summarize the treatment of large-area burns (60% - 80%) with PDRPA infection and respiratory failure in our hospital over the last two years, and to explore a feasible treatment protocol for such patients. We retrospectively analyzed the treatment of five patients with large-area burns accompanied by PDRPA infection and respiratory failure transferred to our hospital from burn units in hospitals in other Chinese cities from January 2008 to February 2010. Before PDRPA infection occurred, all five patients had open wounds with large areas of granulation because of the failure of surgery and dissolving of scar tissue; they had also undergone long-term administration of carbapenems. This therapy included ventilatory support, rigorous repair of wounds, and combined antibiotic therapy targeted at drug-resistance mechanisms, including carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors. Four patients recovered from burns and one died after therapy. First, compromised immunity caused by delayed healing of burn wounds in patients with large-area burns and long-term administration of carbapenems may be the important factors in the initiation and progression of PDRPA infection. Second, if targeted at drug-resistance mechanisms, combined antibiotic therapy using carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors could effectively control PDRPA infection. Third, although patients with large-area burns suffered respiratory failure and had high risks from anesthesia and surgery, only aggressive skin grafting with ventilatory support could control the infection and save lives. Patients may not be able to tolerate a long surgical procedure, so the duration of surgery should be minimized, and the frequency of surgery increased.

Evaluating the effectiveness of an online medical laboratory technician program.

Science.gov (United States)

Hansen-Suchy, Kara

2011-01-01

The purpose of this study was to analyze the effectiveness of an online medical laboratory technician program in the academic preparation and development of laboratory professionals. A semi-quantitative comparative research design was used. Several factors were considered in this evaluation. Academic outcomes between online and campus medical laboratory technician (MLT) students was determined by comparing overall and categorical scores on certification exams as well as first time pass rate. Certification exam scores and first time pass rates were also compared to national norms when possible to do so. Demographic data, including age and experience were compared. Additionally, learning styles were assessed to determine if there was a correlation to overall GPA and MLT GPA and if learning styles could be used to predict successful completion of an online Associates of Applied Science. The research was conducted at an academic university located in the mountain west United States. Participants consisted of online and campus students enrolled in a Medical Laboratory Technician program that graduated with their Associate of Applied Science degree between the years 2007-2009. Results of these years were also compared to graduates from 2004-2006 in the same program. Certification performance and first time pass rates were the major outcomes measured. Age and experience were correlated. Online learning styles and GPA were also compared to successful degree completion. The researcher found no significant difference in certification performance with regard to total and categorical scores, and first time pass rates between campus and online MLT students. Online students were slightly older and had more experience working in a laboratory in some capacity. Correlation studies showed significant positive correlation between learning styles, GPA, and successful completion of an Associate of Applied Science degree. When registry scores were compared to the prior cohort of online

Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections

DEFF Research Database (Denmark)

Schuetz, Philipp; Wirz, Yannick; Sager, Ramon

2018-01-01

BACKGROUND: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety ...

V-TECS Guide for Automobile Air Conditioning and Electrical System Technician.

Science.gov (United States)

Meyer, Calvin F.; Benson, Robert T.

This curriculum guide provides an outline for an eight-unit course to train automobile air conditioning and electrical system technicians. Each unit focuses on a duty that is composed of a number of performance objectives. For each objective, these materials are provided: a task, a standard of performance of task, source of standard, conditions…

Heavy Equipment Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 1912

Science.gov (United States)

Alberta Advanced Education and Technology, 2012

2012-01-01

The graduate of the Heavy Equipment Technician apprenticeship program is a certified journeyperson who will be able to: (1) diagnose repair, and maintain by skills and knowledge gained through training and experience any of the working parts of diesel engines as well as the various components of mobile industrial equipment; (2) use, competently,…

Agricultural Equipment Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 3212

Science.gov (United States)

Alberta Advanced Education and Technology, 2012

2012-01-01

The graduate of the Agricultural Equipment Technician apprenticeship program is a certified journeyperson who will be able to: (1) repair, diagnose and maintain by skill and knowledge gained through training and experience any of the working parts of diesel engines as well as the various components of mobile farm machinery; (2) use, competently,…

Rig Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 5211.1

Science.gov (United States)

Alberta Advanced Education and Technology, 2011

2011-01-01

The graduate of the Rig Technician apprenticeship program is a certified journeyperson who will be able to: (1) take responsibility for personal safety and the safety of others; (2) supervise, coach and train apprentices and floor hands; (3) perform the duties of a motorhand, derrickhand or driller; and (4) perform assigned tasks in accordance…

Synchrony - Cyberknife Respiratory Compensation Technology

International Nuclear Information System (INIS)

Ozhasoglu, Cihat; Saw, Cheng B.; Chen Hungcheng; Burton, Steven; Komanduri, Krishna; Yue, Ning J.; Huq, Saiful M.; Heron, Dwight E.

2008-01-01

Studies of organs in the thorax and abdomen have shown that these organs can move as much as 40 mm due to respiratory motion. Without compensation for this motion during the course of external beam radiation therapy, the dose coverage to target may be compromised. On the other hand, if compensation of this motion is by expansion of the margin around the target, a significant volume of normal tissue may be unnecessarily irradiated. In hypofractionated regimens, the issue of respiratory compensation becomes an important factor and is critical in single-fraction extracranial radiosurgery applications. CyberKnife is an image-guided radiosurgery system that consists of a 6-MV LINAC mounted to a robotic arm coupled through a control loop to a digital diagnostic x-ray imaging system. The robotic arm can point the beam anywhere in space with 6 degrees of freedom, without being constrained to a conventional isocenter. The CyberKnife has been recently upgraded with a real-time respiratory tracking and compensation system called Synchrony. Using external markers in conjunction with diagnostic x-ray images, Synchrony helps guide the robotic arm to move the radiation beam in real time such that the beam always remains aligned with the target. With the aid of Synchrony, the tumor motion can be tracked in three-dimensional space, and the motion-induced dosimetric change to target can be minimized with a limited margin. The working principles, advantages, limitations, and our clinical experience with this new technology will be discussed

Job satisfaction, stress and burnout in anaesthetic technicians in New Zealand.

Science.gov (United States)

Kluger, M T; Bryant, J

2008-03-01

Anaesthetic technicians play a key role in the operating room, yet little is known about their levels of job satisfaction or workplace stress. A blinded, confidential single mail-out survey was posted to anaesthetic technicians in New Zealand. The survey consisted of demographic information, a job satisfaction survey, the Maslach Burnout Inventory and the Short Form 12. At total of 154 forms were returned (51% response rate). Respondents worked predominantly in public hospitals and many had duties outside the operating room. Job satisfaction was related to teamwork, practical nature of work and patient contact, while dissatisfaction was related to lack of respect from nurses and limited career pathway. High to moderate levels of emotional exhaustion (48%), depersonalisation (39%) and low levels of personal accomplishment (58%) were indicators of burnout. The Short Form 12 revealed high levels of physical impairment in 24% and emotional impairment in 35% of respondents. These data suggest that work is needed to evaluate anaesthetic assistants' job structure and actively manage their important physical and emotional sequelae.

Proton Therapy for Thoracoabdominal Tumors

Science.gov (United States)

Sakurai, Hideyuki; Okumura, Toshiyuki; Sugahara, Shinji; Nakayama, Hidetsugu; Tokuuye, Koichi

In advanced-stage disease of certain thoracoabdominal tumors, proton therapy (PT) with concurrent chemotherapy may be an option to reduce side effects. Several technological developments, including a respiratory gating system and implantation of fiducial markers for image guided radiation therapy (IGRT), are necessary for the treatment in thoracoabdominal tumors. In this chapter, the role of PT for tumors of the lung, the esophagus, and liver are discussed.

Management of the infant with respiratory syncytial virus.

Science.gov (United States)

Corey, M A; Clore, E R

1991-04-01

This article examines updated clinical information concerning respiratory syncytial virus (RSV) infection including epidemiology, pathology, clinical manifestations, diagnosis, treatment, nosocomial infection, and prognosis. Also presented is current information on ribavirin therapy, its side effects, and precautions. Research related to the most effective isolation methodology is discussed, as well as nursing diagnoses based on Gordon's Functional Health Patterns and interventions for the infant hospitalized with RSV bronchiolitis and/or pneumonia.

Respiratory

Science.gov (United States)

The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

Current Issues and Challenges in the Use of Aerosolized Surfactant for Respiratory Distress Syndrome in the Newborns

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Dion Darius Samsudin

2013-08-01

Full Text Available BACKGROUND: Surfactant replacement therapy is a recognized treatment for respiratory distress syndrome (RDS in the newborns. Over the past 30 years, human and animal trials have been performed regarding administration of aerosolized surfactant to the injured lung, however the result has been unsatisfactory when compared with instilled surfactant delivery via endotracheal tube (ETT. This review aims to investigate the current issues, challenges and future recommendation of aerosolized surfactant therapy. CONTENT: Five randomized clinical trials in humans and 13 animal trials met the inclusion criteria and were reviewed. Most animal trials agree that this method of treatment is feasible. However, human trials presented conflicting results, and generally showed it to be ineffective. When compared with surfactant delivery via ETT, aerosolized surfactant is less effective in improving respiratory function. SUMMARY: The current data from human trials does not support the implementation of aerosolized surfactant therapy to treat newborns with RDS. Further research is necessary to improve nebulization, delivery, distribution and deposition in the lung, to investigate aerosolized surfactant delivery via ETT and to determine the appropriate dose. KEYWORDS: surfactant, aerosol, prematurity, respiratory distress syndrome.

MRI-related magnetic field exposures and risk of commuting accidents - A cross-sectional survey among Dutch imaging technicians.

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Huss, Anke; Schaap, Kristel; Kromhout, Hans

2017-07-01

Imaging technicians working with magnetic resonance imaging (MRI) may experience acute effects such as vertigo or dizziness when being exposed. A previous study also reported an increased risk of accidents in MRI exposed staff. We aimed at evaluating commuting accident risk in Dutch imaging technicians. Of invited imaging technicians, 490 (29%) filled in a questionnaire pertaining to (near) accidents when driving or riding a bike, health, lifestyle and work practices. We used logistic regression to evaluate the association between exposure to MRI-related electromagnetic fields and risk of commuting (near) accidents in the year prior to the survey, adjusted for a range of potential confounders. Our cross-sectional study indicated an increased risk of (near) accidents if imaging technicians had worked with MRI in the year prior to the survey (odds ratio OR 2.13, 95%CI 1.23-3.69). Risks were higher in persons who worked with MRI more often (OR 2.32, 95%CI 1.25-4.31) compared to persons who worked sometimes with MRI (OR 1.91, 95%CI 0.98-3.72), and higher in those who had likely experienced higher peak exposures to static and time-varying magnetic fields (OR 2.18, 95%CI 1.06-4.48). The effect was seen on commuting accidents that had occurred on the commute from home to work as well as accidents from work to home or elsewhere. Imaging technicians working with MRI scanners may be at an increased risk of commuting (near) accidents. This result needs confirmation and potential risks for other groups (volunteers, patients) should be investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

The respiratory microbiome and respiratory infections

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Unger, Stefan A.; Bogaert, Debby

2017-01-01

Despite advances over the past ten years lower respiratory tract infections still comprise around a fifth of all deaths worldwide in children under five years of age with the majority in low- and middle-income countries. Known risk factors for severe respiratory infections and poor chronic

A pilot survey on the quality of life in respiratory rehabilitation carried out in COPD patients with severe respiratory failure: preliminary data of a novel Inpatient Respiratory Rehabilitation Questionnaire (IRRQ

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Pasqua Franco

2012-11-01

Full Text Available Abstract Background Measuring the state of health is a method for quantifying the impact of an illness on the day-to-day life, health and wellbeing of a patient, providing a quantitative measure of an individual’s quality of life (QoL. QoL expresses patient point of view by a subjective dimension and can express the results of medical intervention. Pulmonary rehabilitation is an essential component in the management of COPD patients, and measuring QoL has become a central focus in the study of this disease. Although nowadays several questionnaires for measuring the QoL in COPD patients are available, there are no questionnaires specifically developed for evaluating QoL in COPD patients undergoing respiratory rehabilitation. The aim of this study was to develop a novel questionnaire for the QoL quantification in COPD patients undergoing in-patient pulmonary rehabilitation program. Methods The questionnaire, administered to COPD patients undergoing long-term oxygen therapy into a respiratory rehabilitation ward, was developed by a simple and graphic layout to be administered to elderly patients. It included one form for admission and another for discharge. It included only tips related to the subjective components of QoL that would be relevant for patient, although likely not strictly related to the respiratory function. A descriptive analysis was performed for the socio-demographic characteristics and both the non-parametric Wilcoxon T-test and the Cronbach’s alpha index were calculated for evaluating the sensitivity of the questionnaire to the effects of respiratory rehabilitation and for identifying its consistency. Results The physical and psychological condition of the 34 COPD patients improved after the rehabilitative treatment and this finding was detected by the questionnaire (overall improvement: 14.2±2.5%, as confirmed by the non-parametric Wilcoxon test (p Conclusions This proposed questionnaire represents a substantial innovation

The influence of a fentanyl and dexmedetomidine combination on external respiratory functions in acute hemorrhage model

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Nikolay G. Vengerovich

2017-01-01

Full Text Available Background. The synthetic opioid analgesic fentanyl is widely used for prophylaxis and therapy of traumatic shock associated with massive bleeding. Its side effects – skeletal muscle rigidity and respiratory center depression – are especially pronounced with repeated administration. It is rational to apply fentanyl in diminished doses in combination with non-opioid analgesics in order to reduce respiratory disturbances risk.Aim. The aim of the work is to justify the influence of opioid analgesic fentanyl and α2 -adrenomimetic dexmedetomidine combination on external respiratory functions in acute hemorrhage model.Materials and methods. Acute loss of 35–40% of circulating blood volume was modeled in experiments on 75 white mongrel male rats. The external respiratory functions (respiratory rate, respiratory volume, breath volume per minute were estimated in animals of 5 groups: 1 – rats without analgesic help (controls; 2–3 – rats receiving a single fentanyl intramuscular injection (ED99 98,96 mcg/kg or fentanyl together with dexme detomidine (ED99 of combination 67,94 mcg/kg 15 min after acute blood loss; 4–5 – rats receiving the same drugs 15 min, 30, 45 and 60 min later.Results. In experimental acute loss of 35–40% of circulating blood volume, 15 min later a secondary acute respiratory failure developed with a drop of respiratory rate, respiratory volume and volume of breath per minute by 30%, 21 and 47% (p < 0,05. The external respiratory functions recoverеd after 4 h mainly due to the increase of respiratory volume. A single intramuscular injection of fentanyl caused respiratory depression 15 min after experimental blood loss which resulted in the decrease of breath volume per minute to 30–61% (p < 0,05 for 90 min. Four intramuscular injections of fentanyl 15 min, 30, 45 and 60 min after hemorrhage caused a severe respiratory dysfunction, accompanied by apnea periods and Biot’s respiration. Respiratory rate was reduced

Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities.

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Pivonello, Rosario; Auriemma, Renata S; Grasso, Ludovica F S; Pivonello, Claudia; Simeoli, Chiara; Patalano, Roberta; Galdiero, Mariano; Colao, Annamaria

2017-02-01

Acromegaly is associated with an enhanced mortality, with cardiovascular and respiratory complications representing not only the most frequent comorbidities but also two of the main causes of deaths, whereas a minor role is played by metabolic complications, and particularly diabetes mellitus. The most prevalent cardiovascular complications of acromegaly include a cardiomyopathy, characterized by cardiac hypertrophy and diastolic and systolic dysfunction together with arterial hypertension, cardiac rhythm disorders and valve diseases, as well as vascular endothelial dysfunction. Biochemical control of acromegaly significantly improves cardiovascular disease, albeit completely recovering to normal mainly in young patients with short disease duration. Respiratory complications, represented mainly by sleep-breathing disorders, particularly sleep apnea, and respiratory insufficiency, frequently occur at the early stage of the disease and, although their severity decreases with disease control, this improvement does not often change the indication for a specific therapy directed to improve respiratory function. Metabolic complications, including glucose and lipid disorders, are variably reported in acromegaly. Treatments of acromegaly may influence glucose metabolism, and the presence of diabetes mellitus in acromegaly may affect the choice of treatments, so that glucose homeostasis is worth being monitored during the entire course of the disease. Early diagnosis and prompt treatment of acromegaly, aimed at obtaining a strict control of hormone excess, are the best strategy to limit the development or reverse the complications and prevent the premature mortality.

Is recurrent respiratory infection associated with allergic respiratory disease?

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de Oliveira, Tiago Bittencourt; Klering, Everton Andrei; da Veiga, Ana Beatriz Gorini

2018-03-13

Respiratory infections cause high morbidity and mortality worldwide. This study aims to estimate the relationship between allergic respiratory diseases with the occurrence of recurrent respiratory infection (RRI) in children and adolescents. The International Study of Asthma and Allergies in Childhood questionnaire and a questionnaire that provides data on the history of respiratory infections and the use of antibiotics were used to obtain data from patients. The relationship between the presence of asthma or allergic rhinitis and the occurrence of respiratory infections in childhood was analyzed. We interviewed the caregivers of 531 children aged 0 to 15 years. The average age of participants was 7.43 years, with females accounting for 52.2%. This study found significant relationship between: presence of asthma or allergic rhinitis with RRI, with prevalence ratio (PR) of 2.47 (1.51-4.02) and 1.61 (1.34-1.93), respectively; respiratory allergies with use of antibiotics for respiratory problems, with PR of 5.32 (2.17-13.0) for asthma and of 1.64 (1.29-2.09) for allergic rhinitis; asthma and allergic rhinitis with diseases of the lower respiratory airways, with PR of 7.82 (4.63-13.21) and 1.65 (1.38-1.96), respectively. In contrast, no relationship between upper respiratory airway diseases and asthma and allergic rhinitis was observed, with PR of 0.71 (0.35-1.48) and 1.30 (0.87-1.95), respectively. RRI is associated with previous atopic diseases, and these conditions should be considered when treating children.

A global picture of pharmacy technician and other pharmacy support workforce cadres

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Koehler, Tamara; Brown, A.

a b s t r a c t Introduction: Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts.

A Canadian Approach to Training Technicians and Technologists In the Earth Sciences.

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Watts, Stephen H.

1983-01-01

Describes two- and three-year undergraduate curricula for training earth science technicians at Sir Sanford Fleming College (Canada), emphasizing practical aspects and close student-faculty interaction. List of employment opportunities for geology graduates based on past placement data and geology curriculum outline are provided in tables. (JN)

Factors that influence standard automated perimetry test results in glaucoma: test reliability, technician experience, time of day, and season.

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Junoy Montolio, Francisco G; Wesselink, Christiaan; Gordijn, Marijke; Jansonius, Nomdo M

2012-10-09

To determine the influence of several factors on standard automated perimetry test results in glaucoma. Longitudinal Humphrey field analyzer 30-2 Swedish interactive threshold algorithm data from 160 eyes of 160 glaucoma patients were used. The influence of technician experience, time of day, and season on the mean deviation (MD) was determined by performing linear regression analysis of MD against time on a series of visual fields and subsequently performing a multiple linear regression analysis with the MD residuals as dependent variable and the factors mentioned above as independent variables. Analyses were performed with and without adjustment for the test reliability (fixation losses and false-positive and false-negative answers) and with and without stratification according to disease stage (baseline MD). Mean follow-up was 9.4 years, with on average 10.8 tests per patient. Technician experience, time of day, and season were associated with the MD. Approximately 0.2 dB lower MD values were found for inexperienced technicians (P Technician experience, time of day, season, and the percentage of false-positive answers have a significant influence on the MD of standard automated perimetry.

Transport Refrigeration Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 4112

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Alberta Advanced Education and Technology, 2012

2012-01-01

The graduate of the Transport Refrigeration Technician apprenticeship program is a certified journeyperson who will be able: (1) to diagnose repair, maintain and operate transport refrigeration equipment used to heat or cool the load as well as of diesel engines, APUs and other prime movers; (2) to use tools and equipment in order to carry out…

Development of a Pharmacy Technician-Driven Program to Improve Vaccination Rates at an Academic Medical Center.

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Hill, John D; Anderegg, Sammuel V; Couldry, Rick J

2017-10-01

Background: Influenza and pneumococcal disease contribute substantially to the burden of preventable disease in the United States. Despite quality measures tied to immunization rates, health systems have struggled to achieve these targets in the inpatient setting. Pharmacy departments have had success through implementation of pharmacist standing order programs (SOP); however, these initiatives are labor-intensive and have not resulted in 100% immunization rates. Objective: The objective of this study was to evaluate a pilot utilizing pharmacy technician interventions, in combination with a nursing SOP, to improve vaccination rates of hospitalized patients for influenza and pneumococcal disease. Methods: A process was developed for pharmacy technicians to identify patients who were not previously screened or immunized during the weekend days on the Cardiovascular Progressive Care unit at the University of Kansas Health-System. Targeted pharmacy technician interventions consisted of phone call reminders and face-to-face discussions with nursing staff. The primary study outcome was the change in immunization compliance rates between the control and intervention groups. Results: Influenza vaccine rates showed a statistically significant increase from 72.2% (52 of 72) of patients during the control group to 92.9% (65 of 70, P = .001) of patients during the intervention group. A pneumococcal vaccination rate of 81.3% (61 of 75) was observed in the control group, compared with 84.3% (59 of 70) of patients in the intervention group ( P = .638). Conclusion: An improvement in inpatient influenza immunization rates can be achieved through targeted follow-up performed by pharmacy technicians, in combination with a nursing-driven SOP.

The role of the pharmacy technician in the skill-mixed district nursing team.

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McGraw, Caroline; Coleman, Bridget; Ashman, Lea; Hayes, Sarah

2012-09-01

Registered nurses in the district nursing service delegate a broad range of medication administration activities to healthcare assistants. Although healthcare assistants have provided extra capacity, not all activities are suitable for delegation to unregulated practitioners. At the same time, their competency assessment is often patient-specific and demands significant registered nursing input. The purpose of this 6-month pilot programme was to test the premise that the employment of a pharmacy technician in the district nursing service would enhance productivity levels and deliver cost savings. Activities delegated included the administration of oral tablets and subcutaneous insulin and low molecular weight heparin injections. The evaluation found that the introduction of the pharmacy technician was associated with neither enhanced productivity nor more than modest cost savings. However, role redesign is a long-term activity and their role could be built on with further competency analysis.