WorldWideScience

Sample records for routine ecg-pulsed 64-row-msct

  1. Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation (''ECG pulsing''): phantom measurements

    International Nuclear Information System (INIS)

    Poll, L.W.; Cohnen, M.; Brachten, S.; Moedder, U.; Ewen, K.

    2002-01-01

    To evaluate the effect of ECG-controlled tube current modulation on radiation exposure in retrospectively-ECG-gated multislice CT (MSCT) of the heart. Material and methods: Three different cardiac MSCT protocols with different slice collimation (4 x 1, and 4 x 2.5 mm), and a pitch-factor of 1.5 and 1.8 were investigated at a multi-slice CT scanner Somatom Volume Zoom, Siemens. An anthropomorphic Alderson-Rando phantom was equipped with LiF-Thermoluminescence dosimeters at several organ sites, and effective doses were calculated using ICRP-weighting factors. Scan protocols were performed with ECG-controlled tube current modulation ('ECG pulsing') at two different heart rates (60 and 80 bpm). These data were compared to previous data from MSCT of the heart without use of 'ECG pulsing'. Results: Radiation exposure with (60 bpm) and without tube current modulation using a 2.5 mm collimation was 1.8 mSv and 2.9 mSv for females, and 1.5 mSv and 2.4 mSv for males, respectively. For protocols using a 1 mm collimation with a pitch-factor of 1.5 (1.8), radiation exposure with and without tube current modulation was 5.6 (6.3) mSv and 9.5 (11.2) mSv for females, and 4.6 (5.2) mSv and 7.7 (9.2) mSv for males, respectively. At higher heart rates (80 bpm) radiation exposure is increased from 1.5-1.8 mSv to 1.8-2.1 mSv, using the 2.5 mm collimation, and from 4.6-5.6 mSv to 5.9-7.2 mSv, for protocols using 1 mm collimation. Conclusions: The ECG-controlled tube current modulation allows a dose reduction of 37% to 44% when retrospectively ECG-gated MSCT of the heart is performed. The tube current - as a function over time - and therefore the radiation exposure is dependent on the heart rate. (orig.) [de

  2. Intelligent Routines

    CERN Document Server

    Anastassiou, George A

    “Intelligent Routines II: Solving Linear Algebra and Differential Geometry with Sage” contains numerous of examples and problems as well as many unsolved problems. This book extensively applies the successful software Sage, which can be found free online http://www.sagemath.org/. Sage is a recent and popular software for mathematical computation, available freely and simple to use. This book is useful to all applied scientists in mathematics, statistics and engineering, as well for late undergraduate and graduate students of above subjects. It is the first such book in solving symbolically with Sage problems in Linear Algebra and Differential Geometry. Plenty of SAGE applications are given at each step of the exposition.

  3. Routine Responses to Disruption of Routines

    Science.gov (United States)

    Guha, Mahua

    2015-01-01

    "Organisational routines" is a widely studied research area. However, there is a dearth of research on disruption of routines. The few studies on disruption of routines discussed problem-solving activities that are carried out in response to disruption. In contrast, this study develops a theory of "solution routines" that are a…

  4. Data format translation routines

    International Nuclear Information System (INIS)

    Burris, R.D.

    1981-02-01

    To enable the effective connection of several dissimilar computers into a network, modification of the data being passed from one computer to another may become necessary. This document describes a package of routines which permit the translation of data in PDP-8 formats to PDP-11 or DECsystem-10 formats or from PDP-11 format to DECsystem-10 format. Additional routines are described which permit the effective use of the translation routines in the environment of the Fusion Energy Division (FED) network and the Elmo Bumpy Torus (EBT) data base

  5. Routines and Organizational Change

    DEFF Research Database (Denmark)

    Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn

    2014-01-01

    Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...... to cope with its task environment. In our nuanced perspective, inertia is not only a consequence of adaptation but also a source of adaptation. This logic is helpful to understand why reliable but apparently inertial organizations keep surviving and often exhibit outstanding performance. We conclude...

  6. Routine sputum culture

    Science.gov (United States)

    Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Elsevier; 2018:chap 36. Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, eds. Laboratory ...

  7. Consuming technologies - developing routines

    DEFF Research Database (Denmark)

    Gram-Hanssen, Kirsten

    2008-01-01

    technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....

  8. The embeddedness of selfish Routines

    DEFF Research Database (Denmark)

    Andersen, Poul Houman

    2001-01-01

    Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well......Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well...

  9. Bedtime routines child wellbeing & development.

    Science.gov (United States)

    Kitsaras, George; Goodwin, Michaela; Allan, Julia; Kelly, Michael P; Pretty, Iain A

    2018-03-21

    Bedtime routines has shown important associations with areas associated with child wellbeing and development. Research into bedtime routines is limited with studies mainly focusing on quality of sleep. The objectives of the present study were to examine the relationship between bedtime routines and a variety of factors associated with child wellbeing and to examine possible determinants of bedtime routines. A total of 50 families with children between 3 and 5 years old took part in the study. Data on bedtime routines, parenting styles, school readiness, children's dental health, and executive function were collected. Children in families with optimal bedtime routines showed better performance in terms of executive function, specifically working memory (t (44)= - 8.51, p ≤ .001), inhibition and attention (t (48)= - 9.70, p ≤ .001) and cognitive flexibility (t (48)= - 13.1, p ≤ .001). Also, children in households with optimal bedtime routines scored higher in their readiness for school (t (48)= 6.92, p ≤ .001) and had better dental health (U = 85.5, p = .011). Parents in households with suboptimal bedtime routines showed worse performance on all measures of executive function including working memory (t (48)= - 10.47, p ≤ .001), inhibition-attention (t (48)= - 10.50, p ≤ .001) and cognitive flexibility (t (48)= - 13.6, p ≤ .001). Finally, parents with optimal bedtime routines for their children deployed a more positive parenting style in general (i.e. authoritative parenting) compared to those with suboptimal bedtime routines (t (48)= - 6.45, p ≤ .001). The results of the present study highlight the potentially important role of bedtime routines in a variety of areas associated with child wellbeing and the need for further research.

  10. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.

    We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

  11. Routine Radiological Environmental Monitoring Plan

    International Nuclear Information System (INIS)

    Bechtel Nevada

    1998-01-01

    The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs

  12. The institutionalization of a routine

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian

    2008-01-01

    -which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world....

  13. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

    2012-01-01

    This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

  14. GRALIB, DISSPLA Plot Routines Emulator

    International Nuclear Information System (INIS)

    Dunford, L.

    1999-01-01

    1 - Description of program or function: GRALIB is a library of graphics subroutines used by PLOTEF. 2 - Method of solution: The PLOTEF library contains routines to generate and manipulate data which are independent of the output graphics device. In order to produce output for a given graphics device - which interact with GRALIB using the DISSPLA conventions - a device driver must be written by the user for this device

  15. Routine Design for Mechanical Engineering

    OpenAIRE

    Brinkop, Axel; Laudwein, Norbert; Maasen, Rudiger

    1995-01-01

    COMIX (configuration of mixing machines) is a system that assists members of the EKATO Sales Department in designing a mixing machine that fulfills the requirements of a customer. It is used to help the engineer design the requested machine and prepare an offer that's to be submitted to the customer. comix integrates more traditional software techniques with explicit knowledge representation and constraint propagation. During the process of routine design, some design decisions have to be mad...

  16. The significance of routines in nursing practice.

    Science.gov (United States)

    Rytterström, Patrik; Unosson, Mitra; Arman, Maria

    2011-12-01

    The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

  17. Routine Early Angioplasty after Fibrinolysis

    DEFF Research Database (Denmark)

    Wang, Zhipeng; Liang, Bo; Mei, Qibing

    2009-01-01

    patients in the group that underwent routine early PCI than in the group that received standard treatment received clopidogrel (Ppatients who undergo PCI, as well as in those who do not, is well established,1...... with early beta-blocker therapy is taken into consideration.3 The overall benefit of clopidogrel and beta-blocker therapy could have influenced the outcome in patients who underwent early PCI. These facts leave the conclusion of the TRANSFER-AMI trial still highly uncertain.......To the Editor: Cantor et al. report that there is a significantly reduced rate of ischemic complications among patients with myocardial infarction with ST-segment elevation who are transferred for PCI within 6 hours after fibrinolysis. However, Table 2 of the article shows that significantly more...

  18. Fit Between Organization Design and Organizational Routines

    Directory of Open Access Journals (Sweden)

    Constance E. Helfat

    2014-07-01

    Full Text Available Despite decades of research on both organization design and organizational routines, little research has analyzed the relationship between them. Here we propose a normative theory in which the effectiveness of organization design and redesign depends on the characteristics of routines. The analysis shows which types of organization designs may be useful as well as which design changes may or may not succeed depending on (a the specificity of routines and (b the dynamic versus static purposes of organizational routines.

  19. Routines Are the Foundation of Classroom Management

    Science.gov (United States)

    Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

    2017-01-01

    Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

  20. 42 CFR 493.931 - Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  1. Technique for comparing automatic quadrature routines

    Energy Technology Data Exchange (ETDEWEB)

    Lyness, J N; Kaganove, J J

    1976-02-01

    The present unconstrained proliferation of automatic quadrature routines is a phenomenon which is wasteful in human time and computing resources. At the root of the problem is an absence of generally acceptable standards or benchmarks for comparing or evaluating such routines. In this paper a general technique, based on the nature of the performance profile, is described which can be used for evaluation of routines.

  2. 40 CFR 141.621 - Routine monitoring.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Routine monitoring. 141.621 Section....621 Routine monitoring. (a) Monitoring. (1) If you submitted an IDSE report, you must begin monitoring..., you must monitor at the location(s) and dates identified in your monitoring plan in § 141.132(f...

  3. Active Movement Warm-Up Routines

    Science.gov (United States)

    Walter, Teri; Quint, Ashleigh; Fischer, Kim; Kiger, Joy

    2011-01-01

    This article presents warm-ups that are designed to physiologically and psychologically prepare students for vigorous physical activity. An active movement warm-up routine is made up of three parts: (1) active warm-up movement exercises, (2) general preparation, and (3) the energy system. These warm-up routines can be used with all grade levels…

  4. External Agents' Effect on Routine Dynamics:Lack of Compliance Resulting in Routine Breakdown

    OpenAIRE

    Busse Hansen, Nicolai

    2014-01-01

    Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic analyses of naturally occurring interactional routine data in the form of recordings of job interviews in an international oil contractor company. The term interactional routine is used to describe recu...

  5. Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

    Science.gov (United States)

    Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

    2015-01-01

    Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

  6. Instrumental neutron activation analysis - a routine method

    International Nuclear Information System (INIS)

    Bruin, M. de.

    1983-01-01

    This thesis describes the way in which at IRI instrumental neutron activation analysis (INAA) has been developed into an automated system for routine analysis. The basis of this work are 20 publications describing the development of INAA since 1968. (Auth.)

  7. External Agents' Effect on Routine Dynamics

    DEFF Research Database (Denmark)

    Busse Hansen, Nicolai

    Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic...... and affiliation are central to how routines are maintained but also susceptible to disruption in case of mis- management. Also the paper contributes with a more fine-tuned understanding of action in terms of them being organized in accordance with preference, which basically means that some actions are preferred...... over others. In producing an action, the relevant next action is projected. However the relevant next action is projected in a specific way and if this is not taken in to account then the routine becomes disrupted. Another core aspect is the notion of deontics that lends itself towards describing who...

  8. Taking medicine at home - create a routine

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

  9. Routine environmental monitoring schedule, calendar year 1997

    Energy Technology Data Exchange (ETDEWEB)

    Markes, B.M., Westinghouse Hanford

    1996-12-10

    This document provides the Environmental Restorations Contractor (ERC) and the Project Hanford Management Contractor.(PHMC) a schedule in accordance with the WHC-CM-7-5, Environmental Compliance` and BHI- EE-02, Environmental Requirements, of monitoring and sampling routines for the Near-Field Monitoring (NFM) program during calendar year (CY) 1997. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near- Field Monitoring and may depend on the site history, radiological status, use, and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1998. The outside perimeter road surveys of 200 East and West Area and the rail survey from the 300 Area to Columbia Center will be performed in the year 2000 per agreement with Department of Energy. Richland Field Office. This schedule does not discuss staffing needs, nor does it list the monitoring equipment to be used in completing specific routines. Personnel performing routines to meet this schedule shall communicate any need for assistance in completing these routines to Radiological Control management and Near-Field Monitoring. After each routine survey is completed, a copy of the survey record, maps, and data sheets will be forwarded to Near-Field Monitoring. These routine surveys will not be considered complete until this documentation is received. At the end of each month, the ERC and PHMC radiological control organizations shall forward a copy of the Routine

  10. Improving care coordination using organisational routines.

    Science.gov (United States)

    Prætorius, Thim

    2016-01-01

    The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

  11. Routine Radiological Environmental Monitoring Plan. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Bechtel Nevada

    1999-12-31

    The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs.

  12. Improving care coordination using organisational routines

    DEFF Research Database (Denmark)

    Prætorius, Thim

    2016-01-01

    Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change......: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research....... Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality...

  13. Conversational routines in English convention and creativity

    CERN Document Server

    Aijmer, Karin

    2014-01-01

    It is surprising how much of everyday conversation consists of repetitive expressions such as 'thank you', 'sorry', would you mind?' and their many variants. However commonplace they may be, they do have important functions in communication.This thorough study draws upon original data from the London-Lund Corpus of Spoken English to provide a discoursal and pragmatic account of the more common expressions found in conversational routines, such as apologising, thanking, requesting and offering.The routines studied in this book range from conventionalized or idiomatized phrases t

  14. Routine maintenance prolongs ESP time between failures

    International Nuclear Information System (INIS)

    Hurst, T.; Lannom, R.W.; Divine, D.L.

    1992-01-01

    This paper reports that routine maintenance of electric submersible motors (ESPs) significantly lengthened the mean time between motor failures (MTBF), decreased operating costs, and extended motor run life in the Sacroc Unit of the Kelly-Snyder field in West Texas. After the oil price boom of the early 1980s. rapidly eroding profit margins from producing properties caused a much stronger focus on reducing operating costs. In Sacroc, ESP operating life and repair costs became a major target of cost reduction efforts. The routine ESP maintenance program has been in place for over 3 years

  15. Absorptive routines and international patent performance

    Directory of Open Access Journals (Sweden)

    Fernando E. García-Muiña

    2017-04-01

    We enrich the treatment of the absorptive capacity phases including the moderating effects between routines associated to the traditional potential-realized absorptive capacities. Taking into account external knowledge search strategies, the deeper external relationships, the better transference and appropriation of specific external knowledge. Nevertheless, when the moderating role of assimilation is included, cooperation agreements appear as the most efficient source of external knowledge. Finally, we show that technological tools let firms store and structure the information making easier its use for international patenting. This positive effect is reinforced in the presence of exploitation routines, since technological knowledge will better fit to the industry's key factors of success.

  16. Generating Novelty Through Interdependent Routines: A Process Model of Routine Work

    NARCIS (Netherlands)

    Deken, F.; Carlile, P.R.; Berends, H.; Lauche, K.

    2016-01-01

    We investigate how multiple actors accomplish interdependent routine performances directed at novel intended outcomes and how this affects routine dynamics over time. We report findings from a longitudinal ethnographic study in an automotive company where actors developed a new business model around

  17. Community Pharmacies As Possible Centres For Routine ...

    African Journals Online (AJOL)

    Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% ...

  18. Age at BCG administration during routine immunization.

    African Journals Online (AJOL)

    Age at BCG administration during routine immunization. R.D. Wammanda , M.J. Gambo and I. Abdulkadir. Department of Paediatrics,. Ahmadu Bello University Teaching Hospital,. Zaria. Correspondence to: Dr.R.D. Wammanda. Email: wammanda@yahoo.com. Summary. In Nigeria, as part of the National Programme on ...

  19. Individual Values, Learning Routines and Academic Procrastination

    Science.gov (United States)

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-01-01

    Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

  20. Individual values, learning routines and academic procrastination.

    Science.gov (United States)

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-12-01

    Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

  1. Probability and statistics with integrated software routines

    CERN Document Server

    Deep, Ronald

    2005-01-01

    Probability & Statistics with Integrated Software Routines is a calculus-based treatment of probability concurrent with and integrated with statistics through interactive, tailored software applications designed to enhance the phenomena of probability and statistics. The software programs make the book unique.The book comes with a CD containing the interactive software leading to the Statistical Genie. The student can issue commands repeatedly while making parameter changes to observe the effects. Computer programming is an excellent skill for problem solvers, involving design, prototyping, data gathering, testing, redesign, validating, etc, all wrapped up in the scientific method.See also: CD to accompany Probability and Stats with Integrated Software Routines (0123694698)* Incorporates more than 1,000 engaging problems with answers* Includes more than 300 solved examples* Uses varied problem solving methods

  2. Computer-aided diagnosis in routine mammography

    International Nuclear Information System (INIS)

    Sittek, H.; Perlet, C.; Helmberger, R.; Linsmeier, E.; Kessler, M.; Reiser, M.

    1998-01-01

    Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system avilable for clinical use in mammography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD-system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading. (orig.) [de

  3. The (Proper) Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul

    2012-01-01

    Sidney Winter (2011), Brian Pentland (2011), and Geoffrey Hodgson and Thorbjørn Knudsen (2011) take issue with the arguments in Teppo Felin and Nicolai J. Foss (2011), along with more generally critiquing the ‘microfoundations project’ related to routines and capabilities. In this rejoinder we ar...... chauvinism; (3) models of mind and man; (4) levels of analysis; (5) agency and uncaused causes; and then further discuss (6) a rationalist alternative....

  4. Peri-colonic haematoma following routine colonoscopy

    OpenAIRE

    Felicity Page; Olfunso Adedeji

    2016-01-01

    Introduction: We present a case of an extra-luminal haematoma following routine colonoscopy. This case highlights an uncommon but potentially life threatening complication in which there is little published literature to date. Presentation of case: A 73 year old male presented with abdominal pain and a reduction in haemoglobin following an uneventful colonoscopy. The imaging had been required as part of colorectal cancer follow up. Initial differential diagnosis included colonic perforatio...

  5. [Routine fluoroscopic investigations after primary bariatric surgery].

    Science.gov (United States)

    Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

    2016-03-01

    Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

  6. Adaptive intrusion data system (AIDS) software routines

    International Nuclear Information System (INIS)

    Corlis, N.E.

    1980-07-01

    An Adaptive Intrusion Data System (AIDS) was developed to collect information from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data-compression, storage, and formatting system; it also incorporates a capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be used for the collection of environmental, bilevel, analog, and video data. This report describes the software routines that control the different AIDS data-collection modes, the diagnostic programs to test the operating hardware, and the data format. Sample data printouts are also included

  7. Adiponectin as a routine clinical biomarker.

    Science.gov (United States)

    Kishida, Ken; Funahashi, Tohru; Shimomura, Iichiro

    2014-01-01

    Adiponectin is a protein synthesized and secreted predominantly by adipocytes into the peripheral blood. However, circulating adiponectin level is inversely related with body weight, especially visceral fat accumulation. The mechanism of this paradoxical relation remains obscure. Low circulating adiponectin concentrations (hypoadiponectinemia; osteoporosis, and cancer (endometrial cancer, postmenopausal breast cancer, leukemia, colon cancer, gastric cancer, prostate cancer). On the other hand, hyperadiponectinemia is associated with cardiac, renal and pulmonary diseases. This review article focuses on the significance of adiponectin as a clinical biomarker of obesity-related diseases. Routine measurement of adiponectin in patients with lifestyle-related diseases is highly recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Radiation dose monitoring in the clinical routine

    Energy Technology Data Exchange (ETDEWEB)

    Guberina, Nika [UK Essen (Germany). Radiology

    2017-04-15

    Here we describe the first clinical experiences regarding the use of an automated radiation dose management software to monitor the radiation dose of patients during routine examinations. Many software solutions for monitoring radiation dose have emerged in the last decade. The continuous progress in radiological techniques, new scan features, scanner generations and protocols are the primary challenge for radiation dose monitoring software systems. To simulate valid dose calculations, radiation dose monitoring systems have to follow current trends and stay constantly up-to-date. The dose management software is connected to all devices at our institute and conducts automatic data acquisition and radiation dose calculation. The system incorporates 18 virtual phantoms based on the Cristy phantom family, estimating doses in newborns to adults. Dose calculation relies on a Monte Carlo simulation engine. Our first practical experiences demonstrate that the software is capable of dose estimation in the clinical routine. Its implementation and use have some limitations that can be overcome. The software is promising and allows assessment of radiation doses, like organ and effective doses according to ICRP 60 and ICRP 103, patient radiation dose history and cumulative radiation doses. Furthermore, we are able to determine local diagnostic reference doses. The radiation dose monitoring software systems can facilitate networking between hospitals and radiological departments, thus refining radiation doses and implementing reference doses at substantially lower levels.

  9. Routine digital pathology workflow: The Catania experience

    Directory of Open Access Journals (Sweden)

    Filippo Fraggetta

    2017-01-01

    Full Text Available Introduction: Successful implementation of whole slide imaging (WSI for routine clinical practice has been accomplished in only a few pathology laboratories worldwide. We report the transition to an effective and complete digital surgical pathology workflow in the pathology laboratory at Cannizzaro Hospital in Catania, Italy. Methods: All (100% permanent histopathology glass slides were digitized at ×20 using Aperio AT2 scanners. Compatible stain and scanning slide racks were employed to streamline operations. eSlide Manager software was bidirectionally interfaced with the anatomic pathology laboratory information system. Virtual slide trays connected to the two-dimensional (2D barcode tracking system allowed pathologists to confirm that they were correctly assigned slides and that all tissues on these glass slides were scanned. Results: Over 115,000 glass slides were digitized with a scan fail rate of around 1%. Drying glass slides before scanning minimized them sticking to scanner racks. Implementation required introduction of a 2D barcode tracking system and modification of histology workflow processes. Conclusion: Our experience indicates that effective adoption of WSI for primary diagnostic use was more dependent on optimizing preimaging variables and integration with the laboratory information system than on information technology infrastructure and ensuring pathologist buy-in. Implementation of digital pathology for routine practice not only leveraged the benefits of digital imaging but also creates an opportunity for establishing standardization of workflow processes in the pathology laboratory.

  10. ACCULIB, Program Library of Mathematical Routines

    International Nuclear Information System (INIS)

    Van Kats, J.M.; Rusman, C.J.; Van der Vorst, H.A.

    1987-01-01

    Description of program or function - ACCULIB is a collection of programs and subprograms for: - approximation and interpolation problems; - the evaluation of series of orthogonal polynomials; - evaluation of the complementary error function; - sorting problems and permutations; - differential equation problems; - linear algebra eigenvalue problems; - optimization problems; - fast Fourier transformations and Fourier series; - numerical quadrature of continuous functions; - linear systems and other linear algebra problems; - bit manipulation and character handling/transmission; - systems of nonlinear equations, in particular the determination of zeros of polynomials; - solution of over-complete systems; - plotting routines for contouring and surface representation; - statistical investigation of data. In addition, many utilities such as code conversion, microfiche production, disk file surveys, layout improvements for ALGOL60 and FORTRAN programs, and the conversion of IBM FORTRAN programs to CDC FORTRAN are included in the collection

  11. Radioligand purification prior to routine receptor assays

    International Nuclear Information System (INIS)

    Le Goff, J.-M.; Berthois, Y.; Martin, P.-M.

    1988-01-01

    The need to repurify the commercially available radioligands [ 3 H]estradiol and [ 3 H]testosterone before use in routine assays was investigated. Storage of these products for 2 months after delivery led to appreciable degradation of [ 3 H]estradiol compared to [ 3 H]testosterone. Unexpectedly, TLC and even HPLC procedures were ineffective in completely restoring the purity of [ 3 H]-estradiol and the unremoved polar products induced important variations in our estrogen receptor assays. An increase in non-specific binding and a concomitant decrease in total binding were observed resulting in an underestimation of specific binding sites and of the affinity constant. In some cases Scatchard analysis was not possible. The authors therefore strongly recommend the repurification of low-stability radioligands and propose an economic time-saving procedure for the purification of [ 3 H]estradiol by solvent differential partition which requires no high-cost investment in apparatus. (author)

  12. ITMETH, Iterative Routines for Linear System

    International Nuclear Information System (INIS)

    Greenbaum, A.

    1989-01-01

    1 - Description of program or function: ITMETH is a collection of iterative routines for solving large, sparse linear systems. 2 - Method of solution: ITMETH solves general linear systems of the form AX=B using a variety of methods: Jacobi iteration; Gauss-Seidel iteration; incomplete LU decomposition or matrix splitting with iterative refinement; diagonal scaling, matrix splitting, or incomplete LU decomposition with the conjugate gradient method for the problem AA'Y=B, X=A'Y; bi-conjugate gradient method with diagonal scaling, matrix splitting, or incomplete LU decomposition; and ortho-min method with diagonal scaling, matrix splitting, or incomplete LU decomposition. ITMETH also solves symmetric positive definite linear systems AX=B using the conjugate gradient method with diagonal scaling or matrix splitting, or the incomplete Cholesky conjugate gradient method

  13. Routine environmental monitoring schedule, calendar year 1995

    International Nuclear Information System (INIS)

    Schmidt, J.W.; Markes, B.M.; McKinney, S.M.

    1994-12-01

    This document provides Bechtel Hanford, Inc. (BHI) and Westinghouse Hanford Company (WHC) a schedule of monitoring and sampling routines for the Operational Environmental Monitoring (OEM) program during calendar year (CY) 1995. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near-Field Monitoring and may depend on the site history, radiological status, use and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1995

  14. ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    G Taneja

    2013-08-01

    Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

  15. Routine airway surveillance in pediatric tracheostomy patients.

    Science.gov (United States)

    Gergin, Ozgul; Adil, Eelam; Kawai, Kosuke; Watters, Karen; Moritz, Ethan; Rahbar, Reza

    2017-06-01

    The aim of this study is to review airway findings in children with tracheostomies who underwent surveillance direct laryngoscopy and bronchoscopy (DLB) to determine the yield of routine airway evaluation in these patients. Retrospective chart review at tertiary referral children's hospital. A retrospective chart review was conducted of all of the children with tracheostomies who underwent DLB after tracheostomy between 1984 and 2015. A total of 303 patients met inclusion criteria. The median time interval between tracheostomy and first follow-up DLB was 12.0 months (IQR 4.8-28.9 months). There was no significant difference in the incidence of airway lesions between patients who underwent endoscopy tracheostomy versus those who had a longer time interval between tracheostomy and DLB (p = 0.16). One hundred sixty seven patients (55.1%) were diagnosed with lesions, with suprastomal granulation (39.9%) being the most common. Symptomatic patients were significantly more likely to have an airway lesion identified (69.9% versus 42.0%; p tracheostomy were significantly more likely to have an airway lesion (p = 0.01). The high incidence of airway lesions noted during surveillance DLB support the utility of routine airway endoscopy in pediatric tracheostomy patients. Symptomatic patients, those with ventilator dependence, or cardiopulmonary or trauma indications for tracheostomy are more likely to have airway lesions and should be monitored closely. The ideal time interval between surveillance endoscopies needs to be examined further. Copyright © 2017. Published by Elsevier B.V.

  16. Treatment goals in psoriasis routine care.

    Science.gov (United States)

    Radtke, M A; Reich, K; Spehr, C; Augustin, Matthias

    2015-07-01

    The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.

  17. Master schedule for CY-1978. Hanford Environmental Surveillance Routine Program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Myers, D.A.; Fix, J.J.

    1977-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. No results are presented in this report. The data collected are available in routine reports issued by the Environmental Evaluations staff

  18. Breaking the Waves: Routines and Rituals in Entrepreneurship Education

    Science.gov (United States)

    Neergaard, Helle; Christensen, Dorthe Refslund

    2017-01-01

    Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on…

  19. [The controversy of routine articulator mounting in orthodontics].

    Science.gov (United States)

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  20. 42 CFR 493.1210 - Condition: Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  1. [Everyday stress, routines and bipolar spectrum].

    Science.gov (United States)

    Gindre, C; Swendsen, J

    2010-06-01

    Bipolar patients relapse more frequently under conditions of stress, even when compliant with prescribed medication. Although the biological bases of stress reactivity remain widely debated, the disruption of biological or circadian rhythms has been suggested as one possible mechanism through which stress increases the risk of episodes. This hypothesis has gained support from recent evidence demonstrating that the disruption of social rhythms is particularly implicated in the onset of manic episodes. However, it is currently unknown to what extent bipolar patients may differ from normal controls in terms of the basic prevalence and nature of daily life routines, or if such individuals are more sensitive to the disruption of such rhythms following exposure to stress. Using a dimensional perspective of bipolar disorder, 1728 French university students were first screened concerning diverse psychological and clinical characteristics. Two hundred and twelve individuals at high or low-risk for mood and substance use disorders were then invited to participate in a week-long period of ambulatory monitoring using the experience sampling method (ESM). During this phase, participants were given a preprogrammed PDA microcomputer which provided ambulatory assessments of behaviour and stress at fixed intervals (randomized across participants). At the end of the ESM phase, the microcomputers were collected and structured diagnostic interviews were administered to each participant. For the purposes of the current study, analyses focused on a subsample of 92 individuals, reflecting the 28 participants who met lifetime criteria for a manic (n=15) or hypomanic episode (n=13), and the 64 individuals who were free of any lifetime disorder. Data were analyzed using hierarchical nonlinear (Bernoulli) models for repeated measures. Covariates included age, sex, frequency of substance use and cognitive vulnerabilities assessed at screening. A Bonferroni correction was applied to adjust

  2. In search for effective methods of routine formation

    Directory of Open Access Journals (Sweden)

    Kandora Marcin

    2017-05-01

    Full Text Available Organizational routines are a frequently researched phenomenon in contemporary management science. Although the available theoretical foundations of Routine Theory seem to have reached a significant degree of maturity over the last thirty years, the same could not be said about the availability of material advice for the management practice. This paper addresses this gap and proposes a framework for an effective routine shaping process. It builds on a brief analysis of available literature on routine formation, supported by case study findings. The approach proposed stresses the importance of the controlled learning process and underlines the importance of deliberate implementation, in contrast to the evolutionary and engineering views on routine emergence.

  3. FASTPLOT, Interface Routines to MS FORTRAN Graphics Library

    International Nuclear Information System (INIS)

    1999-01-01

    1 - Description of program or function: FASTPLOT is a library of routines that can be used to interface with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). The FASTPLOT routines simplify the development of graphics applications and add capabilities such as histograms, Splines, symbols, and error bars. FASTPLOT also includes routines that can be used to create menus. 2 - Methods: FASTPLOT is a library of routines which must be linked with a user's FORTRAN programs that call any FASTPLOT routines. In addition, the user must link with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). 3 - Restrictions on the complexity of the problem: None noted

  4. Lunate chondromalacia: evaluation of routine MRI sequences.

    Science.gov (United States)

    Bordalo-Rodrigues, Marcelo; Schweitzer, Mark; Bergin, Diane; Culp, Randall; Barakat, Mohamed S

    2005-05-01

    Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage. MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema. Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia. We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

  5. Routine dosimetry in a nuclear medicine department

    International Nuclear Information System (INIS)

    Dreuille, O. de; Carbonieres, H. de; Briand-Champlong, J.; Foehrenbach, H.; Guevel, E.; Maserlin, P.; Gaillard, J.F.; Treguier, J.Y.

    2002-01-01

    The nuclear medicine department of the Val de Grace Hospital, in cooperation with the Radiological Protection Army Service, has performed an evaluation of the staff's radio-exposure based on routine dosimetry for six months. The most exposed people are the technicians (2.6 mSv/yr) and the nurse (1.7 mS/yr). The nuclear medicine physicians (0.6 mSv/yr) and the secretaries (0.07 mSv/yr) are far less exposed. The most irradiant occupations are the preparation and the injection of the radiopharmaceuticals (18 mSv/dy) and the realization of the Positron Emission Tomography examinations (19 mSv/dy). The increasing number of PET exams and the development of new tomographs, requiring higher activities, will still increase the exposition level of this working post. This study demonstrates that the exposition doses in nuclear medicine are low compared to the regular limits. Based on these results, only the technicians and the nurse are relevant to the A class. However, these dose levels cannot be neglected for particular positions such as the injection and the PET management. (author)

  6. Routine medicare and radiation exposure. Introductory remarks

    International Nuclear Information System (INIS)

    Hirata, Hideki; Saito, Tsutomu

    2013-01-01

    As an introduction of the title series, outlines of radiation in physics, chemistry, biochemistry, biological effect and protection are explained from the clinical doctors' aspect of routine medicare, and of radiation exposure in which people's interest is raised after the Fukushima Nuclear Power Plant Accident in 2011. For physics, ionizing effects of radiation are described in relation to its quantum energy transfer and its medical utilization like imaging and radiotherapy. Then mentioned in brief is the radiation from elements consisting of human body, cosmic ray and background radiation from the earth, with reference to natural and standardized limits of exposure doses. Radiations from 226 Rn and 40 K are explained as an instance of environmental natural sources together with the concepts of radioactive decay series/scheme, of internal exposure, of hazard like double strand break (DSB) and of medical use such as boron neutron capture therapy (BNCT). For an artifact radiation source, shown are fission products of 235 U by neutron, first yielded in 1945. Evidence of evolution in biochemical repair mechanisms of DSB is explained with a comparison of irradiated drosophila mutation where linear non-threshold (LNT) hypothesis is proposed, and human non-homologous end joining and homologous recombination. Historical process of occupational, medical, public exposures and their protection is finally described from the discovery of X-ray in 1895 to the first ICRP publication in 1958 via the A-bomb explosion in 1945. (T.T.)

  7. Evaluation of macrocytosis in routine hemograms.

    Science.gov (United States)

    Veda, P

    2013-03-01

    Macrocytosis, a condition in which erythrocytes are larger than normal manifests as an increase in mean corpuscular volume (MCV) more than 100 fl. The aim of this study was to identify the underlying causes of macrocytosis, detected in routine hemograms and to evaluate the hematological features in different etiologies. This study included 178 adult patients whose detailed medical history was recorded, and Vitamin B12 assay, folate assay, thyroid function tests, liver function tests, complete blood counts and peripheral smear evaluation was performed. Alcoholism was identified as the etiological factor in 65 cases (36.5%), Vitamin B12 deficiency in 43 cases (24.1%) and drug related in 23 cases (12.9%). These three conditions accounted for 73.6% of macrocytosis. Other causes identified were folate deficiency, liver disease, Myelodysplastic syndrome, chronic renal failure and Aplastic anemia. In 41 cases, the cause of macrocytosis could not be explained. Anemia was observed in 95 cases (53.3%) being most common in Vitamin B12 deficiency. 9 cases (20.9%) of Vitamin B12 deficiency presented with isolated macrocytosis without anemia. It was observed that mean hemoglobin was lower and red cell distribution width (RDW) higher in megaloblastic conditions. Peripheral smear revealed hypersegmented neutrophils in 86% and macro-ovalocytes in 72% of the megaloblastic cases. Complete medical history, red cell parameters and peripheral blood smear are simple, inexpensive tools which assist in identifying the underlying cause of macrocytosis, particularly in resource limited settings. Macrocytosis needs to be evaluated even in the absence of anemia, as it may be the first clue to an underlying pathology.

  8. Routine screening for fetal anomalies: expectations.

    Science.gov (United States)

    Goldberg, James D

    2004-03-01

    Ultrasound has become a routine part of prenatal care. Despite this, the sensitivity and specificity of the procedure is unclear to many patients and healthcare providers. In a small study from Canada, 54.9% of women reported that they had received no information about ultrasound before their examination. In addition, 37.2% of women indicated that they were unaware of any fetal problems that ultrasound could not detect. Most centers that perform ultrasound do not have their own statistics regarding sensitivity and specificity; it is necessary to rely on large collaborative studies. Unfortunately, wide variations exist in these studies with detection rates for fetal anomalies between 13.3% and 82.4%. The Eurofetus study is the largest prospective study performed to date and because of the time and expense involved in this type of study, a similar study is not likely to be repeated. The overall fetal detection rate for anomalous fetuses was 64.1%. It is important to note that in this study, ultrasounds were performed in tertiary centers with significant experience in detecting fetal malformations. The RADIUS study also demonstrated a significantly improved detection rate of anomalies before 24 weeks in tertiary versus community centers (35% versus 13%). Two concepts seem to emerge from reviewing these data. First, patients must be made aware of the limitations of ultrasound in detecting fetal anomalies. This information is critical to allow them to make informed decisions whether to undergo ultrasound examination and to prepare them for potential outcomes.Second, to achieve the detection rates reported in the Eurofetus study, ultrasound examination must be performed in centers that have extensive experience in the detection of fetal anomalies.

  9. The Endogenous Origins of Experience, Routines and Organizational Capabilities

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Felin, Teppo

    2011-01-01

    In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically,...... or rationalist, choice-based approach can provide a more fruitful (though preliminary) foundation for understanding organizational behavior and capabilities.......In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically......, we explicate the behaviorist and empiricist foundations of the organizational routines and capabilities literature and the extant emphasis placed on experience, repetition, and observation as the key antecedents and mechanisms of routines and capabilities. Based on this discussion we highlight...

  10. Routine intracranial pressure monitoring in acute coma.

    Science.gov (United States)

    Forsyth, Rob J; Raper, Joseph; Todhunter, Emma

    2015-11-02

    We know that the brain damage resulting from traumatic and other insults is not due solely to the direct consequences of the primary injury. A significant and potentially preventable contribution to the overall morbidity arises from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) prevents adequate cerebral perfusion with well-oxygenated blood.Detection of raised ICP could be useful in alerting clinicians to the need to improve cerebral perfusion, with consequent reductions in brain injury. To determine whether routine ICP monitoring in severe coma of any cause reduces the risk of all-cause mortality or severe disability at final follow-up. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL Plus, ISI Web of Science (SCI-EXPANDED & CPCI-S), clinical trials registries and reference lists. We ran the most recent search on 22 May 2015. All randomised controlled studies of real-time ICP monitoring by invasive or semi-invasive means in acute coma (traumatic or non-traumatic aetiology) versus clinical care without ICP monitoring (that is, guided only by clinical or radiological inference of the presence of raised ICP). Two authors (ET and RF) worked independently to identify the one study that met inclusion criteria. JR and RF independently extracted data and assessed risk of bias. We contacted study authors for additional information, including details of methods and outcome data. One randomized controlled trial (RCT) meeting the selection criteria has been identified to date.The included study had 324 participants. We judged risk of bias to be low for all categories except blinding of participants and personnel, which is not feasible for this intervention. There were few missing data, and we analysed all on an intention-to-treat basis.Participants could be 13 years of age or older (mean age of sample 29

  11. Modeling Routinization in Games: An Information Theory Approach

    DEFF Research Database (Denmark)

    Wallner, Simon; Pichlmair, Martin; Hecher, Michael

    2015-01-01

    Routinization is the result of practicing until an action stops being a goal-directed process. This paper formulates a definition of routinization in games based on prior research in the fields of activity theory and practice theory. Routinization is analyzed using the formal model of discrete......-time, discrete-space Markov chains and information theory to measure the actual error between the dynamically trained models and the player interaction. Preliminary research supports the hypothesis that Markov chains can be effectively used to model routinization in games. A full study design is presented...

  12. Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

    Science.gov (United States)

    Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

    2010-01-01

    There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

  13. Literature Review Lifestyles and routine activities of South African ...

    African Journals Online (AJOL)

    Journal of Child and Adolescent Mental Health ... Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution. Thozama ... Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are ...

  14. Factors for Radical Creativity, Incremental Creativity, and Routine, Noncreative Performance

    Science.gov (United States)

    Madjar, Nora; Greenberg, Ellen; Chen, Zheng

    2011-01-01

    This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine,…

  15. Endocarditis : Effects of routine echocardiography during Gram-positive bacteraemia

    NARCIS (Netherlands)

    Vos, F J; Bleeker-Rovers, C P; Sturm, P D; Krabbe, P F M; van Dijk, A P J; Oyen, W J G; Kullberg, B J

    2011-01-01

    BACKGROUND: Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in

  16. Thinking Routines: Replicating Classroom Practices within Museum Settings

    Science.gov (United States)

    Wolberg, Rochelle Ibanez; Goff, Allison

    2012-01-01

    This article describes thinking routines as tools to guide and support young children's thinking. These learning strategies, developed by Harvard University's Project Zero Classroom, actively engage students in constructing meaning while also understanding their own thinking process. The authors discuss how thinking routines can be used in both…

  17. Understanding teachers’ routines to inform classroom technology design

    NARCIS (Netherlands)

    An, P.; Bakker, S.; Eggen, J.H.

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer

  18. Understanding Teachers' Routines to Inform Classroom Technology Design

    Science.gov (United States)

    An, Pengcheng; Bakker, Saskia; Eggen, Berry

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

  19. An Element of Practical Knowledge in Education: Professional Routines

    Science.gov (United States)

    Lacourse, France

    2011-01-01

    The question of practical knowledge and its teaching has arisen more perceptibly since the appearance of the aim to professionalize teachers. How can imperceptible knowledge such as professional routines be taught? To establish a social fabric and effective class management, it is essential to call on creative and adaptive professional routines.…

  20. See, Say, Write: A Writing Routine for the Preschool Classroom

    Science.gov (United States)

    Copp, Stefanie B.; Cabell, Sonia Q.; Tortorelli, Laura S.

    2016-01-01

    See, Say, Write is an adaptable classroom writing routine that teachers can use across a range of activities in the preschool classroom. This preschool writing routine offers an opportunity for teachers to build on a shared experience through engagement in rich conversation and writing. After a shared experience, teachers will provide a visual…

  1. The emergence and change of management accounting routines

    NARCIS (Netherlands)

    van der Steen, M.P.

    2011-01-01

    Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

  2. Family routines and rituals following separation: continuity and change

    NARCIS (Netherlands)

    Bakker, W.; Karsten, L.; Mulder, C.H.

    2015-01-01

    Separation always changes family life. The aim of this study is to gain insight into the everyday practices of ‘doing family’ after separation. We focus on two central elements of family life: routines and rituals. While in most families both parents are involved in family routines and rituals, this

  3. 42 CFR 493.1267 - Standard: Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  4. 42 CFR 493.841 - Standard; Routine chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  5. User manual for two simple postscript output FORTRAN plotting routines

    Science.gov (United States)

    Nguyen, T. X.

    1991-01-01

    Graphics is one of the important tools in engineering analysis and design. However, plotting routines that generate output on high quality laser printers normally come in graphics packages, which tend to be expensive and system dependent. These factors become important for small computer systems or desktop computers, especially when only some form of a simple plotting routine is sufficient. With the Postscript language becoming popular, there are more and more Postscript laser printers now available. Simple, versatile, low cost plotting routines that can generate output on high quality laser printers are needed and standard FORTRAN language plotting routines using output in Postscript language seems logical. The purpose here is to explain two simple FORTRAN plotting routines that generate output in Postscript language.

  6. An intelligent stochastic optimization routine for nuclear fuel cycle design

    International Nuclear Information System (INIS)

    Parks, G.T.

    1990-01-01

    A simulated annealing (Metropolis algorithm) optimization routine named AMETROP, which has been developed for use on realistic nuclear fuel cycle problems, is introduced. Each stage of the algorithm is described and the means by which it overcomes or avoids the difficulties posed to conventional optimization routines by such problems are explained. Special attention is given to innovations that enhance AMETROP's performance both through artificial intelligence features, in which the routine uses the accumulation of data to influence its future actions, and through a family of simple performance aids, which allow the designer to use his heuristic knowledge to guide the routine's essentially random search. Using examples from a typical fuel cycle optimization problem, the performance of the stochastic Metropolis algorithm is compared to that of the only suitable deterministic routine in a standard software library, showing AMETROP to have many advantages

  7. Verification and quality control of routine hematology analyzers

    NARCIS (Netherlands)

    Vis, J Y; Huisman, A

    2016-01-01

    Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and

  8. ORGANIZATIONAL ROUTINES IN RUSSIAN COMPANIES: REVIEW OF PRACTICES

    Directory of Open Access Journals (Sweden)

    Olga Valieva

    2014-10-01

    Full Text Available Results of the first stage of the researches conducted in 2012-2013 are presented in article. Researches are connected with studying of transformational processes intra corporate of managemetn practices in the Russian companies and their subsequent institutionalization. Preliminary results showed that in the companies there is a standard set of organizational routines which part are information, and administrative routines, routines of the power of the founder, genetic, institutional and development routines. During research statistically significant connection between types of organizational structures, the sizes of the organization, information processing and administrative practices is established. It is revealed as change of approaches to management of the organization can affect a corruption component.

  9. Pharmaceutical care and the use of routine diagnostic tools by ...

    African Journals Online (AJOL)

    Purpose: To evaluate the use of routine diagnostic tools among community pharmacists in Ibadan,. Nigeria. ... measurement, and tests for serum cholesterol, capillary .... Development .... Duweijua M, Dodoo A, Plange R. Quality Counseling on.

  10. Evaluation of Eigenvalue Routines for Large Scale Applications

    Directory of Open Access Journals (Sweden)

    V.A. Tischler

    1994-01-01

    Full Text Available The NASA structural analysis (NASTRAN∗ program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this article is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the block Lanczos aLgorithm. This eigenvalue routine is now availabLe in several mathematics libraries as well as in severaL commerciaL versions of NASTRAN. In addition, the eRA Y library maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The block Lanczos algorithm was found to be extremely efficient, particularly for very large problems.

  11. Routine hemoglobin electrophoresis for pediatric surgery day case ...

    African Journals Online (AJOL)

    2015-09-25

    Sep 25, 2015 ... 2016 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow ... surgery day case in at-risk populations: Suggested algorithm for screening .... HBE is a routine preoperative investigation before a surgical ...

  12. Unsupervised daily routine and activity discovery in smart homes.

    Science.gov (United States)

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

    The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

  13. User's Manual: Routines for Radiative Heat Transfer and Thermometry

    Science.gov (United States)

    Risch, Timothy K.

    2016-01-01

    Determining the intensity and spectral distribution of radiation emanating from a heated surface has applications in many areas of science and engineering. Areas of research in which the quantification of spectral radiation is used routinely include thermal radiation heat transfer, infrared signature analysis, and radiation thermometry. In the analysis of radiation, it is helpful to be able to predict the radiative intensity and the spectral distribution of the emitted energy. Presented in this report is a set of routines written in Microsoft Visual Basic for Applications (VBA) (Microsoft Corporation, Redmond, Washington) and incorporating functions specific to Microsoft Excel (Microsoft Corporation, Redmond, Washington) that are useful for predicting the radiative behavior of heated surfaces. These routines include functions for calculating quantities of primary importance to engineers and scientists. In addition, the routines also provide the capability to use such information to determine surface temperatures from spectral intensities and for calculating the sensitivity of the surface temperature measurements to unknowns in the input parameters.

  14. Use of WGS in Mycobacterium tuberculosis routine diagnosis

    Directory of Open Access Journals (Sweden)

    Daniela M Cirillo

    2016-01-01

    Conclusion: WGS is a rapid, cost-effective technique that promises to integrate and replace the other tests in routine laboratories for an accurate diagnosis of DR-TB, although it is suitable nowadays for cultured samples only.

  15. Radioprotective shield - an adequate radioprotective device for routine stomatological radiodiagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiltschke, F [Ernst-Moritz-Arndt-Univ., Greifswald (German Democratic Republic); Taschner, P; Koenig, W; Menzel, B [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic)

    1975-01-01

    Starting from the shortcomings of the radioprotective devices at present used in routine stomatological radiodiagnosis, the authors describe the advantages of a radioprotective shield which has been produced in the Greifswald University Stomatological Clinic. On the basis of dosimetric studies, the National Board for Nuclear Safety and Radiological Protection of the GDR (Staatliches Amt fuer Atomsicherheit und Strahlenschutz der DDR) could demonstrate the suitability of this shield as a radioprotective device for routine stomatological radiodiagnosis.

  16. Equipment recommendations for uniform work places for routine stomatological radiodiagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Rother, U [Rostock Univ. (German Democratic Republic). Radiologische Klinik; Taschner, P [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic); Wiltschke, F; Tonne, E; Kuehling, U; Nenning, K

    1977-03-01

    Corresponding to the different objectives, the Working Group on Radiology of the Stomatological Society has designed 6 standardized work places for routine radiodiagnosis in stomatology. Apart from the objectives, the problems related to the division of rooms, equipment, radioprotection and film processing are dealt with separately and specifically. The work places for routine stomatological radiodiagnosis are intended for achieving an improvement in a sector of stomatological care.

  17. Novel structuring routines of titania films for application in photovoltaics

    OpenAIRE

    Niedermeier, Martin A.

    2014-01-01

    Novel routines to structure titania thin films on various length scales are investigated regarding photovoltaic applications. The main focus of the investigations lies on the custom-tailoring of the morphologies of the titania films using sol-gel chemistry in combination with block copolymer templating. Additionally, a low-temperature routine for functional hybrid films as well as the growth of gold as electrode material on top of an organic hole-conductor are investigated. Im Hinblick auf...

  18. Non-routine activities in RP Group in 1995

    International Nuclear Information System (INIS)

    Hoefert, M.; Stevenson, G.R.

    1996-01-01

    The activities not directly concerned with the daily routine, but nevertheless essential to ensure a steady progress in radiation protection at CERN, concern mostly tests and intercomparisons of existing methods (quality control), development of new ideas, methods, and instruments. New projects, another non-routine activity, require in most cases profound studies to prove their feasibility with respect to radiation protection requirements. All these activities are documented in Divisional Reports, Internal Reports and Technical Memoranda, and are listed

  19. Cyclotrons, radionuclides, precursors, and demands for routine versus research compounds

    International Nuclear Information System (INIS)

    Wolf, A.P.

    1984-01-01

    Accelerators for producing commonly used short-lived positron emitters for positron emission tomography are addressed in the context of their use for the preparation of labeled compounds for research and routine biomedical applications. Progress and direction in the preparation and use of radiotracers for studies of the brain are discussed. Advancement to complete automation is stressed as an important factor for the eventual use of positron emission tomography as a routine clinical tool in universities and major medical centers

  20. IONEOS: a fast, analytic, ion equation-of-state routine

    International Nuclear Information System (INIS)

    Cranfill, C.W.; More, R.

    1978-10-01

    A routine IONEOS has been developed to compute ion pressure and specific energy along with their derivatives. The theoretical model used is due to R.D. Cowan and includes non-ideal-gas behavior. The routine is designed for use in large hydrodynamics codes as an improved procedure for splitting the total pressure and specific energy (which are usually tabulated) into ion and electron components

  1. Understanding teachers’ routines to inform classroom technology design

    OpenAIRE

    An, P.; Bakker, S.; Eggen, J.H.

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction to take place both in the center and periphery of users’ attention and naturally shift between the two. We believe that classroom technologies emplo...

  2. Adoption of routine telemedicine in Norway: the current picture

    Science.gov (United States)

    Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

    2014-01-01

    Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

  3. Reference values for generic instruments used in routine outcome monitoring: the leiden routine outcome monitoring study

    Directory of Open Access Journals (Sweden)

    Schulte-van Maaren Yvonne WM

    2012-11-01

    Full Text Available Abstract Introduction The Brief Symptom Inventory (BSI, Mood & Anxiety Symptom Questionnaire −30 (MASQ-D30, Short Form Health Survey 36 (SF-36, and Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF are generic instruments that can be used in Routine Outcome Monitoring (ROM of patients with common mental disorders. We aimed to generate reference values usually encountered in 'healthy' and ‘psychiatrically ill’ populations to facilitate correct interpretation of ROM results. Methods We included the following specific reference populations: 1294 subjects from the general population (ROM reference group recruited through general practitioners, and 5269 psychiatric outpatients diagnosed with mood, anxiety, or somatoform (MAS disorders (ROM patient group. The outermost 5% of observations were used to define limits for one-sided reference intervals (95th percentiles for BSI, MASQ-D30 and DAPP-SF, and 5th percentiles for SF-36 subscales. Internal consistency and Receiver Operating Characteristics (ROC analyses were performed. Results Mean age for the ROM reference group was 40.3 years (SD=12.6 and 37.7 years (SD=12.0 for the ROM patient group. The proportion of females was 62.8% and 64.6%, respectively. The mean for cut-off values of healthy individuals was 0.82 for the BSI subscales, 23 for the three MASQ-D30 subscales, 45 for the SF-36 subscales, and 3.1 for the DAPP-SF subscales. Discriminative power of the BSI, MASQ-D30 and SF-36 was good, but it was poor for the DAPP-SF. For all instruments, the internal consistency of the subscales ranged from adequate to excellent. Discussion and conclusion Reference values for the clinical interpretation were provided for the BSI, MASQ-D30, SF-36, and DAPP-SF. Clinical information aided by ROM data may represent the best means to appraise the clinical state of psychiatric outpatients.

  4. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

    Directory of Open Access Journals (Sweden)

    Kaian Amorim Teles

    Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

  5. Improving Automation Routines for Automatic Heating Load Detection in Buildings

    Directory of Open Access Journals (Sweden)

    Stephen Timlin

    2012-11-01

    Full Text Available Energy managers use weather compensation data and heating system cut off routines to reduce heating energy consumption in buildings and improve user comfort. These routines are traditionally based on the calculation of an estimated building load that is inferred from the external dry bulb temperature at any point in time. While this method does reduce heating energy consumption and accidental overheating, it can be inaccurate under some weather conditions and therefore has limited effectiveness. There remains considerable scope to improve on the accuracy and relevance of the traditional method by expanding the calculations used to include a larger range of environmental metrics. It is proposed that weather compensation and automatic shut off routines that are commonly used could be improved notably with little additional cost by the inclusion of additional weather metrics. This paper examines the theoretical relationship between various external metrics and building heating loads. Results of the application of an advanced routine to a recently constructed building are examined, and estimates are made of the potential savings that can be achieved through the use of the routines proposed.

  6. Older adults' personal routine at time of hospitalization.

    Science.gov (United States)

    Zisberg, Anna; Gur-Yaish, Nurit

    This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Master schedule for CY-1982 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1981-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites

  8. Pulse processing routines for neutron time-of-flight data

    CERN Document Server

    Žugec, P; Guerrero, C; Gunsing, F; Vlachoudis, V; Sabate-Gilarte, M; Stamatopoulos, A; Wright, T; Lerendegui-Marco, J; Mingrone, F; Ryan, J A; Warren, S G; Tsinganis, A; Barbagallo, M

    2016-01-01

    A pulse shape analysis framework is described, which was developed for n_TOF-Phase3, the third phase in the operation of the n_TOF facility at CERN. The most notable feature of this new framework is the adoption of generic pulse shape analysis routines, characterized by a minimal number of explicit assumptions about the nature of pulses. The aim of these routines is to be applicable to a wide variety of detectors, thus facilitating the introduction of the new detectors or types of detectors into the analysis framework. The operational details of the routines are suited to the specific requirements of particular detectors by adjusting the set of external input parameters. Pulse recognition, baseline calculation and the pulse shape fitting procedure are described. Special emphasis is put on their computational efficiency, since the most basic implementations of these conceptually simple methods are often computationally inefficient.

  9. Marshalling embedded routines in support of firm creation

    DEFF Research Database (Denmark)

    Houman Andersen, Poul; Norus, Jesper

    2003-01-01

    The paper has a dual purpose. First, we suggest that entrepreneurs in their establishment of new businesses draw on a range of pre-existing socially embedded routines for creating acceptance by their environment. Also they draw upon external resources that are used in patterning specific practices....... This ability is treated as entrepreneurial assets. Secondly, we argue that the existence and patterning of these socially embedded routines used in new business development are contingent on the institutional context. We see the institutional context as complex and fragmented, composed and shaped by different...

  10. The Emergence of Routines: Entrepreneurship, Organization, and Business History

    DEFF Research Database (Denmark)

    Lubinski, Christina

    2018-01-01

    Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1.......Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1....

  11. Linking child travel routes and routine health data

    Directory of Open Access Journals (Sweden)

    Amy Mizen

    2017-04-01

    Depending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.

  12. Interval of Routine Maintenance and Maintenance Performance: A Literature Review

    Directory of Open Access Journals (Sweden)

    Au-Yong Cheong Peng

    2016-01-01

    Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.

  13. Quality of routine spirometry tests in Dutch general practices.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Crockett, A.J.; Poels, P.J.P.; Dijke, J.J. van; Akkermans, R.P.; Vlek, H.F.; Pieters, W.R.

    2009-01-01

    BACKGROUND: Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. AIM: To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. DESIGN OF STUDY: Analysis

  14. A problem-solving routine for improving hospital operations.

    Science.gov (United States)

    Ghosh, Manimay; Sobek Ii, Durward K

    2015-01-01

    The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

  15. A Sudden Total Loss of Vision After Routine Cataract Surgery ...

    African Journals Online (AJOL)

    We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

  16. Glogs as Non-Routine Problem Solving Tools in Mathematics

    Science.gov (United States)

    Devine, Matthew T.

    2013-01-01

    In mathematical problem solving, American students are falling behind their global peers because of a lack of foundational and reasoning skills. A specific area of difficulty with problem solving is working non-routine, heuristic-based problems. Many students are not provided with effective instruction and often grow frustrated and dislike math.…

  17. Collaborative Referencing between Individuals with Aphasia and Routine Communication Partners.

    Science.gov (United States)

    Hengst, Julie A.

    2003-01-01

    This study examined how four adults with aphasia collaborated with routine communication partners. Overall, these pairs completed the referencing task trials with accuracy and displayed referencing processes that conformed to the collaborative referencing model of communication. However, the pairs also used diverse verbal and nonverbal resources,…

  18. Diagnostic accuracy of routine postoperative body temperature measurements

    NARCIS (Netherlands)

    Vermeulen, Hester; Storm-Versloot, Marja N.; Goossens, Astrid; Speelman, Peter; Legemate, Dink A.

    2005-01-01

    BACKGROUND: On surgical wards, body temperature is routinely measured, but there is no proof that this is useful for detecting postoperative infection. The aim of this study was to compare temperature measurements (the test) with the confirmed absence or presence of a postoperative infection (the

  19. Radiographic demonstration of small intestinal villi on routine clinical studies

    International Nuclear Information System (INIS)

    Gelfand, D.W.; Ott, D.J.

    1981-01-01

    The radiographic demonstration of the small intestinal villi is reported. The villi were demonstrable with both single- and double-contrast methods on routine clinical studies. The primary requirement for their delineation appears to be employment of a high-resolution radiographic system. (orig.) [de

  20. Pitfalls in the routine diagnosis of Staphylococcus aureus | Bello ...

    African Journals Online (AJOL)

    Two hundred isolates of Presumed Staphylococcus aureus from routine clinical specimens, collected from two government hospitals in Abha, Saudi Arabia, had their identity verified. We used the tube coagulase test as our gold standard. Twenty (10%) of the isolates were mis-identified. Reliance by the two laboratories on ...

  1. 32 CFR 318.14 - Blanket routine uses.

    Science.gov (United States)

    2010-07-01

    ... interest of simplicity, economy and to avoid redundancy. (b) Routine Use—Law Enforcement. If a system of... to the OMB in connection with the review of private relief legislation as set forth in OMB Circular A-19 at any stage of the legislative coordination and clearance process as set forth in that Circular...

  2. Types of and reasons for postoperative complications after routine ...

    African Journals Online (AJOL)

    Tooth extraction also called exodontia is one of the most common surgical procedures. This study was to assess the reasons and the types of wound healing complications arising after routine (intra alveolar dental extraction) in a General hospital in Lagos. Consecutive recruitment (convenient sampling) method was used to ...

  3. Modeling the Structure and Complexity of Engineering Routine Design Problems

    NARCIS (Netherlands)

    Jauregui Becker, Juan Manuel; Wits, Wessel Willems; van Houten, Frederikus J.A.M.

    2011-01-01

    This paper proposes a model to structure routine design problems as well as a model of its design complexity. The idea is that having a proper model of the structure of such problems enables understanding its complexity, and likewise, a proper understanding of its complexity enables the development

  4. Routine Activities and Sexual Harassment in the Workplace.

    Science.gov (United States)

    De Coster, Stacy; Estes, Sarah Beth; Mueller, Charles W.

    1999-01-01

    In criminology, routine activities of potential victims can be used to predict victimization. Application to organizational sexual harassment data shows that organizational features (proximity in job location, supervisor or work group guardianship) and individual characteristics (target attractiveness) can predict sexual harassment victimization,…

  5. Perspex in the verification routines for accelerator beam

    International Nuclear Information System (INIS)

    Paredes G, L.; Genis S, R.

    1998-01-01

    It is analyzed the use of a perspex solid phantom, adequately referred to a water phantom, as an auxiliary alternative for the daily stability verification routines or constance of radiation beam, as an option in the case of radiotherapy installations with high charge of accelerator working and with basic dosimetry equipment. (Author)

  6. Routine Violence Risk Assessment in Community Forensic Mental Healthcare

    NARCIS (Netherlands)

    van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

    2010-01-01

    We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

  7. Antibody response to routine measles vaccination among a ...

    African Journals Online (AJOL)

    owner

    2013-02-08

    Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.

  8. Circulating tumor cell isolation and diagnostics: toward routine clinical use

    NARCIS (Netherlands)

    Stolpe, van de A.; Pantel, K.; Sleijfer, S.; Terstappen, L.W.; Toonder, den J.M.J.

    2011-01-01

    From February 7–11, 2011, the multidisciplinary Lorentz Workshop Circulating Tumor Cell (CTC) Isolation and Diagnostics: Toward Routine Clinical Use was held in Leiden (The Netherlands) to discuss progress and define challenges and potential solutions for development of clinically useful circulating

  9. Practising Homelessness: A Typology Approach to Young People's Daily Routines

    Science.gov (United States)

    Mallett, Shelley; Rosenthal, Doreen; Myers, Paul; Milburn, Norweeta; Rotheram-Borus, Mary Jane

    2004-01-01

    In a study exploring the relationship between typology and risk, we investigated the daily routines of a heterogeneous sample of young men and women from two sites who had been homeless for varying periods (N=1289). Cluster analysis yielded four groups--"Partnered", "Socially engaged", "Service connected-harm avoidant", and "Transgressive"--based…

  10. Predictors of routine episiotomy in primigravida women in Oman.

    Science.gov (United States)

    Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

    2016-02-01

    Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  11. POLAND' SYNDROME: An Incidental findings on routine medical ...

    African Journals Online (AJOL)

    Dr Hamidu

    SM is a 20 year, old young man who came for routine medical check for recruitment into a local football club. Born to a 45 ... mimicking a radical mastectomy. A dense ascending line as a result of the absence of the ... centered around reconstructive surgical procedures on the hand. They may however be some functional.

  12. A new generation videokymography for routine clinical vocal fold examination

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    2006-01-01

    Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders.

  13. Introducing routine enquiry about domestic violence in a paediatric setting.

    Science.gov (United States)

    Asiegbunam, Nkiru

    2018-02-01

    Implementation of routine enquiry (RE) about domestic abuse in the multidisciplinary Evelina London Guys and St. Thomas Trust (GSTT) Community Health Services (CHS). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Validating soil phosphorus routines in the SWAT model

    Science.gov (United States)

    Phosphorus transfer from agricultural soils to surface waters is an important environmental issue. Commonly used models like SWAT have not always been updated to reflect improved understanding of soil P transformations and transfer to runoff. Our objective was to validate the ability of the P routin...

  15. Accuracy and Quality of Routine Immunisation Data Monitoring ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    Accuracy and Quality of Routine Immunisation Data Monitoring. System in two South-Eastern Districts of Nigeria. AkinolaAyoola Fatiregun, CeciliaAwogu. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of. Medicine, University ofibadan, Ibadan, Nigeria. ABSTRACT. BACKGROUND.

  16. The birth and routinization of IVF in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    2016-01-01

    How can it be that China today is home to some of the world’s largest IVF clinics, carrying out as many as 30,000 cycles annually? In this article, I address how IVF was developed in China during the early 1980s only to be routinized during the exact same period that one of the world’s most compr...

  17. Supporting Classroom Transitions between Daily Routines: Strategies and Tips

    Science.gov (United States)

    Banerjee, Rashida; Horn, Eva

    2013-01-01

    The purpose of this article is to provide tools for preschool professionals to plan for transitions between daily routines, to identify challenging transitions during the day, and to offer strategies to support transitions in classrooms to prevent challenging behaviors from occurring due to frequent changes. Specifically, the authors answer three…

  18. ORIGINAL ARTICLES Acceptability, feasibility and impact of routine ...

    African Journals Online (AJOL)

    programme, leading to the identification of children with previously undiagnosed HIV ... We explored the acceptability and feasibility of routine HIV screening in ... proportion of previously undiagnosed HIV-positive children aged ..... primary healthcare facilities in South Africa: Attitudes of nurses and child caregivers. Soc Sci ...

  19. Good Quality - the Routinization of Sperm Banking in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    Good Quality is an assemblage ethnography of how sperm banking came to be routinized in China. Based on 8 years of episodic fieldwork at China’s oldest and largest sperm bank in Changsha, Hunan province, the book meticulously chronicles how, beginning in the early 1980s, a unique style of sperm b...

  20. Routine antenatal syphilis screening in South West Nigeria - a ...

    African Journals Online (AJOL)

    Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...

  1. Creating Masterpieces: How Course Structures and Routines Enable Student Performance

    Science.gov (United States)

    Dean, Kathy Lund; Fornaciari, Charles J.

    2014-01-01

    Over a five-year period, we made a persistent observation: Course structures and routines, such as assignment parameters, student group process rules, and grading schemes were being consistently ignored. As a result, we got distracted by correcting these structural issues and were spending less time on student assignment performance. In this…

  2. Routine hemoglobin electrophoresis for pediatric surgery day case ...

    African Journals Online (AJOL)

    Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of ...

  3. Analysis of routine EEG usage in a general adult ICU.

    LENUS (Irish Health Repository)

    McHugh, J C

    2009-09-01

    Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower.

  4. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  5. Benchmarking routine psychological services: a discussion of challenges and methods.

    Science.gov (United States)

    Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

    2014-01-01

    Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

  6. Examining the cost of delivering routine immunization in Honduras.

    Science.gov (United States)

    Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

    2015-05-07

    Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

  7. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Heon Young

    1995-01-01

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  8. Routine chest X-ray in the allergy clinic

    International Nuclear Information System (INIS)

    Garcia-Barredo, M.R.; Usamentiaga, E.; Fidalgo, I.

    1997-01-01

    To determine whether routine chest X-ray is indicated in allergy patients when there is no evidence of cardiopulmonary involvement. A retrospective study to analyze the indications and radiologic findings in 515 consecutive patients who underwent chest X-ray: Positive findings were considered to be any radiological sing that led to the performance of additional diagnostic measures or a change in the therapeutic management of the patient. Positive radiologic findings were observed in 39 cases (7.59%). Only two patients (0.38%) were diagnosed as having diseases that were susceptible to proper treatment. In one of them (0.19%), the failure to perform chest X-ray would have impeded the introduction of proper treatment. We do not recommend carrying out routine chest X-ray in this patient population. (Author) 7 refs

  9. Investigations of CR39 dosimeters for neutron routine dosimetry

    International Nuclear Information System (INIS)

    Weinstein, M.; Abraham, A.; Tshuva, A.; German, U.

    2004-01-01

    CR-39 is a polymeric nuclear track detector which is widely used for neutron dosimetry. CR-39 detector development was conducted at a number of laboratories throughout the world(1,2) , and was accepted also for routine dosimetry. However, there are shortcomings which must be taken into consideration the lack of a dosimetry grade material which causes batch variations, significant angular dependence and a moderate sensitivity. CR-39 also under-responds for certain classes of neutron spectra (lower energy neutrons from reactors or high energy accelerator-produced neutrons).In order to introduce CR-39 as a routine dosimeter at NRCN, a series of checks were performed. The present work describes the results of some of our checks, to characterize the main properties of CR-39 dosimeters

  10. SVM detection of epileptiform activity in routine EEG.

    LENUS (Irish Health Repository)

    Kelleher, Daniel

    2010-01-01

    Routine electroencephalogram (EEG) is an important test in aiding the diagnosis of patients with suspected epilepsy. These recordings typically last 20-40 minutes, during which signs of abnormal activity (spikes, sharp waves) are looked for in the EEG trace. It is essential that events of short duration are detected during the routine EEG test. The work presented in this paper examines the effect of changing a range of input values to the detection system on its ability to distinguish between normal and abnormal EEG activity. It is shown that the length of analysis window in the range of 0.5s to 1s are well suited to the task. Additionally, it is reported that patient specific systems should be used where possible due to their better performance.

  11. Developing non-routine problems for assessing students’ mathematical literacy

    Science.gov (United States)

    Murdiyani, N. M.

    2018-03-01

    The purpose of this study is to develop non-routine problems for assessing the mathematics literacy skills of students, which is valid, practical, and effective. It is based on the previous research said that Indonesian students’ mathematical literacy is still low. The results of this study can be used as a guide in developing the evaluation questions that can train students to improve the ability of solving non-routine problems in everyday life. This research type is formative evaluation that consists of preliminary, self evaluation, expert reviews, one-to-one, small group, and field test. The sample of this research is grade 8 students at one of Junior High School in Yogyakarta. This study results in mathematics literacy problems prototype consisting of level 1 to level 6 problems similar to PISA problems. This study also discusses the examples of students’ answer and their reasoning.

  12. Routine pharmacogenetic testing in clinical practice: dream or reality?

    Science.gov (United States)

    Grossman, Iris

    2007-10-01

    Pharmacogenetics (PGx) has become progressively popular in recent years, thanks to growing anticipation among scientists, healthcare providers and the general public for the incorporation of genetic tests into the diagnostic arsenal at the physician's disposal. Indeed, much research has been dedicated to elucidation of genetic determinants underlying interindividual variability in pharmacokinetic parameters, as well as drug safety and efficacy. However, few PGx applications have thus far been realized in healthcare management. This review uses examples from PGx research of psychiatric drugs to illustrate why the current published findings are inadequate and insufficient for utilization as routine clinical predictors of treatment safety, efficacy or dosing. I therefore suggest the necessary steps to demonstrate the validity, utility and cost-effectiveness of PGx. These recommendations include a whole range of aspects, starting from standardization of criteria and assessment of the technical quality of genotyping assays, up to design of prospective PGx studies, providing the basis for reimbursement programs to be recognized in routine clinical practice.

  13. Factors related to pain during routine photodynamic therapy

    DEFF Research Database (Denmark)

    Miller, I M; Nielsen, J S; Lophaven, S

    2011-01-01

    between pain-reducing intervention and diagnosis, pre-treatment, gender or age was found. CONCLUSIONS: Pain-reducing intervention was required in 44% of the PDT treatments. Intervention was particularly required when treating lesions in areas suited for PDT therapy for cosmetic reasons such as the scalp......BACKGROUND: Pain may be a limiting factor in the use of photodynamic therapy (PDT). The consequences of the pain i.e. the resources spent on pain-intervention during routine PDT therapy are poorly described. OBJECTIVES: To describe the consequences of pain during PDT by describing the use of pain......-reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention. METHODS: Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block. RESULTS: Data from 983 PDT...

  14. Daily medication routine of adolescents with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Cristiane Cardoso de Paula

    2013-12-01

    Full Text Available The objective of this study was to describe the sociodemographic, clinical, and behavioral characteristics of the daily medication routine of adolescents with HIV/AIDS of ages 13 to 19 years, followed at a reference service. This descriptive cross-sectional study was performed with 23 adolescents, using a quantitative approach. Data were collected using a form during appointments at the outpatient clinic. Univariate analysis revealed: females, in the initial phase of adolescence, and vertical transmission. The highlights were: lack of assiduity to appointments; unprotected sex; and consumption of alcohol. Regarding the daily medication routine, subjects depend on their parents or guardians, use strategies to remember to take the medications, and are unaware about the laboratory test for disease management and treatment. There is a need for educative intervention using information and communication technology, such as the Internet, to promote health and autonomy among adolescents. Descriptors: Acquired Immunodeficiency Syndrome; Adolescent Health; Antiretroviral Therapy, Highly Active; Nursing.

  15. Stratification of type 2 diabetes based on routine clinical markers

    DEFF Research Database (Denmark)

    Safai, Narges; Ali, Ashfaq; Rossing, Peter

    2018-01-01

    AIMS: We hypothesized that patients with dysregulated type 2 diabetes may be stratified based on routine clinical markers. METHODS: In this retrospective cohort study, diabetes related clinical measures including age at onset, diabetes duration, HbA1c, BMI, HOMA2-β, HOMA2-IR and GAD65...... autoantibodies, were used for sub-grouping patients by K-means clustering and for adjusting. Probability of diabetes complications (95% confidence interval), were calculated using logistic regression. RESULTS: Based on baseline data from patients with type 2 diabetes (n=2,290), the cluster analysis suggested up....... CONCLUSIONS: Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes....

  16. Master schedule for CY-1981 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1980-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites

  17. Burst suppression in sleep in a routine outpatient EEG

    Directory of Open Access Journals (Sweden)

    Ammar Kheder

    2014-01-01

    Full Text Available Burst suppression (BS is an electroencephalogram (EEG pattern that is characterized by brief bursts of spikes, sharp waves, or slow waves of relatively high amplitude alternating with periods of relatively flat EEG or isoelectric periods. The pattern is usually associated with coma, severe encephalopathy of various etiologies, or general anesthesia. We describe an unusual case of anoxic brain injury in which a BS pattern was seen during behaviorally defined sleep during a routine outpatient EEG study.

  18. Burst suppression in sleep in a routine outpatient EEG ?

    OpenAIRE

    Kheder, Ammar; Bianchi, Matt T.; Westover, M. Brandon

    2014-01-01

    Burst suppression (BS) is an electroencephalogram (EEG) pattern that is characterized by brief bursts of spikes, sharp waves, or slow waves of relatively high amplitude alternating with periods of relatively flat EEG or isoelectric periods. The pattern is usually associated with coma, severe encephalopathy of various etiologies, or general anesthesia. We describe an unusual case of anoxic brain injury in which a BS pattern was seen during behaviorally defined sleep during a routine outpatient...

  19. Routines and Communities of Practice in Public Environmental Procurement Processes

    OpenAIRE

    Larsen, Katarina; Svane, Örjan

    2005-01-01

    Environmental procurement has received increasing attention as a policy tool promoting change towards sustainable consumption and production. The successful implementation of public environmental procurement policy requires the establishment of new routines for user-producer-supplier relationships that enable the integration of environmental aspects. The aim of the study is to analyse the roles of different communities of practice and learning patterns in environmental procurement processes. ...

  20. Knowledge degradation within routine operation practices in TRR - Lessons learned

    International Nuclear Information System (INIS)

    Gharib, M.

    2004-01-01

    Human factors play a major role in almost all sorts of knowledge management. Even in cases such as a nuclear incident, still the human part is prominent. It is showed that how general knowledge is eroded within routine practices and end up to disastrous consequences in abnormal conditions. Therefore relevant organizations should be aware of this natural tendency and find ways to confront it. (author)

  1. Implementing components of the routines-based model

    OpenAIRE

    McWilliam, Robin; Fernández Valero, Rosa

    2015-01-01

    The MBR is comprised of 17 components that can generally be grouped into practices related to (a) functional assessment and intervention planning (for example, Routines-Based Interview), (b) organization of services (including location and staffing), (c) service delivery to children and families (using a consultative approach with families and teachers, integrated therapy), (d) classroom organization (for example, classroom zones), and (e) supervision and training through ch...

  2. A 'Puff' dispersion model for routine and accidental releases

    International Nuclear Information System (INIS)

    Grsic, Z.; Rajkovic, B.; Milutinovic, P.

    1999-01-01

    A Puff dispersion model for accidental or routine releases is presented. This model was used as a constitutive part of an automatic meteorological station.All measured quantities are continuously displayed on PC monitor in a digital and graphical form, they are averaging every 10 minutes and sending to the civil information center of Belgrade. In the paper simulation of a pollutant plume dispersion from The oil refinery 'Pancevo', on April 18 th 1999 is presented. (author)

  3. Routine-industrial planning in the ATOMMASh enterprise

    International Nuclear Information System (INIS)

    Zabara, V.N.; Kovalev, B.V.; Bobrov, A.A.; Gostishchev, V.S.; Edikhanov, V.P.

    1987-01-01

    Structure of automated system for routine-industrial planning, developed at the ATOMMASh enterprise is considered. 11 problems, enabling to calculate the duration of cycles of fabrication and lead of detail putting to departments, schedules of detail production in departments fo year, quater, mounth, production plans in norm-hours, equipment utilization, as well as problems, providing for schedule performance were developed. All operational data on the state of industry are concentrated in the data base of operational control

  4. Should the lateral chest radiograph be routinely performed?

    International Nuclear Information System (INIS)

    Osman, Fatuma; Williams, Imelda

    2014-01-01

    Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

  5. Experience with a routine fecal sampling program for plutonium workers

    International Nuclear Information System (INIS)

    Bihl, D.E.; Buschbom, R.L.; Sula, M.J.

    1993-01-01

    A quarterly fecal sampling program was conducted at the U. S. Department of Energy's Hanford site for congruent to 100 workers at risk for an intake of plutonium oxide and other forms of plutonium. To our surprise, we discovered that essentially all of the workers were excreting detectable activities of plutonium. Further investigation showed that the source was frequent, intermittent intakes at levels below detectability by normal workplace monitoring, indicating the extraordinary sensitivity of fecal sampling. However, the experience of this study also indicated that the increased sensitivity of routine fecal sampling relative to more common bioassay methods is offset by many problems. These include poor worker cooperation; difficulty in distinguishing low-level chronic intakes from a more significant, acute intake; difficulty in eliminating interference from ingested plutonium; and difficulty in interpreting what a single void means in terms of 24-h excretion. Recommendations for a routine fecal program include providing good communication to workers and management about reasons and logistics of fecal sampling prior to starting, using annual (instead of quarterly) fecal sampling for class Y plutonium, collecting samples after workers have been away from plutonium exposure for a least 3 d, and giving serious consideration to improving urinalysis sensitivity rather than going to routine fecal sampling

  6. Measuring anteversion in the femoral neck from routine radiographs

    International Nuclear Information System (INIS)

    Hermann, K.L.; Egund, N.

    1998-01-01

    Purpose: To describe a new method for measuring femoral neck anteversion (FNA) that requires only one lateral radiograph of the knee in addition to routine radiographs of the hip for evaluation of total hip replacement; and to compare the proposed method with FNA measurement by means of 3D CT. Material and Methods: In 18 femoral specimens, radiographic examinations of the hip and knee, in three different rotational positions, and one CT examination were made, and the measurements of FNA were compared. Similarly, in 38 patients with 40 total hip replacements, measurements form routine radiographic examinations of the hip and knee and from CT examinations were compared. The accuracy and reproducibility of the FNA measurements produced by this proposed method were calculated. Results: Accuracy and reproducibility were 2 and 2 for the proposed method in the femoral specimen study, and accuracy was 4 in the hip patient study. The proposed method had a minor flaw that was caused almost solely by differences in knee size at inward rotation of the femur. Conclusion: FNA measurement can be made from a routine radiographic examination of the hip and a lateral view of the knee. This method achieves an acceptable level of accuracy and reproducibility. (orig.)

  7. Utility of routine postoperative chest radiography in pediatric tracheostomy.

    Science.gov (United States)

    Genther, Dane J; Thorne, Marc C

    2010-12-01

    Routine chest radiography following pediatric tracheostomy is commonly performed in order to evaluate for air-tracking complications. Routine chest radiography affords disadvantages of radiation exposure and cost. The primary objective of this study was to determine the utility of routine postoperative chest radiography following tracheostomy in pediatric patients. Secondary objectives were to compare the rates of postoperative complications by various patient and surgeon characteristics. All infants and children 18 years of age or less (n=421) who underwent tracheostomy at a single tertiary-care medical center from January 2000 to April 2009 were included in the study. A combination of data obtained from billing and administrative systems and review of electronic medical records were recorded and compiled in a database for statistical analysis. Three air-tracking complications (2 pneumothoraces and 1 pneumomediastinum) were identified in our population of 421 pediatric patients, for an incidence of 0.71% (95% CI: 0.1-2.0%). No significant relationships were found between the incidence of air-tracking complication and surgical specialty, patient age, or type of procedure (elective, urgent/emergent). Our study identified a low rate of pneumothorax and pneumomediastinum following pediatric tracheostomy. In all three cases, the pneumothorax was suspected clinically. This finding suggests that postoperative chest radiography should be reserved for cases where there is suspicion of a complication on the basis of intraoperative findings or clinical parameters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Factors Associated with Routine Dental Attendance among Aboriginal Australians.

    Science.gov (United States)

    Amarasena, Najith; Kapellas, Kostas; Skilton, Michael R; Maple-Brown, Louise J; Brown, Alex; Bartold, Mark; O'Dea, Kerin; Celermajer, David; Jamieson, Lisa M

    2016-01-01

    To determine factors associated with routine dental attendance in Aboriginal Australians. Data of 271 Aboriginal adults residing in Australia's Northern Territory were used. Routine dental attendance was defined as last visiting a dentist less than one year ago or visiting a dentist for a check-up. Both bivariate and multivariable analytical techniques were used. While 27% visited a dentist in the past year, 29% of these visited for a check-up. In bivariate analysis, being female, low psychological distress, and low clinical attachment loss (CAL) were associated with visiting a dentist within last year. Being aged younger than 39 years, male, no oral health impairment, being caries-free, low CAL, and low apolipoprotein B were associated with visiting for a check-up. Clinical attachment loss remained associated with visiting a dentist less than one year ago while being younger than 39 years and having no oral health impairment remained associated with usually visiting for a check-up in multivariable analysis. Younger age, no oral health impairment, and low CAL were associated with routine dental attendance among Indigenous Australians.

  9. Master schedule for CY-1979 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1978-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site, as conducted by the Environmental Evaluation Section of Battelle, Pacific Northwest Laboratory for the Department of Energy (DOE), is given. Modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, and to monitor Hanford operations for compliance with applicable environmental criteria and Washington State Water Quality Standards. Air quality data are obtained in a separate program administered by the Hanford Environmental Health Foundation. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Water quality data for Hanford Site potable water systems are published each year by the Hanford Environmental Health Foundation. The data collected are available in routine reports issued by the Environmental Evaluations staff. Groundwater data and evaluation are reported in the series, ''Radiological Status of the Groundwater Beneath the Hanford Project for...,'' the latest issue being PNL-2624 for CY-1977. Data from locations within the plant boundaries are presented in the annual ''Environmental Status of the Hanford Site for...'' report series, the most recent report being PNL-2677 for 1977. Data from offsite locations are presented in the annual ''Environmental Surveillance at Hanford for...'' series of reports, the latest being PNL-2614 for 1977

  10. Examining daily activity routines of older adults using workflow.

    Science.gov (United States)

    Chung, Jane; Ozkaynak, Mustafa; Demiris, George

    2017-07-01

    We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. A modified space charge routine for high intensity bunched beams

    International Nuclear Information System (INIS)

    Lapostolle, P.; Garnett, R.W.; Wangler, T.P.

    1996-01-01

    In 1991 a space charge calculation for bunched beam with a three-dimensional ellipsoid was proposed, replacing the usual SCHEFF routines. It removes the cylindrical symmetry required in SCHEFF and avoids the point to point interaction computation, whose number of simulation points is limited. This routine has now been improved with the introduction of two or three ellipsoids giving a good representation of the complex non-symmetrical form of the bunch (unlike the 3-d ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty encountered near the centre (the axis in 2-d problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Comparisons with other space charge routines have been made, particularly with the ones applying other techniques such as SCHEFF. Introduced in the versatile beam dynamics code DYNAC, it should provide a good tool for the study of the various parameters responsible for the halo formation in high intensity linacs. (orig.)

  12. Level-3 Cholesky Factorization Routines Improve Performance of Many Cholesky Algorithms

    DEFF Research Database (Denmark)

    Gustavson, Fred G.; Wasniewski, Jerzy; Dongarra, Jack J.

    2013-01-01

    Four routines called DPOTF3i, i = a,b,c,d, are presented. DPOTF3i are a novel type of level-3 BLAS for use by BPF (Blocked Packed Format) Cholesky factorization and LAPACK routine DPOTRF. Performance of routines DPOTF3i are still increasing when the performance of Level-2 routine DPOTF2 of LAPACK...

  13. Selective versus routine use of episiotomy for vaginal birth

    Science.gov (United States)

    Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

    2017-01-01

    Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

  14. Quality of routine spirometry tests in Dutch general practices

    Science.gov (United States)

    Schermer, Tjard RJ; Crockett, Alan J; Poels, Patrick JP; van Dijke, Jacob J; Akkermans, Reinier P; Vlek, Hans F; Pieters, Willem R

    2009-01-01

    Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. Design of study Analysis of routine spirometry test records. Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation. Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression. Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers. Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria

  15. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    International Nuclear Information System (INIS)

    Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

    2012-01-01

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  16. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Science.gov (United States)

    Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

    2012-07-01

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.

  17. Biomarkers in routine diagnosis of pleural effusions

    Directory of Open Access Journals (Sweden)

    Tiva Nemanič

    2018-03-01

    Full Text Available Background: Pleural fluid biochemical analysis is the first step in pleural effusion (PE diagnostics. Our purpose was to analyse the utility of the biomarkers used at our clinic in the routine diagnosis of PE. Methods: We retrospectively reviewed the PE levels of proteins, lactate dehydrogenase (LDH, alpha amylase (AA, pH and glucose in 433 patients who were treated at the University Clinic Golnik in a one-year period and compared these values with the final identified aetiology of the effusions. Results: The majority of the effusions were determined to be a consequence of malignancy (n = 154 or infection (n = 108. In 94 cases the aetiology of the effusions was heart failure and in 54 cases other diseases, while 23 effusions remained aetiologically undetermined. Considering Light’s criteria, the vast majority of the effusions were correctly classified as exudates or transudates (97.1 %. Comparing paramalignant and malignant effusions, we detected significantly lower values of pleural fluid LDH (p < 0.0005 and proteins (p < 0.0005, and higher pH (p < 0.0005 values in the paramalignant effusions. Conclusion: We have found that pleural LDH and proteins are the most helpful biochemical parameters in our routine diagnosis of pleural effusions and helped us to correctly narrow the aetiological spectrum. Furthermore, significantly higher pleural LDH and protein values and a pH below 7.32 additionally facilitated distinguishing between malignant and paramalignant effusions. Parameters such as glucose and AA are useful in selected cases and have a limited role in routine diagnostics.

  18. Skin dose assessment in routine personnel beta/gamma dosimetry

    International Nuclear Information System (INIS)

    Christensen, P.

    1980-01-01

    The International Commission on Radiological Protection (Publication 26) has recommended a tissue depth of 5 to 10 mg.cm -2 for skin dose assessments. This requirement is generally not fulfilled by routine monitoring procedures because of practical difficulties in using very thin dosemeters with low sensitivity and therefore a high minimum detectable dose. Especially for low-energy beta-ray exposures underestimations of the skin dose by a factor of more than ten may occur. Low-transparent graphite-mixed sintered LiF and Li 2 B 4 0 7 : Mn dosemeters were produced which show a skin-equivalent response to beta and gamma exposures over a wide range of energies. These have found wide-spread application for extremity dosimetry but have not yet been generally introduced in routine personnel beta/gamma monitoring. The following adaptations of existing routine monitoring systems for improved skin dose assessments have been investigated: 1) Placement of a supplementary, thin, skin-dose equivalent dosemeter in the TLD badge to give additional information on low-energy exposures. 2) Introduction of a second photomultiplier in the read-out chamber which enables a simultaneous determination of emitted TL from both sides of the dosemeter separately. This method makes use of the selfshielding of the dosemeter to give information on the low-energy dose contribution. 3) By diffusion of Li 2 B 4 0 7 into solid LiF-dosemeters it was possible to produce a surface layer with a new distinct glow-peak at about 340 deg C which is not present in the undiffused part of the LiF chip, and which can be utilized for the assessment of the skin-dose. Data on energy response and accuracy of dose measurement for beta/gamma exposures are given for the three methods and advantages and disadvantages are discussed (H.K.)

  19. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  20. Innovative Telemonitoring System for Cardiology: From Science to Routine Operation

    Science.gov (United States)

    Kastner, P.; Morak, J.; Modre, R.; Kollmann, A.; Ebner, C.; Fruhwald, FM.; Schreier, G.

    2010-01-01

    Objective Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations. Methods We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool. Results Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%. Conclusion First results confirm the applicability of the revised telemonitoring system in routine operation. PMID:23616835

  1. Cost-effectiveness of routine imaging of suspected appendicitis.

    Science.gov (United States)

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  2. The birth and routinization of IVF in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    2016-01-01

    How can it be that China today is home to some of the world’s largest IVF clinics, carrying out as many as 30,000 cycles annually? In this article, I address how IVF was developed in China during the early 1980s only to be routinized during the exact same period that one of the world’s most...... comprehensive family planning programmes aimed at preventing birth was being rolled out. IVF was not merely imported into China, rather it was experimentally developed within China into a form suitable for its restrictive family planning regulations. As a result, IVF and other assisted reproductive technologies...

  3. Routine dental x-ray : a health hazards

    International Nuclear Information System (INIS)

    Parthasarathy, K.S.

    1978-01-01

    In orthopantography (OPG) technique, a single panoramic x-ray replaces a dozen or so conventional x-ray exposures required for a full-mouth examination. OPG, thus, reduces radiation dose to the patients. However, the very simplicity of the OPG technique may lead to its misuse. The dentists are tempted to take too many OPG films and thus exposing the patients unnecessarily to X radiation. Dentists are advised against making dental x-radiography a routine part of examinations. Greater care should be exercised particularly in the case of children while using OPG. (M.G.B.)

  4. Detection of irradiated food - methods and routine applications

    International Nuclear Information System (INIS)

    Schreiber, G.A.; Helle, N.; Boegl, K.W.

    1993-01-01

    Irradiation of food for the purposes of extension of shelf life, control of microbial load, reduction of pathogenic microorganisms and disinfection is regarded by many consumers with suspicion. One reason is the lack of methods within food-controlling laboratories which can detect irradiation treatment and which are applied to control correct labelling. This review describes the potential of various methods to reveal irradiation treatment. Special emphasis is given to the three most successful methods, thermoluminescence, electron spin resonance spectroscopy and detection of volatiles. The possibilities and limitations of applying the methods in routine control are discussed. (author)

  5. Art as a Means to Disrupt Routine Use of Space

    OpenAIRE

    Martin, K; Dalton, B; Nikolopoulou, M

    2013-01-01

    This paper examines the publicly visible aspects of\\ud counter-terrorism activity in pedestrian spaces as mechanisms\\ud of disruption. We discuss the objectives of counter-terrorism in\\ud terms of disruption of routine for both hostile actors and general\\ud users of public spaces, categorising the desired effects as 1)\\ud triangulation of attention; 2) creation of unexpected performance;\\ud and 3) choreographing of crowd flow. We review the\\ud potential effects of these existing forms of disr...

  6. Special I/O routine based on the BSAM level

    International Nuclear Information System (INIS)

    Okamoto, Masao; Takizuka, Tomonori; Wada, Yoshiyuki; Okada, Takamitsu.

    1977-10-01

    A Special I/O routine ''FORTXDAM'' has been developed, which is based on the BSAM Level. Program ''FORTXDAM'' is useful in input-output of large quantities of data, random access (direct access), usage of the double (or multi) buffers technique or asynchronous input-output. Written in FASP language available for the computer system FACOM 230-75 of JAERI, it consists of six basic sub-programs which can be called in FORTRAN language. FORTXDAM is useful especially in large-scale computer simulations in thermonuclear fusion and plasma physics research. (auth.)

  7. Routine environmental audit of Ames Laboratory, Ames, Iowa

    International Nuclear Information System (INIS)

    1994-09-01

    This document contains the findings identified during the routine environmental audit of Ames Laboratory, Ames, Iowa, conducted September 12--23, 1994. The audit included a review of all Ames Laboratory operations and facilities supporting DOE-sponsored activities. The audit's objective is to advise the Secretary of Energy, through the Assistant Secretary for Environment, Safety and Health, as to the adequacy of the environmental protection programs established at Ames Laboratory to ensure the protection of the environment, and compliance with Federal, state, and DOE requirements

  8. A modified space charge routine for high intensity bunched beams

    International Nuclear Information System (INIS)

    Lapostolle, P.; Lombardi, A.M.; Tanke, E.; Valero, S.; Garnett, R.W.; Wangler, T.P.

    1996-01-01

    A new routine and a computer code (DYNAC) for the calculation of space charge densities in a new generation of linear accelerators for various industrial applications is presented. The new beam dynamics method used in this code, employs a set of quasi-Liouvillian equations, allowing beam dynamics computations in long and complex structures for electrons, as well as protons and ions. With this new beam dynamics method, the coordinates of particles are known at any position in the accelerating elements, allowing multistep space charge calculations. (K.A.)

  9. FASTBUS Standard Routines implementation for Fermilab embedded processor boards

    International Nuclear Information System (INIS)

    Pangburn, J.; Patrick, J.; Kent, S.; Oleynik, G.; Pordes, R.; Votava, M.; Heyes, G.; Watson, W.A. III

    1992-10-01

    In collaboration with CEBAF, Fermilab's Online Support Department and the CDF experiment have produced a new implementation of the IEEE FASTBUS Standard Routines for two embedded processor FASTBUS boards: the Fermilab Smart Crate Controller (FSCC) and the FASTBUS Readout Controller (FRC). Features of this implementation include: portability (to other embedded processor boards), remote source-level debugging, high speed, optional generation of very high-speed code for readout applications, and built-in Sun RPC support for execution of FASTBUS transactions and lists over the network

  10. PAT challenges routine techniques on defect spectroscopy in material science

    International Nuclear Information System (INIS)

    Badawi, E.A.

    2005-01-01

    Atomic or Point Defects are the most simple defects in solids. Due to the small size their direct observation by the routine techniques is not possible. A single type of defects (thermal defect) was observed in the quenching process. Using the Arrhenius method and threshold method we recommended the accurate both method of treatments. The calculated values for formation enthalpies and self-diffusion using positron lifetime and Doppler broadening in a good agreement in (A356.0) and (A413.1). Specifically it is show how PAT detect defect concentrations, (formation- migration) enthalpies and grain size for the material under investigation. Most of the these data are reported

  11. THERMAL: A routine designed to calculate neutron thermal scattering

    International Nuclear Information System (INIS)

    Cullen, D.E.

    1995-01-01

    THERMAL is designed to calculate neutron thermal scattering that is isotropic in the center of mass system. At low energy thermal motion will be included. At high energies the target nuclei are assumed to be stationary. The point of transition between low and high energies has been defined to insure a smooth transition. It is assumed that at low energy the elastic cross section is constant in the center of mass system. At high energy the cross section can be of any form. You can use this routine for all energies where the elastic scattering is isotropic in the center of mass system. In most materials this will be a fairly high energy

  12. Master schedule for CY-1980 Hanford Environmental Surveillance Routine Program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1979-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is presented. The enviromental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Data are reported on the following topics: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurement; portable instrument surveys; and surveillance of waste disposal sites;

  13. Routine Determination of Arsenic in Biological Materials. RCN Report

    International Nuclear Information System (INIS)

    Kroon, J.J.; Das, H.A.

    1970-08-01

    This text describes a routine procedure for the determination of arsenic in biological materials by neutron activation analysis. Unlike most methods published in literature the present analysis is not based on chemical separation by destination. After a first purification by anion-exchange the 76 As-activity (T1/2 = 26,4 h) is isolated by precipitation as the metal. The method was tested by analysis of the standard kale powder. This material was prepared and issued by Bowen in 1966, to provide a reliable standard for the intercomparison of various methods. (author)

  14. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

    The management of the patella in total knee arthroplasty still causes controversy. Whether or not to resurface the patella in primary total knee arthroplasty remains unclear. In this study we examined 220 consecutive total knee replacements, by a single surgeon, where the patella was routinely resurfaced using the inset technique. All patellae were suitable for resurfacing. Patellar thickness was not altered in 54.5% of patellae. In 97.2% the patella was within 2 mm of the original thickness. There were no significant complications. In this study we have found that the inset technique of patella resurfacing in total knee replacement is a simple and safe resurfacing procedure.

  15. Steam table routines for the simulation of nuclear power plants

    International Nuclear Information System (INIS)

    Hall, C.A.; Mutafelija, B.A.; Rapp, J.P.

    1976-01-01

    The dynamic simulation of nuclear power generating stations requires evaluation of a large number of steam and water properties at every integration time step. Some of the interpolation/approximation methods presently used are described with particular emphasis on the use of the bilinear transfinite interpolation method. The fundamental requirements for the steam table routines are outlined and different approaches are compared. The superiority of the bilinear transfinite interpolation method is discussed. The use of the steam table functions in real-time simulation is of particular interest

  16. An invertebrate embryologist's guide to routine processing of confocal images.

    Science.gov (United States)

    von Dassow, George

    2014-01-01

    It is almost impossible to use a confocal microscope without encountering the need to transform the raw data through image processing. Adherence to a set of straightforward guidelines will help ensure that image manipulations are both credible and repeatable. Meanwhile, attention to optimal data collection parameters will greatly simplify image processing, not only for convenience but for quality and credibility as well. Here I describe how to conduct routine confocal image processing tasks, including creating 3D animations or stereo images, false coloring or merging channels, background suppression, and compressing movie files for display.

  17. Non-routine activities in RP Group in 1998

    International Nuclear Information System (INIS)

    Hoefert, M.; Foerkel-Wirth, D.; Otto, T.; Silari, M.; Stevenson, G.R.

    1999-01-01

    This chapter describes activities not directly concerned with the daily routine. These activities are nevertheless an important part of the Group's work as they encompass new projects and developments that require, in most cases, profound studies to prove their feasibility with respect to the radiation protection issues involved. In addition, there are technical and organizational developments in a quest not only to keep the standard of radiation protection at CERN high, but to ensure its constant improvement. All these activities are documented in Divisional Reports, Internal Reports and Technical Memoranda, and are listed in the tables of this chapter

  18. Routines and Concerns in Conduct of Everyday Life

    DEFF Research Database (Denmark)

    Hybholt, Lisbeth

    2015-01-01

    In this paper, I explore the concept conduct of everyday life, namely routines and real life, as they are confronted with empirical observations. The observations are from a study of changes in the conduct of everyday life for individuals who attended a patient education course. The course...... was a part of their treatment after a hospitalisation with depression in a psychiatric ward. I use analysis of the main individual, Steven’s, conduct of everyday life and illustrate my points with models of conduct of everyday life made using beads. The conceptualisation of conduct of everyday life...

  19. Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS)

    Energy Technology Data Exchange (ETDEWEB)

    Bland, Geoffrey [NASA Goddard Space Flight Center (GSFC), Greenbelt, MD (United States)

    2016-06-30

    The use of small unmanned aircraft systems (sUAS) with miniature sensor systems for atmospheric research is an important capability to develop. The Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS) project, lead by Dr. Gijs de Boer of the Cooperative Institute for Research in Environmental Sciences (CIRES- a partnership of NOAA and CU-Boulder), is a significant milestone in realizing this new potential. This project has clearly demonstrated that the concept of sUAS utilization is valid, and miniature instrumentation can be used to further our understanding of the atmospheric boundary layer in the arctic.

  20. Monitoring patients with rheumatoid arthritis in routine care

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

    2014-01-01

    OBJECTIVES: Advances in aggressive use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However......, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage...

  1. Choice of measuring site in external personnel routine dosimetry

    International Nuclear Information System (INIS)

    Rothe, W.

    1975-01-01

    In personnel routine dosimetry the choice of a suitable measuring site is of great importance because there may be great differences between the measured doses and the equivalent doses of the whole body and of single organs, respectively. In the literature there are different points of view with regard to the measuring site particularly if diagnostic X-radiation is used and the body is partly covered with protective clothing. Likewise in most cases the conclusions regarding the most suitable measuring site drawn from measurements of dose distributions on the body surface are not in agreement. (author)

  2. Is Routine Ordering of Both Hemoglobin and Hematocrit Justifiable?

    Science.gov (United States)

    Addison, David J.

    1966-01-01

    In order to assess the value of routine simultaneous hemoglobin and hematocrit determinations, paired determinations in the following groups were studied: (1) 360 consecutive pairs from the hematology laboratory, (2) 95 pairs on general medical patients, (3) 43 pairs on 10 patients with upper gastrointestinal hemorrhage, and (4) 62 pairs on 10 patients with burns. These values were plotted on scatter diagrams. In the 560 pairs only three disparate determinations were found. It is concluded that, in most clinical situations, determination of the hemoglobin or the hematocrit as a screening procedure provides as much useful information as the simultaneous determination of both. PMID:5296947

  3. Selected versus routine use of intraoperative cholangiography during laparoscopic cholecystectomy.

    Science.gov (United States)

    Pickuth, D

    1995-12-01

    Routine use of intraoperative cholangiography during laparoscopic cholecystectomy is still widely advocated and standard in many departments, however, this is discussed controversially. We have developed a new diagnostic strategy to detect bile duct stones. The concept is based on an ultrasound examination and on a screening for the presence of six risk indicators of choledocholithiasis. 120 consecutive patients undergoing laparoscopic cholecystectomy were prospectively screened for the presence of six risk indicators of choledocholithiasis: history of jaundice; history of pancreatitis; hyperbilirubinemia; hyperamylasemia; dilated bile duct; unclear ultrasound findings. The sensitivity of ultrasound and of intraoperative cholangiography in diagnosing bile duct stones was also evaluated. For the detection of bile duct stones, the sensitivity was 77% for ultrasound and 100% for intraoperative cholangiography. 20% of all patients had at least one risk indicator. The presence of a risk indicator correlated significantly with the presence of choledocholithiasis (p concept, we would have avoided 80% of intraoperative cholangiographies without missing a stone in the bile duct. This study lends further support to the view that the routine use of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy is not necessary.

  4. Development, validation and routine control of a radiation process

    International Nuclear Information System (INIS)

    Kishor Mehta

    2010-01-01

    Today, radiation is used in industrial processing for variety of applications; from low doses for blood irradiation to very high doses for materials modification and even higher for gemstone colour enhancement. At present, radiation is mainly provided by either radionuclides or machine sources; cobalt-60 is the most predominant radionuclide in use. Currently, there are several hundred irradiation facilities worldwide. Similar to other industries, quality management systems can assist radiation processing facilities in enhancing customer satisfaction and maintaining and improving product quality. To help fulfill quality management requirements, several national and international organizations have developed various standards related to radiation processing. They all have requirements and guidelines for development, validation and routine control of the radiation process. For radiation processing, these three phases involve the following activities. Development phase includes selecting the type of radiation source, irradiation facility and the dose required for the process. Validation phase includes conducting activities that give assurance that the process will be successful. Routine control then involves activities that provide evidence that the process has been successfully realized. These standards require documentary evidence that process validation and process control have been followed. Dosimetry information gathered during these processes provides this evidence. (authors)

  5. Teaching problem solving using non-routine tasks

    Science.gov (United States)

    Chong, Maureen Siew Fang; Shahrill, Masitah; Putri, Ratu Ilma Indra; Zulkardi

    2018-04-01

    Non-routine problems are related to real-life context and require some realistic considerations and real-world knowledge in order to resolve them. This study examines several activity tasks incorporated with non-routine problems through the use of an emerging mathematics framework, at two junior colleges in Brunei Darussalam. The three sampled teachers in this study assisted in selecting the topics and the lesson plan designs. They also recommended the development of the four activity tasks: incorporating the use of technology; simulation of a reality television show; designing real-life sized car park spaces for the school; and a classroom activity to design a real-life sized dustpan. Data collected from all four of the activity tasks were analyzed based on the students' group work. The findings revealed that the most effective activity task in teaching problem solving was to design a real-life sized car park. This was because the use of real data gave students the opportunity to explore, gather information and give or receive feedback on the effect of their reasons and proposed solutions. The second most effective activity task was incorporating the use of technology as it enhanced the students' understanding of the concepts learnt in the classroom. This was followed by the classroom activity that used real data as it allowed students to work and assess the results mathematically. The simulation of a television show was found to be the least effective since it was viewed as not sufficiently challenging to the students.

  6. Is routine measurement of TSH in hospitalized patients necessary?

    Directory of Open Access Journals (Sweden)

    Amir Bashkin

    2018-04-01

    Full Text Available TSH routine testing in hospitalized patients has low efficacy, but may be beneficial in a selected subgroup of patients. Our aim was to evaluate the efficacy of routine thyroid function tests among patients admitted to internal medicine departments. It is a retrospective study. A randomly selected cohort of hospitalized patients with abnormal thyroid-stimulating hormone (TSH blood tests drawn as part of admission protocol. Patient data were collected from the electronic medical files and analyzed for its efficacy. TSH as a screening test was proven unnecessary in 75% (174 of the study population. Leading causes were non-thyroidal illness syndrome, drugs affecting the test results and subclinical disorders. TSH testing was found to be clinically helpful in only 9 patients; however, all of them had other clinical need for TSH testing. We found a clinically abnormal TSH in 20 patients, hypothyroidism in 11 patients and thyrotoxicosis in 9 patients. Low efficacy ascribed to TSH screening test by this study correlates with recent recommendations that indicate TSH screening in admitted patients only with accompanying clinical suspicion. Most probably, the majority of patients found by screening to have thyrotoxicosis have non-thyroidal illness or drug effects so the threshold for FT4 to diagnose overt thyrotoxicosis should be higher than that in ambulatory patients. In elderly patients, clinically relevant TSH disturbances are more frequent and are harder to diagnose, therefore, TSH screening in this group of patients might be beneficial.

  7. The routine use of modified Borelli's lactritmel agar (MBLA).

    Science.gov (United States)

    Kaminski, G W

    1985-07-01

    The original formula of Borelli's lactritmel agar (BLA)(3) which contains wheat flour, milk and honey, has been modified by replacing the wheat flour with dehydrated Bacto Corn Meal Agar (Difco) and by slightly altering the concentrations of the milk and honey. The modified medium (MBLA) is less turbid, less particulate, and easier to prepare than BLA. Although Trichophyton rubrum usually produces a wine-red pigment with BLA, most strains initially produce a yellow pigment, with the red pigment developing later. The corn meal in MBLA reduces this tendency and stimulates the early formation of deep wine red pigment, MBLA enhances sporulation of dermatophytes and various fungi which fail to sporulate on other media, and maintains characteristic growth without developing pleomorphic degeneration. It has been used routinely since 1972 as a reliable aid to the differentiation of T. rubrum and T. mentagrophytes. Since 1975 selective MBLA has been used as a routine primary isolation medium for dermatophytes, and has proved to be most useful.

  8. Routine clinical application of virtual reality in abdominal surgery.

    Science.gov (United States)

    Sampogna, Gianluca; Pugliese, Raffaele; Elli, Marco; Vanzulli, Angelo; Forgione, Antonello

    2017-06-01

    The advantages of 3D reconstruction, immersive virtual reality (VR) and 3D printing in abdominal surgery have been enunciated for many years, but still today their application in routine clinical practice is almost nil. We investigate their feasibility, user appreciation and clinical impact. Fifteen patients undergoing pancreatic, hepatic or renal surgery were studied realizing a 3D reconstruction of target anatomy. Then, an immersive VR environment was developed to import 3D models, and some details of the 3D scene were printed. All the phases of our workflow employed open-source software and low-cost hardware, easily implementable by other surgical services. A qualitative evaluation of the three approaches was performed by 20 surgeons, who filled in a specific questionnaire regarding a clinical case for each organ considered. Preoperative surgical planning and intraoperative guidance was feasible for all patients included in the study. The vast majority of surgeons interviewed scored their quality and usefulness as very good. Despite extra time, costs and efforts necessary to implement these systems, the benefits shown by the analysis of questionnaires recommend to invest more resources to train physicians to adopt these technologies routinely, even if further and larger studies are still mandatory.

  9. A modified space charge routine for LINAC beam dynamics codes

    International Nuclear Information System (INIS)

    Valero, S.; Lapostolle, P.; Lombardi, A.M.; Tanke, E.; Warner, D.

    1994-01-01

    In 1991 a space charge calculation for bunched beams with three-dimensional ellipsoidal symmetry was proposed for the PARMILA code, replacing the usual SCHEFF routines: it removes the cylindrical symmetry needed for the Fast Fourier Transform method and avoids the point to point interaction computation, where the number of simulation points is limited. This routine has now been improved with the introduction of two (or more) ellipsoids, giving a good representation of actual, pear-shaped bunches (unlike the 3-D ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty caused by statistical effects, encountered near the centre (the axis in 2-D problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Introduced in the new, versatile beam dynamics code, DYNAC, it should provide a good tool for the study of the effects of the various parameters responsible for the halo formation in high intensity linacs. (authors). 11 refs

  10. The prevalence of adrenal incidentaloma in routine clinical practice.

    LENUS (Irish Health Repository)

    Davenport, Colin

    2011-03-10

    The prevalence of adrenal incidentaloma (AI) on computed tomography (CT) in the general population has been reported to be as high as 4.2%. However, many of the previous studies in this field utilised a prospective approach with analysis of CT scans performed by one or more radiologists with a specialist interest in adrenal tumours and a specific focus on identifying the presence of an adrenal mass. A typical radiology department, with a focus on the patient\\'s presenting complaint as opposed to the adrenal gland, may not be expected to diagnose as many adrenal incidentalomas as would be identified in a dedicated research protocol. We hypothesised that the number of AI reported in routine clinical practice is significantly lower than the published figures would suggest. We retrospectively reviewed the reports of all CT thorax and abdomen scans performed in our hospital over a 2 year period. 3,099 patients underwent imaging, with 3,705 scans performed. The median age was 63 years (range 18-98). Thirty-seven true AI were diagnosed during the time period studied. Twenty-two were diagnosed by CT abdomen (22\\/2,227) and 12 by CT thorax (12\\/1,478), a prevalence of 0.98 and 0.81% with CT abdomen and thorax, respectively, for AI in routine clinical practice.

  11. The prevalence of adrenal incidentaloma in routine clinical practice.

    LENUS (Irish Health Repository)

    Davenport, Colin

    2012-02-01

    The prevalence of adrenal incidentaloma (AI) on computed tomography (CT) in the general population has been reported to be as high as 4.2%. However, many of the previous studies in this field utilised a prospective approach with analysis of CT scans performed by one or more radiologists with a specialist interest in adrenal tumours and a specific focus on identifying the presence of an adrenal mass. A typical radiology department, with a focus on the patient\\'s presenting complaint as opposed to the adrenal gland, may not be expected to diagnose as many adrenal incidentalomas as would be identified in a dedicated research protocol. We hypothesised that the number of AI reported in routine clinical practice is significantly lower than the published figures would suggest. We retrospectively reviewed the reports of all CT thorax and abdomen scans performed in our hospital over a 2 year period. 3,099 patients underwent imaging, with 3,705 scans performed. The median age was 63 years (range 18-98). Thirty-seven true AI were diagnosed during the time period studied. Twenty-two were diagnosed by CT abdomen (22\\/2,227) and 12 by CT thorax (12\\/1,478), a prevalence of 0.98 and 0.81% with CT abdomen and thorax, respectively, for AI in routine clinical practice.

  12. Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

    Science.gov (United States)

    Walfish, P G; Strawbridge, H T; Rosen, I B

    1985-12-01

    To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

  13. Implementing cognitive therapies into routine psychosis care: organisational foundations.

    Science.gov (United States)

    Dark, Frances; Whiteford, Harvey; Ashkanasy, Neal M; Harvey, Carol; Crompton, David; Newman, Ellie

    2015-08-05

    Treatment outcomes for people diagnosed with psychosis remain suboptimal due in part to the limited systematic application of evidence based practice (Adm Policy Ment Health, 36: 1-7, 2009) [1]. The Implementation science literature identifies a number of factors organisationally that need to be considered when planning to introduce a particular EBP. Profiling these organisational characteristics at baseline, prior to commencement of service reform can determine the focus of a subsequent implementation plan. This study examined the organisational baseline factors existing in two services promoting the routine use of cognitive interventions for psychosis. One of the services studied has since undertaken organisational structural reform to facilitate the greater uptake of Evidence Based Practice (EBP). The results of this study were used to design an implementation strategy to make cognitive therapies a part of routine psychosis care. One hundred-and-six mental health staff from two metropolitan mental health services in Australia was surveyed to ascertain their attitudes, competencies and interest in Cognitive Behavioural Therapy for psychosis (CBTp) and Cognitive Remediation Therapy (CRT). In addition perceptions of organisational values were profiled using the Organisational Culture Profile (OCP). Fifty five participants were excluded because they completed less than 50% of the survey. The final sample consisted of 51 participants. 48.1% of surveys were completed. Over 50% of staff were interested in CBTp and CRT approaches to psychosis. Staff were aware of existing CBTp and CRT programs but these were not uniformly available throughout the services. Fourteen percent of staff identified as CBT therapist and 35% were trained CRT facilitators. Only 12% of staff were receiving therapy specific supervision. The Organisational Culture Profile (OCP) at baseline revealed highest scores amongst leadership, planning, and humanistic workplace domains, with communication

  14. Routine quality control of high dose rate brachytherapy equipment

    International Nuclear Information System (INIS)

    Guzman Calcina, Carmen S.; Almeida, Adelaide de; Rocha, Jose R. Oliveira

    2001-01-01

    A Quality Assurance program should be installed also for High Dose Rate brachytherapy, in the order to achieve a correct dose administration to the patient and for the safety to those involved directly with the treatment. The work presented here has the following purposes: Analyze the types of equipment tests presented by the official protocols (TG40, TG56 e ARCAL XXX), evaluate the brachytherapy routine tests of protocols from various national and international radiotherapy services and compare the latter with those presented in the official protocols. As a result, we conclude the following: TG56 presents a higher number of tests when compared to the other official protocols and most of the tests presented by the analyzed services are present in TG56. A suggestion for a basic protocol is presented, emphasizing the periodicity and tolerance level of each of the tests. (author)

  15. Routine environmental audit of the Hanford Site, Richland, Washington

    Energy Technology Data Exchange (ETDEWEB)

    1994-05-01

    This report documents the results of the routine environmental audit of the Hanford Site (Hanford), Richland, Washington. During this audit, the activities conducted by the audit team included reviews of internal documents an reports from previous audits and assessments; interviews with US Department of Energy (DOE), State of Washington regulatory, and contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted May 2--13, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health (EH). The audit evaluated the status of programs to ensure compliance with Federal, State, and local environmental laws and regulations; compliance with DOE orders, guidance, and directives; and conformance with accepted industry practices and standards of performance. The audit also evaluated the status and adequacy of the management systems developed to address environmental requirements.

  16. Functional Near Infrared Spectroscopy: Enabling Routine Functional Brain Imaging.

    Science.gov (United States)

    Yücel, Meryem A; Selb, Juliette J; Huppert, Theodore J; Franceschini, Maria Angela; Boas, David A

    2017-12-01

    Functional Near-Infrared Spectroscopy (fNIRS) maps human brain function by measuring and imaging local changes in hemoglobin concentrations in the brain that arise from the modulation of cerebral blood flow and oxygen metabolism by neural activity. Since its advent over 20 years ago, researchers have exploited and continuously advanced the ability of near infrared light to penetrate through the scalp and skull in order to non-invasively monitor changes in cerebral hemoglobin concentrations that reflect brain activity. We review recent advances in signal processing and hardware that significantly improve the capabilities of fNIRS by reducing the impact of confounding signals to improve statistical robustness of the brain signals and by enhancing the density, spatial coverage, and wearability of measuring devices respectively. We then summarize the application areas that are experiencing rapid growth as fNIRS begins to enable routine functional brain imaging.

  17. ACR Appropriateness Criteria® Routine Chest Radiography.

    Science.gov (United States)

    McComb, Barbara L; Chung, Jonathan H; Crabtree, Traves D; Heitkamp, Darel E; Iannettoni, Mark D; Jokerst, Clinton; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H; Ravenel, James G

    2016-03-01

    Chest radiographs are sometimes taken before surgeries and interventional procedures on hospital admissions and outpatients. This manuscript summarizes the American College of Radiology review of the literature and recommendations on routinely performed chest radiographies in these settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  18. Verification and quality control of routine hematology analyzers.

    Science.gov (United States)

    Vis, J Y; Huisman, A

    2016-05-01

    Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and linearity throughout the expected range of results. Yet, which standard should be met or which verification limit be used is at the discretion of the laboratory specialist. This paper offers practical guidance on verification and quality control of automated hematology analyzers and provides an expert opinion on the performance standard that should be met by the contemporary generation of hematology analyzers. Therefore (i) the state-of-the-art performance of hematology analyzers for complete blood count parameters is summarized, (ii) considerations, challenges, and pitfalls concerning the development of a verification plan are discussed, (iii) guidance is given regarding the establishment of reference intervals, and (iv) different methods on quality control of hematology analyzers are reviewed. © 2016 John Wiley & Sons Ltd.

  19. COPD management: role of symptom assessment in routine clinical practice

    Science.gov (United States)

    van der Molen, Thys; Miravitlles, Marc; Kocks, Janwillem WH

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed. PMID:24143085

  20. Routine environmental audit of the Hanford Site, Richland, Washington

    International Nuclear Information System (INIS)

    1994-05-01

    This report documents the results of the routine environmental audit of the Hanford Site (Hanford), Richland, Washington. During this audit, the activities conducted by the audit team included reviews of internal documents an reports from previous audits and assessments; interviews with US Department of Energy (DOE), State of Washington regulatory, and contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted May 2--13, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health (EH). The audit evaluated the status of programs to ensure compliance with Federal, State, and local environmental laws and regulations; compliance with DOE orders, guidance, and directives; and conformance with accepted industry practices and standards of performance. The audit also evaluated the status and adequacy of the management systems developed to address environmental requirements

  1. Informational Aspects of Telepathology in Routine Surgical Pathology

    Directory of Open Access Journals (Sweden)

    Peter Gombas

    2000-01-01

    Full Text Available Application of computer and telecommunication technology calls serious challenges in routine diagnostic pathology. Complete data integration, fast access patients' data to usage of diagnosis thesaurus labeled with standardized codes and free text supplements, complex inquiry of the data contents, data exchange via teleconsultation and multilevel data protection are required functions of an integrated information system. Increasing requirement for teleconsultation transferring a large amount of multimedia data among different pathology information systems raises new questions in telepathology. Creation of complex telematic systems in pathology requires efficient methods of software engineering and implementation. Information technology of object‐oriented modeling, usage of client server architecture and relational database management systems enables more compatible systems in field of telepathology. The aim of this paper is to present a practical example how to unify text based database, image archive and teleconsultation in a frame of an integrated telematic system and to discuss the main conceptual questions of information technology of telepathology.

  2. Decontaminating products for routine decontamination in nuclear power plants

    International Nuclear Information System (INIS)

    Henning, K.

    2001-01-01

    Routine decontamination work that has to be carried out in practical operation includes the cleaning of all kinds of surfaces such as floors, walls and apparatus, the decontamination of professional clothes and of the personnel. In order to ensure a trouble-free functioning of plants for the treatment of waste water and concentrate in nuclear power plants, radioactive liquid wastes appearing in the controlled area should be compatible with the treatment methods in practice. Radioactive concentrates and resides obtained from the treatment methods are mixed with matrix materials like cement or bitumen or treated by roller frame drying and thus are conditioned for intermediate or final storage. Several requirements should be made on decontaminating agents used in the controlled area. Some of these physical-chemical criteria will be described in detail. (R.P.)

  3. Gamification of Clinical Routine: The Dr. Fill Approach.

    Science.gov (United States)

    Bukowski, Mark; Kühn, Martin; Zhao, Xiaoqing; Bettermann, Ralf; Jonas, Stephan

    2016-01-01

    Gamification is used in clinical context in the health care education. Furthermore, it has shown great promises to improve the performance of the health care staff in their daily routine. In this work we focus on the medication sorting task, which is performed manually in hospitals. This task is very error prone and needs to be performed daily. Nevertheless, errors in the medication are crucial and lead to serious complications. In this work we present a real world gamification approach of the medication sorting task in a patient's daily pill organizer. The player of the game needs to sort the correct medication into the correct dispenser slots and is rewarded or punished in real time. At the end of the game, a score is given and the user can register in a leaderboard.

  4. Humour and the Unacceptable in Neil Hamburger’s Routine

    Directory of Open Access Journals (Sweden)

    Daniel Derrin

    2014-08-01

    Full Text Available This paper addresses the comic routine of Australian born U.S. comedian Gregg Turkington’s alter-ego, ‘Neil Hamburger’, from the perspective of Aristotle’s ancient conception of the risible as a species of the unacceptable, or the unseemly. In doing so, it explores two thresholds of acceptability, subjective and social, which are relevant to an understanding of Hamburger’s comic style. The paper argues that Hamburger’s style willfully violates those thresholds, risking the audience’s laughter, and yet working towards the visualization of a less normative kind of ‘unseemliness’ that underlies Hamburger’s politics: reverence for celebrity and the sacred.

  5. T2 black lesions on routine knee MRI: differential considerations

    International Nuclear Information System (INIS)

    Wadhwa, Vibhor; Cho, Gina; Moore, Daniel; Pezeshk, Parham; Coyner, Katherine; Chhabra, Avneesh

    2016-01-01

    The majority of abnormal findings or lesions on T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) are hyperintense due to increased perfusion or fluid content, such as infections, tumours or synovitis. Hypointense lesions on T2-weighted images (both fat-suppressed and non-fat-suppressed) are less common and can sometimes be overlooked. Such lesions have limited differential diagnostic possibilities, and include vacuum phenomenon, loose body, tenosynovial giant cell tumour, rheumatoid arthritis, haemochromatosis, gout, amyloid, chondrocalcinosis, hydroxyapetite deposition disease, lipoma arborescens, arthrofibrosis and iatrogenic lesions. These lesions often show characteristic appearances and predilections in the knee. In this article, the authors describe the MRI features of hypointense T2 lesions on routine knee MRI and outline a systematic diagnostic approach towards their evaluation. (orig.)

  6. Care routines, feeding assistive robotics and the disabled body

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    Care routines, feeding assistive robotics and the disabled body Niels Christian Mossfeldt NickelsenAbstract for 4S, Barcelona, track 62. Short abstract 300 signs including spacesSeveral feeding assistive robotics are described in the literature, but few studies have explored the reception. I report...... from an ethnographic study of the British Neater-Eater robot in a housing institution for the disabled. Due to a number of values the implementation is something of a balancing act.Long abstract 248 wordsSeveral feeding assistive robotics (FAR) are described in the literature; Neater-Eater; My Spoon...... the result is demeaning (Nickelsen, 2013). During the last decade feeding has broadly been eliminated from nurses’ responsibilities and relegated to non-professionals (Martinsen et al. 2007). It has become low status work and as such it is currently robotized. Despite the lack of knowledge...

  7. Management of routine solution gas flaring in Alberta

    International Nuclear Information System (INIS)

    1998-01-01

    Alberta's Clean Air Strategic Alliance (CASA) shares decision-making responsibilities with the Government of Alberta for strategic aspects of air quality. In 1997, the Alliance established the Flaring Project Team to develop recommendations that address potential and observed impacts associated with flaring, with particular focus on 'upstream solution gas' flaring. The upstream industry explores for, acquires, develops, produces and markets crude oil and natural gas. Essentially, solution gas at upstream sites is 'co-produced' during crude oil production. The project team was established to collect and summarize information on flaring and its impacts and to develop recommendations for short-term actions to minimize the practice of routine flaring of solution gas. Another goal of the team is to develop a research strategy to better understand flaring emissions and their effects on human, animal and environmental health. The team is working on developing long-term strategies for actions to address the gas flaring issue. 5 refs., 1 tab., 7 figs

  8. Estimating population effects of vaccination using large, routinely collected data.

    Science.gov (United States)

    Halloran, M Elizabeth; Hudgens, Michael G

    2018-01-30

    Vaccination in populations can have several kinds of effects. Establishing that vaccination produces population-level effects beyond the direct effects in the vaccinated individuals can have important consequences for public health policy. Formal methods have been developed for study designs and analysis that can estimate the different effects of vaccination. However, implementing field studies to evaluate the different effects of vaccination can be expensive, of limited generalizability, or unethical. It would be advantageous to use routinely collected data to estimate the different effects of vaccination. We consider how different types of data are needed to estimate different effects of vaccination. The examples include rotavirus vaccination of young children, influenza vaccination of elderly adults, and a targeted influenza vaccination campaign in schools. Directions for future research are discussed. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Radiation Dose Measurements in Routine X Ray Examinations

    International Nuclear Information System (INIS)

    Osman, H.; Sulieman, A.; Suliman, I.I.; Sam, A.K.

    2011-01-01

    The aim of current study was to evaluate patients radiation dose in routine X-ray examinations in Omdurman teaching hospital Sudan.110 patients was examined (134) radiographs in two X-ray rooms. Entrance surface doses (ESDs) were calculated from patient exposure parameters using DosCal software. The mean ESD for the chest, AP abdomen, AP pelvis, thoracic spine AP, lateral lumber spine, anteroposterior lumber spine, lower limb and for the upper limb were; 231±44 Gy,453± 29 Gy, 567±22 Gy, 311±33 Gy,716±39 Gy, 611±55 Gy,311±23 Gy, and 158±57 Gy, respectively. Data shows asymmetry in distribution. The results of were comparable with previous study in Sudan.

  10. Skin dose assessment in routine personnel beta/gamma dosimetry

    International Nuclear Information System (INIS)

    Christensen, P.

    1980-01-01

    Three alternative methods are outlined by which substantial improvements of the capabilities of existing routine monitoring systems for skin dose assessment can be obtained. The introduction of a supplementary skin dosemeter may be an attractive method for systems with badges that have a capability for an additional dosemeter already built-in. The two-side reading method has limited possibilities because of reduced accuracy for mixed radiation and technical difficulties in using it for TLD systems with planchet heating. The use of a boron diffused LiF layer for skin dose assessment seems to be most attractive method since the only modification needed here is replacement of a dosemeter. However the study of this method is so far only in a preliminary stage and further investigations are needed. (U.K.)

  11. Fundamentals for routined utilization of tomography in beam diagnostic

    International Nuclear Information System (INIS)

    Reichau, Hermine

    2012-01-01

    A general and systematic approach to implement tomography for beam diagnostics has been invented and exemplarily shown for the invention of beam tomography for the Frankfurt Neutron Source. Following the diagnostic pipeline the first step was to prepare the data basis for the tomography reconstruction. For the monitoring, standard parameters have to be obtained with sufficient accuracy. In the context of this work, tomography has been kept as flexible as possible. Firstly, it will be used for the analysis of beam dynamics but also for the further development of beam tomography for routined utilization. Later on it will have to serve as a monitoring system at the end of the LEBT of FRANZ. The data preparation for tomography was demonstrated step by step. The iterated backprojection (FBP) algorithm was derived to show the basic idea of tomography which is contained in all forms of tomography algorithms. In connection with data exhibiting a high signal to noise ratio the FBP obtains the result with the highest accuracy, beyond that the accuracy can be controlled by the number of projections. The algebraic reconstruction and maximum entropy approach were outlined in a nutshell. By the introduction of the diagnostic pipeline in combination with the decision systematics the basis for a routined utilization of tomography in ion beam diagnostics have been established and exemplarily demonstrated on the introduction of beam tomography for FRANZ. A rotatable vacuum chamber has been developed to close a gap between the availability of projections to use the FBP and the small physical space on which they have to be determined. (orig.)

  12. PHYSIOLOGICAL DEMANDS OF YOUNG WOMEN’S COMPETITIVE GYMNASTIC ROUTINES

    Directory of Open Access Journals (Sweden)

    M. Marina

    2014-08-01

    Full Text Available The objective of this study was to investigate the physiological indices of competitive routines in women’s artistic gymnastics by characterizing post-exercise heart rate (HR, oxygen uptake (VO2 and peak blood lactate concentration (Lmax in a group of eight young elite-oriented female gymnasts. HR was continuously monitored with Polar RS400 monitors during the test event simulating a competition environment. Within 5 s of the end of each routine, the breath-by-breath gas analyser mask was placed on the face to record VO2. VO2max was calculated by the backward extrapolation method of the VO2 recovery curve. Lmax was obtained during recovery (min 1, 3, 5, 7 and 10 subsequent to each event. One week later, HR, VO2 and Lmax were measured during an incremental continuous treadmill test. The treadmill test was confirmed as the assessment with the highest physiological demand. The gymnasts reached their highest values of HR (183-199 beats · min- 1, VO2/Bm (33-44 ml · kg-1 · min-1 and Lmax (7-9 mmol · l-1 in the floor and uneven bars exercises. The vault was the event with the lowest HR (154-166 beats · min-1 and Lmax (2.4-2.6 mmol · l-1, and the balance beam had the lowest VO2 (27-35 ml · kg-1 · min-1. The mean relative peak intensities attained in the different events, which ranged from 65 to 85% of the individual VO2max and HRmax recorded in the laboratory, suggest that cardiorespiratory and metabolic demands are higher than previously indicated. The high percentage of VO2 measured, particularly after the floor event, suggests that aerobic power training should not be neglected in women’s artistic gymnastics.

  13. Reducing neonatal pain during routine heel lance procedures.

    Science.gov (United States)

    Morrow, Carla; Hidinger, Andrea; Wilkinson-Faulk, Debbie

    2010-01-01

    To measure the difference in pain scores for newborns who were held and swaddled while undergoing routine heel lance procedures compared to newborns who were lying on their backs and not swaddled during heel lance. Additionally, we sought to compare the total amount of time it took to collect the specimens in each group. A total of 42 neonates recruited from a large tertiary hospital were enrolled in a randomized controlled trial. Infants in the experimental group (n = 22) were swaddled and held in an upright position during routine heel lance procedures while neonates in the control group (n = 20) remained in a standard care position. Pain was measured with the Neonatal Inventory Pain Scale (NIPS) at two points in time for each group (just before the heel lance procedure and at the completion of the heel lance). Total collection time was measured using a stopwatch accurate to 1/100th of a second. Specimen quality was measured based on the number of rejected specimens for each group. Descriptive statistics and t tests were used to analyze the data. The mean NIPS score for neonates who were swaddled and held during the procedure (experimental group) was significantly lower (M = 1.3, SD = .9) than the score for infants in the standard position (control group) (M = 2.7, SD = 1.3), t (40) = -4.48, p lance procedures offers nurses a nonpharmacologic method of neonatal pain reduction for heel sticks. This technique can be easily implemented on any unit independent of facility protocols. Furthermore, the technique is not associated with any cost or policy development, making it more likely that nurses can use it in practice.

  14. Diagnosis of antiphospholipid syndrome in routine clinical practice

    Science.gov (United States)

    Hills, J; Machin, SJ; Cohen, H

    2013-01-01

    The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß2glycoprotein-1 antibodies (aß2GPI). Medium/high-titre aCL/aβ2GPI was defined as >99th percentile. Low-titre aCL/aβ2GPI positivity (>95th < 99th percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ2GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ2GPI only and 18 positive were for both. The omission of aCL or aβ2GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ2GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS. PMID:22988029

  15. Routine testing of Mycoplasma genitalium and Trichomonas vaginalis.

    Science.gov (United States)

    Jenniskens, Marieke L M; Veerbeek, Jan H W; Deurloo, Koen L; van Hannen, Erik J; Thijsen, Steven F T

    2017-06-01

    Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) are common sexual transmitted infections (STI). However, most STI screening programmes do not include routinely detection of these pathogens. Consequently, epidemiological data about MG and TV in the general population is lacking. The current study aims to give insight into the prevalence of both infections, thereby guiding decisions whether testing for these pathogens should be included routinely. Between February 2013 and August 2015, all samples sent to the laboratory of Diakonessenhuis Utrecht for STI testing (i.e. testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG)) were additionally examined for the presence of MG and TV by means of a laboratory-developed RT-PCR. Samples were collected by our hospital or by regional general practitioners. A total of 5628 PCR's were evaluated. In 7.5%, one or more STI were detected. CT was found in 5% and MG was positive in 1.9%. NG was detected in 0.5% and TV was detected in 0.6% of the samples. CT was found more often in primary care than in hospital setting (9.7% vs. 3.0%, p < .05). The same was shown for NG (1.1% vs. 0.2%, p < .05). More men than women were positive for CT (11.2% vs. 3.8%, p < .05) and NG (1.4% vs. 0.3%, p < .05). MG is more prevalent than NG and TV in a regional Dutch population. Furthermore, TV is equally common as NG. Based on our prevalence data, including MG and TV in STI testing protocols should be considered in the future.

  16. [Routine screening of splenic or portal vein thrombosis after splenectomy].

    Science.gov (United States)

    Bouvier, A; Gout, M; Audia, S; Chalumeau, C; Rat, P; Deballon, O

    2017-01-01

    Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy. Since January 2012, all patients undergoing an elective splenectomy had an abdominal CT-scan on postoperative-day 7. Demographic data, pathology, type of surgery, platelet counts before and after surgery, outcome, results of medical imaging, and management of PSVT and its results were recorded. Over 3 years, 52 patients underwent an elective splenectomy. All of them had a CT-scan at postoperative-day 7. A PSVT was found in 11 patients (21.2 %). They were all asymptomatic. Lymphoma and splenomegaly were the main factors associated with PSVT in the univariate analysis. All patients with PSVT were treated with anticoagulation and no complication of PSVT occurred. The follow-up CT confirmed the efficacy of anticoagulation therapy in all patients. Routine screening of PSVT after elective splenectomy is warranted because it allows to start anticoagulant therapy and avoid further life-threatening complications. The incidence of PSVT is particularly high among patients operated on for lymphoma or with splenomegaly. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  17. Efficient linear algebra routines for symmetric matrices stored in packed form.

    Science.gov (United States)

    Ahlrichs, Reinhart; Tsereteli, Kakha

    2002-01-30

    Quantum chemistry methods require various linear algebra routines for symmetric matrices, for example, diagonalization or Cholesky decomposition for positive matrices. We present a small set of these basic routines that are efficient and minimize memory requirements.

  18. Screening for post 32-week preterm birth risk: how helpful is routine perinatal data collection?

    Directory of Open Access Journals (Sweden)

    Wei Luo

    2016-06-01

    Conclusions: For multiparous women, the routine data contains information comparable to some purposely-collected data for predicting preterm risk. But for nulliparous women, the routine data contains insufficient data related to antenatal complications.

  19. DEVELOPING AND INSTRUCTING PRE-PERFORMANCE ROUTINES FOR TENPIN BOWLING COMPETITIONS (1).

    Science.gov (United States)

    Lee, Seungmin; Lee, Keunchul; Kwon, Sungho

    2015-06-01

    This preliminary study developed pre-performance routines for tenpin bowlers and instructed them. To develop the routine, the situations before throwing the ball were divided into four phases; participants were examined through interviews and observations. This study used an A-B design; the A stage included the development of the routines for 3 wk., while the B stage included the instruction and two evaluations of the routine consistency. Practice was implemented for 4 hr. per day for 9 wk. The participants noted they understood the developed routine easily and experienced an atmosphere similar to that of a competition during training through the routines. They found it difficult to practice the relaxation phase, but emphasized that the relaxation phase was helpful. Consistent routines were associated with an improved mental state and performance in a competition. This study suggests that pre-performance routines stabilize the mental state of the athletes, apparently giving them a competitive advantage.

  20. Learning Together and Working Apart: Routines for Organizational Learning in Virtual Teams

    Science.gov (United States)

    Dixon, Nancy

    2017-01-01

    Purpose: Research suggests that teaming routines facilitate learning in teams. This paper identifies and details how specific teaming routines, implemented in a virtual team, support its continual learning. The study's focus was to generate authentic and descriptive accounts of the interviewees' experiences with virtual teaming routines.…

  1. Changing of the Guard: How Different School Leaders Change Organizational Routines

    Science.gov (United States)

    Enomoto, Ernestine K.; Conley, Sharon

    2008-01-01

    While providing stability and uniformity, organizational routines can foster continuous change. Using Feldman's (2000) performative model of routinized action theory, coupled with leadership succession research, we examined how three successive administrations in a California high school revised a student attendance (tardy-monitoring) routine over…

  2. How to Analyze Routines in Teachers' Thinking Processes during Lesson Planning.

    Science.gov (United States)

    Bromme, Rainer

    A justification for the study of teachers' routines, as they affect the preparation of lesson plans, prefaces this paper on teachers' thought processes during lesson planning. In focusing on the importance of research into teachers' routines, it is pointed out that lesson preparation and classroom routines permit teachers to direct attention to…

  3. The Balancing Act: Student Classroom Placement Routines and the Uses of Data in Elementary Schools

    Science.gov (United States)

    Park, Vicki; St. John, Elise; Datnow, Amanda; Choi, Bailey

    2017-01-01

    Purpose: The purpose of this paper is to examine how data are used in classroom placement routines. The authors explore educators' assumptions about the purposes of the classroom placement routine, detailing the ostensive (i.e. structure and template) and performative aspects of the routine itself, and the implications of data use for equity and…

  4. Bone densitometry in the Feminine Climacteric routine study or election?

    International Nuclear Information System (INIS)

    Miranda, C.; Estrella, A.; Bozzolo, A.; Sasson, A.; Berterreche, A.

    2002-01-01

    A descriptive and cross-sectional study was conducted, on the basis of a systematic review of the clinical histories of the database, between July 1999 and July 2001.Strategy consisted of reviewing at random clinical data up to obtaining a sample of 100 patients with bone densitometry by mains of dual energy X ray absorbtiometry (DEXA) device. The standard number was statistically significant and representative of the population under study.Results: It is emphasized that more of a hal of the patients studied presented loss of the bone mineral density and 11% with and altered morphometry of the column, similar to other national and international studies. the risk factors for osteoporosis were presented in 71% of the cases, having those patients older densitometric alterations.Conclusions:considering the results and the situation that generates risk of fracture with its high socioeconomic costs, the authors recommend the routine use of the densitometry in the Feminine Climateric or in its absence, a selective screening, reserving the study for patients with given risk factors.It is proposed a guideline to select patients in which conducting the study ia a priority

  5. Demonstration of the renal venous system at routine nephroangiography

    International Nuclear Information System (INIS)

    Nilsson, P.E.; Aspelin, P.; Holtas, S.

    1985-01-01

    The demonstration of renal veins during routine nephroangiography was retrospectively investigated and blindly scored in 60 patients. Three different types of contrast media were used: one high-osmolar ionic monomeric (metrozoate) and two low-osmolar, the non-ionic monomeric (metrizamide) and the ionic monoacidic dimeric (ioxalate). The renal veins and the inferior vena cava were significantly better and more often demonstrated when ioxaglate was used compared with metrizoate and metrizmide. There was no significant difference between metrizoate and metrizamide. Following semiselective renal artery injection, the main renal veins were demonstrated with a diagnostically acceptable quality with ioxaglate in 76 per cent, with metrizamide in 40 per cent and with metrizoate in 29 per cent. On selective renal artery injection the demonstration of renal veins increased to 85 per cent with ioxaglate and remained unchanged with metrizmide (38%) and metrizoate(26%). Semiselective or selective nephroangiography with ioxaglate at an ordinary dose was in most patients sufficient to allow evaluation of renal vein involvement in disease, rendering high dose selective nephroangiography or selective nephrophlebography unnecessary. A slower diffusion rate of ioxaglate compared with metrizoate and metrizamide is considered to be the major explanation for the better demonstration of the renal veins. (orig.)

  6. Routine environmental reaudit of the Argonne National Laboratory - West

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-04-01

    This report documents the results of the Routine Environmental Reaudit of the Argonne National Laboratory - West (ANL-W), Idaho Falls, Idaho. During this audit, the activities conducted by the audit team included reviews of internal documents and reports from previous audits and assessments; interviews with U.S. Department of Energy (DOE), U.S. Environmental Protection Agency (EPA), State of Idaho Department of Health and Welfare (IDHW), and DOE contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted from October 11 to October 22, 1993, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health (EH). DOE 5482.113, {open_quotes}Environment, Safety, and Health Appraisal Program,{close_quotes} established the mission of EH-24 to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The ultimate goal of EH-24 is enhancement of environmental protection and minimization of risk to public health and the environment. EH-24 accomplishes its mission by conducting systematic and periodic evaluations of the Department`s environmental programs within line organizations, and by utilizing supplemental activities that serve to strengthen self-assessment and oversight functions within program, field, and contractor organizations.

  7. [Unnecessary routine laboratory tests in patients referred for surgical services].

    Science.gov (United States)

    Mata-Miranda, María del Pilar; Cano-Matus, Norberto; Rodriguez-Murrieta, Margarita; Guarneros-Zapata, Idalia; Ortiz, Mario

    2016-01-01

    To question the usefulness of the lab analysis considered routine testing for the identification of abnormalities in the surgical care. To determine the percentage of unnecessary laboratory tests in the preoperative assessment as well as to estimate the unnecessary expenses. A descriptive, cross-sectional study of patients referred for surgical evaluation between January 1st and March 31st 2013. The database of laboratory testing and electronic files were reviewed. Reference criteria from surgical services were compared with the tests requested by the family doctor. In 65% of the patients (n=175) unnecessary examinations were requested, 25% (n=68) were not requested the tests that they required, and only 10% of the patients were requested laboratory tests in accordance with the reference criteria (n=27). The estimated cost in unnecessary examinations was $1,129,552 in a year. The results were similar to others related to this theme, however, they had not been revised from the perspective of the first level of attention regarding the importance of adherence to the reference criteria which could prevent major expenditures. It is a priority for leaders and operational consultants in medical units to establish strategies and lines of action that ensure compliance with institutional policies so as to contain spending on comprehensive services, and which in turn can improve the medical care. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  8. Usefulness of Discarded Vitreous Samples from Routine Vitrectomy

    Directory of Open Access Journals (Sweden)

    Natàlia Vilà

    2016-01-01

    Full Text Available Purpose. To describe the histopathological features of vitreous samples obtained after vitrectomy surgery from diabetic and nondiabetic patients. Methods. Vitreous specimens from 137 patients who underwent vitrectomy for different clinical conditions were analysed. All samples were centrifuged and each resulting pellet was fixed and processed as part of routine paraffin section histopathology. The histopathological features were categorized in a semiquantitative fashion. The samples from diabetic and nondiabetic patients were compared. Results. The 125 included patients (58 diabetic, 60% males were aged 64.2±13.9 years. The presence of hemorrhage, inflammatory cells, and histiocytes was significantly higher in the diabetic group (P<0.001, P=0.028, and P=0.016, resp., showing more vessels (P<0.001 and ghost vessels (P=0.049. The presence of inflammatory cells was the feature with the highest sensitivity for detecting diabetes mellitus (98% and also the highest negative predictive value (89%. In the multivariate analysis, three variables emerged as independent significant predictors of diabetes in vitrectomy samples: hemorrhage, endothelial-lined vessels, and age (P<0.001, P<0.001, and P=0.019, resp.. Conclusions. Different histopathological features can be found in vitreous samples from diabetic patients. Analysis of vitrectomy samples may serve as a tool for diabetes management.

  9. In vivo semiconductor dosimetry as part of routine quality assurance.

    Science.gov (United States)

    Millwater, C J; MacLeod, A S; Thwaites, D I

    1998-06-01

    This paper describes the initial physics testing necessary before diodes can be used for in vivo dosimetry as well as the development of a protocol for clinical use in head and neck treatment and the preliminary results acquired. 50 patients were entered into the pilot study. A total of 300 treatment set-ups were measured (184 entrance doses and 116 exit doses). Wedged and unwedged components of each field were measured separately, making the total number of entrance doses 284 and total number of exit doses 207. There was no significant systematic deviation in the measured entrance dose compared with the expected (mean +0.4%, SD 2.7%). Discrepancies between the observed and expected entrance doses of greater than 5% were recorded in 6% (16/284) of measurements. The mean of the measured exit doses was 2.4% lower than expected (SD 4.8%). Discrepancies between the observed and expected exist doses of greater than 5% were recorded in 32% (67/207) of measurements. Possible causes for these discrepancies are discussed. Overall analysis of the data for individual patients suggest that in one patient out of the 50 there may have been a delivered target volume dose discrepancy of greater than 5% (+6.5%). The significance of the results and the implications for routine use are discussed.

  10. Toshiba General Hospital PACS for routine in- and outpatient clinics

    Science.gov (United States)

    Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

    1996-05-01

    The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

  11. Routine environmental reaudit of the Argonne National Laboratory - West

    International Nuclear Information System (INIS)

    1996-01-01

    This report documents the results of the Routine Environmental Reaudit of the Argonne National Laboratory - West (ANL-W), Idaho Falls, Idaho. During this audit, the activities conducted by the audit team included reviews of internal documents and reports from previous audits and assessments; interviews with U.S. Department of Energy (DOE), U.S. Environmental Protection Agency (EPA), State of Idaho Department of Health and Welfare (IDHW), and DOE contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted from October 11 to October 22, 1993, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health (EH). DOE 5482.113, open-quotes Environment, Safety, and Health Appraisal Program,close quotes established the mission of EH-24 to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The ultimate goal of EH-24 is enhancement of environmental protection and minimization of risk to public health and the environment. EH-24 accomplishes its mission by conducting systematic and periodic evaluations of the Department's environmental programs within line organizations, and by utilizing supplemental activities that serve to strengthen self-assessment and oversight functions within program, field, and contractor organizations

  12. Optimisation of the Future Routine Orbit for Mars Express

    Science.gov (United States)

    Carranza, Manuel; Companys, Vincente

    2007-01-01

    Mars Express (MEX), the first planetary mission of the European Space Agency (ESA), reached Mars on December 25th 2003. Since then it is performing routine operations. Its operational phase had to cover one Martian year, with the possibility of an extension for a second Martian year (i.e. until November 2007). The end of the mission extension is approaching but, given the good health of the payload instruments and the high science return of the mission, there is a strong will to achieve further extensions. Mars Express is also seen as an important asset, capable to provide relay functions for future Martian missions. The ESA Science Program Committee has recently approved a second extension of the MEX mission until May 2009 and even further extensions are possible. Mars Express has an eccentric quasi-polar orbit with a period of approximately 6.72 hours and a pericentre height of about 300 km. Science observations are mainly performed at pericentre (but not only). In addition the orbit has a resonance of 11 revolutions per 3 Martian days. This means that ground tracks corresponding to orbits separated by 11 revolutions are adjacent, such that a given area can be covered by the on-board camera without leaving gaps. The J2 effect of Mars causes a drift of both ascending node and argument of pericentre. The drift of argument of pericentre makes it possible to observe periodically all Mars latitudes from close distance. Illumination conditions at pericentre are influenced by both the drift of the argument of pericentre and the drift of ascending node, as well as by the rotation of Mars around the Sun. The original MEX routine orbit was optimized for the duration of the nominal mission and extension, such that it produced a balanced share of day-side observations (for the optical instruments) and night-side observations (for the radar). The orbit was thus not optimized for the time beyond the assumed extension. Indeed, the evolution of the ascending node and argument of

  13. Routine clinical use of radiopharmaceuticals in Latin American developing countries

    International Nuclear Information System (INIS)

    Mitta, A.E.

    1985-01-01

    The paper describes the routine clinical use of radiopharmaceuticals in the developing countries of Latin America made possible by: (1) the International Atomic Energy Agency (IAEA), which sent experts and equipment to many countries and made a substantial bibliographic contribution on the subject; (2) the Latin American Association of Societies of Nuclear Biology and Medicine (ALASBIMN), which fostered the exchange of data on techniques of radiopharmaceutical preparation and quality control by providing materials for tests, etc., and by publishing quality control manuals in some countries, finally in 1982 producing the Manual of Radiopharmaceutical Quality Control, in collaboration with the Inter-American Nuclear Energy Commission (CIEN) and published by the Organization of American States (OAS); (3) the countries themselves under agreements between their atomic energy commissions; (4) radiopharmacy courses organized by universities, either alone or in collaboration with the IAEA, WHO, etc.; (5) professional workers who established radiopharmaceutical services at private centres. Finally, the societies of nuclear medicine and biology in each country, the World Federation of Nuclear Medicine and Biology, the ALASBIMN, the IAEA, etc. organized symposia and meetings which afforded opportunities to professionals of these countries to receive and exchange information, since in Latin America, given its language and human characteristics, the problems are similar. The countries referred to are Argentina, Brazil, Mexico, Uruguay, Bolivia, Paraguay, Chile, Peru, Ecuador, Colombia, Venezuela, Costa Rica, Guatemala, Puerto Rico, El Salvador and Panama; little is known about Honduras, Nicaragua, the Dominican Republic and Cuba. (author)

  14. A CR-39 track dosemeter for routine individual neutron monitoring

    International Nuclear Information System (INIS)

    Luszik-Bhadra, M.; Alberts, W.G.; Dietz, E.; Guldbakke, S.; Matzke, M.; d'Errico, F.

    1994-01-01

    A personal neutron dosemeter for routine individual monitoring is proposed. It is based on a CR-39 track detector covered on three separate areas by converters with different boron contents and inserted into a commercial TLD albedo dosemeter capsule. The dose readings from three areas of the electrochemically etched CR-39 detector are combined to yield a dose equivalent response which is almost independent of the incident neutron energy in the range from thermal neutrons up to 20 MeV. In addition, the dose contributions of thermal, intermediate and fast neutrons can be determined separately. Unlike the TLD albedo dosemeter, which in general requires prior in-field calibration and whose use is then restricted to that field, this dosemeter can be used in neutron fields without any knowledge of the spectral distribution with the same calibration factor. The angular dependence of the dosemeter's response has been measured and compared with that of the directional dose equivalent H'(10). The lower limit of detection is 0.15 mSv. It is possible to obtain an independent, second dose reading from the same Cr-39 detector for neutron energies above 100 keV. The dosemeter has also been successfully tested for use in accident dosimetry applying chemical etching and an optical density reading of the CR-39 detector. (author)

  15. Using continental land loading for routine data analysis

    Science.gov (United States)

    Petrov, L.

    2013-12-01

    The availability of the hydrological models that are updated regularly made it feasible to apply for analysis of space geodesy data a reduction for 3D displacements caused by the changes in the continental water storage on a routine basis, as it is done for a long time with ocean loading and atmospheric pressure loading. The service of the continental storage water loading was launched in 2013. The service utilizes the outputs of several hydrological models and provides the 3D time series in the form of global maps with 1-3 hour time resolution, time series for the set of ~1000 space geodesy sites, and an on-demand web-based application that allows a user to compute and download the time series of displacements for user-specified sites. The design of such a service and experience of its running are summarized. The loading series were validated by processing all available VLBI data. Results of validation are presented. Impact of using continental water storage for data reduction on estimates of other parameters, such as station velocities, is discussed.

  16. VIDEO-PC, SVGA Routines for FORTRAN on PC

    International Nuclear Information System (INIS)

    1994-01-01

    1 - Description of program or function: These primitives are the lowest level routines needed to perform super VGA graphics on a PC. A sample main program is included that exercises the primitives. Both Lahey and Microsoft FORTRAN's have graphics libraries. However, the libraries do not support 256 color graphics at resolutions greater than 320x200. The primitives bypass these libraries while still conforming to standard usage of BIOS. The supported graphics modes depend upon the PC graphics card and its memory. Super VGA resolutions of 640x480 and 800x600 have been tested on an ATI VGA Wonder card with 512 K memory and on several 80486 PC's (unknown manufacturers) at retail stores. 2 - Method of solution: Both Lahey and Microsoft primitives depend upon sending the correct parameters to the PC BIOS (basic input output system) as discussed in the references. 3 - Restrictions on the complexity of the problem: The primitives were developed for 256 color VGA applications. It is known, for instance, that some CGA and 16 color VGA video modes will not operate correctly using these primitives. Potential users should try the test program on their PC/video card combination to determine applicability

  17. Sequim Marine Research Laboratory routine environmental measurements during CY-1977

    International Nuclear Information System (INIS)

    Fix, J.J.; Blumer, P.J.

    1978-06-01

    Beginning in 1976, a routine environmental program was established at the Marine Research Laboratory (MRL) at Sequim, Washington. The program is intended to demonstrate the negligible impact of current MRL operations on the surrounding environs and to provide baseline data through which any cumulative impact could be detected. The sampling frequency is greater during the first 2 years of the program to provide sufficient initial information to allow reliable estimates of observed radionuclide concentrations and to construct a long-term sampling program. The program is designed, primarily, to determine levels of radioactivity present in selected biota in Sequim Bay. The biota were selected because of their presence near the laboratory and their capacity to concentrate trace elements. Other samples were obtained to determine the radionuclides in Sequim Bay and laboratory drinking water, as well as the ambient radiation exposure levels and surface deposition of fallout radionuclides for the laboratory area. Appendix A provides a summary of the analytical methods used. The present document includes data obtained during CY 1977 in addition to CY-1976 data published previously

  18. COPD management: role of symptom assessment in routine clinical practice

    Directory of Open Access Journals (Sweden)

    van der Molen T

    2013-10-01

    Full Text Available Thys van der Molen,1,2 Marc Miravitlles,3 Janwillem WH Kocks1,21Department of General Practice, 2GRIAC (Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 3Pneumology Department, Hospital Universitari Vall d'Hebron, Biomedical Research Networking Centre in Respiratory Diseases (CIBERES, Barcelona, SpainAbstract: Patients with chronic obstructive pulmonary disease (COPD present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients' everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed.Keywords: chronic obstructive pulmonary disease, symptoms, questionnaires

  19. Implementing shared decision making in routine mental health care.

    Science.gov (United States)

    Slade, Mike

    2017-06-01

    Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence. It is argued that SDM is "polyvalent", a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high-quality decision support tools; integrating SDM with other recovery-supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes - social marketing and the hospitality industry - are identified. © 2017 World Psychiatric Association.

  20. Building shielding effects on radiation doses from routine radionuclide releases

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1977-01-01

    In calculating population doses from the release of radionuclides to the atmosphere, it is usually assumed that man spends all of his time outdoors standing on a smooth infinite plane. Realistically, however, man spends most of the time indoors, so that substantial reductions in radiation doses may result compared with the usual estimates. Calculational models were developed to study the effects of building structures on radiation doses from routine releases of radionuclides to the atmosphere. Both internal dose from inhaled radionuclides and external photon dose from airborne and surface-deposited radionuclides are considered. The effect of building structures is described quantitatively by a dose reduction factor, which is the ratio of the dose inside a structure to the corresponding dose with no structure present. The internal dose from inhaled radionuclides is proportional to the radionuclide concentration in the air. Assuming that the outdoor airborne concentration is constant with time, the time-dependence of the indoor airborne concentration in terms of the structure air ventilation rate, the deposition velocities for radionuclides on the inside floor, walls, and ceiling, and the radioactive decay constant, were calculated

  1. Residence-Based Fear of Crime: A Routine Activities Approach.

    Science.gov (United States)

    Lai, Yung-Lien; Ren, Ling; Greenleaf, Richard

    2017-07-01

    Most fear-of-crime research uses resident's neighborhood as a key reference location to measure fear, yet the location effects of one's own dwelling unit on crime-specific fear has not been explicitly studied theoretically in the literature. Drawing upon routine activities theory, this study undertakes an investigation into the levels and determinants of residence-based fear of crime across three racial/ethnic groups-Whites, African Americans, and non-White Hispanics. Data used in the analyses were collected from a random-sample telephone survey of 1,239 respondents in Houston, Texas. The results derived from factor analyses revealed that residents do distinguish between fear in the neighborhood and fear at home. Proximity to motivated offenders measured by perception of crime was found to be the most salient predictor of fear, followed by the measures of target vulnerability and capable guardianship. In addition, residence-based fear varies significantly across racial/ethnic groups. The significance of these findings and the policy implications are highlighted.

  2. Ideal Gas Resonance Scattering Kernel Routine for the NJOY Code

    International Nuclear Information System (INIS)

    Rothenstein, W.

    1999-01-01

    In a recent publication an expression for the temperature-dependent double-differential ideal gas scattering kernel is derived for the case of scattering cross sections that are energy dependent. Some tabulations and graphical representations of the characteristics of these kernels are presented in Ref. 2. They demonstrate the increased probability that neutron scattering by a heavy nuclide near one of its pronounced resonances will bring the neutron energy nearer to the resonance peak. This enhances upscattering, when a neutron with energy just below that of the resonance peak collides with such a nuclide. A routine for using the new kernel has now been introduced into the NJOY code. Here, its principal features are described, followed by comparisons between scattering data obtained by the new kernel, and the standard ideal gas kernel, when such comparisons are meaningful (i.e., for constant values of the scattering cross section a 0 K). The new ideal gas kernel for variable σ s 0 (E) at 0 K leads to the correct Doppler-broadened σ s T (E) at temperature T

  3. ''Routine'' brain CT in psychiatric patients - does it make sense?

    International Nuclear Information System (INIS)

    Pickuth, D.; Heywang-Koebrunner, S.H.; Spielmann, R.P.

    1999-01-01

    Purpose: To prospectively assess the spectrum of brain CT findings in psychiatric patients and to determine the number of patients that had an underlying cause for the symptoms. Patients and methods: Over a period of six months, 142 patients (78 males, 64 females; median age 61 [18-91] years) were referred for CT brain scans. Their scans were reviewed, along with the clinical information that was provided in the request form. All the hard copies were reviewed to assess areas of ischaemia, infarction, atrophy, tumours, and haematomas. The majority of requests were to exclude vascular event or space-occupying lesions. Clinical indications included mood disorders (depression, mania), schizophrenic disorders, dementia, personality and behavioural disorders. Results: 31 (22%) were normal. 111 (78%) had varying degrees of ischaemia, infarction and cerebral/cerebellar atrophy. 7 (4.9%) had space-occupying lesions which included two gliomas and five meningiomas. There were two chronic subdural haematomas and one arteriovenous malformation. Conclusion: 1. In our series, pathologic findings in 'routine' brain CT's were encountered in 78%. 2. The incidence of brain tumours was 4.9%, compared with 0.00005% of the general population. 3. CT scanning in psychiatric patients is cost-effective and especially indicated when there is an atypical presentation, or inadequate response to standard treatment. (orig.) [de

  4. Screening esophagus during routine ultrasound: medical and cost benefits.

    Science.gov (United States)

    Abd Elrazek, Abd Elrazek M A; Eid, Khaled A; El-Sherif, Abd Elhalim A; Abd El Al, Usama M; El-Sherbiny, Samir M; Bilasy, Shymaa E

    2015-01-01

    Cost-effectiveness analysis is an approach used to determine the value of a medical care option and refers to a method used to assess the costs and health benefits of an intervention. Upon the diagnosis of liver cirrhosis, the current guidelines recommend that all cirrhotic patients have to be screened for the presence of esophageal varices by endoscopy. In addition, patients with a positive family history of esophageal cancer are screened annually. These approaches place a heavy burden on endoscopy units, and repeated testing over time may have a detrimental effect on patient compliance. Following the recommendations of a recent study entitled 'Detection of risky esophageal varices using two dimensional ultrasound: when to perform endoscopy', the intra-abdominal portion of the esophagus of 1100 patients was divided into a hepatic group, which included 650 patients, and a nonhepatic group, which included 450 patients, who presented with manifestations of liver diseases and gastrointestinal symptoms, respectively, and were examined using standard two-dimensional ultrasound (US) to evaluate cost effectiveness, standard issues, and medical benefits using conventional US. The overall effectiveness analysis of 1100 patients yielded a 41% cost standard benefit calculated to be $114,760 in a 6-month study. Two-dimensional US can play an important role in screening for esophageal abnormalities, thus saving money and time. The esophagus should be screened during routine conventional abdominal US.

  5. Routine use of humidification with nasal continuous positive airway pressure.

    Science.gov (United States)

    Worsnop, C J; Miseski, S; Rochford, P D

    2010-09-01

    Heated humidification can reduce nasal symptoms caused by continuous positive airway pressure (CPAP) treatment, but its routine use has not been studied over the medium term in a randomized controlled trial. The aim of this study is to determine if heated humidification would reduce nasal symptoms and improve adherence with CPAP treatment in all patients with sleep apnoea irrespective of whether they had nasal symptoms initially. A randomized, parallel group design. Patients were treated for 3 months with a Fisher & Paykel HC201 pump with built-in heated humidification, or with the heater disabled and without water. Adherence was measured with a timer built into the pumps. Nasal symptoms were measured with a 10-cm visual analogue scale. There were 25 in the humidification group and 29 in the non-humidification group. After 12 weeks mean (standard deviation) adherence with CPAP was 4.7 (2.4) and 4.5 (2.2) hours per night respectively. Nasal symptoms that were reduced were nose blocked* 6 (12), 18 (26); sneezing* 4 (8), 15 (25); dry nose* 8 (12), 24 (33); stuffy nose* 7 (14), 22(31); dry mouth* 13 (18), 33(36); and runny nose* 6 (17), 14 (29). Parameters marked with an asterisk '*' had P humidification with CPAP in all patients with sleep apnoea reduced nasal symptoms, but did not improve adherence. © 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.

  6. An improved scattering routine for collimation tracking studies at LHC

    CERN Document Server

    Tambasco, Claudia; Salvachua Ferrando, Maria Belen; Cavoto, Gianluca

    The present Master thesis work has been carried out at CERN in the framework of the LHC (Large Hadron Collider) Collimation project. The LHC accelerates proton beams up to 7 TeV colliding in the experiment detectors installed in four points of the accelerator ring. The LHC is built to store a energy of 360MJ for each beam. The energy deposition induced by local beam losses could quench the superconducting magnets located around the accelerator beam pipes. To prevent and keep under control dangerous beam losses, an efficient collimation system is required. In addition, the achievable LHC beam intensity is related to the beam loss rate and, consequently, to the cleaning efficiency of the collimation system. Collimation studies at LHC are carried out also by means of simulations by using SixTrack, a dedicated simulation tool that tracks a large numbers of particles for many turns around the ring. The SixTrack code includes a scattering routine to model proton interactions with the material of the collimators j...

  7. Routines, roles, and responsibilities for aligning scientific and classroom practices

    Science.gov (United States)

    Ford, Michael J.; Wargo, Brian M.

    2007-01-01

    Reform efforts in science education have focused on engaging students in authentic scientific practices. For these efforts to succeed, detailed articulations of scientific practice need to be linked to understandings of classroom practice. Here we characterize engagement in practice generally in terms of 3Rs: routines, roles, and responsibilities. We argue that there is a misalignment between the 3Rs of scientific practice and the practices common in classrooms, and that this misalignment poses a considerable obstacle for beginning teachers who attempt to implement reform pedagogy. As part of a secondary methods course, 16 preservice teachers (PSTs) participated in two exemplar activities designed to engage them in scientific practices. The PST performances suggest that at least initially, they did not consider authentic scientific practices appropriate for classroom activities, implying a pedagogical repertoire dominated by the 3Rs of traditional classrooms. PST performances, however, evidenced a shift in the 3Rs from those common in classrooms to those required by these activities, suggesting that their visions for classrooms are malleable and underlining the importance of aligning the 3Rs of scientific and classroom practices during teacher preparation.

  8. Falling into a routine: from habits to situated practices.

    Science.gov (United States)

    Cohn, Simon; Lynch, Rebecca

    2017-11-01

    In line with the concept of 'nudging' people to change their behaviour, there has been increased attention on habit as a focus for psychologically-based health interventions. It is hoped that behaviours initiated by interventions not only become so regular that they are normalised into people's everyday lives, but that through repetition they may eventually become fixed and habitual. In this paper we draw on people's accounts of participating in a trial designed to encourage greater physical activity, and attend to the ways they describe their engagement with interventions within wider narratives of their everyday lives. In contrast to the idea that habit refers to automatic behaviour cued by external stimuli and governed by unconscious cognitive processes, our study describes how people identify many diverse elements that are felt to have equal significance in achieving a routine. Paradoxically, the sense of stability derives not from exact repetition, but from the ability for an assemblage of elements to be configured slightly differently each time. We consequently argue that attending to the diverse range of contextual elements bracketed off from interventions designed to be tested in trials, and the idea that continuity might emerge from variation, demands a reconceptualisation of the concept of habit adopted within many areas of current health psychology. © 2017 Foundation for the Sociology of Health & Illness.

  9. URBAN CHILDHOOD ROUTINES MEDIATED BY TECHNOLOGY: A VISUAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    González-Patiño, Javier

    2011-07-01

    Full Text Available With the goal of documenting routines in which a technological component had some type of impact and observe the influences of immediate environments, exploring meaning and sense, interviews and some observations and, especially, a series of photographs taken by a young girl about her daily life were collected. The purpose of this article is to foster a critical debate about the social and developmental consequences that have been attributed to changes in the living conditions of contemporary Western urban children. For the analytical approach and the analysis of the data, it was especially important to take into consideration the characteristics of the case study participant, a high social class 12 year old pre-adolescent who lives in a home where a large variety of information and communication technology equipment is at her disposal. The conclusions that are presented mainly revolve around two issues. First, related to the emergence of multimodal communication situations, of increasingly semiotic complexity, promoted by digital practices visible in different styles of mediation in the uses of technologies identified as: "convergence", "divergence" and "accessibility". Second, that these technological practices facilitate transformations in space, whether public, private or virtual, altering the importance that traditionally held by other places in the processes of socialization of urban children. This article is published in Spanish.

  10. Integration of CBIR in radiological routine in accordance with IHE

    Science.gov (United States)

    Welter, Petra; Deserno, Thomas M.; Fischer, Benedikt; Wein, Berthold B.; Ott, Bastian; Günther, Rolf W.

    2009-02-01

    Increasing use of digital imaging processing leads to an enormous amount of imaging data. The access to picture archiving and communication systems (PACS), however, is solely textually, leading to sparse retrieval results because of ambiguous or missing image descriptions. Content-based image retrieval (CBIR) systems can improve the clinical diagnostic outcome significantly. However, current CBIR systems are not able to integrate their results with clinical workflow and PACS. Existing communication standards like DICOM and HL7 leave many options for implementation and do not ensure full interoperability. We present a concept of the standardized integration of a CBIR system for the radiology workflow in accordance with the Integrating the Healthcare Enterprise (IHE) framework. This is based on the IHE integration profile 'Post-Processing Workflow' (PPW) defining responsibilities as well as standardized communication and utilizing the DICOM Structured Report (DICOM SR). Because nowadays most of PACS and RIS systems are not yet fully IHE compliant to PPW, we also suggest an intermediate approach with the concepts of the CAD-PACS Toolkit. The integration is independent of the particular PACS and RIS system. Therefore, it supports the widespread application of CBIR in radiological routine. As a result, the approach is exemplarily applied to the Image Retrieval in Medical Applications (IRMA) framework.

  11. Various dedicated imaging systems for routine nuclear medical applications

    International Nuclear Information System (INIS)

    Bela Kari; Tamas Gyorke; Erno Mako; Laszlo Nagy; Jozsef Turak; Oszkar Partos

    2004-01-01

    The most essential problems of nuclear medical imaging are resolution, signal/noise ratio (S/N) and sensitivity. Nowadays, the vast majority of the Anger system gamma cameras in clinical application are using parallel projection. The main problem of this projection method is the highly dependence of the image quality on the distance from the collimator surface as well as any improvement in the resolution with the distance -i.e. reduction of image blur- significantly reduces sensitivity. The aim of our research and development work was to create imaging geometry, collimator and detector constructions optimized to particular organs (brain, heart, thyroid), where it is simultaneously possible to increase the resolution and sensitivity. Main concept of the imaging geometry construction is based on the size, location and shape of a particular organ. In case of brain SPECT imaging a multiple head (4 heads in cylinder symmetric approximation) arrangement with extra high intrinsic resolution (<2.5 mm) dedicated detector design provide feasible solution for routine clinical application. The imaging system was essentially designed for Tc-99m and I-123 isotopes. The application field can be easily extended for functional small animal research and new born baby studies. Very positive feedbacks were received from both technical (stability and reproducibility of the technical parameters) and clinical sides in the past 2 years routine applications. A unique, novel conception ultra compact dedicated dual head SPECT system has been created only for 2D, 3D nuclear cardiac applications for Tc-99m and T1-201 labeled radio-pharmaceuticals. The two rectangular detectors (with <2.6 mm intrinsic resolution) are mounted fix in 90 degree geometry and move inside the special formed gantry arrangement. The unique and unusual gantry is designed to keep the detector heads as close as possible to the patient, while the patient is not exposed by any moving part. This special construction also

  12. Milne, a routine for the numerical solution of Milne's problem

    Science.gov (United States)

    Rawat, Ajay; Mohankumar, N.

    2010-11-01

    The routine Milne provides accurate numerical values for the classical Milne's problem of neutron transport for the planar one speed and isotropic scattering case. The solution is based on the Case eigen-function formalism. The relevant X functions are evaluated accurately by the Double Exponential quadrature. The calculated quantities are the extrapolation distance and the scalar and the angular fluxes. Also, the H function needed in astrophysical calculations is evaluated as a byproduct. Program summaryProgram title: Milne Catalogue identifier: AEGS_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEGS_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 701 No. of bytes in distributed program, including test data, etc.: 6845 Distribution format: tar.gz Programming language: Fortran 77 Computer: PC under Linux or Windows Operating system: Ubuntu 8.04 (Kernel version 2.6.24-16-generic), Windows-XP Classification: 4.11, 21.1, 21.2 Nature of problem: The X functions are integral expressions. The convergence of these regular and Cauchy Principal Value integrals are impaired by the singularities of the integrand in the complex plane. The DE quadrature scheme tackles these singularities in a robust manner compared to the standard Gauss quadrature. Running time: The test included in the distribution takes a few seconds to run.

  13. Routine soil testing to monitor heavy metals and boron

    Directory of Open Access Journals (Sweden)

    Abreu Cleide Aparecida de

    2005-01-01

    Full Text Available Microelements are an important issue in agriculture, due to their need as micronutrients for plants and also to the possibility of the build-up of toxic levels for plants and animals. Five micronutrients (B, Cu, Fe, Mn, and Zn are routinely determined in soil analysis for advisory purposes. Other four elements (Cd, Cr, Pb, and Ni are considered environmentally important heavy metals in farmland soils. Thus high contents of these metals in cropland might go eventually unnoticed. In this paper we present an approach that can be used to monitor the contents of the nine elements in farmland soils using advisory soil testing. A total of 13,416 soil samples from 21 Brazilian states, 58% of them from the state of São Paulo, sent by farmers were analyzed. Boron was determined by hot water extraction and the other metals were determined by DTPA (pH 7.3 extraction. The ranges of content, given in mg dm-3 soil, were the following: B, 0.01-10.6; Cu, 0.1-56.2; Fe, 0.5-476; Mn, 1-325; Zn, 1-453; Cd, 0.00-3.43, Cr, 0.00-42.9; Ni, 0.00-65.1; Pb, 0.00-63.9. The respective average values for São Paulo were: B-0.32; Cu-2.5; Fe-36; Mn-16; Zn-4.8; Cd-0.02; Cr-0.03; Ni-0.18; Pb-0.85. For other states the results are in the same ranges. The higher values are indicative of anthropogenic inputs, either due to excess application of fertilizers or to industrial or mining activities. The conclusion is that massive chemical analysis of farmland soil samples could serve as a database for indicating potential micronutrient deficiency and excesses or heavy metal buil-up in croplands, allowing preventive actions to be taken.

  14. Are chest radiographs routinely necessary following thoracostomy tube removal?

    International Nuclear Information System (INIS)

    Pacharn, Preeyacha; Heller, Daniel N.D.; Kammen, Bamidele F.; Bryce, Thomas J.; Bailey, Richard A.; Brasch, Robert C.; Reddy, Mohan V.

    2002-01-01

    Objective: Chest radiographs (CXRs) are routinely obtained at many institutions in all pediatric patients following thoracostomy tube removal to search for pneumothorax (PTX). To aid in evaluating the necessity of this practice, this study investigates whether clinical signs and symptoms may be a sensitive predictor of PTX in such patients. Materials and methods: Reports from CXRs obtained following chest tube removal in all pediatric patients (374 patients) who underwent cardiac surgery with chest tube placement over 1 year were reviewed. For cases with reported PTX, the PTX was quantified and chart review was performed to assess whether signs and symptoms of PTX preceded the CXR result. Results: Fifty-one of 374 children (13.6%) had a radiographically defined PTX within 6 h after thoracostomy tube removal. The PTX was large (>40%) in 2 children, moderate (20-40%) in 5 children, and small (<20%) in 44 children. Symptoms (dyspnea, tachypnea, respiratory distress) or signs (increased oxygen requirement, worsening arterial blood gas and/or hypotension) of respiratory distress were present at the time of the initial CXR in six of seven patients, who later underwent a major clinical intervention, and in one patient who did not. Major clinical interventions were performed in all patients with a large PTX, four of five patients with a moderate PTX, and one patient with a small PTX that later enlarged. Conclusions: Clinical signs and symptoms identified nearly all patients with significant pneumothoraces. Future prospective investigations may examine reserving chest radiography following chest tube removal for select groups, such as symptomatic patients or those with tenuous cardiovascular status. (orig.)

  15. Adoption of telemedicine: from pilot stage to routine delivery

    Directory of Open Access Journals (Sweden)

    Zanaboni Paolo

    2012-01-01

    Full Text Available Abstract Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1 the process of adoption of telemedicine in comparison with other technologies; and 2 the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify

  16. Barrierefreiheit zur Routine machen – Praxisfall: Digitale Bibliothek

    Directory of Open Access Journals (Sweden)

    Susanne Baudisch

    2015-04-01

    Full Text Available Sechs Jahre sind vergangen seit Deutschland am 24. Februar 2009 die Behindertenrechtskonvention der Vereinten Nationen (BRK, die die volle Teilhabe aller Menschen an der Gesellschaft als Menschenrecht festschreibt, ratifizierte. Bereits seit 2002 gibt es in Deutschland ein Behindertengleichstellungsgesetz (BGG, den barrierefreien Zugang zu Informations- und Kommunikationstechnologien regelt die Barrierefreie Informationstechnik-Verordnung (BITV. Aus Sicht des Gesetzgebers sind die Rahmenbedingungen gegeben, Barrierefreiheit gehört inzwischen zum gängigen Vokabular im öffentlichen und teils auch privatwirtschaftlichen Bereich. Längst möchte man meinen, es sei ein alter Hut, Barrierefreiheit als Kernanliegen zu thematisieren oder gar einzufordern. Dies betrifft auch den rasant wachsenden Bereich digitaler Medien, der Wissen und Bildung für jedermann verfügbar macht - oder machen sollte. Vor diesem Hintergrund stellen sich die Autoren der Frage, inwieweit Barrierefreiheit in den digitalen Angeboten wissenschaftlicher und öffentlicher Bibliotheken in Deutschland angekommen ist; ob diese Angebote tatsächlich von allen genutzt werden können. Ausgehend von rechtlichen Grundlagen und Normen werden Formate und Standards für barrierefreie Netzpublikationen an Beispielen diskutiert. Im Fokus stehen einerseits Werkzeuge zum Suchen und Finden digitaler Information (Kataloge und Rechercheoberflächen, andererseits Ausgabeformate digitaler Dokumente (wie XML, PDF, EPUB oder TEI. Den Abschluss bilden Empfehlungen für (Digitale Bibliotheken und deren Verbände, um Barrierefreiheit künftig zur Routine zu machen. Das Fazit: Barrierefreiheit muss gewollt, geplant und sinnvoll umgesetzt werden. Technische Komponenten sind ein wichtiger, doch meist erst der zweite Schritt.

  17. Early studies of instant-fMRI for routine examination

    International Nuclear Information System (INIS)

    Sakurai, Yuuki; Harada, Kuniaki; Nagahama, Hiroshi; Akatsuka, Yoshihiro; Shinozaki, Jun

    2010-01-01

    Authors are developing a low-burden, short-time acquisition method of functional magnetic resonance imaging (fMRI) with 3T machine, named ''Instant-fMRI'', aiming for its application to routine examinations, of which results of early studies on identification of the language hemisphere are reported. Subjects were 10 healthy volunteers (8 males, 2 females, mean age 34.2 y, 8 right-handers) and 5 right-hander patients with brain tumor (4 males, 1 female, mean age 50 y). The machine was GE Signa HDx 3.0T ver. 14, using 8 channel head coil. For Instant-fMRI, T1-weighted imaging sequence for mapping was in fast spoiled gradient recalled acquisition in the steady state (fSPGR) mode (scan time: 1 min 44 sec) and fMRI sequence, in GRE-EPI (scan time: 1 min), which thus required only about 3 min in total. Reference was defined to be the anterior-posterior commissure line, to which parallel sections involving centriciput and cerebellum were acquired. Rest (30 sec)-task (shiritori language game, 30 sec) cycle was to be one in instant-fMRI in contrast to three in the conventional fMRI. Volunteers received both instant-fMRI and conventional fMRI and patients, the former alone. Data were analyzed by GE Brain Wave PA. Right and left hemisphere of the left and right hander, respectively, was identified to be activated by instant-fMRI in 9 of 10 volunteers and in all patients, and by the conventional fMRI, in all volunteers. The instant-fMRI can be a useful examination of other brain functions as well as identifying the language field when acquisition parameters for desired diagnostic purpose are optimized. (T.T.)

  18. Adoption of telemedicine: from pilot stage to routine delivery

    Science.gov (United States)

    2012-01-01

    Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and

  19. Economic evaluation of routine infant rotavirus immunisation program in Japan.

    Science.gov (United States)

    Hoshi, Shu-Ling; Kondo, Masahide; Okubo, Ichiro

    2017-05-04

    Two rotavirus vaccines are currently available in Japan. We estimated the incremental cost-effectiveness ratio (ICER) of routine infant rotavirus immunisation program without defining which vaccine to be evaluated, which reflects the current deliberation at the Health Science Council in charge of Immunisation and Vaccine established by the Ministry of Health, Labor and Welfare of Japan. Three ICERs were estimated, one from payers' perspective and 2 from societal perspective depending on the scenarios to uptake vaccines. The health statuses following the birth cohort were as follows: not infected by rotavirus, asymptomatic infection, outpatients after infection, hospitalised after infection, developing encephalitis/encephalopathy followed by recovery, sequelae, and death. Costs of per course of vaccination was ¥30,000 (US$283; US$1 = ¥106). The model runs for 60 months with one month cycle. From payers' perspective, estimated ICERs were ¥6,877,000 (US$64,877) per QALY. From societal perspective, immunisation program turns out to be cost-saving for 75% simultaneous vaccination scenario, while it is at ¥337,000 (US$3,179) per QALY gained with vaccine alone scenario. The probability of rotavirus immunisation program to be under ¥5,000,000 (US$47,170) per QALY was at 19.8%, 40.7%, and 75.6% when costs per course of vaccination were set at ¥30,000 (US$283), ¥25,000 (US$236), and ¥20,000 (US$189), respectively. Rotavirus immunisation program has a potential to be cost-effective from payers' perspective and even cost-saving from societal perspective in Japan, however, caution should be taken with regard to the interpretation of the results as cost-effectiveness is critically dependent on vaccination costs.

  20. Assessing immunization data quality from routine reports in Mozambique

    Directory of Open Access Journals (Sweden)

    Mavimbe João C

    2005-10-01

    Full Text Available Abstract Background Worldwide immunization coverage shows an increase in the past years but the validity of the official reports for measuring change over time has been questioned. Facing this problem, donor supported initiatives like the Global Alliance for Vaccine and Immunizations, have been putting a lot of effort into assessing the quality of data used, since accurate immunization information is essential for the Expanded Program on Immunization managers to track and improve program performance. The present article, discusses the practices on record keeping, reporting and the support mechanism to ensure data quality in Mozambique. Methods A process evaluation study was carried out in Mozambique in one district (Cuamba in Niassa Province, between January and March 2003. The study was based on semi-structured interviews, participant observation and review of the data collection materials. Results Differences were found for all vaccine types when comparing facility reports with the tally sheets. The same applies when comparing facility reports with district reports. The study also showed that a routine practice during supervision visits was data quality assessment for the outpatient services but none related to data consistency between the tally sheets and the facility report. For the Expanded Program on Immunization, supervisors concentrated more on the consistency checks between data in the facility reports and the number of vaccines received during the same period. Meetings were based on criticism, for example, why health workers did not reach the target. Nothing in terms of data quality was addressed nor validation rules. Conclusion In this paper we have argued that the quality of data, and consequently of the information system, must be seen in a broader perspective not focusing only on technicalities (data collection tools and the reporting system but also on support mechanisms. Implications of a poor data quality system will be

  1. Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

    Science.gov (United States)

    Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

    2015-01-01

    Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

  2. Clinical experience with routine diode dosimetry for electron beam radiotherapy

    International Nuclear Information System (INIS)

    Yaparpalvi, Ravindra; Fontenla, Doracy P.; Vikram, Bhadrasain

    2000-01-01

    Purpose: Electron beam radiotherapy is frequently administered based on clinical setups without formal treatment planning. We felt, therefore, that it was important to monitor electron beam treatments by in vivo dosimetry to prevent errors in treatment delivery. In this study, we present our clinical experience with patient dose verification using electron diodes and quantitatively assess the dose perturbations caused by the diodes during electron beam radiotherapy. Methods and Materials: A commercial diode dosimeter was used for the in vivo dose measurements. During patient dosimetry, the patients were set up as usual by the therapists. Before treatment, a diode was placed on the patient's skin surface and secured with hypoallergenic tape. The patient was then treated and the diode response registered and stored in the patient radiotherapy system database via our in-house software. A customized patient in vivo dosimetry report showing patient details, expected and measured dose, and percent difference was then generated and printed for analysis and record keeping. We studied the perturbation of electron beams by diodes using film dosimetry. Beam profiles at the 90% prescription isodose depths were obtained with and without the diode on the beam central axis, for 6-20 MeV electron beams and applicator/insert sizes ranging from a 3-cm diameter circular field to a 25 x 25 cm open field. Results: In vivo dose measurements on 360 patients resulted in the following ranges of deviations from the expected dose at the various anatomic sites: Breast (222 patients) -20.3 to +23.5% (median deviation 0%); Head and Neck (63 patients) -21.5 to +14.8% (median -0.7%); Other sites (75 patients) -17.6 to +18.8% (median +0.5%). Routine diode dosimetry during the first treatment on 360 patients (460 treatment sites) resulted in 11.5% of the measurements outside our acceptable ±6% dose deviation window. Only 3.7% of the total measurements were outside ±10% dose deviation. Detailed

  3. "How Was Your Weekend?": Developing the Interactional Competence in Managing Routine Inquiries

    Science.gov (United States)

    Waring, Hansun Zhang

    2013-01-01

    Given the cross-cultural differences underlying interactional routines such as "How are you?" or "How was your weekend?", managing such routine inquiries can be problematic for second language learners. Based on data from an adult ESL (English as a second language) class, this conversation analytic study shows how learners develop their competence…

  4. Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Yang Zhang

    2017-06-01

    Conclusions: The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level.

  5. Avian Influenza Virus A (H5N1), Detected through Routine Surveillance, in Child, Bangladesh

    Science.gov (United States)

    Alamgir, A.S.M.; Sultana, Rebecca; Islam, M. Saiful; Rahman, Mustafizur; Fry, Alicia M.; Shu, Bo; Lindstrom, Stephen; Nahar, Kamrun; Goswami, Doli; Haider, M. Sabbir; Nahar, Sharifun; Butler, Ebonee; Hancock, Kathy; Donis, Ruben O.; Davis, Charles T.; Zaman, Rashid Uz; Luby, Stephen P.; Uyeki, Timothy M.; Rahman, Mahmudur

    2009-01-01

    We identified avian influenza virus A (H5N1) infection in a child in Bangladesh in 2008 by routine influenza surveillance. The virus was of the same clade and phylogenetic subgroup as that circulating among poultry during the period. This case illustrates the value of routine surveillance for detection of novel influenza virus. PMID:19751601

  6. [Routine oral examinations and specific after-care for removable partial dentures

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Keltjens, H.M.A.M.; Creugers, N.H.J.

    2011-01-01

    Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in

  7. Developing Routines in Large Inter-organisational Projects: A Case Study of an Infrastructure Megaproject

    Directory of Open Access Journals (Sweden)

    Therese Eriksson

    2015-08-01

    Full Text Available General management research has increasingly recognised the significance of routines in organisational performance. Among organisational tasks, megaprojects depend more on routines selected and created within the project than standard, small-scale projects do, owing largely to their size, duration, and uniqueness. Within this context, the present paper investigates how project routines were established and developed during the early design phase of an inter-organisational megaproject. A case study of a large public infrastructure project was conducted, in which data were collected during observations, semi-structured interviews, and project document studies over the course of three years. Results of analysis revealed that the client exerted the greatest impact on choice of routines and that the temporary nature of tasks limited efforts to fine-tune routines. Changes in routines were primarily reactive to new knowledge concerning project needs. The findings suggest that meta-routines to consciously review routines should be used to a greater extent and designed to capture supplier experiences as well.

  8. 32 CFR 701.121 - Processing “routine use” disclosures.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.121 Processing “routine use... be in writing and state that it is being made under a “routine use” established by a specific PA... and maintain a disclosure accounting of the information released. (See § 701.111.) (b) Failure to cite...

  9. 42 CFR 493.941 - Hematology (including routine hematology and coagulation).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Hematology (including routine hematology and....941 Hematology (including routine hematology and coagulation). (a) Program content and frequency of challenge. To be approved for proficiency testing for hematology, a program must provide a minimum of five...

  10. Acceptability of routine offer of HIV testing (opt-out approach) among ...

    African Journals Online (AJOL)

    Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered routinely to all pregnant women unless they decline testing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana. Design: Cross-sectional study of 270 ...

  11. The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer ...

    African Journals Online (AJOL)

    Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease. Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients ...

  12. Patient's needs and preferences in routine follow-up after treatment for breast cancer

    NARCIS (Netherlands)

    de Bock, GH; Bonnema, J; Zwaan, RE; de Velde, CJH; Kievit, J; Stiggelbout, AM

    2004-01-01

    The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The

  13. IT Infrastructure to Support the Secondary Use of Routinely Acquired Clinical Imaging Data for Research

    NARCIS (Netherlands)

    K.Y.E. Leung (Esther); F. van der Lijn (Fedde); H.A. Vrooman (Henri); M.C.J.M. Sturkenboom (Miriam); W.J. Niessen (Wiro)

    2014-01-01

    textabstractWe propose an infrastructure for the automated anonymization, extraction and processing of image data stored in clinical data repositories to make routinely acquired imaging data available for research purposes. The automated system, which was tested in the context of analyzing routinely

  14. The cognitive role of routine activities: the case of familiar field interventions in nuclear power plants

    International Nuclear Information System (INIS)

    Noizet, A.

    2000-01-01

    Routine works incorporate part of the environment as their own control (exo-monitoring). The routine activity is itself in the self-monitoring situation of a cognitive control, which moves with the constraints, and which is not in direct relation with the errors made and detected, but which is in relation with the check of mastery. (J.S.)

  15. Use of Songs to Promote Independence in Morning Greeting Routines for Young Children with Autism

    Science.gov (United States)

    Kern, Petra; Wolery, Mark; Aldridge, David

    2007-01-01

    This study evaluated the effects of individually composed songs on the independent behaviors of two young children with autism during the morning greeting/entry routine into their inclusive classrooms. A music therapist composed a song for each child related to the steps of the morning greeting routine and taught the children's teachers to sing…

  16. performance routines followed by free throw shooting accuracy in secondary basketball players

    Directory of Open Access Journals (Sweden)

    Phelps Ashley

    2015-12-01

    Full Text Available Study aim: The purpose of the current study was to determine whether existing pre-performance routines had an effect on free throw shooting accuracy in high school pupils as compared to shooting without a pre-performance routine.

  17. Cultural Responsiveness and Routines: When Center and Home Don't Match

    Science.gov (United States)

    Gonzalez-Mena, Janet

    2010-01-01

    This article discusses cultural responsiveness and routines of child care centers that do not match what families are accustomed to at home. It can be difficult to discuss cultural differences in some routine caregiving activities because of the standards, rules, regulations, best practices, and health concerns that those trained in early…

  18. Is Routine Preoperative Chest X-ray Indicated in Elderly Patients ...

    African Journals Online (AJOL)

    Background: In our hospital pre-operative chest x-ray (CXR) are routinely requested without prior establishment of any medical indication for patients of 70 or more years of age who are undergoing elective surgery. The aim of this study was to determine if routine preoperative chest x-rays are justifiably indicated for elderly ...

  19. Alanine/ESR dosimetry system for routine use in radiation processing

    International Nuclear Information System (INIS)

    Kojima, T.; Haruyama, Y.; Tachibana, H.; Tanaka, R.; Okamoto, J.; Hara, H.; Kashiwazaki, S.

    1993-01-01

    A new alanine-polystyrene(PS) dosimeter prepared with simplified molding procedure and an automatic desk-top dose-reader of alanine dosimeter were developed for the purpose of routine use. Combination of these two allows us to apply a reliable alanine/ESR dosimetry system to routine dosimetric process control in industrial gamma radiation processing. (Author)

  20. How characteristic routines of clinical departments influence students' self-regulated learning : A grounded theory study

    NARCIS (Netherlands)

    Berkhout, J J; Slootweg, I. A.; Helmich, Esther; Teunissen, P W; van der Vleuten, C. P. M.; Jaarsma, A. D. C.

    2017-01-01

    Background: In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students' self-regulated learning (SRL) is unknown.Aim: This study explores how characteristic routines of clinical departments influence

  1. Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

    Science.gov (United States)

    2010-01-15

    information. 2.0 DESCRIPTION Naval Submarine Medical Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway 50818 Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

  2. Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

    Directory of Open Access Journals (Sweden)

    Thomas G. Di Virgilio

    2016-11-01

    Discussion: Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term brain health which requires further study.

  3. Clinical relevance of routinely measured vital signs in hospitalized patients: a systematic review

    NARCIS (Netherlands)

    Storm-Versloot, Marja N.; Verweij, Lotte; Lucas, Cees; Ludikhuize, Jeroen; Goslings, J. Carel; Legemate, Dink A.; Vermeulen, Hester

    2014-01-01

    Conflicting evidence exists on the effectiveness of routinely measured vital signs on the early detection of increased probability of adverse events. To assess the clinical relevance of routinely measured vital signs in medically and surgically hospitalized patients through a systematic review.

  4. Can complex health interventions be evaluated using routine clinical and administrative data? - a realist evaluation approach.

    Science.gov (United States)

    Riippa, Iiris; Kahilakoski, Olli-Pekka; Linna, Miika; Hietala, Minni

    2014-12-01

    Interventions aimed at improving chronic care typically consist of multiple interconnected parts, all of which are essential to the effect of the intervention. Limited attention has been paid to the use of routine clinical and administrative data in the evolution of these complex interventions. The purpose of this study is to examine the feasibility of routinely collected data when evaluating complex interventions and to demonstrate how a theory-based, realist approach to evaluation may increase the feasibility of routine data. We present a case study of evaluating a complex intervention, namely, the chronic care model (CCM), in Finnish primary health care. Issues typically faced when evaluating the effects of a complex intervention on health outcomes and resource use are identified by using routine data in a natural setting, and we apply context-mechanism-outcome (CMO) approach from the realist evaluation paradigm to improve the feasibility of using routine data in evaluating complex interventions. From an experimentalist approach that dominates the medical literature, routine data collected from a single centre offered a poor starting point for evaluating complex interventions. However, the CMO approach offered tools for identifying indicators needed to evaluate complex interventions. Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange. © 2014 John Wiley & Sons, Ltd.

  5. Socioeconomic Segregation of Activity Spaces in Urban Neighborhoods: Does Shared Residence Mean Shared Routines?

    Directory of Open Access Journals (Sweden)

    Christopher R. Browning

    2017-02-01

    Full Text Available Residential segregation by income and education is increasing alongside slowly declining black-white segregation. Segregation in urban neighborhood residents’ nonhome activity spaces has not been explored. How integrated are the daily routines of people who live in the same neighborhood? Are people with different socioeconomic backgrounds that live near one another less likely to share routine activity locations than those of similar education or income? Do these patterns vary across the socioeconomic continuum or by neighborhood structure? The analyses draw on unique data from the Los Angeles Family and Neighborhood Survey that identify the location where residents engage in routine activities. Using multilevel p2 (network models, we analyze pairs of households in the same neighborhood and examine whether the dyad combinations across three levels of SES conduct routine activities in the same location, and whether neighbor socioeconomic similarity in the co-location of routine activities is dependent on the level of neighborhood socioeconomic inequality and trust. Results indicate that, on average, increasing SES diminishes the likelihood of sharing activity locations with any SES group. This pattern is most pronounced in neighborhoods characterized by high levels of socioeconomic inequality. Neighborhood trust explains a nontrivial proportion of the inequality effect on the extent of routine activity sorting by SES. Thus stark, visible neighborhood-level inequality by SES may lead to enhanced effects of distrust on the willingness to share routines across class.

  6. DB90: A Fortran Callable Relational Database Routine for Scientific and Engineering Computer Programs

    Science.gov (United States)

    Wrenn, Gregory A.

    2005-01-01

    This report describes a database routine called DB90 which is intended for use with scientific and engineering computer programs. The software is written in the Fortran 90/95 programming language standard with file input and output routines written in the C programming language. These routines should be completely portable to any computing platform and operating system that has Fortran 90/95 and C compilers. DB90 allows a program to supply relation names and up to 5 integer key values to uniquely identify each record of each relation. This permits the user to select records or retrieve data in any desired order.

  7. Building Micro-Foundations for the Routines, Capabilities, and Performance Links

    DEFF Research Database (Denmark)

    Abell, Peter; Felin, Teppo; Foss, Nicolai Juul

    2007-01-01

    a neglect of micro-foundations - is incomplete. There are no mechanisms that work solely on the macro-level, directly connecting routines and capabilities to firm-level outcomes. While routines and capabilities are useful shorthand for complicated patterns of individual action and interaction, ultimately...... they are best understood at the micro-level. Second, we provide a formal model that shows precisely why macro explanation is incomplete and which exemplifies how explicit micro-foundations may be built for notions of routines and capabilities and for how these impact firm performance....

  8. Community-driven demand creation for the use of routine viral load testing: a model to scale up routine viral load testing.

    Science.gov (United States)

    Killingo, Bactrin M; Taro, Trisa B; Mosime, Wame N

    2017-11-01

    HIV treatment outcomes are dependent on the use of viral load measurement. Despite global and national guidelines recommending the use of routine viral load testing, these policies alone have not translated into widespread implementation or sufficiently increased access for people living with HIV (PLHIV). Civil society and communities of PLHIV recognize the need to close this gap and to enable the scale up of routine viral load testing. The International Treatment Preparedness Coalition (ITPC) developed an approach to community-led demand creation for the use of routine viral load testing. Using this Community Demand Creation Model, implementers follow a step-wise process to capacitate and empower communities to address their most pressing needs. This includes utlizing a specific toolkit that includes conducting a baseline assessment, developing a treatment education toolkit, organizing mobilization workshops for knowledge building, provision of small grants to support advocacy work and conducting benchmark evaluations. The Community Demand Creation Model to increase demand for routine viral load testing services by PLHIV has been delivered in diverse contexts including in the sub-Saharan African, Asian, Latin American and the Caribbean regions. Between December 2015 and December 2016, ITPC trained more than 240 PLHIV activists, and disbursed US$90,000 to network partners in support of their national advocacy work. The latter efforts informed a regional, community-driven campaign calling for domestic investment in the expeditious implementation of national viral load testing guidelines. HIV treatment education and community mobilization are critical components of demand creation for access to optimal HIV treatment, especially for the use of routine viral load testing. ITPC's Community Demand Creation Model offers a novel approach to achieving this goal. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of

  9. Logistic Regression Analysis of Operational Errors and Routine Operations Using Sector Characteristics

    National Research Council Canada - National Science Library

    Pfleiderer, Elaine M; Scroggins, Cheryl L; Manning, Carol A

    2009-01-01

    ...) and routine operation (RO) traffic samples. OE data were derived from SATORI re-creations of OEs occurring at the Indianapolis Air Route Traffic Control Center between 9/17/2001 and 12/10/2003...

  10. Eigenvalue routines in NASTRAN: A comparison with the Block Lanczos method

    Science.gov (United States)

    Tischler, V. A.; Venkayya, Vipperla B.

    1993-01-01

    The NASA STRuctural ANalysis (NASTRAN) program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this paper is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the Block Lanczos algorithm by Boeing Computer Services (BCS). This eigenvalue routine is now available in the BCS mathematics library as well as in several commercial versions of NASTRAN. In addition, CRAY maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The Block Lanczos algorithm was found to be extremely efficient, in particular, for very large size problems.

  11. Predicting initial client engagement with community mental health services by routinely measured data

    NARCIS (Netherlands)

    Roeg, D.P.K.; van de Goor, L.A.M.; Garretsen, H.F.L.

    2015-01-01

    Engagement is a determinant of how well a person will respond to professional input. This study investigates whether, in practice, routinely measured data predict initial client engagement with community mental health services. Engagement, problem severity, client characteristics, and duration

  12. Stakeholder involvement in development and implementation of appropriate emergency preparedness routines in Slovakia

    International Nuclear Information System (INIS)

    Duranova, T.

    2009-01-01

    The presentation presents the process of stakeholder involvement in development and implementation of appropriate emergency preparedness routines in Slovakia in last five years. The presentation gives detailed information on used practices and real process taken place in Slovakia

  13. Routine road maintenance water quality and habitat guide : best management practices

    Science.gov (United States)

    2009-01-01

    Since June 9, 1999 the Oregon Department of Transportation (ODOT) has implemented the Routine Road Maintenance: Water Quality and Habitat Guide Best Management Practices (the Guide), and is considered the cornerstone of the ODOT'd Office of Maintenan...

  14. an evaluation of the routine use of syntometrine with the delivery of ...

    African Journals Online (AJOL)

    oxytocic administration at the end of the second sta.ge was ... mmcular ergometrine with hyalase and later intramuscular ... described a technique of lifting the uterus abdominally, ... universally accepted, is the routine use of oxytocic drugs.

  15. Valeur de l'endoscopie de routine dans le diagnostic de la gastrite ...

    African Journals Online (AJOL)

    Valeur de l'endoscopie de routine dans le diagnostic de la gastrite chronique antrale à Yaoundé. D Noah Noah, F Ankouane Andoulo, SAF Eloumou Bagnaka, PJA Atangana, C Tzeuton, EC Ndjitoyap Ndam ...

  16. Learning and remembering strategies of novice and advanced jazz dancers for skill level appropriate dance routines.

    Science.gov (United States)

    Poon, P P; Rodgers, W M

    2000-06-01

    This study examined the influence of the challenge level of to-be-learned stimulus on learning strategies in novice and advanced dancers. In Study 1, skill-level appropriate dance routines were developed for novice and advanced jazz dancers. In Study 2, 8 novice and 9 advanced female jazz dancers attempted to learn and remember the two routines in mixed model factorial design, with one between-participants factor: skill level (novice or advanced) and two within-participants factors: routine (easy or difficult) and performance (immediate or delayed). Participants were interviewed regarding the strategies used to learn and remember the routines. Results indicated that advanced performers used atypical learning strategies for insufficiently challenging stimuli, which may reflect characteristics of the stimuli rather than the performer. The qualitative data indicate a clear preference of novice and advanced performers for spatial compatibility of stimuli and response.

  17. Increased power of resting-state gamma oscillations in autism spectrum disorder detected by routine electroencephalography

    NARCIS (Netherlands)

    van Diessen, Eric; Senders, Joeky; Jansen, Floor E.; Boersma, Maria; Bruining, Hilgo

    2015-01-01

    Experimental studies suggest that increased resting-state power of gamma oscillations is associated with autism spectrum disorder (ASD). To extend the clinical applicability of this finding, we retrospectively investigated routine electroencephalography (EEG) recordings of 19 patients with ASD and

  18. A preliminary study to understand tacit knowledge and visual routines of medical experts through gaze tracking.

    Science.gov (United States)

    Anderson, Blake; Shyu, Chi-Ren

    2010-11-13

    Many decisions made by medical experts are based on scans from advanced imaging technologies. Interpreting a medical image is a trained, systematic procedure and an excellent target for identifying potential visual routines through image informatics. These visual routines derived from experts contain many clues about visual knowledge and its representation. This study uses an inexpensive webcam-based gaze tracking method to collect data from multiple technologists' survey of medical and non-medical images. Through computational analysis of the results, we expect to provide insight into the behaviors and properties related to medical visual routines. Discovering the visual processes associated with medical images will help us recognize and understand the tacit knowledge gained from extensive experience with medical imagery. These expert routines could potentially be used to reduce medical error, train new experts, and provide an understanding of the human visual system in medicine.

  19. The effectiveness of online cognitive behavioral treatment in routine clinical practice

    NARCIS (Netherlands)

    Ruwaard, J.; Lange, A.; Schrieken, B.; Dolan, C.V.; Emmelkamp, P.

    2012-01-01

    Context Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. Objective To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. Design An

  20. The effectiveness of online cognitive behavioral treatment in routine clinical practice

    NARCIS (Netherlands)

    Ruwaard, Jeroen; Lange, Alfred; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul

    2012-01-01

    CONTEXT: Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. OBJECTIVE: To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. DESIGN: An

  1. Increasing Efficiency of Routine Robot Space Operations through Adjustable Autonomy and Learning from Human Instructions

    Data.gov (United States)

    National Aeronautics and Space Administration — This research aims to address the execution of repetitive, routine and potentially hazardous tasks by robots operating in crewed low Earth orbit, lunar and...

  2. The 9 to 5 routine: advancing the understanding of occupational transition for new immigrants.

    Science.gov (United States)

    Movsessian, Yeraz

    2013-01-01

    This paper offers a reflection on temporal routines that underscore daily work life and work transitions. This reflection includes views of a Canadian student who examines work transitions through lived experiences and observation of the Chilean work/home routine. A narrative reflection on lived experience is used to examine 9 to 5 work transitions. There is a blending of work and daily life routines that provide a balance for workers in Chile and there are differences across countries in the valuing of work and daily life routines. Narrative reflections about work and work transitions can highlight differences at the macro level that can yield personal insights into challenges in transitioning into work for new immigrants.

  3. Value of routine blood tests for prediction of mortality risk in hip fracture patients

    DEFF Research Database (Denmark)

    Mosfeldt, Mathias; Pedersen, Ole Birger Vesterager; Riis, Troels

    2012-01-01

    There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission.......There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission....

  4. Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

    1983-12-01

    This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes

  5. An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway

    OpenAIRE

    Thompson, Jo; Brown, Jayne; Davies, Andrew

    2014-01-01

    Introduction: This report describes a service evaluation of the 'added value' of routine specialist palliative care team (SPCT) involvement with patients on the Liverpool Care Pathway for the Dying Patient (LCP). Methods: In the authors' hospital, patients that are commenced on the LCP are routinely referred to the SPCT. They are reviewed on the day of referral and then at least every other day, depending on the clinical situation. The data for this report was obtained by reviewing the S...

  6. The Magnitude of Hemoglobin–Drop in Obstetrics and Gynecologic Operations (Is Routine Hb Check Necessary?)

    OpenAIRE

    J. Nasohi; B. Falakaflaki

    2004-01-01

    Routine hemoglobin check after obstetrics and gynecologic operations is common and recommended by textbooks, but there are just few literatures regarding to the value of routine Hb check. The purpose of this study was to determine the changes of hemoglobin and it’s effects on clinical management after obstetrics and gynecologic operations . This study was undertaken on low risk patients who underwent hysterectomy, removal of dnexal mass , C-Section , A.P repair , tub...

  7. The nexus between organizational routines and projects\\ud A goal-based perspective

    OpenAIRE

    Olufemi, Moses; Hope, Alex; Osborne, Allan

    2015-01-01

    It has long been established that routines can be sources of stability and change within organizations. It has been suggested however that an understanding of routines alone is not enough for explaining how new actions emerge in organizations. In arguing that traditional forms of organizational structure are not flexible enough to adapt to new actions (Ansoff, 1980), some theorists have proposed projects as management methods for adapting to fast changes occurring in the business environment....

  8. FeetForward: On Blending New Classroom Technologies into Secondary School Teachers’ Routines

    OpenAIRE

    An , Pengcheng; Bakker , Saskia; Eggen , Berry

    2017-01-01

    Part 5: Interaction at the Workplace; International audience; Secondary school teachers have complex, intensive and dynamic routines in their classrooms, which makes their attentional resources limited for human-computer interaction. Leveraging principles of peripheral interaction can reduce attention demanded by technologies and interactions could blend more seamlessly into the everyday routine. We present the design and deployment of FeetForward - an open-ended, and foot-based peripheral in...

  9. Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines

    OpenAIRE

    Kluge, Annette; Gronau, Norbert

    2018-01-01

    To cope with the already large, and ever increasing, amount of information stored in organizational memory, “forgetting,” as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management), forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the liter...

  10. Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

    Science.gov (United States)

    Lanza, H Isabella; Drabick, Deborah A G

    2011-01-01

    Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

  11. Changing in Convergence: The Impact of TV News Routines on the Usage of Online UGC Sources

    Directory of Open Access Journals (Sweden)

    Huei-Ling Liu

    2014-10-01

    Full Text Available Online videos, or so called user-generated content, have been used in TV news frequently because of recent media convergence. This study examined whether this phenomenon influences news routines, and whether new characteristics of news routines have emerged because of the dependency on UGC sources. A qualitative research method was adopted, and 15 Taiwanese TV journalists were interviewed. The results show that the high dependence on the Internet for obtaining news has encouraged journalists producing news without having to leave newsroom. New routines have been formed in new production. At organizational levels, the search for online materials has been routinized, Journalist’ newsgathering and reporting are no longer original and initial but follow the hit topics on the Internet, Moreover, and news coverage currently focuses on format instead of meaning. At interorganizational level, TV news organizations monitor and imitate each other to adjust their routines. This paper shows that some unprofessional behaviors of journalists have become reasonable because of news routines changed. Consequently, the ethical and professional controversies have been ignored in newsroom.

  12. Are daily routine chest radiographs useful in critically ill, mechanically ventilated patients? A randomized study.

    Science.gov (United States)

    Clec'h, Christophe; Simon, Paul; Hamdi, Aïcha; Hamza, Lilia; Karoubi, Philippe; Fosse, Jean-Philippe; Gonzalez, Frédéric; Vincent, François; Cohen, Yves

    2008-02-01

    Whether chest radiographs (CXRs) in mechanically ventilated patients should be routinely obtained or only when an abnormality is anticipated remains debated. We aimed to compare the diagnostic, therapeutic and outcome efficacy of a restrictive prescription of CXRs with that of a routine prescription, focusing on delayed diagnoses and treatments potentially related to the restrictive prescription. Randomized controlled trial. Intensive care unit of the Avicenne Teaching Hospital, Bobigny, France. All consecutive patients mechanically ventilated for > or = 48h between January and June 2006. Patients were randomly assigned to have daily routine CXRs (routine prescription group) or clinically indicated CXRs (restrictive prescription group). For each CXR, a questionnaire was completed addressing the reason for the CXR, the new findings, and any subsequent therapeutic intervention. The endpoints were the rates of new findings, the rates of new findings that prompted therapeutic intervention, the rate of delayed diagnoses, and mortality. Eighty-four patients were included in the routine prescription group and 81 in the restrictive prescription group. The rates of new findings and the rates of new findings that prompted therapeutic intervention in the restrictive prescription group and in the routine prescription group were 66% vs. 7.2% (p < 0.0001), and 56.4% vs. 5.5% (p < 0.0001) respectively. The rate of delayed diagnoses in the restrictive prescription group was 0.7%. Mortality was similar. Restrictive use of CXRs in mechanically ventilated patients was associated with better diagnostic and therapeutic efficacies without impairing outcome.

  13. The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

    LENUS (Irish Health Repository)

    Neary, Peter M

    2012-01-01

    Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours.

  14. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

    Science.gov (United States)

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-06-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

  15. Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

    Directory of Open Access Journals (Sweden)

    Nurudeen Amusat

    2014-12-01

    Full Text Available Question: In the 6 months after total knee arthroplasty (TKA, what is the pattern of pain resolution and functional recovery in people without diabetes, with diabetes that does not impact on routine activities, and with diabetes that does impact on routine activities? Is diabetes that impacts on routine activities an independent predictor of slower resolution of pain and functional recovery after TKA? Design: Community-based prospective observational study. Participants: A consecutive cohort of 405 people undergoing primary TKA, of whom 60 (15% had diabetes. Participants with diabetes were also asked preoperatively whether diabetes impacted on their routine activities. Participants were categorised into three groups: no diabetes (n = 345, diabetes with no impact on activities (n = 41, and diabetes that impacted activities (n = 19. Outcome measures: Pain and function were measured using the Western Ontario and McMaster Universities (WOMAC Osteoarthritis Index within the month before surgery and 1, 3 and 6 months after surgery. Demographic, medical and surgical factors were also measured, along with depression, social support and health-related quality of life. Results: No baseline differences in pain and function were seen among the three groups (p > 0.05. Adjusting for age, gender and contralateral joint involvement across the 6 postoperative months, participants with diabetes that impacted on routine activities had pain scores that were 8.3 points higher (indicating greater pain and function scores that were 5.4 points higher (indicating lower function than participants without diabetes. Participants with diabetes that doesn’t impact on routine activities had similar recovery to those without diabetes. Conclusion: People undergoing TKA who report preoperatively that diabetes impacts on their routine activities have less recovery over 6 months than those without diabetes or those with diabetes that does not impact on routine activities

  16. Balancing enablers and constraints within organisational routines : A case-study of in-store goods flow at two IKEA stores in Europe

    OpenAIRE

    Arcidiacono, Fabio; Franssen, Rico

    2016-01-01

    Considering the importance of routine execution within firm replication, exploring the balance between organisational routine development in terms of variations and routine constraints of this variation, with the goal of allowing for improvements without deviating too far from the original routine that makes it a success. Aim: Shed light onto how routine variations are managed in the face of the two extremes; no routine development at all and too much routine development. Methodology: This qu...

  17. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Directory of Open Access Journals (Sweden)

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

  18. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Science.gov (United States)

    Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

    2015-01-01

    A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

  19. Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice.

    Science.gov (United States)

    Antoine, Clemence; Benfari, Giovanni; Michelena, Hector I; Malouf, Joseph F; Nkomo, Vuyisile T; Thapa, Prabin; Enriquez-Sarano, Maurice

    2018-05-31

    Background -Echocardiographic quantitation of degenerative mitral regurgitation (DMR) is recommended whenever possible in clinical guidelines but is criticized and its scalability to routine clinical practice doubted. We hypothesized that echocardiographic DMR quantitation, performed in routine clinical practice by multiple practitioners predicts independently long-term survival, and thus is essential to DMR management. Methods -We included patients diagnosed with isolated mitral-valve-prolapse 2003-2011 and any degree of MR quantified by any physician/sonographer in routine clinical practice. Clinical/echocardiographic data acquired at diagnosis were retrieved electronically. Endpoint was mortality under medical treatment analyzed by Kaplan-Meir method and Proportional-Hazard models. Results -The cohort included 3914 patients (55% male) aged 62±17 years, with left ventricular ejection fraction (LVEF) 63±8% and routinely measured effective regurgitant orifice area (EROA) 19[0-40] mm 2 During follow-up (6.7±3.1 years) 696 patients died under medical management and 1263 underwent mitral surgery. In multivariate analysis, routinely measured EROA was associated with mortality (adjusted-hazard-ratio 1.19[1.13-1.24] p 40 mm 2 threshold. Conclusions -Echocardiographic DMR quantitation is scalable to routine practice and is independently associated with clinical outcome. Routinely measured EROA is strongly associated with long-term survival under medical treatment. Excess mortality vs. the general population appears in the "moderate" DMR range and steadily increases with higher EROA. Hence, individual EROA values should be integrated into therapeutic considerations, additionally to categorical DMR grading.

  20. Limited utility of routine surveillance imaging for classical Hodgkin lymphoma patients in first complete remission.

    Science.gov (United States)

    Pingali, Sai Ravi; Jewell, Sarah W; Havlat, Luiza; Bast, Martin A; Thompson, Jonathan R; Eastwood, Daniel C; Bartlett, Nancy L; Armitage, James O; Wagner-Johnston, Nina D; Vose, Julie M; Fenske, Timothy S

    2014-07-15

    The objective of this study was to compare the outcomes of patients with classical Hodgkin lymphoma (cHL) who achieved complete remission with frontline therapy and then underwent either clinical surveillance or routine surveillance imaging. In total, 241 patients who were newly diagnosed with cHL between January 2000 and December 2010 at 3 participating tertiary care centers and achieved complete remission after first-line therapy were retrospectively analyzed. Of these, there were 174 patients in the routine surveillance imaging group and 67 patients in the clinical surveillance group, based on the intended mode of surveillance. In the routine surveillance imaging group, the intended plan of surveillance included computed tomography and/or positron emission tomography scans; whereas, in the clinical surveillance group, the intended plan of surveillance was clinical examination and laboratory studies, and scans were obtained only to evaluate concerning signs or symptoms. Baseline patient characteristics, prognostic features, treatment records, and outcomes were collected. The primary objective was to compare overall survival for patients in both groups. For secondary objectives, we compared the success of second-line therapy and estimated the costs of imaging for each group. After 5 years of follow-up, the overall survival rate was 97% (95% confidence interval, 92%-99%) in the routine surveillance imaging group and 96% (95% confidence interval, 87%-99%) in the clinical surveillance group (P = .41). There were few relapses in each group, and all patients who relapsed in both groups achieved complete remission with second-line therapy. The charges associated with routine surveillance imaging were significantly higher than those for the clinical surveillance strategy, with no apparent clinical benefit. Clinical surveillance was not inferior to routine surveillance imaging in patients with cHL who achieved complete remission with frontline therapy. Routine

  1. Visual Thinking Routines: A Mixed Methods Approach Applied to Student Teachers at the American University in Dubai

    Science.gov (United States)

    Gholam, Alain

    2017-01-01

    Visual thinking routines are principles based on several theories, approaches, and strategies. Such routines promote thinking skills, call for collaboration and sharing of ideas, and above all, make thinking and learning visible. Visual thinking routines were implemented in the teaching methodology graduate course at the American University in…

  2. Rules and routines in organizations and the management of safety rules

    Energy Technology Data Exchange (ETDEWEB)

    Weichbrodt, J. Ch.

    2013-07-01

    This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

  3. Rules and routines in organizations and the management of safety rules

    International Nuclear Information System (INIS)

    Weichbrodt, J. Ch.

    2013-01-01

    This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

  4. Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

    Science.gov (United States)

    Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

    2016-12-01

    To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

  5. Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution.

    Science.gov (United States)

    Lutya, Thozama Mandisa

    2010-12-01

    The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex.

  6. Methods to improve routine bioassay monitoring for freshly separated, poorly transported plutonium

    International Nuclear Information System (INIS)

    Bihl, D.E.; Lynch, T.P.; Carbaugh, E.H.; Sula, M.J.

    1988-09-01

    Several human cases involving inhalation of plutonium oxide at Hanford have shown clearance half-times from the lung that are much longer than the 500-day half-time recommended for class Y plutonium in Publication 30 of the International Commission on Radiological Protection(ICRP). The more tenaciously retained material is referred to as super class Y plutonium. The ability to detect super class Y plutonium by current routine bioassay measurements is shown to be poor. Pacific Northwest Laboratory staff involved in the Hanford Internal Dosimetry Program investigated four methods to se if improvements in routine monitoring of workers for fresh super class Y plutonium are feasible. The methods were lung counting, urine sampling, fecal sampling, and use of diethylenetriaminepentaacetate (DTPA) to enhance urinary excretion. Use of DTPA was determined to be not feasible. Routine fecal sampling was found to be feasible but not recommended. Recommendations were made to improve the detection level for routine annual urinalysis and routine annual lung counting. 12 refs., 9 figs., 7 tabs

  7. Automated lung volumetry from routine thoracic CT scans: how reliable is the result?

    Science.gov (United States)

    Haas, Matthias; Hamm, Bernd; Niehues, Stefan M

    2014-05-01

    Today, lung volumes can be easily calculated from chest computed tomography (CT) scans. Modern postprocessing workstations allow automated volume measurement of data sets acquired. However, there are challenges in the use of lung volume as an indicator of pulmonary disease when it is obtained from routine CT. Intra-individual variation and methodologic aspects have to be considered. Our goal was to assess the reliability of volumetric measurements in routine CT lung scans. Forty adult cancer patients whose lungs were unaffected by the disease underwent routine chest CT scans in 3-month intervals, resulting in a total number of 302 chest CT scans. Lung volume was calculated by automatic volumetry software. On average of 7.2 CT scans were successfully evaluable per patient (range 2-15). Intra-individual changes were assessed. In the set of patients investigated, lung volume was approximately normally distributed, with a mean of 5283 cm(3) (standard deviation = 947 cm(3), skewness = -0.34, and curtosis = 0.16). Between different scans in one and the same patient the median intra-individual standard deviation in lung volume was 853 cm(3) (16% of the mean lung volume). Automatic lung segmentation of routine chest CT scans allows a technically stable estimation of lung volume. However, substantial intra-individual variations have to be considered. A median intra-individual deviation of 16% in lung volume between different routine scans was found. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  8. Clinician’s Attitudes to the Introduction of Routine Weighing in Pregnancy

    Directory of Open Access Journals (Sweden)

    Tim Hasted

    2016-01-01

    Full Text Available Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (reintroduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians’ perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence.

  9. [Use of routine data from statutory health insurances for federal health monitoring purposes].

    Science.gov (United States)

    Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

    2014-04-01

    Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.

  10. Routine recovery: an ethical plan for greatly increasing the supply of transplantable organs.

    Science.gov (United States)

    Spital, Aaron; Taylor, James S

    2008-04-01

    All current organ procurement policies require some form of consent. Many families refuse to permit organ recovery from a recently deceased relative; therefore, the major cost of requiring consent is the loss of some lives that could have been saved through transplantation. Here, we argue for a much more efficient approach to organ procurement from brain dead individuals - routine recovery of all transplantable organs without consent. Careful analysis of the relevant literature shows that, compared with its competitors, routine recovery has the greatest potential to increase cadaveric organ procurement and save lives while causing very little harm. Furthermore, a recent survey suggests that 30% of the US public would already accept routine recovery even though the respondents were not educated regarding the value of this approach. Patients on the transplant waiting list are dying while organs that could have saved them are being buried or burned because of family refusal to allow posthumous organ procurement. Routine recovery would eliminate this tragic loss of life-saving organs without violating ethical principles. Indeed, we argue that of all the proposals designed to increase the supply of transplantable cadaveric organs, routine recovery is the best.

  11. Design and implementation of the modified signed digit multiplication routine on a ternary optical computer.

    Science.gov (United States)

    Xu, Qun; Wang, Xianchao; Xu, Chao

    2017-06-01

    Multiplication with traditional electronic computers is faced with a low calculating accuracy and a long computation time delay. To overcome these problems, the modified signed digit (MSD) multiplication routine is established based on the MSD system and the carry-free adder. Also, its parallel algorithm and optimization techniques are studied in detail. With the help of a ternary optical computer's characteristics, the structured data processor is designed especially for the multiplication routine. Several ternary optical operators are constructed to perform M transformations and summations in parallel, which has accelerated the iterative process of multiplication. In particular, the routine allocates data bits of the ternary optical processor based on digits of multiplication input, so the accuracy of the calculation results can always satisfy the users. Finally, the routine is verified by simulation experiments, and the results are in full compliance with the expectations. Compared with an electronic computer, the MSD multiplication routine is not only good at dealing with large-value data and high-precision arithmetic, but also maintains lower power consumption and fewer calculating delays.

  12. Intelligent stochastic optimization routine for in-core fuel cycle design

    International Nuclear Information System (INIS)

    Parks, G.T.

    1988-01-01

    Any reactor fuel management strategy must specify the fuel design, batch sizes, loading configurations, and operational procedures for each cycle. To permit detailed design studies, the complex core characteristics must necessarily be computer modeled. Thus, the identification of an optimal fuel cycle design represents an optimization problem with a nonlinear objective function (OF), nonlinear safety constraints, many control variables, and no direct derivative information. Most available library routines cannot tackle such problems; this paper introduces an intelligent stochastic optimization routine that can. There has been considerable interest recently in the application of stochastic methods to difficult optimization problems, based on the statistical mechanics algorithms originally attributed to Metropolis. Previous work showed that, in optimizing the performance of a British advanced gas-cooled reactor fuel stringer, a rudimentary version of the Metropolis algorithm performed as efficiently as the only suitable routine in the Numerical Algorithms Group library. Since then the performance of the Metropolis algorithm has been considerably enhanced by the introduction of self-tuning capabilities by which the routine adjusts its control parameters and search pattern as it progresses. Both features can be viewed as examples of artificial intelligence, in which the routine uses the accumulation of data, or experience, to guide its future actions

  13. The Surgical Teams' Perception of the Effects of a Routine Intraoperative Pause.

    Science.gov (United States)

    Erestam, Sofia; Angenete, Eva; Derwinger, Kristoffer

    2016-12-01

    A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine. A majority were positive to scheduled pauses. The surgeons often felt refreshed and at times changed their view on both anatomy and their surgical strategy. They were also perceived by other team members as improved regarding communication. All groups felt that patient safety was promoted. There were differences by profession in perception of team communication. The pause routine was well perceived by the surgical team. A majority believed that scheduled and regular pauses contribute to improved patient safety and better team communication. There were also findings of differences in communication and experience of team coherence between personnel categories that could benefit from further acknowledgement and exploration.

  14. Families experiencing housing instability: the effects of housing programs on family routines and rituals.

    Science.gov (United States)

    Mayberry, Lindsay Satterwhite; Shinn, Marybeth; Benton, Jessica Gibbons; Wise, Jasmine

    2014-01-01

    Maintenance of family processes can protect parents, children, and families from the detrimental effects of extreme stressors, such as homelessness. When families cannot maintain routines and rituals, the stressors of poverty and homelessness can be compounded for both caregivers and children. However, characteristics of living situations common among families experiencing homelessness present barriers to the maintenance of family routines and rituals. We analyzed 80 in-depth interviews with parents who were experiencing or had recently experienced an instance of homelessness. We compared their assessments of challenges to family schedules, routines, and rituals across various living situations, including shelter, transitional housing programs, doubled-up (i.e., living temporarily with family or friends), and independent housing. Rules common across shelters and transitional housing programs impeded family processes, and parents felt surveilled and threatened with child protective service involvement in these settings. In doubled-up living situations, parents reported adapting their routines to those of the household and having parenting interrupted by opinions of friends and family members. Families used several strategies to maintain family routines and rituals in these living situations and ensure consistency and stability for their children during an otherwise unstable time. (c) 2014 APA, all rights reserved.

  15. Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives.

    Science.gov (United States)

    Baird, Kathleen; Creedy, Debra K; Saito, Amornrat S; Eustace, Jennifer

    2018-01-15

    Routine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time. To evaluate the longitudinal impact of a domestic violence training and support program to promote midwives' routine antenatal enquiry for domestic violence using a mixed methods design. Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives' knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change. Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z=4.88, p90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral. Training, support processes, and referral pathways, contributed to midwives' sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence. Copyright © 2018. Published by Elsevier Ltd.

  16. A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy.

    Science.gov (United States)

    Bingham, Jason; Kaufman, Jedediah; Hata, Kai; Dickerson, James; Beekley, Alec; Wisbach, Gordon; Swann, Jacob; Ahnfeldt, Eric; Hawkins, Devon; Choi, Yong; Lim, Robert; Martin, Matthew

    2017-09-01

    Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. To determine the efficacy of IOLT and if routine use has any benefit over selective use. Eight teaching hospitals, including private, university, and military facilities. A multicenter, retrospective analysis over a 5-year period. The efficacy of the IOLT for identifying unsuspected staple line defects and for predicting postoperative leaks was evaluated. An anonymous survey was also collected reflecting surgeons' practices and beliefs regarding IOLT. From January 2010 through December 2014, 4284 patients underwent sleeve gastrectomy. Of these, 37 patients (.9%) developed a postoperative leak, and 2376 patients (55%) received an IOLT. Only 2 patients (0.08%) had a positive finding. Subsequently, 21 patients with a negative IOLT developed a leak. IOLT demonstrated a sensitivity of only 8.7%. There was a nonsignificant trend toward increased leak rates when an IOLT was performed versus when IOLT was not performed. Leak rates were not statistically different between centers that routinely perform IOLT versus those that selectively perform IOLT. Routine IOLT had very poor sensitivity and was negative in 91% of patients who later developed postoperative leaks. The use of IOLT was not associated with a decrease in the incidence of postoperative leaks, and routine IOLT had no benefit over selective leak testing. IOLT should not be used as a quality indicator or "best practice" for bariatric surgery. Published by Elsevier Inc.

  17. Screen Exposure During Daily Routines and a Young Child's Risk for Having Social-Emotional Delay.

    Science.gov (United States)

    Raman, Sajani; Guerrero-Duby, Sara; McCullough, Jennifer L; Brown, Miraides; Ostrowski-Delahanty, Sarah; Langkamp, Diane; Duby, John C

    2017-11-01

    This cross-sectional study assessed associations between social-emotional development in young children and their number of daily routines involving an electronic screen. We hypothesized children with poor social-emotional development have a significant portion of daily routines occurring with a screen. Two hundred and ten female caregivers of typically developing children 12 to 36 months old completed the Ages and Stages Questionnaire: Social-Emotional (ASQ: SE) and a media diary. Caregivers completed the diary for 1 day around 10 daily routines (Waking Up, Diapering/Toileting, Dressing, Breakfast, Lunch, Naptime, Playtime, Dinner, Bath, and Bedtime). Median number of daily routines occurring with a screen for children at risk and not at risk for social-emotional delay (as defined by the ASQ: SE) was 7 versus 5. Children at risk for social-emotional delay were 5.8 times more likely to have ≥5 routines occurring with a screen as compared to children not at risk for delay (χ 1 2 = 9.28, N = 210, P = .002; 95% confidence interval = 1.66-20.39).

  18. Engaging adolescents with LD in higher order thinking about history concepts using integrated content enhancement routines.

    Science.gov (United States)

    Bulgren, Janis; Deshler, Donald D; Lenz, B Keith

    2007-01-01

    The understanding and use of historical concepts specified in national history standards pose many challenges to students. These challenges include both the acquisition of content knowledge and the use of that knowledge in ways that require higher order thinking. All students, including adolescents with learning disabilities (LD), are expected to understand and use concepts of history to pass high-stakes assessments and to participate meaningfully in a democratic society. This article describes Content Enhancement Routines (CERs) to illustrate instructional planning, teaching, and assessing for higher order thinking with examples from an American history unit. Research on the individual components of Content Enhancement Routines will be illustrated with data from 1 of the routines. The potential use of integrated sets of materials and procedures across grade levels and content areas will be discussed.

  19. Generic environmental statement on the routine use of plutonium-powered cardiac pacemakers

    International Nuclear Information System (INIS)

    Shoup, R.L.; Robinson, T.W.; O'Donnell, F.R.

    1976-01-01

    The purpose of a continuing program at ORNL is to provide technical assistance to the NRC on writing and editing of the final environmental statement on the routine use of nuclear-powered (primarily 238 Pu) cardiac pacemakers. This environmental statement defines the safety and reliability standards that nuclear-powered pacemakers are required to meet. All aspects of the risks to the patients, the public, and the environment are evaluated both for the routine use of plutonium-powered pacemakers and for postulated accidents involving pacemaker patients. Benefits derived from the use of plutonium-powered units are discussed and weighed against the risks in order to determine whether routine use is justified. Available alternative pacemakers with various performance characteristics are compared with respect to costs and to the needs of pacemaker patients

  20. Daily Family Routines of Italian and Ecuadorian Immigrant Mothers in Everyday Life

    Directory of Open Access Journals (Sweden)

    Nadia Rania

    2015-10-01

    Full Text Available This study compares Italian mothers’ and Ecuadorian immigrant mothers’ daily family routines. Thirty mothers took part in this investigation: 15 Italians (M = 37.5 years, with ages ranging from 30 to 42 years and 15 Ecuadorians (M = 36.1 years, with ages ranging from 18 to 46 years and having lived in Italy for an average of 15 years, with children ranging in age from 4 to 8 years. The objective is to highlight the differences and similarities between the daily routines and family relations that characterize the lives of each of the two groups of participants. The instruments employed in service of these aims were in-depth interviews and diaries. The results showed similarities regarding the routines of Italian and Ecuadorian families. However, a relevant difference emerged regarding their perceptions of social support. Specifically, Italians receive more social support from their parents than do Ecuadorians, who are supported more by other relatives or by friends.

  1. From frequency of use to social integration: The mediation of routinization and infusion in Tuenti community

    Directory of Open Access Journals (Sweden)

    José L. Roldán

    2017-05-01

    Full Text Available This study examines post-adoption behaviors (i.e., frequency of use, routinization and infusion and their effects on the sense of community in the domain of social network sites. In particular, this contribution formulates mediation hypotheses, which posit how frequency of use affects social integration via routinization and infusion. The data was collected from 278 users of Tuenti, a highly-popular social network site among the Spanish college student population during the period 2006–2012. Results from partial least squares structural equation modeling (PLS-SEM show these sophisticated types of usage are interrelated in such a way that routinization and infusion (a fully mediate the effect of frequency of use on social integration; and (b exert significant influences on social integration, as an active sense of belongingness to a social network site. In order to attain social integration, it is therefore essential for managers to devise strategies to foster advanced post-adoption behaviors.

  2. Clearer, Simpler and more Efficient LAPACK Routines for Symmetric Positive Definite Band Factorization

    DEFF Research Database (Denmark)

    Gustavson, Fred G.; Quintania-Orti, Enrique S.; Quintana-Orti, Gregorio

    We describe a minor format change for representing a symmetric band matrix AB using the same array space specified by LAPACK. In LAPACK, band codes operating on the lower part of a symmetric matrix reference matrix element (i, j) as AB1+i−j,j . The format change we propose allows LAPACK band codes...... to reference the (i, j) element as ABi,j . Doing this yields lower band codes that use standard matrix terminology so that they become clearer and hence easier to understand. As a second contribution, we simplify the LAPACK Cholesky Band Factorization routine pbtrf by reducing from six to three the number...... of subroutine calls one needs to invoke during a right-looking block factorization step. Our new routines perform exactly the same number of floating-point arithmetic operations as the current LAPACK routine pbtrf. Almost always they deliver higher performance. The experimental results show...

  3. System for remote routine monitoring of power equipment at TPP and NPP

    International Nuclear Information System (INIS)

    Kantsedalov, V.G.; Samojlenko, V.P.; Doroshenko, V.A.

    1988-01-01

    A system for remote routine monitoring of TPP and NPP pipeline metals is described. The principal functional unit of the system is the unit of remote routine methods and techniques for studying and monitoring the metal and properties. The system is equipped with 5 types of routine monitoring equipment: robots, remote aggregated complexes, periodical diagnostic monitors, other means of metal diagnostics (endoscopes, introscopes). All current information enters the unit for estimating and forecasting the service life of power unit, where it is compared with the standard indices of reliability, duravility and efficiency. The system considered permits to reduce significantly or minimize the scope of works on metal monitoring during overhauls, increase intermonitoring and interrepairing compaigns to 8 years

  4. Routine general practice care for panic disorder within the lifestyle approach to managing panic study

    Directory of Open Access Journals (Sweden)

    Rodney A. Lambert

    2012-07-01

    Full Text Available Routine general practice (GP care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts. Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions. Trial arm, occupational therapyled lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health than at baseline (9 referrals; 2 mental health were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.

  5. Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines

    Directory of Open Access Journals (Sweden)

    Annette Kluge

    2018-02-01

    Full Text Available To cope with the already large, and ever increasing, amount of information stored in organizational memory, “forgetting,” as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management, forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues that are relevant in the forgetting of routines, and discuss a meta-cue called the “situational strength” cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues, we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

  6. Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines.

    Science.gov (United States)

    Kluge, Annette; Gronau, Norbert

    2018-01-01

    To cope with the already large, and ever increasing, amount of information stored in organizational memory, "forgetting," as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management), forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues) that are relevant in the forgetting of routines, and discuss a meta-cue called the "situational strength" cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues), we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

  7. Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

    Science.gov (United States)

    Tan, S G; Lim, S H; Malathi, I

    1995-11-01

    A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

  8. Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis.

    Science.gov (United States)

    Zhang, Yang; Xiao, Xiong; Zhang, Junting; Gao, Zhixian; Ji, Nan; Zhang, Liwei

    2017-06-01

    To evaluate the diagnostic accuracy of routine blood examinations and Cerebrospinal Fluid (CSF) lactate level for Post-neurosurgical Bacterial Meningitis (PBM) at a large sample-size of post-neurosurgical patients. The diagnostic accuracies of routine blood examinations and CSF lactate level to distinguish between PAM and PBM were evaluated with the values of the Area Under the Curve of the Receiver Operating Characteristic (AUC -ROC ) by retrospectively analyzing the datasets of post-neurosurgical patients in the clinical information databases. The diagnostic accuracy of routine blood examinations was relatively low (AUC -ROC CSF lactate level achieved rather high diagnostic accuracy (AUC -ROC =0.891; CI 95%, 0.852-0.922). The variables of patient age, operation duration, surgical diagnosis and postoperative days (the interval days between the neurosurgery and examinations) were shown to affect the diagnostic accuracy of these examinations. The variables were integrated with routine blood examinations and CSF lactate level by Fisher discriminant analysis to improve their diagnostic accuracy. As a result, the diagnostic accuracy of blood examinations and CSF lactate level was significantly improved with an AUC -ROC value=0.760 (CI 95%, 0.737-0.782) and 0.921 (CI 95%, 0.887-0.948) respectively. The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Sequencing-based breast cancer diagnostics as an alternative to routine biomarkers.

    Science.gov (United States)

    Rantalainen, Mattias; Klevebring, Daniel; Lindberg, Johan; Ivansson, Emma; Rosin, Gustaf; Kis, Lorand; Celebioglu, Fuat; Fredriksson, Irma; Czene, Kamila; Frisell, Jan; Hartman, Johan; Bergh, Jonas; Grönberg, Henrik

    2016-11-30

    Sequencing-based breast cancer diagnostics have the potential to replace routine biomarkers and provide molecular characterization that enable personalized precision medicine. Here we investigate the concordance between sequencing-based and routine diagnostic biomarkers and to what extent tumor sequencing contributes clinically actionable information. We applied DNA- and RNA-sequencing to characterize tumors from 307 breast cancer patients with replication in up to 739 patients. We developed models to predict status of routine biomarkers (ER, HER2,Ki-67, histological grade) from sequencing data. Non-routine biomarkers, including mutations in BRCA1, BRCA2 and ERBB2(HER2), and additional clinically actionable somatic alterations were also investigated. Concordance with routine diagnostic biomarkers was high for ER status (AUC = 0.95;AUC(replication) = 0.97) and HER2 status (AUC = 0.97;AUC(replication) = 0.92). The transcriptomic grade model enabled classification of histological grade 1 and histological grade 3 tumors with high accuracy (AUC = 0.98;AUC(replication) = 0.94). Clinically actionable mutations in BRCA1, BRCA2 and ERBB2(HER2) were detected in 5.5% of patients, while 53% had genomic alterations matching ongoing or concluded breast cancer studies. Sequencing-based molecular profiling can be applied as an alternative to histopathology to determine ER and HER2 status, in addition to providing improved tumor grading and clinically actionable mutations and molecular subtypes. Our results suggest that sequencing-based breast cancer diagnostics in a near future can replace routine biomarkers.

  10. [Routine oral examinations and specific after-care for removable partial dentures].

    Science.gov (United States)

    de Baat, C; Witter, D J; Keltjens, H M A M; Creugers, N H J

    2011-01-01

    Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in relation to the removable partial dentures, maintenance, restorative and prosthetic treatment may be indicated. Maintenance treatments are indicated for small and easily retrievable alterations. In removable partial denture treatment, adequate space between prepared tooth and denture is essential. Possible prosthetic treatments of a removable partial denture are relining, rebasing, improving or renewing the maxillomandibular relation, repairment, and extension.

  11. Cyber Journalism: Journal writing’s digitizing, Neo routines and Job stress

    Directory of Open Access Journals (Sweden)

    Mariana Loreta Magallanes Udovicich

    2015-02-01

    Full Text Available This paper analyzes the institutional and professional reorganization of Diagonales Journal’s newsroom, La Plata, Buenos Aires, Argentina, in its digitization context since December 2011. Based on deep interviews done to employees and former employees, this paper retrieves the professional experience of Cyber Journalism as part of emerging work routines. At the same time this article aims to approach the personal consequences that these processes have caused to the professionals involved. In this context, we recover some factors that, according to the interviews, have been identified as newsroom's routine stressors during the transition to digital edition.

  12. Interpreted consultations as 'business as usual'? An analysis of organisational routines in general practices.

    Science.gov (United States)

    Greenhalgh, Trisha; Voisey, Christopher; Robb, Nadia

    2007-09-01

    UK general practices operate in an environment of high linguistic diversity, because of recent large-scale immigration and of the NHS's commitment to provide a professional interpreter to any patient if needed. Much activity in general practice is co-ordinated and patterned into organisational routines (defined as repeated patterns of interdependent actions, involving multiple actors, bound by rules and customs) that tend to be stable and to persist. If we want to understand how general practices are responding to pressures to develop new routines, such as interpreted consultations, we need to understand how existing organisational routines change. This will then help us to address a second question, which is how the interpreted consultation itself is being enacted and changing as it becomes routinised (or not) in everyday general practice. In seeking answers to these two questions, we undertook a qualitative study of narratives of interpreted primary care consultations in three London boroughs with large minority ethnic populations. In 69 individual interviews and two focus groups, we sought accounts of interpreted consultations from service users, professional interpreters, family member interpreters, general practitioners, practice nurses, receptionists, and practice managers. We asked participants to tell us both positive and negative stories of their experiences. We analysed these data by searching for instances of concepts relating to the organisational routine, the meaning of the interpreted consultation to the practice, and the sociology of medical work. Our findings identified a number of general properties of the interpreted consultation as an organisational routine, including the wide variation in the form of adoption, the stability of the routine, the adaptability of the routine, and the strength of the routine. Our second key finding was that this variation could be partly explained by characteristics of the practice as an organisation, especially

  13. Routine operation of an Elliott 903 computer in a clinical chemistry laboratory

    Science.gov (United States)

    Whitby, L. G.; Simpson, D.

    1973-01-01

    Experience gained in the last four years concerning the capabilities and limitations of an 8K Elliott 903 (18-bit word) computer with magnetic tape backing store in the routine operation of a clinical chemistry laboratory is described. Designed as a total system, routine operation has latterly had to be confined to data acquisition and process control functions, due primarily to limitations imposed by the choice of hardware early in the project. In this final report of a partially successful experiment the opportunity is taken to review mistakes made, especially at the start of the project, to warn potential computer users of pitfalls to be avoided. PMID:4580240

  14. Routine use of daily oral vitamin K to treat infants with cystic fibrosis.

    Science.gov (United States)

    Cottam, Sophie T; Connett, Gary J

    2015-10-01

    Vitamin K is routinely administered after birth in the UK to prevent haemorrhagic disease of the newborn. Despite this, vitamin K-deficient coagulopathy still occurs in infants with high morbidity and mortality. Up to 50% of late onset bleeding presents with intracranial haemorrhage. The risk of developing vitamin K coagulopathy is higher in infants with cystic fibrosis (CF) and those that are exclusively breast fed due to low vitamin K levels in breast milk and intestinal changes in bacterial flora. Oral vitamin K supplementation is a simple addition to routine CF treatment during infancy to prevent complications from significant coagulopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Properties of electret ionization chambers for routine dosimetry in photon radiation fields

    International Nuclear Information System (INIS)

    Doerschel, B.; Pretzsch, G.

    1985-01-01

    The main properties of photon routine dosemeters are their energy and angular dependence as well as their measuring range and accuracy. The determination of radiation exposure from dosemeter response is based on the choice of an appropriate conversion factor taking into account the influence of body backscattering on the dosemeter response. Measuring range and accuracy of an electret ionization chamber first of all depend on electret stability, methods of charge measurement, and geometry of the chamber. The dosemeter performance is described for an electret ionization chamber which was designed for application to routine monitoring of radiation workers. (author)

  16. Summary of typical routine maintenance activities at Tokai Reprocessing Plant. Supplement (March, 2002)

    International Nuclear Information System (INIS)

    2002-03-01

    Typical maintenance activities, such as replacement of worn out parts and cleaning of filter elements, routinely performed during steady operation are summarized. [The Summary of Typical Routine Maintenance Activities at Tokai Reprocessing Plant] (JNC TN 8450 2001-006) was already prepared in September, 2001. The purpose of this summary is to give elementary understanding on these activities to people who are responsible for explanation them to the public. At this time, the same kind of summary is prepared as a supplement of the previous one. (author)

  17. One-dimensional nodal neutronics routines for the TRAC-BD1 thermal-hydraulics program

    International Nuclear Information System (INIS)

    Nigg, D.W.

    1983-09-01

    Nuclear reactor core transient neutronic behavior is currently modeled in the TRAC-BD1 code using a point-reactor kinetics formulation. This report describes a set of subroutines based on the Analytic Nodal Method that were written to provide TRAC-BD1 with a one-dimensional space-dependent neutronics capability. Use of the routines is illustrated with several test problems. The results of these problems show that the Analytic Nodal neutronics routines have desirable accuracy and computing time characteristics and should be a useful addition to TRAC-BD1

  18. PELLET: a computer routine for modeling pellet fueling in tokamak plasmas

    International Nuclear Information System (INIS)

    Houlberg, W.A.; Iskra, M.A.; Howe, H.C.; Attenberger, S.E.

    1979-01-01

    Recent experimental results of frozen hydrogenic pellet injection into hot tokamak plasmas and substantial agreement with theoretical predictions have led to a much greater interest in pellets as a means of refueling plasmas. The computer routine PELLET has been developed and used as an aid in assessing pellet ablation models and the effects of pellets on plasma behavior. PELLET provides particle source profiles under various options for the ablation model and can be coupled either to a fluid transport code or to a brief routine which supplies the required input parameters

  19. Comparison of two oestrus synchronisation protocols administered to dairy cows during routine reproduction services

    DEFF Research Database (Denmark)

    Viora, L; Denwood, M; Ellis, K

    2015-01-01

    Progesterone-based oestrus synchronisation protocols are frequently used for treatment of cows presented for examination during routine reproduction management service. This study aimed to evaluate the effect of the addition of gonadotrophin-releasing hormone (GnRH) at the start of a progesterone......-based oestrus synchronisation protocol for cows presented for examination during routine veterinary service on a commercial dairy farm over 10 months. Overall 139 animals were retained in the study, of which 78 received a standard progesterone-based treatment (STD) and 61 received the same treatment...

  20. ORCODE.77: a computer routine to control a nuclear physics experiment by a PDP-15 + CAMAC system, written in assembler language and including many new routines of general interest

    International Nuclear Information System (INIS)

    Dickens, J.K.; McConnell, J.W.

    1977-01-01

    ORCODE.77 is a versatile data-handling computer routine written in MACRO (assembler) language for a PDP-15 computer with EAE (extended arithmetic capability) connected to a CAMAC interface. The Interrupt feature of the computer is utilized. Although the code is oriented for a specific experimental problem, there are many routines of general interest, including a CAMAC Scaler handler, an executive routine to interpret and act upon three-character teletype commands, concise routines to type out double-precision integers (both octal and decimal) and floating-point numbers and to read in integers and floating-point numbers, a routine to convert to and from PDP-15 FORTRAN-IV floating-point format, a routine to handle clock interrupts, and our own DECTAPE handling routine. Routines having specific applications which are applicable to other very similar applications include a display routine using CAMAC instructions, control of external mechanical equipment using CAMAC instructions, storage of data from an Analog-to-digital Converter, analysis of stored data into time-dependent pulse-height spectra, and a routine to read the contents of a Nuclear Data 5050 Analyzer and to prepare DECTAPE output of these data for subsequent analysis by a code written in PDP-15-compiled FORTRAN-IV

  1. Implementing a routine, voluntary HIV testing program in a Massachusetts county prison.

    Science.gov (United States)

    Liddicoat, Rebecca V; Zheng, Hui; Internicola, Jeanne; Werner, Barbara G; Kazianis, Arthur; Golan, Yoav; Rubinstein, Eric P; Freedberg, Kenneth A; Walensky, Rochelle P

    2006-11-01

    Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (pprison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

  2. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

    NARCIS (Netherlands)

    Belderok, S.M.; van den Hoek, A.; Kint, J.A.; van der Loeff, M.F.S.; Sonder, G.J.B.

    2011-01-01

    Background: Travellers' diarrhoea (TD) is the most common infectious disease among travellers. In the Netherlands, stand-by or prophylactic antibiotics are not routinely prescribed to travellers. This study prospectively assessed the incidence rate, risk factors, and treatment of TD among

  3. Implementation aspects of image management, archiving, and communication systems in routine clinical use

    NARCIS (Netherlands)

    Haar Romenij, ter B.M.

    1991-01-01

    Implementation of a digital imaging network in routine clinical use is a difficult task. Not only the high technical requirements, but especially the complexity of the organization of the diagnostic information flow in a hospital makes commitment essential in PACS implementation. The application of

  4. Using Thinking Routines as a Pedagogy for Teaching English as a Second Language in Palestine

    Science.gov (United States)

    Dajani, Majida

    2016-01-01

    This study examined the results of promoting Palestinian students' engagement and fostering their understanding in addition to their inquiry skills through the application of thinking routines. Six teachers teaching fourth and fifth grades participated voluntarily in this action research project during the school year 2014-2015. The researcher…

  5. Guidelines for the Calibration of Routine Dosimetry Systems for use in Radiation Processing

    DEFF Research Database (Denmark)

    Sharpe, Peter; Miller, Arne

    A set of guidelines has been developed to assist in the calibration of routine dosimetry systems for use in industrial radiation processing plants. Topics covered include the calibration of equipment, the performance of calibration irradiations and the derivation of mathematical functions...

  6. Feasibility and reliability of a newly developed antenatal risk score card in routine care

    NARCIS (Netherlands)

    E. Birnie; E.A.P. Steegers; Drs. H.W. Torij; M.J. Veen; J. Poeran; G.J. Bonsel

    2015-01-01

    A population-based cross-sectional study (feasibility) and a cohort study (inter-rater reliability) to study in routine care the feasibility and inter-rater reliability of the Rotterdam Reproductive Risk Reduction risk score card (R4U), a new semi-quantitative score card for use during the antenatal

  7. Prometheus: the implementation of clinical coding schemes in French routine general practice

    Directory of Open Access Journals (Sweden)

    Laurent Letrilliart

    2006-09-01

    Conclusions Coding health problems on a routine basis proved to be feasible. However, this process can be used on a more widespread basis and linked to other management data only if physicians are specially trained and rewarded, and the software incorporates large terminologies mapped with classifications.

  8. Promoting Early Literacy via Practicing Invented Spelling: A Comparison of Different Mediation Routines

    Science.gov (United States)

    Levin, Iris; Aram, Dorit

    2013-01-01

    The present study compared the effects of different mediation routines provided to kindergartners from families of low socioeconomic status on the students' invented spelling attempts and on their gains obtained on spelling and other early literacy skills (letter naming, sounds of letters, word segmentation, and word decoding). The effects of the…

  9. Improved method of producing satisfactory sections of whole eyeball by routine histology.

    Science.gov (United States)

    Arko-Boham, Benjamin; Ahenkorah, John; Hottor, Bismarck Afedo; Dennis, Esther; Addai, Frederick Kwaku

    2014-02-01

    To overcome the loss of structural integrity when eyeball sections are prepared by wax embedding, we experimentally modified the routine histological procedure and report satisfactorily well-preserved antero-posterior sections of whole eyeballs for teaching/learning purposes. Presently histological sections of whole eyeballs are not readily available because substantial structural distortions attributable to variable consistency of tissue components (and their undesired differential shrinkage) result from routine processing. Notably, at the dehydration stage of processing, the soft, gel-like vitreous humor considerably shrinks relative to the tough fibrous sclera causing collapse of the ocular globe. Additionally, the combined effects of fixation, dehydration, and embedding at 60°C renders the eye lens too hard for microtome slicing at thicknesses suitable for light microscopy. We satisfactorily preserved intact antero-posterior sections of eyeballs via routine paraffin wax processing procedure entailing two main modifications; (i) careful needle aspiration of vitreous humor and replacement with molten wax prior to wax infiltration; (ii) softening of lens in trimmed wax block by placing a drop of concentrated liquid phenol on it for 3 h during microtomy. These variations of the routine histological method produced intact whole eyeball sections with retinal detachment as the only structural distortion. Intact sections of the eyeball obtained compares well with the laborious, expensive, and 8-week long celloidin method. Our method has wider potential usability than costly freeze drying method which requires special skills and equipment (cryotome) and does not produce whole eyeball sections. Copyright © 2013 Wiley Periodicals, Inc.

  10. Parent-Implemented Bedtime Fading and Positive Routines for Children with Autism Spectrum Disorders

    Science.gov (United States)

    Delemere, Emma; Dounavi, Katerina

    2018-01-01

    Sleep disorders affect a large portion of those with autism spectrum disorder. Behavioural interventions have been found to increase appropriate sleep behaviours. This study sought to examine the efficacy of two stimulus control interventions (bedtime fading and positive routines) on total sleep duration, sleep onset latency and frequency and…

  11. 42 CFR 413.314 - Determining payment amounts: Routine per diem rate.

    Science.gov (United States)

    2010-10-01

    ... Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods... reflect area wage differences and the cost reporting period beginning date (if necessary) and is subject... appropriate wage index; and (ii) A nonlabor-related portion. (2) A routine capital-related cost portion. (3...

  12. Low Risk of Thromboembolic Events After Routine Administration of Tranexamic Acid in Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Madsen, Rune V; Nielsen, Christian S.; Kallemose, Thomas

    2017-01-01

    BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated...

  13. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies.

    Science.gov (United States)

    Mairinger, Fabian D; Walter, Robert Fh; Vollbrecht, Claudia; Hager, Thomas; Worm, Karl; Ting, Saskia; Wohlschläger, Jeremias; Zarogoulidis, Paul; Zarogoulidis, Konstantinos; Schmid, Kurt W

    2014-01-01

    Isothermal multiple displacement amplification (IMDA) can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. A total of 250 μg DNA (concentration 5 μg/μL) was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA.

  14. Going outside in Winter: A Qualitative Study of Preschool Dressing Routines

    Science.gov (United States)

    Hatcher, Beth; Squibb, Betsy

    2011-01-01

    The exploratory study focused on describing typical routines of preparing for winter outdoor play with preschool children and their teachers. Naturalistic observations, interviews and photographs resulted in extensive examples of children's development in cognitive understanding of winter and winter-related concepts. Observations of teachers and…

  15. Ethnographic study of ICT-supported collaborative work routines in general practice

    Science.gov (United States)

    2010-01-01

    Background Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Methods/design Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Discussion Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice. PMID:21190583

  16. Practical Issues in Implementing Whole-Genome-Sequencing in Routine Diagnostic Microbiology

    NARCIS (Netherlands)

    Rossen, John W A; Friedrich, Alexander W; Moran-Gilad, Jacob

    BACKGROUND: next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology that is being adopted in microbiology, the integration of NGS into clinical and routine workflows needs to be carefully managed. AIM: to review the practical aspects of

  17. 40 CFR 63.2251 - What are the requirements for the routine control device maintenance exemption?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are the requirements for the routine control device maintenance exemption? 63.2251 Section 63.2251 Protection of Environment... and Composite Wood Products General Compliance Requirements § 63.2251 What are the requirements for...

  18. Health physics routine at the Instituto de Energia Atomica, Sao Paulo (Brazil)

    International Nuclear Information System (INIS)

    Sordi, G.M.A.A.

    1976-01-01

    The routine health physics work at the IEAR-1 reactor and the modifications that are being made, are described. The Personal Dosimetry Laboratory, Waste Disposal and Decontamination Laboratory, Shielding Calculation Section, Dosimetry Laboratory, Radioactive Source and Instrumentation Calibration, are presented. Methods of calibration of radioactive sources and instrumentation are also presented [pt

  19. Planning and Implementing the Daily Routine in Slovene Kindergartens and Reggio Emilia Concept

    Science.gov (United States)

    Bercnik, Sanja; Devjak, Tatjana

    2012-01-01

    Authors in this paper present the design and implementation of daily routines in Slovenian kindergartens. Slovenian national document for preschool education, "Curriculum for Kindergartens" (1999), describes daily kindergarten activities (communication and interaction with and among children, use of compliment and reprehension, and rules…

  20. An 8-year experience with routine SL mix patch testing supplemented with Compositae mix in Denmark

    DEFF Research Database (Denmark)

    Paulsen, E; Andersen, Klaus Ejner; Hausen, B M

    2001-01-01

    Routine patch testing with sesquiterpene lactone (SL) mix, supplemented with Compositae mix (CM) and other Compositae extracts and allergens where appropriate, was evaluated over an 8-year period. 190 of 4386 patients tested (4.3%) were Compositae-sensitive, 143 females (mean age 51.5 years) and ...

  1. Civic Journalism and Nonelite Sourcing: Making Routine Newswork of Community Connectedness.

    Science.gov (United States)

    Massey, Brian L.

    1998-01-01

    Compares the number of "average" citizens brought into the news in three newspapers. Finds nonelite information sources in numerical parity with elite sources in a civic-journalism newspaper, but finds the frequency and directness of their news voices largely unchanged. Finds that routine civic journalism did more to tone down elites'…

  2. Are routine repeat chest x-rays before leaving the trauma room useful?

    NARCIS (Netherlands)

    Lemmers, M.; Saltzherr, T. P.; Beenen, L. F. M.; Ponsen, K. J.; Goslings, J. C.

    2010-01-01

    Several guidelines advocate multiple chest x-rays during primary resuscitation of trauma patients. Some local hospital protocols include a repeat x-ray before leaving the trauma resuscitation room (TR). The purpose of this study was to determine the value of routine repeat x-rays. One-year data of

  3. The Value of Family Routines for the Academic Success of Vulnerable Adolescents

    Science.gov (United States)

    Roche, Kathleen M.; Ghazarian, Sharon R.

    2012-01-01

    This study examined associations between mother reports of family routines and adolescent academic success. The authors used prospective data from "Welfare, Children, and Families: A Three City Study" (N = 1,147), a study of low-income urban youth and mothers. The vast majority of youth were African American (43%) or Latino (47%); youth were an…

  4. The Diagnostic Value of Routine Contrast Esophagram in Anastomotic Leaks After Esophagectomy.

    Science.gov (United States)

    Hu, Zhongwu; Wang, Xiaowe; An, Xush; Li, Wenjin; Feng, Yun; You, Zhenbing

    2017-08-01

    Routine contrast esophagram has been shown to be increasingly limited in diagnosing anastomotic leaks after esophagectomy. Patients undergoing esophagectomy from 2013 to 2014 at Huai'an First Peoples' Hospital were identified. We retrospectively analyzed patients who underwent routine contrast esophagram on postoperative day 7 (range 6-10) to preclude anastomotic leaks after esophagectomy. In 846 patients who underwent esophagectomy, a cervical anastomosis was performed in 286 patients and an intrathoracic anastomosis in 560 patients. There were 57 (6.73%) cases with anastomotic leaks, including cervical leaks in 36 and intrathoracic leaks in 21 patients. In the cervical anastomotic leak patients, 13 were diagnosed by early local clinical symptoms and 23 underwent routine contrast esophagram. There were 7 (30.4%) true-positive, 11 (47.8%) false-negative, and five (21.8%) equivocal cases. In the intrathoracic anastomotic leak patients, four (19%) were diagnosed by clinical symptoms, 16 (76.2%) were true positives, and one (4.8%) was a false negative. Aspiration occurred in five patients with cervical anastomoses and in eight patients with intrathoracic anastomoses; aspiration pneumonitis did not occur in these cases. Gastrografin and barium are safe contrast agents to use in post-esophagectomy contrast esophagram. Because of the low sensitivity in detecting cervical anastomotic leaks, routine contrast esophagram is not advised. For patients with intrathoracic anastomoses, it is still an effective method for detecting anastomotic leaks.

  5. Competing Stimuli in the Treatment of Multiply Controlled Problem Behavior during Hygiene Routines

    Science.gov (United States)

    Long, Ethan S.; Hagopian, Louis P.; DeLeon, Iser G.; Marhefka, Jean Marie; Resau, Dawn

    2005-01-01

    The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies…

  6. An evaluation of the routine use of syntometrine with the delivery of ...

    African Journals Online (AJOL)

    An analysis of two years' deliveries (1959 and 1969) at Queen Victoria Maternity Hospital has demonstrated a marked fall in the postpartum blood loss, postpartum haemorrhage rate and duration of the third stage of labour, since the introduction of the routine use of Syntometrine with the delivery of the anterior shoulder of ...

  7. Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: pilot study.

    Science.gov (United States)

    Keser, Ilke; Kirdi, Nuray; Meric, Aydin; Kurne, Asli Tuncer; Karabudak, Rana

    2013-01-01

    This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

  8. Reducing Bedtime Disturbance and Night Waking Using Positive Bedtime Routines and Sleep Restriction

    Science.gov (United States)

    Christodulu, Kristin V.; Durand, V. Mark

    2004-01-01

    The purpose of this study was to investigate behavioral interventions designed to reduce sleep difficulties in four young children with developmental disorders. Positive bedtime routines and sleep restriction were successful in eliminating bedtime disturbances and nighttime awakenings in four children with significant sleep problems. Positive…

  9. A virtual asthma clinic for children: fewer routine outpatient visits, same asthma control

    NARCIS (Netherlands)

    Wijngaart, L.S. van den; Roukema, J.; Boehmer, A.L.M.; Brouwer, M.L.; Hugen, C.A.C.; Niers, L.E.M.; Sprij, A.J.; Rikkers-Mutsaerts, E.; Rottier, B.L.; Donders, A.R.T.; Verhaak, C.M.; Pijnenburg, M.W.; Merkus, P.J.

    2017-01-01

    eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised

  10. Towards the normalization of cybercrime victimization : A routine activities analysis of cybercrime in europe

    NARCIS (Netherlands)

    Junger, Marianne; Montoya, L.; Hartel, Pieter H.; Heydari, Maliheh

    2017-01-01

    This study investigates the relationships between users' routine activities and socio-economic characteristics and three forms of cybercrime victimization of 1) online shopping fraud, 2) online banking fraud and 3) cyber-attacks (i.e. DDoS attacks). Data from the Eurobarometer, containing a sample

  11. A multigrid based 3D space-charge routine in the tracking code GPT

    NARCIS (Netherlands)

    Pöplau, G.; Rienen, van U.; Loos, de M.J.; Geer, van der S.B.; Berz, M.; Makino, K.

    2005-01-01

    Fast calculation of3D non-linear space-charge fields is essential for the simulation ofhigh-brightness charged particle beams. We report on our development of a new 3D spacecharge routine in the General Particle Tracer (GPT) code. The model is based on a nonequidistant multigrid Poisson solver that

  12. The use of routinely collected computer data for research in primary care: opportunities and challenges.

    NARCIS (Netherlands)

    Lusignan, S. de; Weel, C. van

    2006-01-01

    INTRODUCTION: Routinely collected primary care data has underpinned research that has helped define primary care as a specialty. In the early years of the discipline, data were collected manually, but digital data collection now makes large volumes of data readily available. Primary care informatics

  13. No survival benefit associated with routine surveillance imaging for Hodgkin lymphoma in first remission

    DEFF Research Database (Denmark)

    Jakobsen, L. H.; Hutchings, M.; Brown, P d N

    2016-01-01

    The use of routine imaging for patients with classical Hodgkin lymphoma (HL) in complete remission (CR) is controversial. In a population-based study, we examined the post-remission survival of Danish and Swedish HL patients for whom follow-up practices were different. Follow-up in Denmark includ...

  14. Underreporting of side effects of standard first-line ART in the routine ...

    African Journals Online (AJOL)

    Malawi Medical Journal; 23(4): 116-118 December 2011. Side effects of standard first line in ART 116. Underreporting of side effects of standard first-line. ART in the routine setting in Blantyre, Malawi. Abstract. Introduction. In the Malawi ART programme, 92% of 250,000 patients are using the standard first-line regime of ...

  15. The Utrecht Health Project: Optimization of routine healthcare data for research

    International Nuclear Information System (INIS)

    Grobbee, Diederick E.; Hoes, Arno W.; Verheij, Theo J. M.; Schrijvers, Augustinus J. P.; Ameijden, Erik J. C. van; Numans, Mattijs E.

    2005-01-01

    Background. Research on the impact of changes in healthcare policy, developments in community and public health and determinants of health and disease during lifetime may effectively make use of routine healthcare data. These data, however, need to meet minimal criteria for quality and completeness. Research opportunities are further improved when routine data are supplemented with a standardized 'baseline' assessment of the full population. This formed the basis for a new study initiated in a newly developed large residential area in Leidsche Rijn, part of the city of Utrecht, the Netherlands.Methods. All new inhabitants are invited by their general practitioner to participate in the Utrecht Health Project (UHP). Informed consent is obtained and an individual health profile (IHP) is made by dedicated research nurses. The IHP is the starting point for the UHP research database as well as for the primary care electronic medical records. Follow-up data are collected through continuous linkage with the computerized medical files recorded by the general practitioners. UHP staff in each practice takes care of quality management of registration as well as data handling.Results. Currently, over 60 of invited new residents in the area have given informed consent with participation steadily increasing. Discussion. The Utrecht Health Project combines key elements of traditional epidemiologic cohort studies with the current power of routine electronic medical record keeping in primary care. The research approach optimizes routine health care data for use in scientific research

  16. Elements for designing ALARA programmes for the maintenance and routine operations of nuclear facilities

    International Nuclear Information System (INIS)

    Lefaure, C.; Croft, J.R.

    1991-01-01

    This article briefly reviews the three fundamental elements for designing ALARA programmes for the maintenance and routine operations of nuclear facilities. These are the need for commitment of all parties involved, the need for specific ALARA organizational structures and the systematic use of ALARA tools. (UK)

  17. A first step towards miniaturized HPLC systems in analytical routine laboratories

    NARCIS (Netherlands)

    Straten, van M.A.; Vermeer, E.A.; Claessens, H.A.

    1996-01-01

    This article shows that the first step towards the miniaturization of HPLC systems can be made without any, or only slight, modification to conventional equipment. Minor (less expensive) equipment modifications, particularly the use of micro-detector cells, allow the routine use of 3.2- and 2.1-mm

  18. Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology

    NARCIS (Netherlands)

    Rossen, J. W. A.; Friedrich, A. W.; Moran-Gilad, J.

    Background: Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. Aim: To review the practical aspects of implementing bacterial

  19. Dealing with a positive result: routine HIV testing of pregnant women in Vietnam

    NARCIS (Netherlands)

    Oosterhoff, P.; Hardon, A.P.; Nguyen, T.A.; Pham, N.Y.; Wright, P.

    2008-01-01

    HIV testing is an essential component of PMTCT. It can be offered to pregnant women through different testing models, ranging from voluntary counseling and testing (VCT) to routine and mandatory testing. This study was conducted in Hanoi, Vietnam, where HIV-prevalence is low among the general

  20. Resistentie tegen antibiotica bij routine-isolaten van bacterien in zeven streeklaboratoria

    NARCIS (Netherlands)

    de Neeling AJ; Hemmes JH; van Klingeren B

    1993-01-01

    In 1990-1992 seven regional Public Health Laboratories sent the results of all their routine determinations of antibiotic susceptibility to the RIVM. Each year data from approximately 125000 isolates were collected on floppy disks. During the investigation no striking changes in the level of

  1. Time reduction and automation of routine planning activities through the use of macros

    International Nuclear Information System (INIS)

    Alaman, C.; Perez-Alija, J.; Herrero, C.; Real, C. del; Osorio, J. L.; Almansa, J.

    2011-01-01

    The use of macros in scheduler automates Adac Pinnacle3 much of the routine activities in the planning process, from the display options and placement of beams, to, among other possibilities, systematic naming them and export of the physical and clinical dosimetry. This automation allows reduction of the times associated with the planning process and an error reduction.

  2. Increasing Completion of Classroom Routines through the Use of Picture Activity Schedules

    Science.gov (United States)

    Watson, Kamille J.; DiCarlo, Cynthia F.

    2016-01-01

    Teachers spend the first few days of school teaching routines to children that will help transitions in the classroom between different activities. When children have difficulty, they move more slowly and/or require teacher prompting. A picture activity schedule intervention (Breitfelder in Teach Except Child Plus 4(5):2-15, 2008; Bryan and Gast…

  3. Use of Graphic Systems in the Routine of a Regular Classroom with a Disabled Student

    Science.gov (United States)

    Deliberato, Débora; Nunes, Leila Regina d'Oliveira Paula

    2015-01-01

    The school environment adapted to the diversity of students is an important goal, but it is a challenge when it comes to the diversity of students with disabilities. The aim of this study was to describe the use of graphic systems in the routine of a preschool classroom through a collaborative program. The study included a teacher, 22 children of…

  4. Everyday Routines: A Window into the Cultural Organization of Family Child Care

    Science.gov (United States)

    Tonyan, Holli A.

    2015-01-01

    Eco(logical)-cultural Theory suggests that a daily routine results from individuals adapting cultural ideas to the constraints of a local context or ecology. Using Ecocultural Theory, this research examined family child care providers' descriptions of daily activities and overall approach to understand cultural models. The results highlighted a…

  5. Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

    Science.gov (United States)

    Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

    2017-01-01

    Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

  6. 47 CFR 0.457 - Records not routinely available for public inspection.

    Science.gov (United States)

    2010-10-01

    ... inspection. 0.457 Section 0.457 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records § 0.457 Records not routinely... a determination is pending. (b) Materials that are related solely to the internal personnel rules...

  7. Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Calder, Alistair D. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); Kiho, Liina [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children, Cardiorespiratory Unit, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Sebire, Neil J. [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

    2014-03-15

    Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

  8. Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

    International Nuclear Information System (INIS)

    Arthurs, Owen J.; Calder, Alistair D.; Kiho, Liina; Taylor, Andrew M.; Sebire, Neil J.

    2014-01-01

    Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

  9. Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

    Science.gov (United States)

    Pierce, Jessica S; Jordan, Sara S; Arnau, Randolph C

    2018-04-06

    This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

  10. Towards the Construction of a Framework to Deal with Routine Problems to Foster Mathematical Inquiry

    Science.gov (United States)

    Santos-Trigo, Manuel; Camacho-Machin, Matias

    2009-01-01

    To what extent does the process of solving textbook problems help students develop a way of thinking that is consistent with mathematical practice? Can routine problems be transformed into problem solving activities that promote students' mathematical reflection? These questions are used to outline and discuss features of an inquiry framework…

  11. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

    NARCIS (Netherlands)

    Belderok, Sanne-Meike; van den Hoek, Anneke; Kint, Joan A.; Schim van der Loeff, Maarten F.; Sonder, Gerard Jb

    2011-01-01

    Travellers' diarrhoea (TD) is the most common infectious disease among travellers. In the Netherlands, stand-by or prophylactic antibiotics are not routinely prescribed to travellers. This study prospectively assessed the incidence rate, risk factors, and treatment of TD among immunocompetent

  12. Child Routines and Self-Regulation Serially Mediate Parenting Practices and Externalizing Problems in Preschool Children

    Science.gov (United States)

    Bater, Lovina Rose; Jordan, Sara Sytsma

    2017-01-01

    Background: Studies clearly indicate that parenting practices relate to child externalizing behaviors, although the mechanisms underlying this relation are less well understood. There has been limited evaluation of child routines and self-regulation in relation to these variables, and no known studies have evaluated all of these variables…

  13. Stress steroid levels and the short-term impact of routine dehorning ...

    African Journals Online (AJOL)

    Routine dehorning procedures resulted in a short-term stress response expressed by a significant increase in fGCM levels 48 h post-dehorning, with stress steroid levels returning to pre-dehorning concentrations 72 h after the procedure. Keywords: faecal glucocorticoid metabolites, non-invasive hormone monitoring, ...

  14. The relevance of Vdrl as routine test in pregnant women: a critical ...

    African Journals Online (AJOL)

    Aim: To critically determine the relevance of Venereal Diseases Research Laboratories (VDRL) investigation as a routine serological screening for syphilis among pregnant women who receive antenatal care at the University of Nigeria Teaching Hospital (UNTH). Methods: A retrospective chart review of result of serological ...

  15. High Incidence of Asymptomatic Syphilis in HIV-Infected MSM Justifies Routine Screening

    NARCIS (Netherlands)

    Branger, Judith; van der Meer, Jan T. M.; van Ketel, Ruud J.; Jurriaans, Suzanne; Prins, Jan M.

    2009-01-01

    Background: Recently, the incidence of syphilis has risen, mainly among men having sex with men (MSM), many of whom are coinfected with HIV. Current guidelines recommend at least yearly syphilis testing in this group. In this study, we assessed the yield of routine syphilis screening in outpatient

  16. Ethnographic study of ICT-supported collaborative work routines in general practice.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Myall, Michelle; Russell, Jill

    2010-12-29

    Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice.

  17. The situational and time-varying context of routines in television viewing: An event history analysis

    NARCIS (Netherlands)

    Westerik, H.; Renckstorf, K.; Wester, F.P.J.; Lammers, J.G.M.

    2005-01-01

    Building on an action theoretical perspective, it is assumed that most television viewing is a routine response to frequently occurring situations, which together make up everyday life. This interplay between television viewing and everyday life was studied using data from a national survey among

  18. How characteristic routines of clinical departments influence students' self-regulated learning: A grounded theory study.

    Science.gov (United States)

    Berkhout, J J; Slootweg, I A; Helmich, E; Teunissen, P W; van der Vleuten, C P M; Jaarsma, A D C

    2017-11-01

    In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students' self-regulated learning (SRL) is unknown. This study explores how characteristic routines of clinical departments influence medical students' SRL. Six focus groups including 39 purposively sampled participants from one Dutch university were organized to study how characteristic routines of clinical departments influenced medical students' SRL from a constructivist paradigm, using grounded theory methodology. The focus groups were audio recorded, transcribed verbatim and were analyzed iteratively using constant comparison and open, axial and interpretive coding. Students described that clinical departments influenced their SRL through routines which affected the professional relationships they could engage in and affected their perception of a department's invested effort in them. Students' SRL in a clerkship can be supported by enabling them to engage others in their SRL and by having them feel that effort is invested in their learning. Our study gives a practical insight in how clinical departments influenced students' SRL. Clinical departments can affect students' motivation to engage in SRL, influence the variety of SRL strategies that students can use and how meaningful students perceive their SRL experiences to be.

  19. Diagnostic value of radionuclide imaging combined with routine CT in detecting hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Lu Xuemin; Yu Shuhong; Han Jiankui

    2011-01-01

    Objective: To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods: Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99 Tc m -sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99 Tc m -diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. χ 2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results: Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter >3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were 60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type, 50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 for small foci (with maximal diameter ≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone (χ 2 =4.48, P<0.05; χ 2 =4.27, P<0.05). Conclusion: Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients. (authors)

  20. Very poor agreement between routine outpatient clinic office and ambulatory blood pressure: time to improve an old hospital outpatient clinic routine?

    Science.gov (United States)

    Reinhard, Mark; Poulsen, Per L; Christensen, Kent L

    2016-12-01

    We investigated the agreement between elevated outpatient clinic office blood pressure (OC-OBP) as measured in the daily routine in our University Hospital Cardiology Outpatient Clinic and subsequent awake ambulatory blood pressure (AABP). In all patients referred for ambulatory blood pressure monitoring from our Cardiology Outpatient Clinic, we identified OC-OBP and changes in medication in the period from 1 January 2014 to 15 September 2015. The AABP was used as a reference measurement for the OC-OBP. A total of 183 patients were included in the study. Their mean age was 62.1±14.0 years and 49% were women. The mean systolic OC-OBP was 166.8±17.9 mmHg and the difference between the mean systolic OC-OBP and AABP was 28.0±19.5 mmHg (Pclinic agrees poorly with AABP and may lead to unnecessary treatment and pharmacologically induced symptomatic hypotension, particularly in elderly patients. The results of this study urgently call for alternative solutions to routine OC-OBP in hospital outpatient clinics.

  1. Parents’ Traditional Cultural Values and Mexican-Origin Young Adults’ Routine Health and Dental Care

    Science.gov (United States)

    Updegraff, Kimberly A.; Kuo, Sally I-Chun; McHale, Susan M.; Umaña-Taylor, Adriana J.; Wheeler, Lorey A.

    2017-01-01

    Purpose To investigate the prospective associations between Mexican-origin mothers’ and fathers’ traditional cultural values and young adults’ health and dental care utilization and to test the moderating role of youth gender. Methods Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents’ cultural values (time 1) and young adults’ health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents’ traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents’ cultural values and young adults’ routine care. Results Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23–9.83, p = .019). Furthermore, for females only, mothers’ more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08–.64, p = .005) and dental care (OR = .26; 95% CI: .09–.75, p = .012) in young adulthood. Conclusions Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. PMID:27988108

  2. Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow.

    Science.gov (United States)

    Hayes, Gillian R; Lee, Charlotte P; Dourish, Paul

    2011-08-01

    The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training. We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives. Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use. Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

    Directory of Open Access Journals (Sweden)

    Kwan B

    2018-04-01

    Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

  4. Isothermal multiple displacement amplification: a methodical approach enhancing molecular routine diagnostics of microcarcinomas and small biopsies

    Directory of Open Access Journals (Sweden)

    Mairinger FD

    2014-08-01

    Full Text Available Fabian D Mairinger,1 Robert FH Walter,2 Claudia Vollbrecht,3 Thomas Hager,1 Karl Worm,1 Saskia Ting,1 Jeremias Wohlschläger,1 Paul Zarogoulidis,4 Konstantinos Zarogoulidis,4 Kurt W Schmid1 1Institute of Pathology, 2Ruhrlandklinik, West German Lung Center, University Hospital Essen, Essen, 3Institute of Pathology, University Hospital Cologne, Cologne, Germany; 4Pulmonary Department, Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece Background and methods: Isothermal multiple displacement amplification (IMDA can be a powerful tool in molecular routine diagnostics for homogeneous and sequence-independent whole-genome amplification of notably small tumor samples, eg, microcarcinomas and biopsies containing a small amount of tumor. Currently, this method is not well established in pathology laboratories. We designed a study to confirm the feasibility and convenience of this method for routine diagnostics with formalin-fixed, paraffin-embedded samples prepared by laser-capture microdissection. Results: A total of 250 µg DNA (concentration 5 µg/µL was generated by amplification over a period of 8 hours with a material input of approximately 25 cells, approximately equivalent to 175 pg of genomic DNA. In the generated DNA, a representation of all chromosomes could be shown and the presence of elected genes relevant for diagnosis in clinical samples could be proven. Mutational analysis of clinical samples could be performed without any difficulty and showed concordance with earlier diagnostic findings. Conclusion: We established the feasibility and convenience of IMDA for routine diagnostics. We also showed that small amounts of DNA, which were not analyzable with current molecular methods, could be sufficient for a wide field of applications in molecular routine diagnostics when they are preamplified with IMDA. Keywords: isothermal multiple displacement amplification, isothermal, whole

  5. Institutionalized unpredictability and café routines: The case of young people in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Čelebičić Vanja

    2017-01-01

    Full Text Available When life is very unpredictable or uncertain, a routine set of practices may become a very significant element in a person’s daily life, as it may allow a sense of protection from the unknown (Ehn & Löfgren 2010 and encourage feelings of belonging (Rapport & Dawson 1998. In this article I explore how people relate to the immediate future when their presents are filled with unpredictability. More specifically, I explore the everyday practices around café routines of some young people living in Bihać, a town in northwestern Bosnia- Herzegovina (BiH. Popular discourses often link between young people's tendencies to spend time in cafés with apathy and letargy, or alternativley with bad economic conditions. However, these views, whether empathetic or critical, are neither adeqate nor very empowering. Instead, I suggest that we must view café routines within the context of what I call ‘institutionalized unpredictability’. This allows us to distance ourselves from thinking about young people’s practices through dominant paradigms of engagement and disengagement and opens up the possibility to view café routines as ‘radically unpolitical' acts (Farthing 2010. I argue that café routines are both young people’s response to ‘institutionalized unpredictability’, as well as their way to criticize and reproduce it. I further show how institutionalized unpredictability was shaping and shaped by both state and nonstate related practices, relationships, processes and aspirations, suggesting that this is precisely what made it so powerfully pervasive and debilitating.

  6. Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

    Science.gov (United States)

    Rossen, J W A; Friedrich, A W; Moran-Gilad, J

    2018-04-01

    Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  7. Accuracy of routine cytology and immunocytochemistry in preoperative diagnosis of oral amelanotic melanomas in dogs.

    Science.gov (United States)

    Przeździecki, Rafał; Czopowicz, Michał; Sapierzyński, Rafał

    2015-12-01

    Amelanotic melanomas are one of the most common oral malignancies. The cytologic and histopathologic differentiation between amelanotic melanoma, sarcoma, and poorly differentiated carcinoma is often difficult or even impossible. The aim of this study was to assess the reliability of routine cytology and immunocytochemistry in preoperative diagnosis of canine oral amelanotic melanoma. Cytologic preparations from undifferentiated canine oral tumors were stained with Giemsa and by immunocytochemistry (ICC) using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies. The final cytologic diagnosis (including ICC) was compared to the final diagnosis based on histopathology and immunohistochemistry (IHC) results, and sensitivity and specificity of cytologic examination were determined. Final cytologic diagnoses of 38 cases agreed well with the histopathologic/immunohistochemical diagnoses, thus both specificity and sensitivity of combined routine cytology and ICC were 100% (95% confidence interval 90.8-100%). Of 32 oral tumors, diagnosis of amelanotic melanoma, sarcoma, and carcinoma was made using routine cytology and ICC. In 4 of 6 aspirates taken from lymph nodes, a preliminary diagnosis of metastatic amelanotic melanoma corresponded with the final diagnosis. Both sensitivity and specificity of routine cytology in diagnosis of amelanotic melanomas were considered moderate (66.7% and 85.7%, respectively). In conclusion, routine cytology is a reliable diagnostic method for canine oral amelanotic melanoma and metastatic amelanotic melanoma, and ICC, using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies, is an excellent supporting method for presurgical diagnosis of poorly differentiated oral malignancies in dogs. © 2015 American Society for Veterinary Clinical Pathology.

  8. The impact of electronic health records on collaborative work routines: A narrative network analysis.

    Science.gov (United States)

    Chao, Chia-An

    2016-10-01

    This study examined collaborative work routines and changes after the implementation of a perinatal EHR. The change process and underlying drivers were analyzed to offer insight into why changes - intended or unintended - did or did not occur and their implications for EHR design and implementation. This mixed-method case study included both qualitative and quantitative information. Pre- and post-implementation observations took place over an 18-month period totaling 90h. Formal and informal interviews with administrative and clinical staff, pre- and post-implementation surveys, project meeting observations, and artifact review supplemented data gathered from the observations. Workflow and narrative network analyses of work routines were used to identify changes pre- and post-EHR and to represent different perspectives of work routines. EHR improved documentation efficiency and in- and out-patient information exchange, but increased variability in documentation. Some variabilities were institutionally sanctioned or tolerated, but other variabilities - while ingenious and emblematic of the generative nature of routines enabled by the EHR - were problematic. EHR's support for clinician communication and coordination was limited and its cognitive support insufficient. In some cases, EHR increased cognitive load as the unlocalized EHR scattered information, and the lengthy printouts contributed to information fragmentation and made information retrieval more difficult. The process of the EHR implementation and the changes observed was the confluence of three factors: resource constraint - in particular EHR expertise and experience - not uncommon in many community hospitals; the functional properties of the EHR focusing on information aggregation, storage, and retrieval; and the extant culture and practice of healthcare emphasizing autonomy and flexibility. While collaborative and communication changes were prompted by EHR implementation, the system played a minimal

  9. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    Science.gov (United States)

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Routine intraoperative leak testing for sleeve gastrectomy: is the leak test full of hot air?

    Science.gov (United States)

    Bingham, Jason; Lallemand, Michael; Barron, Morgan; Kuckelman, John; Carter, Preston; Blair, Kelly; Martin, Matthew

    2016-05-01

    Staple line leak after sleeve gastrectomy (SG) is a rare but dreaded complication with a reported incidence of 0% to 8%. Many surgeons routinely test the staple line with an intraoperative leak test (IOLT), but there is little evidence to validate this practice. In fact, there is a theoretical concern that the leak test may weaken the staple line and increase the risk of a postop leak. Retrospective review of all SGs performed over a 7-year period was conducted. Cases were grouped by whether an IOLT was performed, and compared for the incidence of postop staple line leaks. The ability of the IOLT for identifying a staple line defect and for predicting a postoperative leak was analyzed. Five hundred forty-two SGs were performed between 2007 and 2014. Thirteen patients (2.4%) developed a postop staple line leak. The majority of patients (n = 494, 91%) received an IOLT, including all 13 patients (100%) who developed a subsequent clinical leak. There were no (0%) positive IOLTs and no additional interventions were performed based on the IOLT. The IOLT sensitivity and positive predictive value were both 0%. There was a trend, although not significant, to increase leak rates when a routine IOLT was performed vs no routine IOLT (2.6% vs 0%, P = .6). The performance of routine IOLT after SG provided no actionable information, and was negative in all patients who developed a postoperative leak. The routine use of an IOLT did not reduce the incidence of postop leak, and in fact was associated with a higher leak rate after SG. Published by Elsevier Inc.

  11. Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

    Science.gov (United States)

    Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

    2015-06-01

    Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

  12. ESTIMATION OF ROUTINE DISCHARGE OF RADIONUCLIDES ON POWER REACTOR EXPERIMENTAL RDE

    Directory of Open Access Journals (Sweden)

    P.M. Udiyani

    2017-02-01

    Full Text Available Experimental power reactor (RDE which is planned to be constructed by BATAN is a kind of High Temperature Gas Cooled Reactor (HTGR with 10 MWth power. HTGR is a helium gas-cooled reactor with TRISO-coated fuel that is able to confine fission products remained in the core. Although the fission products released into the environment are very small, in order to comply the regulations the study about environmental radiation on normal or routine operation condition need to be performed. Estimation of radiology in the environment involves the source term released into the environment under routine operation condition. The purpose of this study is to estimate the source term released into the environment based on postulation of normal or routine operations of RDE. The research approach starts with an assumption that there are defects and impurities in the TRISO fuel because of limitation during the fabrication. Mechanism of fission products release from the fuel to the environment was created based on the safety features design of RDE. Radionuclides inventories in the reactor were calculated using ORIGEN-2 whose library has been modified for HTGR type, and the assumptions of defects of the TRISO fuel and release fraction for each compartment of RDE safety system used a reference parameter. The results showed that the important source terms of RDE are group of noble gases (Kr and Xe, halogen (I, Sr, Cs, H-3, and Ag. Activities of RDE source terms for routine operations have no significant difference with the HTGR source terms with the same power. Keywords: routine discharge, radionuclide, source term, RDE, HTGR

  13. Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

    OpenAIRE

    Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf Sommer; Nielsen, Eva M.; Aarestrup, Frank Møller

    2014-01-01

    Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

  14. Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

    OpenAIRE

    Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

    2014-01-01

    Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

  15. Implementation of a physically based water percolation routine in the Crocus/SURFEX (V7.3 snowpack model

    Directory of Open Access Journals (Sweden)

    C. J. L. D'Amboise

    2017-09-01

    Full Text Available We present a new water percolation routine added to the one-dimensional snowpack model Crocus as an alternative to the empirical bucket routine. This routine solves the Richards equation, which describes flow of water through unsaturated porous snow governed by capillary suction, gravity and hydraulic conductivity of the snow layers. We tested the Richards routine on two data sets, one recorded from an automatic weather station over the winter of 2013–2014 at Filefjell, Norway, and the other an idealized synthetic data set. Model results using the Richards routine generally lead to higher water contents in the snow layers. Snow layers often reached a point at which the ice crystals' surface area is completely covered by a thin film of water (the transition between pendular and funicular regimes, at which feedback from the snow metamorphism and compaction routines are expected to be nonlinear. With the synthetic simulation 18 % of snow layers obtained a saturation of  >  10 % and 0.57 % of layers reached saturation of  >  15 %. The Richards routine had a maximum liquid water content of 173.6 kg m−3 whereas the bucket routine had a maximum of 42.1 kg m−3. We found that wet-snow processes, such as wet-snow metamorphism and wet-snow compaction rates, are not accurately represented at higher water contents. These routines feed back on the Richards routines, which rely heavily on grain size and snow density. The parameter sets for the water retention curve and hydraulic conductivity of snow layers, which are used in the Richards routine, do not represent all the snow types that can be found in a natural snowpack. We show that the new routine has been implemented in the Crocus model, but due to feedback amplification and parameter uncertainties, meaningful applicability is limited. Updating or adapting other routines in Crocus, specifically the snow compaction routine and the grain metamorphism routine, is needed

  16. Managing routine food choices in UK families: the role of convenience consumption.

    Science.gov (United States)

    Carrigan, Marylyn; Szmigin, Isabelle; Leek, Sheena

    2006-11-01

    The paper explores the meaning of convenience food for UK mothers, investigating the relationship between mothers and their families' food. The study examines the role of convenience food within the food strategies of contemporary UK families, and aims to elicit consumption meanings in the broader social context of family relationships with food, their rituals, routines and conventions. The findings reveal convenience has multiple meanings for UK women, and that convenience food has been incorporated into reinterpreted versions of homemade and "proper" meals. A hierarchy of acceptable convenience food is presented by the mothers, who tackle complex and conflicting family routines by introducing convenience solutions. Rules of eating have evolved, yet remain essentially controlled by the mother in terms of nutrition. While the traditional model of "proper" food remains aspirational, contemporary family lifestyles require that convenience food become part of the equation.

  17. The benefit of external cephalic version with tocolysis as a routine procedure in late pregnancy

    DEFF Research Database (Denmark)

    Thunedborg, P; Fischer-Rasmussen, W; Tollund, L

    1991-01-01

    The effectiveness of external cephalic version with tocolysis when routinely used in the 37th week of gestation is reported. The procedure had earlier been ruled out in our department, was found effective in a prospective study, and afterwards settled as a routine. Among 1038 women with single...... breech presentation, 882 could be offered an attempt of external cephalic version during the period 1982-1988. Attempt of version was carried out in 316 women resulting in a vertex presentation at delivery in 100. The success rate on average was 35%. The estimated reduction of breech deliveries was 100...... serious complications were associated with the procedure. Two cases of intra-uterine fetal death occurred 2 and 5 weeks, respectively, after successful, uncomplicated version to vertex presentation. No obvious connection with the external cephalic version could be demonstrated. The effectiveness...

  18. Don't believe everything you hear: Routine validation of audiovisual information in children and adults.

    Science.gov (United States)

    Piest, Benjamin A; Isberner, Maj-Britt; Richter, Tobias

    2018-04-05

    Previous research has shown that the validation of incoming information during language comprehension is a fast, efficient, and routine process (epistemic monitoring). Previous research on this topic has focused on epistemic monitoring during reading. The present study extended this research by investigating epistemic monitoring of audiovisual information. In a Stroop-like paradigm, participants (Experiment 1: adults; Experiment 2: 10-year-old children) responded to the probe words correct and false by keypress after the presentation of auditory assertions that could be either true or false with respect to concurrently presented pictures. Results provide evidence for routine validation of audiovisual information. Moreover, the results show a stronger and more stable interference effect for children compared with adults.

  19. Study of the development of a safety culture by describing routine work

    International Nuclear Information System (INIS)

    Takagi, Miho; Maeda, Noriyuki; Iida, Hiroyasu

    2017-01-01

    In this study, we considered safety culture as how an organization and its employees pay attention to risks, and how it reduces them. Our study is based on Schein's model of organizational culture. The theory of organizational culture maintains that if we change level 1 (behavior), then level 3 (assumption) changes. We considered a method to foster a safety culture based on this theory. To begin, we described the routine work of an organization by using the functional resonance analysis method (FRAM). Then, we confirmed the risk reduction behaviors being done there. We found that it is necessary for the organization to be involved in a positive fashion to reduce risks, and we offered some behaviors that the organization can encourage during routine work. We thought that when these new behaviors become habits of organization members, the safety culture of the organization will be fostered. (author)

  20. Evaluation of changes in vertebral body density following administration of contrast medium during routine CT examination

    International Nuclear Information System (INIS)

    Janicek, M.; Bruna, J.; Stenhova, H.

    1984-01-01

    The possibility is discussed of depicting changes in the density of spongiosis of the vertebral body in normal patients after intravenous administration of a bolus of 40 ml 60% Diazetrizoate in the course of a routine CT examination. The average increase in density immediately after the administration of the contrast medium is 12 H (8%), in the course of 10 minutes is reduced to 5 H (4%) against the initial values in native examination. These average changes are statistically significant, in individual patients, however, the increase in density following the administration of a contrast medium fluctuates considerably (from 0.7% to 10%). Only systematic comparison with various pathological conditions will make it possible to assess the possibilities of the evaluation of the structure of the vertebral body in routine CT with the administration of a contrast medium into the blood flow. (author)

  1. An Open-Source Auto-Calibration Routine Supporting the Stormwater Management Model

    Science.gov (United States)

    Tiernan, E. D.; Hodges, B. R.

    2017-12-01

    The stormwater management model (SWMM) is a clustered model that relies on subcatchment-averaged parameter assignments to correctly capture catchment stormwater runoff behavior. Model calibration is considered a critical step for SWMM performance, an arduous task that most stormwater management designers undertake manually. This research presents an open-source, automated calibration routine that increases the efficiency and accuracy of the model calibration process. The routine makes use of a preliminary sensitivity analysis to reduce the dimensions of the parameter space, at which point a multi-objective function, genetic algorithm (modified Non-dominated Sorting Genetic Algorithm II) determines the Pareto front for the objective functions within the parameter space. The solutions on this Pareto front represent the optimized parameter value sets for the catchment behavior that could not have been reasonably obtained through manual calibration.

  2. Android-Based Daily Routine Organizing Application for Elementary School Students Living with ASD.

    Science.gov (United States)

    Barta, Eva A; Guzsvinecz, Tibor; Sik Lanyi, Cecilia; Szucs, Veronika

    2017-01-01

    Today, more and more children with Autism Spectrum disorder are diagnosed, which means that around 1% of the population is concerned. Most of the concerned can acquire daily routine tasks by a bit of help and can fit in the society. As Besio et al. said, "…play is an instinctive need for both humans….In children with disabilities, depending on the type of functional limitations, the spontaneity of play is lost and the activity becomes problematic. Children with cognitive and intellectual impairments have a difficulties in communication, social interactions,….Since play is also a window for children's cognitive development, children may be perceived as more developmentally delayed than they actually are, leading to reduce expectations on the part of adults." The aim of the authors was to create an Android based application which helps 6-9 year old children living with Autism Spectrum disorder to learn everyday tasks and acquire everyday routine.

  3. Assessing the Macro-Level Correlates of Malware Infections Using a Routine Activities Framework.

    Science.gov (United States)

    Holt, Thomas J; Burruss, George W; Bossler, Adam M

    2018-05-01

    The ability to gain unauthorized access to computer systems to engage in espionage and data theft poses a massive threat to individuals worldwide. There has been minimal focus, however, on the role of malicious software, or malware, which can automate this process. This study examined the macro-correlates of malware infection at the national level by using an open repository of known malware infections and utilizing a routine activities framework. Negative inflated binomial models for counts indicated that nations with greater technological infrastructure, more political freedoms, and with less organized crime financial impact were more likely to report malware infections. The number of Computer Emergency Response Teams (CERTs) in a nation was not significantly related with reported malware infection. The implications of the study for the understanding of malware infection, routine activity theory, and target-hardening strategies are discussed.

  4. Children's expressions of negative emotions and adults' responses during routine cardiac consultations.

    Science.gov (United States)

    Vatne, Torun M; Ruland, Cornelia M; Ørnes, Knut; Finset, Arnstein

    2012-03-01

    One function of expressing emotion is to receive support. The aim of this study was to assess how children with heart disease express negative emotions during routine consultations, and examine the interaction between children's expressions and adults' responses. Seventy children, aged 7-13 years, completed measures of anxiety and were videotaped during cardiology visits. Adult-child interactions were analyzed using the Verona Definitions of Emotional Sequences. Children expressed negative emotion, mainly in subtle ways; however, adults rarely recognized and responded to these expressions. The frequency of children's expressions and adults' responses were related to the child's age, level of anxiety, and verbal participation. Children do not openly express negative emotions frequently during routine cardiac consultations; they are more likely to provide subtle cues of negative emotion. When expression of negative emotions does occur, adults may consider using the opportunity to explore the child's emotional experiences.

  5. Incidence of ischemic lesions by diffusion-weighted imaging after carotid endarterectomy with routine shunt usage

    International Nuclear Information System (INIS)

    Inoue, Tomohiro; Tsutsumi, Kazuo; Adachi, Shinobu; Tanaka, Shota; Yako, Kyoko; Saito, Kuniaki; Kunii, Naoto; Maeda, Keiitirou

    2006-01-01

    Temporary intraluminal shunt was used during 72 consecutive carotid endarterectomies (CEAs) in 61 patients (bilateral CEA in 11 patients) during October 2001 and September 2005. The medical records of these patients were retrospectively reviewed. All procedures were performed with routine shunt insertion without monitoring such as electroencephalography. Pre- and postoperative diffusion-weighted magnetic resonance (MR) imaging was used to detect ischemic complications. Postoperative angiography was performed in 70 cases to detect abnormalities such as major stenosis or dissection of the distal end. Symptomatic ischemic complication occurred in one patient at 1 month. Postoperative diffusion-weighted MR imaging detected new hyperintense lesions in three patients including the symptomatic patient. Postoperative angiography confirmed that the distal end was satisfactory in all cases. The incidence of ischemic lesions of embolic origin after CEA with routine shunt usage is acceptably low if the procedure of shunt device insertion and removal is meticulously conducted. (author)

  6. Implementation of TMA and digitalization in routine diagnostics of breast pathology

    DEFF Research Database (Denmark)

    Rossing, Henrik Holm; Talman, Maj-Lis; Laenkholm, Anne-Vibeke

    2012-01-01

    To ensure optimal treatment of breast cancer patients, breast tumours are classified based on clinico-pathological features. As part of this process, routine diagnostics of breast tumours includes histological typing and grading, as well as profiling by use of an immunohistochemistry panel...... of antibodies, probes and in situ hybridization. This will, as a minimum, include assessment of oestrogen receptor (OR) and HER2. The individual preparation and staining of many breast tumours in a large laboratory with this standard panel is thus time consuming and costly. Herein, we show that in breast cancer...... routine diagnostics the use of the tissue microarray technique in combination with digitalization of the stained multi-slides is not only economical, with a considerable cost reduction, but it also enhances standardization of tumour profiling. We demonstrate that 2 mm breast tumour cores correlate...

  7. Routine blood tests are associated with short term mortality and can improve emergency department triage

    DEFF Research Database (Denmark)

    Kristensen, Michael; Iversen, Anne Kristine Servais; Gerds, Thomas Alexander

    2017-01-01

    BACKGROUND: Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm. METHODS...... registration. Multiple logistic regressions were used to predict 30-day mortality. Validation was performed by applying the regression models on the 2013 validation cohort. RESULTS: Thirty-day mortality was 5.3%. The routine blood tests had a significantly stronger discriminative value on 30-day mortality...... compared to the formalized triage (AUC 88.1 [85.7;90.5] vs. 63.4 [59.1;67.5], p blood tests was able to identify a larger number of low risk patients (n = 2100, 30-day mortality 0.1% [95% CI 0.0;0.3%]) compared to formalized triage (n = 1591, 2.8% [95% CI 2...

  8. Behavioral Logistics - Analysis of behavioral routines and governance structures in the interorganizational maritime transport chain

    Directory of Open Access Journals (Sweden)

    2010-09-01

    Full Text Available The strong improvements in information and communication systems as well as better transshipment technologies provide the platform for more efficient transport within interorganizational transport chains. Nevertheless these technologies do not automatically optimize systems based on routines and behavioral patterns, established over the last decades. Logisticians - in theory and practice - have to consider the field of behavioral science to describe and analyse transport problems regarding to involved actors' strategic behavior and social embeddedness, too. The objective of this paper is to illustrate behavioral aspects of supposed technical problems in interorganizational transport chains. Therefore, this paper analyses behavioral routines and governance structures in the interorganizational maritime transport chain using a case study, dealing with the generation and circulation of transport information at the earliest point available, so called "estimated time of arrival" (ETA.

  9. [Use of PubMed to improve evidence-based medicine in routine urological practice].

    Science.gov (United States)

    Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

    2013-03-01

    Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

  10. Eosinophilia in routine blood samples as a biomarker for solid tumor development

    DEFF Research Database (Denmark)

    Andersen, Christen Bertel L; Siersma, V.D.; Hasselbalch, H.C.

    2014-01-01

    eosinophilia in routine blood samples as a potential biomarker of solid tumor development in a prospective design. MATERIAL AND METHODS: From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356 196 individuals with at least one differential cell count (DIFF) encompassing...... was increased with mild eosinophilia [OR 1.93 (CI 1.29-2.89), p = 0.0013]. No associations with eosinophilia were observed for the remaining solid cancers. CONCLUSION: We demonstrate that eosinophilia in routine blood samples associates with an increased risk of bladder cancer. Our data emphasize...... that additional preclinical studies are needed in order to shed further light on the role of eosinophils in carcinogenesis, where it is still unknown whether the cells contribute to tumor immune surveillance or neoplastic evolution....

  11. Assessing the need for a routine monitoring program in three Nuclear Medicine centers in Chile

    International Nuclear Information System (INIS)

    Astudillo, R.; Hermosilla, A.; Diaz-Londono, G.; Garcia, M.

    2015-01-01

    The workers performing different activities with radionuclides in nuclear medicine centers are at potential risk of external exposure and internal contamination. The IAEA Safety Guide No. RS-G-1.2 proposed criteria for determining the need for a routine monitoring program to assess internal contamination. For this purpose, an Excel template containing the IAEA criteria was applied in three nuclear medicine centers in Chile. The results show that it is necessary to carry out a routine monitoring program for five workers who handle 131 I and three for 99m Tc. We propose to implement this template at a national level in order to improve the conditions of radiation protection in the participating centers. (authors)

  12. The application of computer technique in routine neutron activation analysis using high resolution gamma ray spectrometry

    International Nuclear Information System (INIS)

    Szopa, Z.; Plejewska, M.; Staszelis, J.

    1982-01-01

    A full system of four computer programs for routine - qualitative and quantitative - neutron activation analysis (NAA) using high resolution gamma ray-spectrometry had been elaborated. The structure and possibilities of the ''data flow'' programs i.e. programs DIDPDP and DIDCDC, dedicated for fast and reliable ''off line'' data transfer between the buffer memory of the spectrometric line (9-track magnetic tape) and the fast access memory (disc) of the used computers PDP-11/45 and CYBER-73 had been presented. The structure and organization of the ''data processing'' programs i.e. programs SAWAPS and MAZYG had been presented as well. The utility and reliability of these programs in the case of the large-scale, routine NAA, exampled by analysis of filters with air polutants, had been tested and discussed. Programs are written mainly in FORTRAN. (author)

  13. Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

    Science.gov (United States)

    Inaba, T.; Nakazawa, Y.; Yoshida, K.; Kato, Y.; Hattori, A.; Kimura, T.; Hoshi, T.; Ishizu, T.; Seo, Y.; Sato, A.; Sekiguchi, Y.; Nogami, A.; Watanabe, S.; Horigome, H.; Kawakami, Y.; Aonuma, K.

    2017-11-01

    A 64-channel Nb-based DC-SQUID magnetocardiography (MCG) system was installed at the University of Tsukuba Hospital (UTH) in March 2007 after obtaining Japanese pharmaceutical approval and insurance reimbursement approval. In the period between 2008 and 2016, the total number of patients was 10 085. The heart diseases diagnosed in fetuses as well as adults are mainly atrial arrhythmia, abnormal repolarization, ventricular arrhythmia, and fetal arrhythmia. In most cases of insufficient diagnostic accuracy with electrocardiography, SQUID MCG precisely revealed these heart diseases as an abnormal electrical current distribution. Based on success in routine examinations, SQUID MCG is now an indispensable clinical instrument with diagnostic software tuned up during routine use at UTH.

  14. Physical therapy in preschool classrooms: successful integration of therapy into classroom routines.

    Science.gov (United States)

    Sekerak, Darlene Massey; Kirkpatrick, Dana B; Nelson, Kristal C; Propes, June H

    2003-01-01

    This exploratory investigation identifies factors that contribute to success of physical therapy services delivered in the context of the daily routines in preschool classroom settings. Ten pediatric physical therapists from rural and urban communities across North Carolina served as informants during telephone interviews. Qualitative analysis of the data led to the identification of six major themes: interactions among classroom personnel, impact of the classroom environment, individual characteristics of the child, logistical considerations, administrative policies and practices, and service delivery options. All 10 informants shared the perception that the cooperation and commitment of the teacher was essential for successful incorporation of therapy activities in classroom routines. Furthermore, the informants agreed that multiple models of service delivery were necessary to meet the individual needs of children. These results lead the authors to question the wisdom of promoting any one service delivery model as "best practice" and suggest guidelines for successful integration of physical therapy in the preschool classroom.

  15. Automation and use of robotic arm for development and routine production of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Salvadori, P.A.; Di Sacco, S.; Riva, A.; Fusani, L.

    1993-01-01

    The target of a radiopharmaceutical group is twofold: production of radiotracers for clinical use (routine) and development of new compounds. The level of activity to be handled selects the strategy to be used for radiocompounds handling, ranging from direct manipulation during basic development at microcurie level to sophisticated equipments such as automated black-boxes and robotic arms at curie level. The authors looked for a common solution, to both the management of routine productions and the problems arising during activity scaling up in new tracer development, by choosing a robotic arm integrated by a variety of specialized automatic devices able to perform actions which are difficult (too slow, too precise, too complicated, etc.,) to be made by the robot. The final solution from this approach is a open-quotes synthetic stationclose quotes with flexible architecture which can be used for different applications without harware modification/adaptation

  16. Serum HER-2 concentrations for monitoring women with breast cancer in a routine oncology setting

    DEFF Research Database (Denmark)

    Sørensen, Patricia Diana; Jakobsen, Erik Hugger; Langkjer, Sven Tyge

    2009-01-01

    BACKGROUND: The purpose of this study was to determine the positive predictive value (PPV) of positive serum human epidermal growth factor receptor-2 (HER-2) for monitoring women with breast cancer following diagnosis and treatment in a routine clinical setting. METHODS: Serum HER-2 was measured...... could be determined in ten tissue-positive patients was 3-24 months (mean 11.3 months), when compared to standard clinical imaging methods. CONCLUSIONS: Serum HER-2 is a useful marker for the detection of recurrence of breast cancer and for monitoring the effect of treatment, especially in tissue HER-2...... in 1348 patients with breast cancer: 837 during routine oncology clinic visits and 511 following new diagnosis. All patients with positive serum HER-2, 1/5 of negative patients from the oncology clinic, and all the newly diagnosed were followed; a total of 862 patients. Serum HER-2 was measured using...

  17. Routine calcium measurement is not necessary after most thyroid surgeries: a prospective clinical study.

    LENUS (Irish Health Repository)

    Quinn, E M

    2010-12-01

    Calcium levels are often measured to diagnose postoperative hypocalcaemia following thyroidectomy. The aims of this study were to (i) prospectively determine the incidence of symptomatic and biochemical hypocalcaemia following thyroidectomy, (ii) to identify if any associations exist between hypocalcaemia, type of surgery, histological diagnosis, specimen size\\/weight and the presence of histological parathyroid tissue and (iii) to evaluate the necessity of routine measurement of calcium levels following all thyroidectomies.

  18. Routine plasma analysis for 2-[18F]fluorotyrosine by SAX-cartridges

    International Nuclear Information System (INIS)

    Kling, P.; Coenen, H.H.; Stoecklin, G.

    1990-01-01

    There is a great necessity for simple, reliable, and fast methods of plasma analysis. While HPLC is generally the most effective method, it is rather time consuming and expensive in a routine setting with numerous plasma samples. The authors have developed a new method for determination of the amino acid analogue 2-[ 18 F]fluorotyrosine using SAX columns (Adsorbex R SAX, 400 mg, Merck). The results obtained agree within 5% with those determined by reverse phase HPLC

  19. A simple method for plasma total vitamin C analysis suitable for routine clinical laboratory use

    OpenAIRE

    Robitaille, Line; Hoffer, L. John

    2016-01-01

    Background In-hospital hypovitaminosis C is highly prevalent but almost completely unrecognized. Medical awareness of this potentially important disorder is hindered by the inability of most hospital laboratories to determine plasma vitamin C concentrations. The availability of a simple, reliable method for analyzing plasma vitamin C could increase opportunities for routine plasma vitamin C analysis in clinical medicine. Methods Plasma vitamin C can be analyzed by high performance liquid chro...

  20. Functional connectivity experiments reflect routine movement behavior of a tropical hummingbird species.

    Science.gov (United States)

    Volpe, Noelia L; Hadley, Adam S; Robinson, W Douglas; Betts, Matthew G

    Translocation experiments, in which researchers displace animals and then monitor their movements to return home, are commonly used as tools to assess functional connectivity of fragmented landscapes. Such experiments are purported to have important advantages of being time efficient and of standardizing “motivation” to move across individuals. Yet, we lack tests of whether movement behavior of translocated birds reflects natural behavior of unmanipulated birds. We compared the routine movement behavior of a tropical hummingbird, the Green Hermit (Phaethornis guy), to that of experimentally translocated individuals. We tested for differences in site selection patterns during movement at two spatial scales (point and path levels). We also compared movement rates between treatments. Behaviors documented during translocation experiments reflected those observed during routine movements. At the point level, both translocated and non-translocated birds showed similar levels of preference for mature tropical forest. At the path level, step selection functions showed both translocated and non-translocated hummingbirds avoiding movement across non-forested matrix and selecting streams as movement corridors. Movement rates were generally higher during translocation experiments. However, the negative influence of forest cover on movement rates was proportionately similar in translocation and routine movement treatments. We report the first evidence showing that movement behavior of birds during translocation experiments is similar to their natural movement behavior. Therefore, translocation experiments may be reliable tools to address effects of landscape structure on animal movement. We observed consistent selection of landscape elements between translocated and non-translocated birds, indicating that both routine and translocation movement studies lead to similar conclusions regarding the effect of landscape structure and forest composition on functional connectivity

  1. Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

    Energy Technology Data Exchange (ETDEWEB)

    Creeden, Sean G.; Rao, Anil G.; Eklund, Meryle J.; Hill, Jeanne G.; Thacker, Paul G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2017-03-15

    Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy. To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures. We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management. We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam. Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold. (orig.)

  2. Versatile IEEE-488 data acquisition and control routines for a diode array spectrophotometer

    OpenAIRE

    Shiundu, Paul M.; Wade, Adrian P.

    1991-01-01

    The UV-visible diode array spectrophotometer is a work-horse instrument for many laboratories. This article provides simple data acquisition and control routines in Microsoft QuickBasic for a HP-8452A diode array spectrophotometer interfaced to an IBM PC/XT/AT, or compatible, microcomputer. These allow capture of full spectra and measure absorbance at one or several wavelengths at preset time intervals. The variance in absorbance at each wavelength is available as an option.

  3. Versatile IEEE-488 data acquisition and control routines for a diode array spectrophotometer

    Science.gov (United States)

    Shiundu, Paul M.

    1991-01-01

    The UV-visible diode array spectrophotometer is a work-horse instrument for many laboratories. This article provides simple data acquisition and control routines in Microsoft QuickBasic for a HP-8452A diode array spectrophotometer interfaced to an IBM PC/XT/AT, or compatible, microcomputer. These allow capture of full spectra and measure absorbance at one or several wavelengths at preset time intervals. The variance in absorbance at each wavelength is available as an option. PMID:18924888

  4. Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation

    Directory of Open Access Journals (Sweden)

    Bruijnzeels Marc

    2007-08-01

    Full Text Available Abstract Background Tailor-made approaches enable the uptake of interventions as they are seen as a way to overcome the incompatibility of general interventions with local knowledge about the organisation of routine medical practice and the relationship between the patients and the professionals in practice. Our case is the Quattro project which is a prevention programme for cardiovascular diseases in high-risk patients in primary health care centres in deprived neighbourhoods. This programme was implemented as a pragmatic trial and foresaw the importance of local knowledge in primary health care and internal, or locally made, guidelines. The aim of this paper is to show how this prevention programme, which could be tailored to routine care, was implemented in primary care. Methods An ethnographic design was used for this study. We observed and interviewed the researchers and the practice nurses. All the research documents, observations and transcribed interviews were analysed thematically. Results Our ethnographic process evaluation showed that the opportunity of tailoring intervention procedures to routine care in a pragmatic trial setting did not result in a well-organised and well-implemented prevention programme. In fact, the lack of standard protocols hindered the implementation of the intervention. Although it was not the purpose of this trial, a guideline was developed. Despite the fact that the developed guideline functioned as a tool, it did not result in the intervention being organised accordingly. However, the guideline did make tailoring the intervention possible. It provided the professionals with the key or the instructions needed to achieve organisational change and transform the existing interprofessional relations. Conclusion As tailor-made approaches are developed to enable the uptake of interventions in routine practice, they are facilitated by the brokering of tools such as guidelines. In our study, guidelines facilitated

  5. Gastro-oesophageal reflux symptoms and coeliac disease: no role for routine duodenal biopsy.

    Science.gov (United States)

    Mooney, Peter D; Evans, Kate E; Kurien, Matthew; Hopper, Andrew D; Sanders, David S

    2015-06-01

    Coeliac disease (CD) has been linked to gastro-oesophageal reflux disease (GORD). Previous studies have demonstrated an increased prevalence of reflux in patients with CD. However data on the risk for CD in patients presenting with reflux are conflicting. The aim of this study was to establish the prevalence of CD in patients with GORD and to elucidate the mechanisms for reflux symptoms in newly diagnosed CD patients. Group A: patients who had undergone routine duodenal biopsy were prospectively recruited between 2004 and 2014. Diagnostic yield was compared with that of a screening cohort. Group B: 32 patients with newly diagnosed CD who had undergone oesophageal manometry and 24-h pH studies were prospectively recruited. Group A: 3368 patients (58.7% female, mean age 53.4 years) underwent routine duodenal biopsy. Of these patients, 850 (25.2%) presented with GORD. The prevalence of CD among GORD patients was 1.3% (0.7-2.4%), which was not significantly higher than that in the general population (P=0.53). Within the context of routine duodenal biopsy at endoscopy (when corrected for concurrent symptoms, age and sex), reflux was found to be negatively associated with CD [adjusted odds ratio 0.12 (0.07-0.23), Preflux. On manometry, 9% had a hypotensive lower oesophageal sphincter and 40.6% had oesophageal motor abnormalities, with 25% significantly hypocontractile. On pH studies, 33% demonstrated reflux episodes. The prevalence of undiagnosed CD among GORD patients is similar to that in the general population, and routine duodenal biopsy cannot be recommended. A significant number of patients with newly diagnosed CD were found to have reflux and/or oesophageal dysmotility on pH/manometry studies; this may explain the high prevalence of reflux symptoms in CD.

  6. Stakeholder involvement in development and design of appropriate emergency preparedness routines in Slovakia

    International Nuclear Information System (INIS)

    Duranova, T.; Kusovska, Z.; Metke, E.; Sladek, V.; Sokolikova, A.

    2009-01-01

    The paper presents the process of stakeholder involvement in development and implementation of appropriate emergency preparedness routines in Slovakia in last five years. The paper presents the discussion of good practices, which made the work undertaken valuable and effective. The paper reflects the lessons learned during the course representing five years of stakeholder involvement effort. The paper gives detailed information on used practices and real process taken place in Slovakia. (authors)

  7. Computer-based Creativity Enhanced Conceptual Design Model for Non-routine Design of Mechanical Systems

    Institute of Scientific and Technical Information of China (English)

    LI Yutong; WANG Yuxin; DUFFY Alex H B

    2014-01-01

    Computer-based conceptual design for routine design has made great strides, yet non-routine design has not been given due attention, and it is still poorly automated. Considering that the function-behavior-structure(FBS) model is widely used for modeling the conceptual design process, a computer-based creativity enhanced conceptual design model(CECD) for non-routine design of mechanical systems is presented. In the model, the leaf functions in the FBS model are decomposed into and represented with fine-grain basic operation actions(BOA), and the corresponding BOA set in the function domain is then constructed. Choosing building blocks from the database, and expressing their multiple functions with BOAs, the BOA set in the structure domain is formed. Through rule-based dynamic partition of the BOA set in the function domain, many variants of regenerated functional schemes are generated. For enhancing the capability to introduce new design variables into the conceptual design process, and dig out more innovative physical structure schemes, the indirect function-structure matching strategy based on reconstructing the combined structure schemes is adopted. By adjusting the tightness of the partition rules and the granularity of the divided BOA subsets, and making full use of the main function and secondary functions of each basic structure in the process of reconstructing of the physical structures, new design variables and variants are introduced into the physical structure scheme reconstructing process, and a great number of simpler physical structure schemes to accomplish the overall function organically are figured out. The creativity enhanced conceptual design model presented has a dominant capability in introducing new deign variables in function domain and digging out simpler physical structures to accomplish the overall function, therefore it can be utilized to solve non-routine conceptual design problem.

  8. Computer-based creativity enhanced conceptual design model for non-routine design of mechanical systems

    Science.gov (United States)

    Li, Yutong; Wang, Yuxin; Duffy, Alex H. B.

    2014-11-01

    Computer-based conceptual design for routine design has made great strides, yet non-routine design has not been given due attention, and it is still poorly automated. Considering that the function-behavior-structure(FBS) model is widely used for modeling the conceptual design process, a computer-based creativity enhanced conceptual design model(CECD) for non-routine design of mechanical systems is presented. In the model, the leaf functions in the FBS model are decomposed into and represented with fine-grain basic operation actions(BOA), and the corresponding BOA set in the function domain is then constructed. Choosing building blocks from the database, and expressing their multiple functions with BOAs, the BOA set in the structure domain is formed. Through rule-based dynamic partition of the BOA set in the function domain, many variants of regenerated functional schemes are generated. For enhancing the capability to introduce new design variables into the conceptual design process, and dig out more innovative physical structure schemes, the indirect function-structure matching strategy based on reconstructing the combined structure schemes is adopted. By adjusting the tightness of the partition rules and the granularity of the divided BOA subsets, and making full use of the main function and secondary functions of each basic structure in the process of reconstructing of the physical structures, new design variables and variants are introduced into the physical structure scheme reconstructing process, and a great number of simpler physical structure schemes to accomplish the overall function organically are figured out. The creativity enhanced conceptual design model presented has a dominant capability in introducing new deign variables in function domain and digging out simpler physical structures to accomplish the overall function, therefore it can be utilized to solve non-routine conceptual design problem.

  9. MAXDOSE-SR: A routine release atmospheric dose model used at SRS

    International Nuclear Information System (INIS)

    Simpkins, A.A.

    2000-01-01

    MAXDOSE-SR is a PC version of the dosimetry code MAXIGASP, which was used to calculate doses to the maximally exposed offsite individual for routine atmospheric releases of radioactive material at the Savannah River Site (SRS). Complete code description, verification of models, and user's manual have been included in this report. Minimal input is required to run the program, and site specific parameters are used when possible

  10. Imaging features suggestive of a conjoined nerve root on routine axial MRI

    Energy Technology Data Exchange (ETDEWEB)

    Song, Su Jin; Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeongi-do (Korea); Choi, Ja-Young; Hong, Sung Hwan; Kim, Na Ra [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-Do (Korea)

    2008-02-15

    The purpose of our study is to evaluate imaging features suggestive of a conjoined nerve root on routine axial MRI. Two radiologists and two surgeons retrospectively reviewed the MRI of three cases in which a conjoined nerve root was discovered during operation and found three suggestive signs on routine axial MR images: ''corner'' (asymmetric morphology of the anterolateral corner of the dural sac), ''fat crescent'' (intervening extradural fat between the asymmetric dura and the nerve root), and ''parallel'' signs (visualization of the entire parallel course of the nerve root at the disc level). Two radiologists prospectively found these signs during routine MRI interpretation sessions over a period of 6 months. If one or a combination of signs were noted on axial MR images, contiguous axial scans were additionally obtained. Three cases that were previously found during operations were also included. Prevalence and confidence scores for each sign were assessed on axial T1- and T2-weighted images. Twelve patients showed one or a combination of the three signs, 9 had contiguous axial MR scans. Five cases were confirmed by operation. The prevalence of the corner, fat crescent, and parallel signs were 12 out of 12 (100%), 6 out of 12 (50%), and 8 out of 12 (67.7%) on axial T1-weighted images. The overall diagnostic confidence was higher on T1- than on T2-weighted images (P < 0.05). On routine axial L-spine MRI, corner, fat crescent, and parallel signs are suggestive of and assist in the recognition of a conjoined nerve root. (orig.)

  11. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids.

    Science.gov (United States)

    Marcellin, Louis; Senat, Marie Victoire; Benachi, Alexandra; Regis, Sophie; Cabrol, Dominique; Goffinet, François

    2017-05-24

    To evaluate whether routine measurement of cervical length (CL) by transvaginal ultrasound (TVU) in twin pregnancies can enable identification of women who will give birth before 34 weeks and require antenatal corticosteroids (ACSs), and whether it can limit their administration to women who will give birth later. Retrospective comparative study in two tertiary referral centers in France. Women with twin gestations followed in two tertiary university hospital maternity units and who delivered from January 1, 2007 to December 31, 2009 were included. In one center, TVU was targeted to women with cases of suspected preterm labor, while the other center used it monthly for all twin pregnancies. The main outcome measure was the administration of a full course of ACS to twins delivered before 34 weeks. Two hundred and seventy women were eligible in the "targeted use" group, and 296 women in the "routine use" group. The rate of administration of at least one full course of ACS for twins born before 34 weeks did not differ between the two groups (85.0% in the targeted use group and 90.0% in the routine use group, P=0.40), but the rate of such administration for those born after 34 weeks was lower in the targeted use group (25.7% vs. 81.2%, P<0.01). On adjusting for confounders using logistic regression modeling, no significant difference in ACS administration before 34 weeks was found between the two groups [adjusted odds ratio (aOR), 0.71, 95% confidence interval (CI), 0.39-1.30]. Routine monitoring performed every month of CL with TVU does not affect the rate of administration of ACS to twins born before 34 weeks, but is associated with a higher rate of such administration for those born later in the specific center of the study.

  12. Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management

    OpenAIRE

    Yuval; Y. Rimon; E. R. Graber; A. Furman

    2013-01-01

    A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanization often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate...

  13. Analyzing Effectiveness of Routine Pleural Drainage After Nuss Procedure: A Randomized Study.

    Science.gov (United States)

    Pawlak, Krystian; Gąsiorowski, Łukasz; Gabryel, Piotr; Smoliński, Szymon; Dyszkiewicz, Wojciech

    2017-12-01

    The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure. Patients were prospectively randomized into two groups. In 58 patients, a 28F chest tube was routinely introduced into the right pleural cavity during procedure for 2 consecutive days (group I). In the remaining 45 patients, the drain was not inserted (group II). No statistically significant differences were found between the study groups, including sex, age, body mass index, or clinical subjective and objective factors in the preoperative evaluation. Group II manifested more complications in the early postoperative period; however, this was not statistically significant (group I vs group II; p = 0.0725). Pneumothorax requiring additional chest tube placement was statistically significant (group I vs group II; p = 0.0230). Other complications were also more frequent among patients from group II, although this did not reach statistical significance. Follow up was 22.9 ± 6.4 months. Routine drainage of the pleural cavity during the Nuss procedure significantly reduces the incidence of postoperative pneumothorax and should be considered as a routine procedure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Description of work for routine groundwater sampling at the Environmental Restoration Disposal Facility

    International Nuclear Information System (INIS)

    Ford, B.H.

    1996-09-01

    This document provides a description of work and field implementation guidance for routine (post-baseline) groundwater monitoring sampling program at the Environmental Restoration Disposal Facility. The purpose of this program is to (1) meet the intent of the applicable or relevant and appropriate requirements; (2) document baseline groundwater conditions; (3) monitor those conditions for change; and (4) allow for modifications to groundwater sampling if required by the leachate management program

  15. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    OpenAIRE

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological...

  16. An approach to routine individual internal dose monitoring at the object 'Shelter' personnel considering uncertainties

    International Nuclear Information System (INIS)

    Mel'nichuk, D.V.; Bondarenko, O.O.; Medvedjev, S.Yu.

    2002-01-01

    An approach to organisation of routine individual internal dose monitoring of the personnel of the Object 'Shelter' is presented in the work, that considers individualised uncertainties. In this aspect two methods of effective dose assessment based on bioassay are considered in the work: (1) traditional indirect method at which application results of workplace monitoring are not taken into account, and (2) a combined method in which both results of bioassay measurements and workplace monitoring are considered

  17. How hard do mineworkers work? An assessment of workplace stress associated with routine mining activities

    CSIR Research Space (South Africa)

    Schutte, PC

    2012-03-01

    Full Text Available . 2 METHODOLOGY 2.1 Physiological strain The Physiological Strain Index (PSI) is a useful tool to determine the impact of environmental tem- peratures and physical work on individuals. The PSI is based on core body temperature and heart rate... of heat built up during muscle contraction, while heart rate re- flects demands placed on the circulatory system in How hard do mineworkers work? An assessment of workplace stress as- sociated with routine mining activities P.C. Schutte CSIR...

  18. A Case Study of Crestwood Primary School: Organizational Routines Implemented For Data-Driven Decison Making

    OpenAIRE

    Williams, Kimberly Graybeal

    2014-01-01

    The research study investigated how organizational routines influenced classroom and intervention instruction in a primary school. Educators have used student data for decades but they continue to struggle with the best way to use data to influence instruction. The historical overview of the research highlighted the context of data use from the Effective Schools movement through the No Child Left Behind Act noting the progression of emphasis placed on student data results. While numerous rese...

  19. Resfria - a computational routine for thermal-hydraulic analysis of a cooldown in the PWR

    International Nuclear Information System (INIS)

    Silva Neto, A.J. da; Maciel Filho, L.A.

    1989-01-01

    This paper presents the computer code RESFRIA, designed to calculate the process parameters in a PWR nuclear power plant during a cooldown normal procedure. The procedure is described and some of the models developed to the simulation of systems and equipments are presented. A simplified flowchart of the computational routine and the results in the form of a diagram, for a typical PWR nuclear power plant, are also presented. (author)

  20. What is the yield of routine chest radiography following tube thoracostomy for trauma?

    Science.gov (United States)

    Kong, Victor Y; Oosthuizen, George V; Clarke, Damian L

    2015-01-01

    Routine chest radiography (CXR) following tube thoracostomy (TT) is a standard practice in most trauma centres worldwide. Evidence supporting this routine practice is lacking and the actual yield is unknown. We performed a retrospective review of 1042 patients over a 4-year period who had a routine post-insertion CXR performed in accordance with current ATLS® recommendations. A total 1042 TTs were performed on 1004 patients. Ninety-one per cent of patients (913/1004) were males, and the median age for all patients was 24 years. Seventy-five per cent of all injuries (756/1004) were from penetrating trauma, and the remaining 25% (248/1004) were from blunt. The initial pathologies requiring TT were: haemopneumothorax: 34% (339/1042), haemothroax: 31% (314/1042), simple pneumothorax: 25% (256/1042), tension pneumothorax: 8% (77/1042) and open pneumothorax: 5% (54/1042). One hundred and three patients had TTs performed on clinical grounds alone without a pre-insertion CXR [Group A]. One hundred and ninety-one patients had a pre-insertion CXR but had persistent clinical concerns following insertion [Group B]. Seven hundred and ten patients had pre-insertion CXR but no clinical concerns following insertion [Group C]. Overall, 15% (152/1004) [9 from Group A, 111 from Group B and 32 from Group C] of all patients had their clinical management influenced as a direct result of the post-insertion CXR. Despite the widely accepted practice of routine CXR following tube thoracostomy, the yield is relatively low. In many cases, good clinical examination post tube insertion will provide warnings as to whether problems are likely to result. However, in the more rural setting, and in resource challenged environments, there is a relatively high yield from the CXR, which alters management. Further prospective studies are needed to establish or refute the role of the existing ATLS® guidelines in these specific environments. Copyright © 2014 Elsevier Ltd. All rights reserved.