WorldWideScience

Sample records for specific clinical situations

  1. Athletic Training Clinical Instructors as Situational Leaders.

    Science.gov (United States)

    Meyer, Linda Platt

    2002-12-01

    OBJECTIVE: To present Situational Leadership as a model that can be implemented by clinical instructors during clinical education. Effective leadership occurs when the leadership style is matched with the observed followers' characteristics. Effective leaders anticipate and assess change and adapt quickly and grow with the change, all while leading followers to do the same. As athletic training students' levels of readiness change, clinical instructors also need to transform their leadership styles and strategies to match the students' ever-changing observed needs in different situations. DATA SOURCES: CINAHL (1982-2002), MEDLINE (1990-2001), SPORT Discus (1949-2002), ERIC (1966-2002), and Internet Web sites were searched. Search terms included leadership, situational leadership, clinical instructors and leadership, teachers as leaders, and clinical education. DATA SYNTHESIS: Situational Leadership is presented as a leadership model to be used by clinical instructors while teaching and supervising athletic training students in the clinical setting. This model can be implemented to improve the clinical-education process. Situational leaders, eg, clinical instructors, must have the flexibility and range of skills to vary their leadership styles to match the challenges that occur while teaching athletic training students. CONCLUSIONS/RECOMMENDATIONS: This leadership style causes the leader to carry a substantial responsibility to lead while giving power away. Communication is one of the most important leadership skills to develop to become an effective leader. It is imperative for the future of the profession that certified athletic trainers continue to develop effective leadership skills to address the changing times in education and expectations of the athletic training profession.

  2. Situation-specific theories from the middle-range transitions theory.

    Science.gov (United States)

    Im, Eun-Ok

    2014-01-01

    The purpose of this article was to analyze the theory development process of the situation-specific theories that were derived from the middle-range transitions theory. This analysis aims to provide directions for future development of situation-specific theories. First, transitions theory is concisely described with its history, goal, and major concepts. Then, the approach that was used to retrieve the situation-specific theories derived from transitions theory is described. Next, an analysis of 6 situation-specific theories is presented. Finally, 4 themes reflecting commonalities and variances in the theory development process are discussed with implications for future theoretical development.

  3. Methodological Consequences of Situation Specificity: Biases in Assessments

    Directory of Open Access Journals (Sweden)

    Jean-Luc Patry

    2011-02-01

    Full Text Available Social research is plagued by many biases. Most of them are due to situation specificity of social behavior and can be explained using a theory of situation specificity. The historical background of situation specificity in personality social psychology research is briefly sketched, then a theory of situation specificity is presented in detail, with as centerpiece the relationship between the behavior and its outcome which can be described as either the more, the better or not too much and not too little. This theory is applied to reliability and validity of assessments in social research. The distinction between maximum performance and typical performance is shown to correspond to the two behavior-outcome relations. For maximum performance, issues of reliability and validity are much easier to be solved, whereas typical performance is sensitive to biases, as predicted by the theory. Finally, it is suggested that biases in social research are not just systematic error, but represent relevant features to be explained just as other behavior, and that the respective theories should be integrated into a theory system.

  4. [Healthcare management of an epilepsy clinic: factors involved in the demand for health care and clinical situation of patients].

    Science.gov (United States)

    García-Martín, Guillermina; Martín-Reyes, Guillermina; Dawid-Milner, Marc Stefan; Chamorro-Muñoz, M Isabel; Pérez-Errazquin, Francisco; Romero-Acebal, Manuel

    2013-05-16

    Epilepsy is a chronic illness that requires a long-term periodic follow-up of the patient and this means that as time goes by the number of patients attended increases, with the ensuing added cost for the healthcare system. To determine the factors involved in the time until an epileptic patient's next visit. Our sample consisted of a selection of patients who visited the epilepsy clinic at our hospital consecutively during one year. Their clinical situation and relationship with the medical advice they were given, together with the factors involved in the time elapsed until the next visit, were analysed by means of predictive econometric models. There is a clear association between the patient's clinical situation and the modification of the treatment proposed by the neurologist in the previous visit. The factors involved in the time until the next visit were the frequency of seizures, adverse side effects from medicines -above all those that affect cognition- and the medical advice given to the patient. Polytherapy, psychoaffective disorders or the patient's social situation were not found to be significant. Follow-up visits in a specific epilepsy clinic improves the patient's situation. This is the first analysis of the demand for healthcare in patients with epilepsy conducted by means of econometric methods and from a mixed physician-patient perspective. Since the factors that determine the time until the next visit can be modified, the number of visits per year could be reduced, thus improving patients' clinical situation. We suggest a greater amount of time should be spent per visit so as to be able to have a bearing on it and thereby cut costs in the long term.

  5. Engaging design materials, formats and Framings in specific, situated co-designing

    DEFF Research Database (Denmark)

    Agger Eriksen, Mette

    Engaging co-designers in specific situations of co- designing often also means engaging tangible working materials. However, it can be challenging, so rather than seeing it as applying design methods, the paper propose applying what I call a micro-material perspective. The practical concept captu......-design situations" clustered in three quite well- known types of co-design situations framed for; Exploring Current Use(r) Practices, Mapping Networks and Co-Designing (Possible) Futures.......Engaging co-designers in specific situations of co- designing often also means engaging tangible working materials. However, it can be challenging, so rather than seeing it as applying design methods, the paper propose applying what I call a micro-material perspective. The practical concept...... captures both paying attention to the physical design materials, the formats of their exploration and the framings of focus when understanding and planning such specific co-design situations. To exemplify applying the perspective, the paper describes and discusses six specific examples of "co...

  6. Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

    Science.gov (United States)

    Gillespie, Mary

    2010-11-01

    Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Perceived levels of frustration during clinical situations in athletic training students.

    Science.gov (United States)

    Heinerichs, Scott; Curtis, Neil; Gardiner-Shires, Alison

    2014-01-01

    Athletic training students (ATSs) are involved in various situations during the clinical experience that may cause them to express levels of frustration. Understanding levels of frustration in ATSs is important because frustration can affect student learning, and the clinical experience is critical to their development as professionals. To explore perceived levels of frustration in ATSs during clinical situations and to determine if those perceptions differ based on sex. Cross-sectional study with a survey instrument. A total of 14 of 19 professional, undergraduate athletic training programs accredited by the Commission on Accreditation of Athletic Training Education in Pennsylvania. Of a possible 438 athletic training students, 318 (72.6%) completed the survey. The Athletic Training Student Frustration Inventory was developed and administered. The survey gathered demographic information and included 24 Likert-scale items centering on situations associated with the clinical experience. Descriptive statistics were computed on all items. The Mann-Whitney U was used to evaluate differences between male and female students. A higher level of frustration was perceived during the following clinical situations: lack of respect by student-athletes and coaching staffs, the demands of the clinical experience, inability of ATSs to perform or remember skills, and ATSs not having the opportunity to apply their skills daily. Higher levels of frustration were perceived in female than male ATSs in several areas. Understanding student frustration during clinical situations is important to better appreciate the clinical education experience. Low levels of this emotion are expected; however, when higher levels exist, learning can be affected. Whereas we cannot eliminate student frustrations, athletic training programs and preceptors need to be aware of this emotion in order to create an environment that is more conducive to learning.

  8. Correlates of hepatitis B virus health-related behaviors of Korean Americans: a situation-specific nursing theory.

    Science.gov (United States)

    Lee, Haeok; Fawcett, Jacqueline; Yang, Jin Hyang; Hann, Hie-Won

    2012-12-01

    The purpose of this article is to explain the evolution of a situation-specific theory developed to enhance understanding of health-related behaviors of Korean Americans (KAs) who have or are at risk for a chronic hepatitis B virus (HBV) infection. The situation-specific theory evolved from an integration of the Network Episode Model, studies of health-related behaviors of people with HBV infection, and our studies of and practice experiences with Asian American individuals with HBV infection. The major concepts of the theory are sociocultural context, social network, individual-level factors, illness experience, and health-related behaviors. The major propositions of the theory are that sociocultural context, social network, and individual-level factors influence the illness experience, and that sociocultural context, social network, individual-level factors, and the illness experience influence health-related behaviors of KAs who have or are at risk for HBV infection. This situation-specific theory represents a translation of abstract concepts into clinical reality. The theory is an explanation of correlates of health-related HBV behaviors of KAs. The next step is to develop and test the effectiveness of a nursing intervention designed to promote behaviors that will enhance the health of KAs who have or are at risk for HBV infection, and that takes into account sociocultural context, social network, individual-level factors, and illness experience. © 2012 Sigma Theta Tau International.

  9. Multiparametric monitoring of tissue vitality in clinical situations

    Science.gov (United States)

    Mayevsky, Avraham; Manor, Tamar; Meilin, Sigal; Razon, Nisim; Ouknine, George E.; Ornstein, Eugene

    2001-05-01

    The monitoring of various tissue's physiological and biochemical parameters is one of the tools used by the clinicians to improve diagnosis capacity. As of today, the very few devices developed for real time clinical monitoring of tissue vitality are based on a single parameter measurement. Tissue energy balance could be defined as the ratio between oxygen or energy supply and demand. In order to determine the vitality of the brain, for example, it is necessary to measure at least the following 3 parameters: Energy Demand--potassium ion homeostasis; Energy Supply-- cerebral blood flow; Energy Balance--mitochondrial NADH redox state. For other tissues one can measure various energy demand processes specific to the tested organ. We have developed a unique multiparametric monitoring system tested in various experimental and clinical applications. The multiprobe assembly (MPA) consists of a fiber optic probe for measurement of tissue blood flow and mitochondrial NADH redox state, ion selective electrodes (K+, Ca2+, H+), electrodes for electrical activities (ECoG or ECG and DC potential), temperature probe and for monitoring the brain - Intra Cranial Pressure probe (ICP). The computerized monitoring system was used in the neurological intensive care unit to monitor comatose patients for a period of 24-48 hours. Also, a simplified MPA was used in the neurosurgical operating room or during organ transplantation procedure. It was found that the MPA could be used in clinical situations and that the data collected has a significant diagnosis value for the medical team.

  10. Identity-specific motivation: How distinct identities direct self-regulation across distinct situations.

    Science.gov (United States)

    Browman, Alexander S; Destin, Mesmin; Molden, Daniel C

    2017-12-01

    Research on self-regulation has traditionally emphasized that people's thoughts and actions are guided by either (a) domain-general motivations that emerge from a cumulative history of life experiences, or (b) situation-specific motivations that emerge in immediate response to the incentives present in a particular context. However, more recent studies have illustrated the importance of understanding the interplay between such domain-general and situation-specific motivations across the types of contexts people regularly encounter. The present research, therefore, expands existing perspectives on self-regulation by investigating how people's identities -the internalized roles, relationships, and social group memberships that define who they are-systemically guide when and how different domain-general motivations are activated within specific types of situations. Using the motivational framework described by regulatory focus theory (Higgins, 1997), Studies 1 and 2 demonstrate that people indeed have distinct, identity-specific motivations that uniquely influence their current self-regulation when such identities are active. Studies 3-5 then begin to explore how identity-specific motivations are situated within people's larger self-concept. Studies 3a and 3b demonstrate that the less compatible people's specific identities, the more distinct are the motivations connected to those identities. Studies 4-5 then provide some initial, suggestive evidence that identity-specific motivations are not a separate, superordinate feature of people's identities that then alter how they pursue any subordinate, identity-relevant traits, but instead that such motivations emerge from the cumulative motivational significance of the subordinate traits to which the identities themselves become attached. Implications for understanding the role of the self-concept in self-regulation are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. The situation-specific theory of pain experience for Asian American cancer patients.

    Science.gov (United States)

    Im, Eun-Ok

    2008-01-01

    Studies have indicated the need for theories that explain and target ethnic-specific cancer pain experiences, including those of Asian Americans. In this article, I present a situation-specific theory that explains the unique cancer pain experience of Asian Americans. Unlike other existing theories, this situation-specific theory was developed on the basis of evidence, including a systematic literature review and research findings, making it comprehensive and highly applicable to research and practice with Asian American patients with cancer. Thus, this theory would strengthen the interconnections among theory, evidence, and practice in pain management for Asian American cancer patients.

  12. Can eye-tracking technology improve situational awareness in paramedic clinical education?

    Science.gov (United States)

    Williams, Brett; Quested, Andrew; Cooper, Simon

    2013-01-01

    Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing medical error: eye-tracking technology can be used to provide an objective and qualitative measure of the initial perception component of SA. Feedback from eye-tracking technology can be used to improve the understanding and teaching of SA in clinical contexts, and consequently, has potential for reducing clinician error and the concomitant adverse events.

  13. Situational theory of leadership.

    Science.gov (United States)

    Waller, D J; Smith, S R; Warnock, J T

    1989-11-01

    The situational theory of leadership and the LEAD instruments for determining leadership style are explained, and the application of the situational leadership theory to the process of planning for and implementing organizational change is described. Early studies of leadership style identified two basic leadership styles: the task-oriented autocratic style and the relationship-oriented democratic style. Subsequent research found that most leaders exhibited one of four combinations of task and relationship behaviors. The situational leadership theory holds that the difference between the effectiveness and ineffectiveness of the four leadership styles is the appropriateness of the leader's behavior to the particular situation in which it is used. The task maturity of the individual or group being led must also be accounted for; follower readiness is defined in terms of the capacity to set high but attainable goals, willingness or ability to accept responsibility, and possession of the necessary education or experience for a specific task. A person's leadership style, range, and adaptability can be determined from the LEADSelf and LEADOther questionnaires. By applying the principles of the situational leadership theory and adapting their managerial styles to specific tasks and levels of follower maturity, the authors were successful in implementing 24-hour pharmacokinetic dosing services provided by staff pharmacists with little previous experience in clinical services. The situational leadership model enables a leader to identify a task, set goals, determine the task maturity of the individual or group, select an appropriate leadership style, and modify the style as change occurs. Pharmacy managers can use this model when implementing clinical pharmacy services.

  14. SU-F-E-16: A Specific Training Package for Medical Physicists in Support to Nuclear and Radiological Emergency Situations

    International Nuclear Information System (INIS)

    Meghzifene, A; Berris, T

    2016-01-01

    Purpose: To provide the professional medical physicists with adequate competencies and skills in order to help them get prepared to support Nuclear or Radiological Emergency (NRE) situations. Methods: Although clinical medical physicists working have in-depth knowledge in radiation dosimetry, including dose reconstruction and dose measurements, they are usually not involved in NRE situations. However, in a few instances where medical physicists were involved in NREs, it appeared that many lacked specific knowledge and skills that are required in such situations. This lack of specific knowledge and skills is probably due to the fact that most current medical physics curricula do not include a specific module on this topic. As a response to this finding, the IAEA decided to initiate a project to develop a specific training package to help prepare medical physicists to support NRE situations. The training package was developed with the kind support of the Government of Japan and in collaboration with Fukushima Medical University (FMU) and the National Institute of Radiological Sciences (NIRS). Results: The first International Workshop to test the training package was held in Fukushima, Japan in June 2015. It consisted of lectures, demonstrations, simulation, role play, and practical sessions followed by discussions. The training was delivered through 14 modules which were prepared with the support of 12 lecturers. A knowledge assessment test was done before the workshop, followed by the same test done at the end of the Workshop, to assess the knowledge acquired during the training. Conclusion: The Workshop was successfully implemented. The overall rating of the workshop by the participants was excellent and all participants reported that they acquired a good understanding of the main issues that are relevant to medical physics support in case of NRE situations. They are expected to disseminate the knowledge to other medical physicists in their countries.

  15. SU-F-E-16: A Specific Training Package for Medical Physicists in Support to Nuclear and Radiological Emergency Situations

    Energy Technology Data Exchange (ETDEWEB)

    Meghzifene, A; Berris, T [International Atomic Energy Agency, Vienna, Vienna (Austria)

    2016-06-15

    Purpose: To provide the professional medical physicists with adequate competencies and skills in order to help them get prepared to support Nuclear or Radiological Emergency (NRE) situations. Methods: Although clinical medical physicists working have in-depth knowledge in radiation dosimetry, including dose reconstruction and dose measurements, they are usually not involved in NRE situations. However, in a few instances where medical physicists were involved in NREs, it appeared that many lacked specific knowledge and skills that are required in such situations. This lack of specific knowledge and skills is probably due to the fact that most current medical physics curricula do not include a specific module on this topic. As a response to this finding, the IAEA decided to initiate a project to develop a specific training package to help prepare medical physicists to support NRE situations. The training package was developed with the kind support of the Government of Japan and in collaboration with Fukushima Medical University (FMU) and the National Institute of Radiological Sciences (NIRS). Results: The first International Workshop to test the training package was held in Fukushima, Japan in June 2015. It consisted of lectures, demonstrations, simulation, role play, and practical sessions followed by discussions. The training was delivered through 14 modules which were prepared with the support of 12 lecturers. A knowledge assessment test was done before the workshop, followed by the same test done at the end of the Workshop, to assess the knowledge acquired during the training. Conclusion: The Workshop was successfully implemented. The overall rating of the workshop by the participants was excellent and all participants reported that they acquired a good understanding of the main issues that are relevant to medical physics support in case of NRE situations. They are expected to disseminate the knowledge to other medical physicists in their countries.

  16. Theory-practice integration in selected clinical situations

    Directory of Open Access Journals (Sweden)

    M Davhana-Maselesele

    2001-09-01

    Full Text Available The current changes in health care systems challenge knowledgeable, mature and independent practitioners to integrate theoretical content with practice. The aim of this study was to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on rendering of family planning services to clients as a component of Community Nursing Science. Structured observation schedules were used to observe the theoretical content of the curriculum as well as the practical application of what has been taught in the clinical area. The findings of the study revealed that there was a need for an integrated holistic curriculum, which would address the needs of the community. It was concluded that a problem-based and community-based curriculum, intersectoral collaboration between college and hospital managements and student involvement in all processes of teaching and learning would improve the integration of theory and practice. There also appeared to be a need for tutors to be more involved in clinical teaching and accompaniment.

  17. A situation-specific theory of Midlife Women's Attitudes Toward Physical Activity (MAPA).

    Science.gov (United States)

    Im, Eun-Ok; Stuifbergen, Alexa K; Walker, Lorraine

    2010-01-01

    This paper presents a situation specific theory-the Midlife Women's Attitudes Toward Physical Activity (MAPA) theory-that explains how women's attitudes toward physical activity influence their participation in physical activity. Using the integrative approach of Im, the theory was developed based on the Attitude, Social Influence, and Self Efficacy Model; a review of the related literature; and a study of women's attitudes toward physical activity. As a situation-specific theory, the MAPA theory can be linked easily to nursing practice and research projects related to physical activity in midlife women, especially interventions aimed at increasing midlife women's participation in physical activity. Copyright 2010 Mosby, Inc. All rights reserved.

  18. Can eye-tracking technology improve situational awareness in paramedic clinical education?

    OpenAIRE

    Williams, Brett; Cooper,Simon; Quested,Andrew

    2013-01-01

    Brett Williams,1 Andrew Quested,1 Simon Cooper21Department of Community Emergency Health and Paramedic Practice, 2School of Nursing and Midwifery, Berwick, Monash University, Frankston, VIC, AustraliaAbstract: Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing ...

  19. SPECIFICITY OF SELF-PRESERVATION MOTIVATION IN EXTREME SITUATION

    Directory of Open Access Journals (Sweden)

    Ekaterina Anatolevna Karacheva

    2015-02-01

    Full Text Available The article presents the results of the study motivation of self-preservation in an extreme situation. Usually extreme situation unfold from the point of view of functioning, health, high negative level mental stress and tension. The extreme situation is the situation of human activity to which man acts, carrying out certain activities. The article provides an overview of russian and foreign authors dealing with this problem. Theoretical models of motivation of self-preservation Z. Freud, A. Maslow, G. Murray, M. Magomed-Eminov. The study explores the leading motivation in an extreme situation and analyzed the levels of motivation of self-preservation. The study was conducted in the Afghan veterans, using a method of unfinished sentences and other. Identified two levels of motivation of self-preservation: individual and personal. Revealed that the motivation of self-preservation is the leading motivation in an extreme situation.

  20. Impact of Expectancy-Value and Situational Interest Motivation Specificity on Physical Education Outcomes

    Science.gov (United States)

    Ding, Haiyong; Sun, Haichun; Chen, Ang

    2013-01-01

    To be successful in learning, students need to be motivated to engage and learn. The domain-specificity motivation theory articulates that student motivation is often determined by the content being taught to them. The purpose of this study was to extend the theory by determining domain-specificity of situational interest and expectancy-value…

  1. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation.

    Science.gov (United States)

    Carrión, Silvia; Roca, Maria; Costa, Alicia; Arreola, Viridiana; Ortega, Omar; Palomera, Elisabet; Serra-Prat, Mateu; Cabré, Mateu; Clavé, Pere

    2017-08-01

    Oropharyngeal dysphagia (OD) is a prevalent risk factor for malnutrition (MN) in older patients and both conditions are related to poor outcome. To explore the nutritional status in older patients with OD in a chronic and an acute clinical situation. We examined 95 older (≥70 years) patients with OD associated to chronic neurological diseases or aging, and 23 older patients with OD and acute community-acquired pneumonia (CAP) with videofluoroscopy; and 15 older people without OD. We collected nutritional status, measured with the Mini Nutritional Assessment (MNA ® ), anthropometric measurements, and biochemistry and bioimpedance for body composition. Functional status was assessed with the Barthel index. 1) Taking into consideration patients with OD with chronic conditions, 51.1% presented a MNA ® ≤23.5; 16.7%, sarcopenia and a) reduced visceral and muscular protein compartments and fat compartment; b) muscular weakness c) intracellular water depletion, and d) reduced body weight. Patients with OD and MNA ® ≤23 needed higher levels of nectar viscosity for a safe swallow and had increased oropharyngeal residue at spoon-thick viscosity. 2) Patients with OD and CAP, 69.5%, presented an MNA ® ≤23.5 and 29.4% sarcopenia, the inflammatory response of the pneumonia adding to the more severe depletion in visceral protein and muscular mass. Prevalence of impaired nutritional status (malnutrition risk, and sarcopenia) among older patients with OD associated with either chronic or acute conditions is very high. In patients with OD and chronic diseases, poor nutritional status further impairs OD with an increase in oropharyngeal residue at spoon-thick viscosity. In the acute setting there is inflammation and an additional protein deficiency. These findings will help develop specific products both for OD and nutritional status in each specific clinical situation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights

  2. RELATION BETWEEN LATENT SPECIFIC MOTOR ABILITIES AND SITUATION MOTOR SKILLS WITH VOLLEYBALL PLAYERS AGED FROM 16 TO 17

    Directory of Open Access Journals (Sweden)

    Rabit Veseli

    2015-05-01

    Full Text Available The game of volleyball with its dynamic character is present in the world of the sport with permanent development and growing popularity and fans. Volleyball is part of a pollystructural complex sports activities. It is performed on a ground of a relatively small size (18 x 9 meters and is a kind of game that requires of players a high level of advanced motoric abilities (speed, strength, endurance, a fast rate of visual reaction, explosivity, as well as specific motoric skills (precision etc.. Scientific conclusion as well as the growing number of conducted researches in the very game, have a real contribution to its modern development and level of popularity. Situation-motoric skills make a significant dimension in the structure of volleyball game. The subject of the research is specific-motoric abilities and situation-motoric skills of 52 volleyball players aged from 16 to 17. The basic goal of the research is to establish the effect of specific-motoric abilities on situation-motoric skills of volleyball players in latent space. In order to assess the specific-motoric abilities 9 tests are used, and to assess the situation-motoric skills 3 precision tests are used. The results obtained from the 12 applied tests are worked out through the basic statistic parameters. Through component factor analysis 3 latent specific-motoric dimensions are isolated as well as one situation-motoric dimension. By regressive analysis there is established a low but statistically significant relation between the criterion and predictor latent dimensions. That confirms the dependence and relation between the specific-motoric abilities and situation-motoric skills. Researches in the fi eld of similar questions have been conducted by the following authors: Jurko et al., 2013 and Nešić, et al., 2011.

  3. Current situation of hospital-based endocrinology and clinical nutrition in Spain.

    Science.gov (United States)

    Angeles Gálvez Moreno, M

    2008-01-01

    In 2006, the Healthcare Commission of Spanish Society of Endocrinology and Nutrition did a survey in order to know the actual situation of endocrinology and clinical nutrition healthcare in Public Sanitary Systems in Spain. The survey has been more extensive than the last and it has taken up number and geographical distribution of specialists in Spain in addition to data about clinical assistance. The mean of public hospitals with endocrinologist participation has been 50%. Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.

  4. Positive results of clinical educational support in situations of psychological distress.

    Science.gov (United States)

    Tavormina, Dominique

    2014-11-01

    Education is a complex process that involves the individual in the course of his entire life and leads to the maturation and the overall development of his personality. The educational process involves the complete growth of each and completes the infinite possibilities that every child has potential since birth. Education also is a necessity for the human being, as only adequate environmental stimulation causes the mental processes to begin. In fact, the higher intellectual functions, such as language, thought, memory, emerge only from social and educational experiences of the child. The educational surgery creates experiences and learning that allow the person to change by improving the efficiency of synaptic connections. Clinical pedagogy has developed in Italy in the last decades of the twentieth century with the aim of research and experimenting educational purposes suitable for different situations in order to provide each subject with appropriate development opportunities. Clinical pedagogical support is offered in the form of artistic or bodily activities and represents for the individual a positive environment that allows the development of different brain areas and the potential inherent in them. The various methods are suitable for any situation of existential discomfort, which are understood as moments of personal growth.

  5. Development of a situation-specific theory for explaining health-related quality of life among older South Korean adults with type 2 diabetes.

    Science.gov (United States)

    Chang, Sun Ju; Im, Eun-Ok

    2014-01-01

    The purpose of the study was to develop a situation-specific theory for explaining health-related quality of life (QOL) among older South Korean adults with type 2 diabetes. To develop a situation-specific theory, three sources were considered: (a) the conceptual model of health promotion and QOL for people with chronic and disabling conditions (an existing theory related to the QOL in patients with chronic diseases); (b) a literature review using multiple databases including Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and two Korean databases; and (c) findings from our structural equation modeling study on health-related QOL in older South Korean adults with type 2 diabetes. The proposed situation-specific theory is constructed with six major concepts including barriers, resources, perceptual factors, psychosocial factors, health-promoting behaviors, and health-related QOL. The theory also provides the interrelationships among concepts. Health care providers and nurses could incorporate the proposed situation-specific theory into development of diabetes education programs for improving health-related QOL in older South Korean adults with type 2 diabetes.

  6. The Situation-Specific Theory of Heart Failure Self-Care: Revised and Updated.

    Science.gov (United States)

    Riegel, Barbara; Dickson, Victoria Vaughan; Faulkner, Kenneth M

    2016-01-01

    Since the situation-specific theory of heart failure (HF) self-care was published in 2008, we have learned much about how and why patients with HF take care of themselves. This knowledge was used to revise and update the theory. The purpose of this article was to describe the revised, updated situation-specific theory of HF self-care. Three major revisions were made to the existing theory: (1) a new theoretical concept reflecting the process of symptom perception was added; (2) each self-care process now involves both autonomous and consultative elements; and (3) a closer link between the self-care processes and the naturalistic decision-making process is described. In the revised theory, HF self-care is defined as a naturalistic decision-making process with person, problem, and environmental factors that influence the everyday decisions made by patients and the self-care actions taken. The first self-care process, maintenance, captures those behaviors typically referred to as treatment adherence. The second self-care process, symptom perception, involves body listening, monitoring signs, as well as recognition, interpretation, and labeling of symptoms. The third self-care process, management, is the response to symptoms when they occur. A total of 5 assumptions and 8 testable propositions are specified in this revised theory. Prior research illustrates that all 3 self-care processes (ie, maintenance, symptom perception, and management) are integral to self-care. Further research is greatly needed to identify how best to help patients become experts in HF self-care.

  7. Lexical spelling in children and adolescents with specific language impairment: variations with the writing situation.

    Science.gov (United States)

    Broc, Lucie; Bernicot, Josie; Olive, Thierry; Favart, Monik; Reilly, Judy; Quémart, Pauline; Uzé, Joël

    2013-10-01

    The goal of this study was to compare the lexical spelling performance of children and adolescents with specific language impairment (SLI) in two contrasting writing situations: a dictation of isolated words (a classic evaluative situation) and a narrative of a personal event (a communicative situation). Twenty-four children with SLI and 48 typically developing children participated in the study, split into two age groups: 7-11 and 12-18 years of age. Although participants with SLI made more spelling errors per word than typically developing participants of the same chronological age, there was a smaller difference between the two groups in the narratives than in the dictations. Two of the findings are particularly noteworthy: (1) Between 12 and 18 years of age, in communicative narration, the number of spelling errors of the SLI group was not different from that of the typically developing group. (2) In communicative narration, the participants with SLI did not make specific spelling errors (phonologically unacceptable), contrary to what was shown in the dictation. From an educational perspective or that of a remediation program, it must be stressed that the communicative narration provides children-and especially adolescents-with SLI an opportunity to demonstrate their improved lexical spelling abilities. Furthermore, the results encourage long-term lexical spelling education, as adolescents with SLI continue to show improvement between 12 and 18 years of age. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Situational Method Engineering

    OpenAIRE

    Henderson-Sellers, Brian; Ralyte, Jolita; Par, Agerfalk; Rossi, Matti

    2014-01-01

    While previously available methodologies for software – like those published in the early days of object technology – claimed to be appropriate for every conceivable project, situational method engineering (SME) acknowledges that most projects typically have individual characteristics and situations. Thus, finding the most effective methodology for a particular project needs specific tailoring to that situation. Such a tailored software development methodology needs to take into account all t...

  9. Articular dysfunction patterns in patients with mechanical neck pain: a clinical algorithm to guide specific mobilization and manipulation techniques.

    Science.gov (United States)

    Dewitte, Vincent; Beernaert, Axel; Vanthillo, Bart; Barbe, Tom; Danneels, Lieven; Cagnie, Barbara

    2014-02-01

    In view of a didactical approach for teaching cervical mobilization and manipulation techniques to students as well as their use in daily practice, it is mandatory to acquire sound clinical reasoning to optimally apply advanced technical skills. The aim of this Masterclass is to present a clinical algorithm to guide (novice) therapists in their clinical reasoning to identify patients who are likely to respond to mobilization and/or manipulation. The presented clinical reasoning process is situated within the context of pain mechanisms and is narrowed to and applicable in patients with a dominant input pain mechanism. Based on key features in subjective and clinical examination, patients with mechanical nociceptive pain probably arising from articular structures can be categorized into specific articular dysfunction patterns. Pending on these patterns, specific mobilization and manipulation techniques are warranted. The proposed patterns are illustrated in 3 case studies. This clinical algorithm is the corollary of empirical expertise and is complemented by in-depth discussions and knowledge exchange with international colleagues. Consequently, it is intended that a carefully targeted approach contributes to an increase in specificity and safety in the use of cervical mobilizations and manipulation techniques as valuable adjuncts to other manual therapy modalities. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. [Clinical research outside of teaching hospitals: Current situation in north-eastern France].

    Science.gov (United States)

    Goetz, C; Dupoux, A; Déloy, L; Hertz, C; Jeanmaire, T; Parneix, N

    2015-04-01

    Most clinical research in France takes place in teaching hospitals. There are, however, many advantages to developing it in other hospitals: access to innovative treatments, improvement in healthcare quality, attractiveness of hospitals, increased trial inclusion rates and reduced selection bias. The objectives of our study were to report on the current situation of clinical research outside teaching hospitals. A three-stage survey was conducted between January 2012 and May 2013 in non-teaching hospitals of north-eastern France. First, questionnaires were sent to administrative and medical boards of all hospitals with more than 100 beds, then to head doctors of every department in hospitals with more than 300 beds and finally meetings were organized with members of 20 selected hospitals. The administrative and medical boards of 85 hospitals participated in the first stage of the survey; half of these hospitals were engaged in clinical research activities and for 10 the internal structuring was cross-disciplinary. Answers from 178 departments were obtained during the second stage; 47% reported a clinical research activity. Meetings with research teams in 20 hospitals allowed us to identify difficulties concerning research funding, transversal organization and sponsoring. Clinical research existed in more than half of the respondent non-teaching hospitals. Obstacles to its development can be grouped in three categories: 1) internal structuring of clinical research, 2) access to information and knowledge of how clinical research functions and to interlocutors outside the hospital and 3) access to skills necessary to sponsor clinical research. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Situational method engineering

    CERN Document Server

    Henderson-Sellers, Brian; Ågerfalk, Pär J; Rossi, Matti

    2014-01-01

    While previously available methodologies for software ? like those published in the early days of object technology ? claimed to be appropriate for every conceivable project, situational method engineering (SME) acknowledges that most projects typically have individual characteristics and situations. Thus, finding the most effective methodology for a particular project needs specific tailoring to that situation. Such a tailored software development methodology needs to take into account all the bits and pieces needed for an organization to develop software, including the software process, the

  12. Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions

    International Nuclear Information System (INIS)

    Ba-Ssalamah, Ahmed; Uffmann, Martin; Bastati, Nina; Herold, Christian; Schima, Wolfgang; Saini, Sanjai

    2009-01-01

    Screening of the liver for hepatic lesion detection and characterization is usually performed with either ultrasound or CT. However, both techniques are suboptimal for liver lesion characterization and magnetic resonance (MR) imaging has emerged as the preferred radiological investigation. In addition to unenhanced MR imaging techniques, contrast-enhanced MR imaging can demonstrate tissue-specific physiological information, thereby facilitating liver lesion characterization. Currently, the classes of contrast agents available for MR imaging of the liver include non-tissue-specific extracellular gadolinium chelates and tissue-specific hepatobiliary or reticuloendothelial agents. In this review, we describe the MR features of the more common focal hepatic lesions, as well as appropriate imaging protocols. A special emphasis is placed on the clinical use of non-specific and liver-specific contrast agents for differentiation of focal liver lesions. This may aid in the accurate diagnostic workup of patients in order to avoid invasive procedures, such as biopsy, for lesion characterization. A diagnostic strategy that considers the clinical situation is also presented. (orig.)

  13. Can teamwork and situational awareness (SA) in ED resuscitations be improved with a technological cognitive aid? Design and a pilot study of a team situation display.

    Science.gov (United States)

    Parush, A; Mastoras, G; Bhandari, A; Momtahan, K; Day, K; Weitzman, B; Sohmer, B; Cwinn, A; Hamstra, S J; Calder, L

    2017-12-01

    Effective teamwork in ED resuscitations, including information sharing and situational awareness, could be degraded. Technological cognitive aids can facilitate effective teamwork. This study focused on the design of an ED situation display and pilot test its influence on teamwork and situational awareness during simulated resuscitation scenarios. The display design consisted of a central area showing the critical dynamic parameters of the interventions with an events time-line below it. Static information was placed at the sides of the display. We pilot tested whether the situation display could lead to higher scores on the Clinical Teamwork Scale (CTS), improved scores on a context-specific Situational Awareness Global Assessment Technique (SAGAT) tool, and team communication patterns that reflect teamwork and situational awareness. Resuscitation teamwork, as measured by the CTS, was overall better with the presence of the situation display as compared with no situation display. Team members discussed interventions more with the situation display compared with not having the situation display. Situational awareness was better with the situation display only in the trauma scenario. The situation display could be more effective for certain ED team members and in certain cases. Overall, this pilot study implies that a situation display could facilitate better teamwork and team communication in the resuscitation event. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. 'What the hell is water?' How to use deliberate clinical inertia in common emergency department situations.

    Science.gov (United States)

    Egerton-Warburton, Diana; Cullen, Louise; Keijzers, Gerben; Fatovich, Daniel M

    2018-06-01

    Appropriate deliberate clinical inertia refers to the art of doing nothing as a positive clinical response. It includes shared decision-making to improve patient care with the use of clinical judgement. We discuss common clinical scenarios where the use of deliberate clinical inertia can occur. The insertion of peripheral intravenous cannulae, investigating patients with suspected renal colic and the investigation of low risk chest pain are all opportunities for the thoughtful clinician to 'stand there' and use effective patient communication to avoid low value tests and procedures. Awareness is key to identifying these opportunities to practice deliberate clinical inertia, as many of the situations may be so much a part of our environment that they are hidden in plain view. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. 'Oh my God, I can't handle this!': trainees' emotional responses to complex situations.

    Science.gov (United States)

    Helmich, Esther; Diachun, Laura; Joseph, Radha; LaDonna, Kori; Noeverman-Poel, Nelleke; Lingard, Lorelei; Cristancho, Sayra

    2018-02-01

    Dealing with emotions is critical for medical trainees' professional development. Taking a sociocultural and narrative approach to understanding emotions, we studied complex clinical situations as a specific context in which emotions are evoked and influenced by the social environment. We sought to understand how medical trainees respond to emotions that arise in those situations. In an international constructivist grounded theory study, 29 trainees drew two rich pictures of complex clinical situations, one exciting and one frustrating. Rich pictures are visual representations that capture participants' perceptions about the people, situations and factors that create clinical complexity. These pictures were used to guide semi-structured, individual interviews. We analysed visual materials and interviews in an integrated way, starting with looking at the drawings, doing a 'gallery walk', and using the interviews to inform the aesthetic analysis. Participants' drawings depicted a range of personal emotions in response to complexity, and disclosed unsettling feelings and behaviours that might be considered unprofessional. When trainees felt confident, they were actively participating, engaged in creative problem-solving strategies, and emphasised their personal involvement. When trainees felt the situation was beyond their control, they described how they were running away from the situation, hiding themselves behind others or distancing themselves from patients or families. A sense of control seems to be a key factor influencing trainees' emotional and behavioural responses to complexity. This is problematic, as complex situations are by their nature emergent and dynamic, which limits possibilities for control. Following a social performative approach to emotions, we should help students understand that feeling out of control is an inherent property of participating in complex clinical situations, and, by extension, that it is not something they will 'grow out of

  16. "Oh my God, I can't handle this!' : trainees' emotional responses to complex situations

    NARCIS (Netherlands)

    Helmich, Esther; Diachun, Laura; Joseph, Radha; LaDonna, Kori; Noeverman-Poel, Nelleke; Lingard, Lorelei; Cristancho, Sayra

    ContextDealing with emotions is critical for medical trainees' professional development. Taking a sociocultural and narrative approach to understanding emotions, we studied complex clinical situations as a specific context in which emotions are evoked and influenced by the social environment. We

  17. Is it really not possible to use electronic personal dosimeters in clinical exposure situations?

    International Nuclear Information System (INIS)

    Borowski, M.; Poppe, B.; Looe, H.K.; Boetticher, H. von

    2010-01-01

    Purpose: Due to significant measuring inaccuracies that can occur under certain conditions, the use of electronic personal dosimeters in statutory measurements in X-ray diagnostics is currently legally restricted. The present study investigates the clinically relevant situations in which measurement errors of more then 20 % can be anticipated. Materials and Methods: Four series of experiments were made, comparing the results of the electronic personal dosimeter EPD Mk2.3 to those of reference dosimeters (TLDs and diagnostic dosimeters). On the one hand, personal doses have been determined in the routine operation of controlled areas in various departments. On the other hand, measurements on phantoms have been conducted in extreme but realistic situations under radiation protection. Experiments were conducted in unweakened scattered radiation as well as in unattenuated and attenuated direct radiation. Results: The tested electronic personal dosimeter type meets the requirements regarding measurement accuracy for 'official' personal dosimeters in all of the examined clinically relevant scattered radiation fields. Only if exposed to radiation directly, an underestimation of the dose can occur and can be greater than 90 %. Conclusion: In the range of scattered radiation of diagnostic X-ray equipment, even in pulsed fields, the use of electronic personal dosimeters is reasonable. Considerable measurement errors can only arise in radiation fields that are not realistic under regular conditions and even in connection with most accidents. (orig.)

  18. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations with staff during clinical placement: A qualitative study.

    Science.gov (United States)

    McCloughen, Andrea; Foster, Kim

    2017-04-20

    To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations. Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences and development of effective relationships. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations is not well known. A qualitative design, using semi-structured interviews to explore experiences of challenging interpersonal situations during clinical placement (Phase two of a larger mixed-methods study). Final-year Australian university nursing and pharmacy students (n = 20) were purposefully recruited using a range of Emotional Intelligence scores (derived in Phase one), measured using the GENOS Emotional intelligence Inventory (concise version). Challenging interpersonal situations involving student-staff and intrastaff conflict, discourteous behaviour and criticism occurred during clinical placement. Students used personal and relational strategies, incorporating emotionally intelligent behaviours, to manage these encounters. Strategies included reflecting and reframing, being calm, controlling discomfort and expressing emotions appropriately. Emotionally intelligent behaviours are effective to manage stressful interpersonal interactions. Methods for strengthening these behaviours should be integrated into education of nursing and pharmacy students and qualified professionals. Education within the clinical/workplace environment can incorporate key interpersonal skills of collaboration, social interaction and reflection, while also attending to sociocultural contexts of the healthcare setting. Students and staff are frequently exposed

  19. Emotion regulation through listening to music in everyday situations.

    Science.gov (United States)

    Thoma, Myriam V; Ryf, Stefan; Mohiyeddini, Changiz; Ehlert, Ulrike; Nater, Urs M

    2012-01-01

    Music is a stimulus capable of triggering an array of basic and complex emotions. We investigated whether and how individuals employ music to induce specific emotional states in everyday situations for the purpose of emotion regulation. Furthermore, we wanted to examine whether specific emotion-regulation styles influence music selection in specific situations. Participants indicated how likely it would be that they would want to listen to various pieces of music (which are known to elicit specific emotions) in various emotional situations. Data analyses by means of non-metric multidimensional scaling revealed a clear preference for pieces of music that were emotionally congruent with an emotional situation. In addition, we found that specific emotion-regulation styles might influence the selection of pieces of music characterised by specific emotions. Our findings demonstrate emotion-congruent music selection and highlight the important role of specific emotion-regulation styles in the selection of music in everyday situations.

  20. Weed control by direct injection of plant protection products according to specific situations

    Directory of Open Access Journals (Sweden)

    Krebs, Mathias

    2016-02-01

    Full Text Available Precision Farming in agriculture allows a site-specific management of the crop. The aim of plant protection is to apply plant protection products (PPP according to the site specific requirements on the field. Within the context of a research program to promote innovation, a sprayer with direct injection of plant protection products was developed. The direct injection offers site specific spraying of different individual PPP in a single pass. The sprayer prototype is equipped with a special spray boom combining three nozzle lines. In order to prevent delay times, the nozzle lines are preloaded before spraying. First results for weed control from test stand measurements and field trials showed that the injection pumps work with high accuracy. The prototype can be used without delay times site specific with up to three different herbicides. Field trials for site-specific weed control in winter wheat demonstrate the applicability of the system under practical conditions. By treatment of subareas herbicides and therefore costs could be saved. A reduction in yield compared with the conventionally treated field areas could not be ascertained. Also an efficacy reduction through washout of active ingredient from target surfaces due to simultaneous use of all three nozzle lines with up to 1050 l/ha application rate could not be detected. At high water spray rates, the efficacy effect occurs delayed. Overall, the newly developed direct injection system proved fieldabillity during the first tests. So weed control can be carried out situation-responsive, which can save herbicides and environmental impacts are reduced.

  1. The current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture

    International Nuclear Information System (INIS)

    Wang Luchang; Wu Chungen; Cheng Yongde

    2011-01-01

    As an effective, safe and less-invasive technique in interventional radiology, percutaneous vertebroplasty has satisfactory therapeutic results with fewer complications in treating osteoporosis vertebral compression fracture. This paper aims to make a comprehensive review of the current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture. (authors)

  2. Building shared situational awareness in surgery through distributed dialog

    Directory of Open Access Journals (Sweden)

    Gillespie BM

    2013-03-01

    Full Text Available Brigid M Gillespie,1 Karleen Gwinner,2 Nicole Fairweather,3 Wendy Chaboyer41NHMRC Research Centre for Clinical Excellence in Nursing Interventions for Hospitalised Patients (NCREN and Research Centre for Clinical and Community Practice Innovation (RCCCPI, Griffith Health Institute, Griffith University, Queensland, 2Griffith Centre for Cultural Research, Griffith University, Queensland, 3Department of Anaesthesiology, Princess Alexandra Hospital, Queensland, Australia, 4Excellence in Nursing Interventions for Hospitalized Patients (NCREN Research Centre for Clinical and Community Practice INHMRC Centre of Research Innovation (RCCCPI, Griffith Health Institute, Griffith University Queensland, AustraliaBackground: Failure to convey time-critical information to team members during surgery diminishes members' perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness.Methods: Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semistructured interviews were performed with 24 participants from anesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used.Results: The domain "coordinating decisions in surgery" was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, ie, synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority.Conclusion: Strategies used to convey decisions that enhanced shared situational awareness included the use of "self-talk", closed-loop communications, and

  3. Development of the Huddle Observation Tool for structured case management discussions to improve situation awareness on inpatient clinical wards.

    Science.gov (United States)

    Edbrooke-Childs, Julian; Hayes, Jacqueline; Sharples, Evelyn; Gondek, Dawid; Stapley, Emily; Sevdalis, Nick; Lachman, Peter; Deighton, Jessica

    2018-05-01

    'Situation Awareness For Everyone' (SAFE) was a 3-year project which aimed to improve situation awareness in clinical teams in order to detect potential deterioration and other potential risks to children on hospital wards. The key intervention was the 'huddle', a structured case management discussion which is central to facilitating situation awareness. This study aimed to develop an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. A cross-sectional observational design was used to psychometrically develop the 'Huddle Observation Tool' (HOT) over three phases using standardised psychometric methodology. Huddles were observed across four NHS paediatric wards participating in SAFE by five researchers; two wards within specialist children hospitals and two within district general hospitals, with location, number of beds and length of stay considered to make the sample as heterogeneous as possible. Inter-rater reliability was calculated using the weighted kappa and intraclass correlation coefficient. Inter - rater reliability was acceptable for the collaborative culture (weighted kappa=0.32, 95% CI 0.17 to 0.42), environment items (weighted kappa=0.78, 95% CI 0.52 to 1) and total score (intraclass correlation coefficient=0.87, 95% CI 0.68 to 0.95). It was lower for the structure and risk management items, suggesting that these were more variable in how observers rated them. However, agreement on the global score for huddles was acceptable. We developed an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Future research should examine whether observational evaluations of huddles are associated with other indicators of safety on clinical wards (eg, safety climate and incidents of patient harm), and whether scores on the HOT are associated with improved situation awareness and reductions in deterioration and adverse

  4. Situated cognition in clinical visualization: the role of transparency in GammaKnife neurosurgery planning.

    Science.gov (United States)

    Dinka, David; Nyce, James M; Timpka, Toomas

    2009-06-01

    The aim of this study was to investigate how the clinical use of visualization technology can be advanced by the application of a situated cognition perspective. The data were collected in the GammaKnife radiosurgery setting and analyzed using qualitative methods. Observations and in-depth interviews with neurosurgeons and physicists were performed at three clinics using the Leksell GammaKnife. The users' ability to perform cognitive tasks was found to be reduced each time visualizations incongruent with the particular user's perception of clinical reality were used. The main issue here was a lack of transparency, i.e. a black box problem where machine representations "stood between" users and the cognitive tasks they wanted to perform. For neurosurgeons, transparency meant their previous experience from traditional surgery could be applied, i.e. that they were not forced to perform additional cognitive work. From the view of the physicists, on the other hand, the concept of transparency was associated with mathematical precision and avoiding creating a cognitive distance between basic patient data and what is experienced as clinical reality. The physicists approached clinical visualization technology as though it was a laboratory apparatus--one that required continual adjustment and assessment in order to "capture" a quantitative clinical reality. Designers of visualization technology need to compare the cognitive interpretations generated by the new visualization systems to conceptions generated during "traditional" clinical work. This means that the viewpoint of different clinical user groups involved in a given clinical task would have to be taken into account as well. A way forward would be to acknowledge that visualization is a socio-cognitive function that has practice-based antecedents and consequences, and to reconsider what analytical and scientific challenges this presents us with.

  5. Sensitivity and Specificity of Clinical and Laboratory Otolith Function Tests.

    Science.gov (United States)

    Kumar, Lokesh; Thakar, Alok; Thakur, Bhaskar; Sikka, Kapil

    2017-10-01

    To evaluate clinic based and laboratory tests of otolith function for their sensitivity and specificity in demarcating unilateral compensated complete vestibular deficit from normal. Prospective cross-sectional study. Tertiary care hospital vestibular physiology laboratory. Control group-30 healthy adults, 20-45 years age; Case group-15 subjects post vestibular shwannoma excision or post-labyrinthectomy with compensated unilateral complete audio-vestibular loss. Otolith function evaluation by precise clinical testing (head tilt test-HTT; subjective visual vertical-SVV) and laboratory testing (headroll-eye counterroll-HR-ECR; vesibular evoked myogenic potentials-cVEMP). Sensitivity and specificity of clinical and laboratory tests in differentiating case and control subjects. Measurable test results were universally obtained with clinical otolith tests (SVV; HTT) but not with laboratory tests. The HR-ECR test did not indicate any definitive wave forms in 10% controls and 26% cases. cVEMP responses were absent in 10% controls.HTT test with normative cutoff at 2 degrees deviations from vertical noted as 93.33% sensitive and 100% specific. SVV test with normative cutoff at 1.3 degrees noted as 100% sensitive and 100% specific. Laboratory tests demonstrated poorer specificities owing primarily to significant unresponsiveness in normal controls. Clinical otolith function tests, if conducted with precision, demonstrate greater ability than laboratory testing in discriminating normal controls from cases with unilateral complete compensated vestibular dysfunction.

  6. The situational interest of undergraduate students in zoophysiology

    DEFF Research Database (Denmark)

    Dohn, Niels Bonderup; Madsen, Peter Teglberg; Malte, H.

    2009-01-01

    Situational interest has been identified as an important motivational variable that has an impact on students' academic performances, yet little is known about how the specific variable of the learning environment might trigger students' situational interest. The purpose of this study...... of the faculty and should be considered when planning instruction. By focusing on the enhancement of situational interest in physiology lessons, faculty members can find ways to foster students' involvement in specific content areas and increase levels of academic motivation...

  7. Disciplining behavior of dog owners in problem situations: The factorial structure

    NARCIS (Netherlands)

    Ben Michael-Steinberg, Judith; Korzilius, H.P.L.M.; Vossen, J.M.H.; Felling, A.J.A.

    2000-01-01

    The purpose of the study was to investigate the magnitude and structure of situation-specific owner emotions and behavioral reactions in problematic situations involving a dog. The following questions were addressed: 1. What is the magnitude of situation-specific owner emotions and reactions in a

  8. Comparative clinical evaluation of removable partial dentures made of two different materials in Kennedy Applegate class II partially edentulous situation.

    Science.gov (United States)

    Hundal, Maninder; Madan, Rajesh

    2015-12-01

    Cast Chromium Cobalt alloy has been the material of choice for fabricating Removable Partial Dentures (RPDs) but has certain drawbacks. Newer materials like the flexible Nylon based Super Polyamide have been introduced to overcome these drawbacks. The present study has compared the above two materials for nine clinical parameters. The study was carried out on 30 patients presenting with a Kennedy Applegate class II partially edentulous situation who were divided into two equal groups and clinically assessed. Statistically significant results were obtained in favor of flexible RPDs, in the parameters of 'aesthetics' and 'overall patient satisfaction'. Both groups showed more or less similar values for 'frequency of fracture of the prosthesis during usage' with the incidence being slightly higher for patients wearing the cast RPDs. The clinical parameters of 'oral soft tissue tolerance', 'gingival health', 'periodontal health' and 'adaptability in areas with undercut' were statistically at par for all the 30 patients thus suggesting the comparable biocompatibility of the two materials. The highlight of this study was the relative ease in fabrication of the flexible RPDs as compared to the cast RPDs. Based on the favorable clinical results of this study, it can be summarized that the flexible RPDs is a viable alternative to cast RPDs in Kennedy Applegate class II partially edentulous situation in the short term.

  9. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy

    DEFF Research Database (Denmark)

    Khinchi, M S; Poulsen, Lars K.; Carat, F

    2004-01-01

    Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed.......Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed....

  10. A methodology for evaluation of a markup-based specification of clinical guidelines.

    Science.gov (United States)

    Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

    2008-11-06

    We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers, and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains with encouraging results.

  11. Learning Situations in Nursing Education: A Concept Analysis.

    Science.gov (United States)

    Shahsavari, Hooman; Zare, Zahra; Parsa-Yekta, Zohreh; Griffiths, Pauline; Vaismoradi, Mojtaba

    2018-02-01

    acknowledge that the application of this concept will include the student's clinical learning experiences. More studies are required to determine factors influencing the creation of a successful learning situation from the perspectives of nurse educators and nursing students, clinical nurses and patients.

  12. Donor-specific rejection: Clinical and scan correlation

    International Nuclear Information System (INIS)

    Wilson, M.A.; Mehta, R.C.; Perlman, S.B.; Servilla, K.; Sollinger, H.W.; Deierhoi, M.H.; Belzer, F.O.

    1986-01-01

    All 470 scans on 132 consecutive renal transplantation patients were reviewed. Scan patterns identified included acute tubular necrosis and conventional rejection. A new pattern, donor specific rejection (DSR), was identified in 24 of 42 patients on the living related donor specific transfusion (DST) protocol. This was characterized by good perfusion and extraction but significant renal stasis of tracer. This pattern was unique to the DST recipients and improved with antirejection therapy. The clinical features (incidence, temporal onset) and severity (duration, serum creatinines) are compared in these patient populations. DSR occurs more frequently than conventional rejection but is a milder process

  13. Consequences of contextual factors on clinical reasoning in resident physicians

    NARCIS (Netherlands)

    McBee, E.; Ratcliffe, T.; Picho, K.; Artino, A.R.; Schuwirth, L.; Kelly, W.; Masel, J.; Vleuten, C. van der; Durning, S.J.

    2015-01-01

    Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe

  14. Performance specifications and six sigma theory: Clinical chemistry and industry compared.

    Science.gov (United States)

    Oosterhuis, W P; Severens, M J M J

    2018-04-11

    Analytical performance specifications are crucial in test development and quality control. Although consensus has been reached on the use of biological variation to derive these specifications, no consensus has been reached which model should be preferred. The Six Sigma concept is widely applied in industry for quality specifications of products and can well be compared with Six Sigma models in clinical chemistry. However, the models for measurement specifications differ considerably between both fields: where the sigma metric is used in clinical chemistry, in industry the Number of Distinct Categories is used instead. In this study the models in both fields are compared and discussed. Copyright © 2018. Published by Elsevier Inc.

  15. An Automated System for Generating Situation-Specific Decision Support in Clinical Order Entry from Local Empirical Data

    Science.gov (United States)

    Klann, Jeffrey G.

    2011-01-01

    Clinical Decision Support is one of the only aspects of health information technology that has demonstrated decreased costs and increased quality in healthcare delivery, yet it is extremely expensive and time-consuming to create, maintain, and localize. Consequently, a majority of health care systems do not utilize it, and even when it is…

  16. Cyber defense and situational awareness

    CERN Document Server

    Kott, Alexander; Erbacher, Robert F

    2015-01-01

    This book is the first publication to give a comprehensive, structured treatment to the important topic of situational awareness in cyber defense. It presents the subject in a logical, consistent, continuous discourse, covering key topics such as formation of cyber situational awareness, visualization and human factors, automated learning and inference, use of ontologies and metrics, predicting and assessing impact of cyber attacks, and achieving resilience of cyber and physical mission. Chapters include case studies, recent research results and practical insights described specifically for th

  17. Specific phobias in older adults: characteristics and differential diagnosis.

    Science.gov (United States)

    Coelho, Carlos M; Gonçalves, Daniela C; Purkis, Helena; Pocinho, Margarida; Pachana, Nancy A; Byrne, Gerard J

    2010-08-01

    Differential diagnosis implies identifying shared and divergent characteristics between clinical states. Clinical work with older adults demands not only the knowledge of nosological features associated with differential diagnosis, but also recognition of idiosyncratic factors associated with this population. Several factors can interfere with an accurate diagnosis of specific phobia in older cohorts. The goal of this paper is to review criteria for specific phobia and its differential diagnosis with panic disorder, agoraphobia, post-traumatic stress disorder and obsessive compulsive disorder, while stressing the specific factors associated with aging. A literature search regarding specific phobia in older adults was carried out using PubMed. Relevant articles were selected and scanned for further pertinent references. In addition, relevant references related to differential diagnosis and assessment were used. Etiologic factors, specificity of feared stimulus or situation, fear predictability and the nature of phobic situations are key points to be assessed when implementing a differential diagnosis of specific phobia. First, age-related sensory impairments are common and interfere both with information processing and communication. Second, medical illnesses create symptoms that might cause, interfere with, or mimic anxiety. Third, cohort effects might result in underreporting, through the inability to communicate or recognize anxiety symptoms, misattributing them to physical conditions. Finally, diagnostic criteria and screening instruments were usually developed using younger samples and are therefore not adapted to the functional and behavioral characteristics of older samples.

  18. Birth Order, Gender and Affiliation in Various Situations.

    Science.gov (United States)

    Fox, Shaul

    1981-01-01

    Administered two questionnaires to 800 Israeli subjects which examine the affiliation need in four groups of situations. No differences were found between first and later-borns in their tendency to associate with others. Results showed significant interaction between sex and specific situational factors. (Author/RC)

  19. Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa.

    Science.gov (United States)

    Nadri, Johara; Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Baltazar, Cynthia S; Banla Kere, Abiba; Bwire, Godfrey; Coulibaly, Daouda; Kacou N'Douba, Adele; Kagirita, Atek; Keita, Sakoba; Koivogui, Lamine; Landoh, Dadja E; Langa, Jose P; Miwanda, Berthe N; Mutombo Ndongala, Guy; Mwakapeje, Elibariki R; Mwambeta, Jacob L; Mengel, Martin A; Gessner, Bradford D

    2018-04-01

    During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.

  20. Specific Gene Loci of Clinical Pseudomonas putida Isolates.

    Directory of Open Access Journals (Sweden)

    Lázaro Molina

    Full Text Available Pseudomonas putida are ubiquitous inhabitants of soils and clinical isolates of this species have been seldom described. Clinical isolates show significant variability in their ability to cause damage to hosts because some of them are able to modulate the host's immune response. In the current study, comparisons between the genomes of different clinical and environmental strains of P. putida were done to identify genetic clusters shared by clinical isolates that are not present in environmental isolates. We show that in clinical strains specific genes are mostly present on transposons, and that this set of genes exhibit high identity with genes found in pathogens and opportunistic pathogens. The set of genes prevalent in P. putida clinical isolates, and absent in environmental isolates, are related with survival under oxidative stress conditions, resistance against biocides, amino acid metabolism and toxin/antitoxin (TA systems. This set of functions have influence in colonization and survival within human tissues, since they avoid host immune response or enhance stress resistance. An in depth bioinformatic analysis was also carried out to identify genetic clusters that are exclusive to each of the clinical isolates and that correlate with phenotypical differences between them, a secretion system type III-like was found in one of these clinical strains, a determinant of pathogenicity in Gram-negative bacteria.

  1. [Advocating standardization and customization of corneal refractive surgery in Chinese domestic situation].

    Science.gov (United States)

    Zhang, F J; Song, Y Z

    2016-07-01

    With the improvement and application of excimer laser and femtosecond laser equipment in clinical ophthalmology, the diversified strategies for corneal refractive surgery candidates have been provided. Based on the trend of " all-laser treatment", it is very necessary to take the domestic situation into consideration when a standard and customized choice is made according to the indications of each specific surgical type. The characteristics and limitations of various surgeries are elucidated and commented here in order to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2016, 52: 481-485).

  2. Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

    Science.gov (United States)

    Halsey, Eric S.; Marks, Morgan A.; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Methodology and Principal Findings Between the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Conclusions/Significance Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype. PMID:22563516

  3. Correlation of serotype-specific dengue virus infection with clinical manifestations.

    Directory of Open Access Journals (Sweden)

    Eric S Halsey

    Full Text Available Disease caused by the dengue virus (DENV is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4 with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype.Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%, DENV-2 (4.3%, DENV-3 (41.5%, or DENV-4 (14.4%. When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations.Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

  4. Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

    Science.gov (United States)

    Mader, Luzius; Rueegg, Corina S; Vetsch, Janine; Rischewski, Johannes; Ansari, Marc; Kuehni, Claudia E; Michel, Gisela

    2016-01-01

    Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment. As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years). Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry. We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers). Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007). However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002), which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07) were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71) increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73) and >2 children (OR = 0.48, CI:0.30-0.75); and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36). Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education, additional

  5. Non-specific chronic orofacial pain patients' experiences of everyday life situations: a qualitative study.

    Science.gov (United States)

    Wolf, Eva; Nilner, Maria; Petersson, Kerstin

    2016-01-01

    Chronic orofacial pain is a complex condition with consequences that affect daily living. The aim was to analyse nonspecific chronic orofacial pain patients'experiences of everyday life situations, using a qualitative approach. Eleven women and 3 men (21 to 77years) were selected through a purposive sampling among chronic orofacial pain patients referred to the Faculty of Odontology's orofacial pain unit at Malmö University, Malmö Sweden. All selected subjects agreed to participate. Data were obtained via two thematic in-depth interviews with each subject. Interviews were taped and transcribed verbatim.Text dealing with the subjects' daily experiences was identified in all interviews and analysed using qualitative content analysis that focused on manifest content. In everyday life situations, the analysis of nonspecific chronic orofacial pain patients' narrations exposed a fear of conflict, of personal weakness, and of the intangible; they also exposed self-blame and avoidance of fear-triggering situations. Eight of the 14 subjects did not spontaneously mention any situation in which they were content during daily living. When the patients spoke about everyday life experiences, the main finding was that unpleasant emotions dominated the subjects'experiences. In conclusion, the chronic orofacial pain condition cannot be understood as an isolated phenomenon; it must be considered in rela- tion to the person who is suffering from the condition.

  6. Learning through Situated Innovation

    DEFF Research Database (Denmark)

    Dittrich, Yvonne; Eriksén, Sara; Wessels, Bridgette

    2014-01-01

    Specific, situated participatory design (PD) practices have always been at the heart of Participatory Design research. The role of the very situatedness and specificity of PD practice for theory-building within PD research is, however, seldom discussed explicitly. In this article, we explore why...... of such a pragmatic epistemology of PD on understanding and arguing for PD research approaches. These concepts are illustrated referring to PD practices as experienced in PD research projects. Our epistemological argumentation supports the emphasis on exploring new PD practices and learning and theorizing about PD...

  7. Digital map and situation surface: a team-oriented multidisplay workspace for network enabled situation analysis

    Science.gov (United States)

    Peinsipp-Byma, E.; Geisler, Jürgen; Bader, Thomas

    2009-05-01

    System concepts for network enabled image-based ISR (intelligence, surveillance, reconnaissance) is the major mission of Fraunhofer IITB's applied research in the area of defence and security solutions. For the TechDemo08 as part of the NATO CNAD POW Defence against terrorism Fraunhofer IITB advanced a new multi display concept to handle the shear amount and high complexity of ISR data acquired by networked, distributed surveillance systems with the objective to support the generation of a common situation picture. Amount and Complexity of ISR data demands an innovative man-machine interface concept for humans to deal with it. The IITB's concept is the Digital Map & Situation Surface. This concept offers to the user a coherent multi display environment combining a horizontal surface for the situation overview from the bird's eye view, an attached vertical display for collateral information and so-called foveatablets as personalized magic lenses in order to obtain high resolved and role-specific information about a focused areaof- interest and to interact with it. In the context of TechDemo08 the Digital Map & Situation Surface served as workspace for team-based situation visualization and analysis. Multiple sea- and landside surveillance components were connected to the system.

  8. Chimeric antigen receptor (CAR-specific monoclonal antibody to detect CD19-specific T cells in clinical trials.

    Directory of Open Access Journals (Sweden)

    Bipulendu Jena

    Full Text Available Clinical trials targeting CD19 on B-cell malignancies are underway with encouraging anti-tumor responses. Most infuse T cells genetically modified to express a chimeric antigen receptor (CAR with specificity derived from the scFv region of a CD19-specific mouse monoclonal antibody (mAb, clone FMC63. We describe a novel anti-idiotype monoclonal antibody (mAb to detect CD19-specific CAR(+ T cells before and after their adoptive transfer. This mouse mAb was generated by immunizing with a cellular vaccine expressing the antigen-recognition domain of FMC63. The specificity of the mAb (clone no. 136.20.1 was confined to the scFv region of the CAR as validated by inhibiting CAR-dependent lysis of CD19(+ tumor targets. This clone can be used to detect CD19-specific CAR(+ T cells in peripheral blood mononuclear cells at a sensitivity of 1∶1,000. In clinical settings the mAb is used to inform on the immunophenotype and persistence of administered CD19-specific T cells. Thus, our CD19-specific CAR mAb (clone no. 136.20.1 will be useful to investigators implementing CD19-specific CAR(+ T cells to treat B-lineage malignancies. The methodology described to develop a CAR-specific anti-idiotypic mAb could be extended to other gene therapy trials targeting different tumor associated antigens in the context of CAR-based adoptive T-cell therapy.

  9. Issues of damage estimation under radiation emergency situation

    International Nuclear Information System (INIS)

    Volobuev, P.V.; Kozlova, N.I.

    2005-01-01

    The specificity of social, economical and ecological consequences of major radiation emergency situation is considered in the paper. The definitions and structure of direct and indirect damage under radiation emergency situation are given. The priority components of immediate expenses and those of long-term living on the contaminated territories are considered in the paper. (author)

  10. The angiosome concept in clinical practice: implications for patient-specific recanalization procedures.

    Science.gov (United States)

    Brodmann, M

    2013-10-01

    Below-the-knee (BTK) disease with the clinical presentation of critical limb ischemia is associated with a high rate of limb loss due to minor and major amputations. The main problem is to find a way to optimize blood flow to the critical limb area. BTK joint the down-stream diverges into 3 arms which supply different areas. Different concepts exist how optimal blood flow to the critical ischemic areas BTK can be achieved, either by treating as many vessels as can be reopened by an endovascular procedure, or by going for the two main BTK vessels, or in an outstanding situation also to treat the inflow of collaterals to achieve as much blood flow down the foot as possible. Derived from plastic surgery for the purpose of healing of flaps, the angiosome concept has been developed. An angiosome is an anatomic unit of tissue (consisting of skin, subcutaneous tissue, fascia, muscle and bone) fed by a source artery and drained by specific veins. From that point of view it can be presumed that revascularization of the source artery to the angiosome might result in better wound healing and limb salvage rates. The angiosome treatment concept of BTK disease refers to the concept in cardiology, where discrimination of reversible ischemia areas is made and respective vessels leading to these areas are treated in a distinctive way.

  11. Associations between pathogen-specific clinical mastitis and somatic cell count patterns

    NARCIS (Netherlands)

    Haas, de Y.; Veerkamp, R.F.; Barkema, H.W.; Gröhn, Y.T.; Schukken, Y.H.

    2004-01-01

    Associations were estimated between pathogen-specific cases of clinical mastitis (CM) and somatic cell count (SCC) patterns based on deviations from the typical curve for SCC during lactation and compared with associations between pathogen-specific CM and lactation average SCC. Data from 274 Dutch

  12. Serum albumin: accuracy and clinical use.

    Science.gov (United States)

    Infusino, Ilenia; Panteghini, Mauro

    2013-04-18

    Albumin is the major plasma protein and its determination is used for the prognostic assessment of several diseases. Clinical guidelines call for monitoring of serum albumin with specific target cut-offs that are independent of the assay used. This requires accurate and equivalent results among different commercially available methods (i.e., result standardization) through a consistent definition and application of a reference measurement system. This should be associated with the definition of measurement uncertainty goals based on medical relevance of serum albumin to make results reliable for patient management. In this paper, we show that, in the current situation, if one applies analytical goals for serum albumin measurement derived from its biologic variation, the uncertainty budget derived from each step of the albumin traceability chain is probably too high to fulfil established quality levels for albumin measurement and to guarantee the accuracy needed for clinical usefulness of the test. The situation is further worsened if non-specific colorimetric methods are used for albumin measurement as they represent an additional random source of uncertainty. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. A Study on Situated Cognition: Product Dissection's Effect on Redesign Activities

    Science.gov (United States)

    Grantham, Katie; Okudan Kremer, Gül E.; Simpson, Timothy W.; Ashour, Omar

    2013-01-01

    Situated cognition theory describes the context of a learning activity's effect on learner's cognition. In this paper, we use situated cognition theory to examine the effect of product dissection on product redesign activities. Two specific research questions are addressed: 1) Does situated cognition, in the form of product dissection, improve…

  14. Aplicación del modelo de situación clínica a la consulta psicológica The "Clinical situation" Model as applied to psychological consultation

    Directory of Open Access Journals (Sweden)

    Pedro A Menéndez

    2006-12-01

    Full Text Available El presente proyecto se propone investigar la aplicación del modelo de situación clínica en la labor de consulta clínica psicológica. Por "situación clínica" entendemos la articulación de la diversidad de fenómenos que aparecen en la consulta. Supone semiología múltiple, epistemología convergente y actitud técnica dispuesta a la planificación y la interdisciplina. Corresponde al psicólogo clínico brindar una respuesta acorde a la consulta en términos comprensibles para el entrevistado. Se propone trabajar sobre lo volcado por los psicólogos clínicos (admisores y terapeutas en las entrevistas y en los informes correspondientes. Es éste un trabajo sobre las consecuencias que la comprensión en términos de"situación clínica" depara para quienes la aplican en la práctica por ellos reconocida en las admisiones y en el curso del proceso terapéutico. Es propósito de esta investigación trasladar los resultados a la actividad docente; situación clínica y consulta psicológica constituyen conceptos fundamentales de la técnica psicoterapéutica y de la actitud del profesional en su labor clínica.The present project delves into the applicability of the "Clinical Situation" model in the psychological consultation context. By "Clinical Situation" we mean articulation of the myriad phenomena appearing during consultation. It supposes a multiple semiology, converging epistemology and a technical attitude oriented towards planning and interdisciplinary work. The clinical psychologist must give a response that is in agreement with consultation, in terms that are understandable by the interviewed. We propose to work on direct transcriptions and reports of interviews by the clinical psychologists themselves, both on admissions and therapy. This means, this will be a report on the consequences that the understanding in terms of a "clinical situation" brings to those practicing it in admissions and during the therapeutic process. This

  15. The Role of MDMA (Ecstasy) in Coping with Negative Life Situations Among Urban Young Adults

    Science.gov (United States)

    Moonzwe, Lwendo S.; Schensul, Jean J.; Kostick, Kristin M.

    2011-01-01

    This article examines the role of Ecstasy (MDMA or 3, 4-methylenedioxymethamphetamine) as a drug used for self-medication and coping with both short- and long-term negative life situations. We show that urban youth who do not have a specific diagnosed mental illness are more likely than those who have been diagnosed and have received treatment to use Ecstasy to cope with both situational stress and lifetime trauma. Diagnosed and treated youth sometimes self-medicate with other drugs, but do not choose Ecstasy for mediation of their psychological stress. We discuss the implications of self-medication with Ecstasy for mental health services to urban youth experiencing mental health disparities, and for the continued testing and prescription of MDMA for therapeutic use in controlled clinical settings. PMID:22111403

  16. Analysis of application for situational teaching method in tourism English teaching

    Directory of Open Access Journals (Sweden)

    Li Jing

    2016-01-01

    Full Text Available Faced with China’s English teaching problems today, it is not enough to just know that the situational teaching method can be effectively applied in a wide range of English teaching, but there is a must to embody the specific application value of the situational teaching method. This paper first analyzes tourism English teaching in China through establishing the quantifiable group-index hierarchical structure model to obtain the optimal training program of China’s tourism English talents, and then carries out a detailed analysis of the application and role of the situational teaching method in training of the tourism English ability to obtain the specific application scope and application value of the situational teaching method in the tourism English teaching.

  17. Legal assessment of current situation on orphan patients in Lithuania.

    Science.gov (United States)

    Spokiene, Indre

    2008-01-01

    After Lithuania joined the European Union, the Regulation (EC) No. 141/2000 on orphan medicinal products and Commission Regulation (EC) No. 847/2000 came into force as part of national legislation. Member States must adopt specific measures to increase knowledge on rare diseases and to improve their detection, diagnosis, and treatment. The aim of this article was to present and to assess the current legal situation on orphan patients and their treatment in Lithuania, to identify legislation gaps, and to propose some ideas how to facilitate the solution of the existing problems in this field. For this purpose, European Union and Lithuanian legal documents on rare medicinal products are examined using a comparative method. With reference to inventory of Member States' incentives for rare diseases in national level, the most important issues, which orphan patients face to in Lithuania, are singled out. In Lithuania, the situation of orphan patients in terms of protection of patient rights is insufficiently determined. The access to effective health care services or approved therapies in some cases is restricted. Working relationships between genetic services and various clinical specialists as well as with those in primary care are not legally determined; the number of clinical trials aimed at orphan medicinal products is low. These results suggest a need for awareness raising among Lithuanian Government, health care specialists, patient organizations about the importance to improve practical implementation of European Union legislation and progressive experience of some European countries in this field.

  18. Malingering in clinical practice with specific reference to psychiatry ...

    African Journals Online (AJOL)

    Malingering in clinical practice with specific reference to psychiatry and psychology. Frans J Hugo, Frances Hemp. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers ...

  19. Social anxiety and heavy situational drinking: coping and conformity motives as multiple mediators.

    Science.gov (United States)

    Terlecki, Meredith A; Buckner, Julia D

    2015-01-01

    Individuals with clinically elevated social anxiety are at greater risk for alcohol use disorder, and the relation between social anxiety and drinking problems is at least partially accounted for by drinking more in negative emotional (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) situations. Identification of cognitive/motivational factors related to drinking in these high-risk situations could inform the development of treatment and prevention interventions for these high-risk drinkers. The current cross-sectional study examined the mediating effect of drinking motives on the relationship between social anxiety and drinking these high-risk situations among undergraduates (N=232). Clinically elevated social anxiety was associated with greater coping and conformity motives. Both coping and conformity motives mediated the relation between social anxiety and heavier alcohol consumption in negative emotional and personal/intimate contexts. Multiple mediation analyses indicated that these motives work additively to mediate the social anxiety-drinking situations relationship, such that heavy situational drinking among undergraduates with clinically elevated social anxiety can be jointly attributed to desire to cope with negative affect and to avoid social scrutiny. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Validation of the Italian Version of the Dizziness Handicap Inventory, the Situational Vertigo Questionnaire, and the Activity-Specific Balance Confidence Scale for Peripheral and Central Vestibular Symptoms

    Directory of Open Access Journals (Sweden)

    Silvia Colnaghi

    2017-10-01

    Full Text Available Neurophysiological measurements of the vestibular function for diagnosis and follow-up evaluations provide an objective assessment, which, unfortunately, does not necessarily correlate with the patients’ self-feeling. The literature provides many questionnaires to assess the outcome of rehabilitation programs for disequilibrium, but only for the Dizziness Handicap Inventory (DHI is an Italian translation available, validated on a small group of patients suffering from a peripheral acute vertigo. We translated and validated the reliability and validity of the DHI, the Situational Vertigo Questionnaire (SVQ, and the Activities-Specific Balance Confidence Scale (ABC in 316 Italian patients complaining of dizziness due either to a peripheral or to a central vestibular deficit, or in whom vestibular signs were undetectable by means of instrumental testing or clinical evaluation. Cronbach’s coefficient alpha, the homogeneity index, and test–retest reproducibility, confirmed reliability of the Italian version of the three questionnaires. Validity was confirmed by correlation test between questionnaire scores. Correlations with clinical variables suggested that they can be used as a complementary tool for the assessment of vestibular symptoms. In conclusion, the Italian versions of DHI, SVQ, and ABC are reliable and valid questionnaires for assessing the impact of dizziness on the quality of life of Italian patients with peripheral or central vestibular deficit.

  1. Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany.

    Science.gov (United States)

    Schreyer, Andreas G; Steinhäuser, René T; Rosenberg, Britta

    2018-02-07

     Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany.  Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly.  Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly.  Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner.   · Currently there is no reimbursement for image interpretation and presentation in boards.. · Second opinions can only be reimbursed for patients with private insurance or privately recompensed.. · The E-Health law allows reimbursement for tele-counsel in very complex situations.. · It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.. · Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine - A Review of

  2. [Situational leadership in nursing in a health institution in Bucaramanga, Colombia].

    Science.gov (United States)

    Torres-Contreras, Claudia Consuelo

    2013-01-01

    In nursing, it is crucial to know the leadership style required in each situation to act as a leader. The clinical nurse must have an effective leadership style that suits the situations presented during the performance of their functions, in order to achieve the objectives in the care of the patient and family. To describe the situational leadership styles present in nurses in hospital departments, including intensive care, according to the theory of Hersey and Blanchard and to determine the relationship between leadership styles and occupational variables. A cross-sectional descriptive study was conducted on a sample population of 107nurses working in clinical areas of hospital and intensive care in two health institutions. The Dr. Herman Bachenheimer situational leadership tool was applied to nursing staff. The nurses at the hospital area (61) and intensive care (46) have mainly a guide-leadership style (35.4%), followed by a participative style (33.9%) and manager-style (27.9%). Delegation leadership style (2.8%) was not present in clinical nurses. There is no significant relationship between leadership styles and the time working in the institution. A statistically significant relationship was found between leadership styles and length of management experience in the clinical area (P=.011). The predominant leadership style of hospital nurses is to guide, and for intensive care nurses it is participatory. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Situational Analysis and Engineering Work Practices

    DEFF Research Database (Denmark)

    Buch, Anders; Andersen, Vibeke

    2013-01-01

    boundaries in order to investigate the dynamics of cultural reproduction in expert work practices. The paper will propose a new research agenda that – inspired by George Marcus’ multi-sited ethnographic methodology (Marcus 1998) and Adele Clarke’s situational analysis (Clarke 2005) – analyze (and contrasts...... of analysis and allowing the situation to be scalable. Likewise, it aspires to overcome the widespread dualism of ‘text’ and ‘con-text’ that pervades contemporary social science methods. We will argue that expert work practices – although reproduced and enacted in local settings – are also enactments......Studies of work practices of scientists and engineers inspired by Science and Technology Studies (STS) provide new material for a richer understanding of expert cultures and expert work practices. However, the specific and strictly situated focus of many of these studies threatens to limit...

  4. Instructional Plans and Situated Learning: The Challenge of Suchman's Theory of Situated Action for Instructional Designers and Instructional Systems.

    Science.gov (United States)

    Streibel, Michael J.

    This paper discusses the implications of Lucy Suchman's conclusion that a theory of situated action--i.e., the actual sense that specific users make out of specific Xeroxing events--is truer to the lived experience of Xerox users than a cognitive account of the user's plans--e.g., the hierarchy of subprocedures for how Xerox machines should be…

  5. Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

    Directory of Open Access Journals (Sweden)

    Luzius Mader

    Full Text Available Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment.As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years. Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry.We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers. Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007. However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002, which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07 were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71 increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73 and >2 children (OR = 0.48, CI:0.30-0.75; and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36.Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education

  6. A Multidisciplinary Delphi Consensus-Based Checklist to Define Clinical Documentation Tools for Both Routine and Research Purposes

    Directory of Open Access Journals (Sweden)

    Cecilia Veraar

    2018-01-01

    Full Text Available Background: To the best of our knowledge, a strategic approach to define the contents of structured clinical documentation tools for both clinical routine patient care and research purposes has not been reported so far, although electronic health record will become more and more structured and detailed in the future. Objective: To achieve an interdisciplinary consensus on a checklist to be considered for the preparation of disease- and situation-specific clinical documentation tools. Methods: A 2-round Delphi consensus-based process was conducted both with 19 physicians of different disciplines and 14 students from Austria, Switzerland, and Germany. Agreement was defined as 80% or more positive votes of the participants. Results: The participants agreed that a working group should be set up for the development of structured disease- or situation-specific documentation tools (97% agreement. The final checklist included 4 recommendations concerning the setup of the working group, 12 content-related recommendations, and 3 general and technical recommendations (mean agreement [standard deviation] = 97.4% [4.0%], ranging from 84.2% to 100.0%. Discussion and Conclusion: In the future, disease- and situation-specific structured documentation tools will provide an important bridge between registries and electronic health records. Clinical documentation tools defined according to this Delphi consensus-based checklist will provide data for registries while serving as high-quality data acquisition tools in routine clinical care.

  7. Biosimilars in Dermatology: Current Situation (Part I).

    Science.gov (United States)

    Puig, L; Carretero, G; Daudén, E; Ferrándiz, C; Marrón, S E; Martorell, A; Pérez-Suárez, B; Rodriguez-Cerdeira, C; Ruiz-Villaverde, R; Sánchez-Carazo, J L; Velasco, M

    2015-09-01

    The first biosimilar version of a biologic agent used to treat psoriasis (infliximab) entered the Spanish market on February 16 of this year, and more biosimilars can be expected to follow in the coming months and years. Logically, this new situation will have economic repercussions and alter prescribing patterns among dermatologists. In this article, we review regulatory issues related to the approval of biosimilars, with a particular focus on the situation in the European Union. We will examine analytical characterization studies and special considerations for clinical trials with biosimilars, and also look at several somewhat contentious issues, such as the extrapolation of indications, interchangeability, and automatic substitution. Finally, we will review the biosimilars with indications for psoriasis currently in the clinical development pipeline and assess their potential to offer comparable efficacy and safety to the reference product while contributing to the sustainability of the public health care system. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  8. Systematic review of effectiveness of situated e-learning on medical and nursing education.

    Science.gov (United States)

    Feng, Jui-Ying; Chang, Yi-Ting; Chang, Hsin-Yi; Erdley, William Scott; Lin, Chyi-Her; Chang, Ying-Ju

    2013-08-01

    Because of the complexity of clinical situations, traditional didactic education is limited in providing opportunity for student-patient interaction. Situated e-learning can enhance learners' knowledge and associated abilities through a variety of activities. Healthcare providers who interact with virtual patients in designed situations may avoid unnecessary risks and encounters with real patients. However, the effectiveness of situated e-learning is inconsistent. The purpose of this study is to determine the effectiveness of situated e-learning in prelicensure and postlicensure medical and nursing education. Literature databases of PubMed, Medline, CINAHL, ERIC, and Cochrane Library were searched. The study eligibility criteria included articles published in English, which examined the effectiveness of situated e-learning on the outcomes of knowledge and performance for clinicians or students in medicine and nursing. Effect sizes were calculated with 95% confidence intervals. Fourteen articles were included for meta-analysis. Situated e-learning could effectively enhance learners' knowledge and performance when the control group received no training. Compared to traditional learning, the effectiveness of situated e-learning on performance diminished but still remained significant whereas the effect become insignificant on knowledge. The subgroup analyses indicate the situated e-learning program significantly improved students' clinical performance but not for clinicians. Situated e-learning is an effective method to improve novice learners' performance. The effect of situated e-learning on the improvement of cognitive ability is limited when compared to traditional learning. Situated e-learning is a useful adjunct to traditional learning for medical and nursing students. © 2013 Sigma Theta Tau International.

  9. Myositis specific autoantibodies; specificity and clinical applications.

    NARCIS (Netherlands)

    Hengstman, G.J.D.

    2005-01-01

    The sera of about half of the patients with myositis contain autoantibodies that are specific for this group of diseases compared to other inflammatory connective tissue disorders. In a recent study we showed that these myositis specific autoantibodies (MSAs) are also specific for myositis as

  10. Implementation synergies that exploit situational knowledge strategically

    DEFF Research Database (Denmark)

    Quitzau, Maj-Britt; Petersen, Jens-Phillip

    This paper illustrates how strategic and situated forms of knowledge may increase capacity to implement energy strategies in local urban development projects. Through analysis of front runner implementation projects, we show that the involved planners utilize situational learning processes...... strategically to develop more viable implementation trajectories. These findings resonate well with relational and network orienteered research in contemporary planning theory. In the selected case studies, we can see that planners deliberately seek to extend traditional planning approaches, like e.......g. regulation, with broader context‐specific learning processes. In doing so, we argue that – what we call – an implementation synergy is established by interlacing different forms of situational knowledge with strategic knowledge about how to reach a desired energy target. In conclusion, the paper identifies...

  11. Prostate specific antigen and its clinical application

    International Nuclear Information System (INIS)

    Xu Yang

    2000-01-01

    Prostate-Specific Antigen (PSA), a serine proteases, is a glycoprotein consisting of a single polypeptide chain. Secreted exclusively by epithelial cells of the prostate gland, PSA is found largely in seminal plasma. Only a small amount of PSA can be found in normal serum. Serum PSA levels are found to be, considerably increased in prostate cancer patients. A number of studies on PSA have made great achievement on its biochemistry, analytical method and clinical application. PSA as one of the most important tumor marker, is used to help diagnosis and monitor the therapeutic efficacy of prostate cancer

  12. Intra-individual gait pattern variability in specific situations: Implications for forensic gait analysis.

    Science.gov (United States)

    Ludwig, Oliver; Dillinger, Steffen; Marschall, Franz

    2016-07-01

    In this study, inter- and intra-individual gait pattern differences are examined in various gait situations by means of phase diagrams of the extremity angles (cyclograms). 8 test subjects walked along a walking distance of 6m under different conditions three times each: barefoot, wearing sneakers, wearing combat boots, after muscular fatigue, and wearing a full-face motorcycle helmet restricting vision. The joint angles of foot, knee, and hip were recorded in the sagittal plane. The coupling of movements was represented by time-adjusted cyclograms, and the inter- and intra-individual differences were captured by calculating the similarity between different gait patterns. Gait pattern variability was often greater between the defined test situations than between the individual test subjects. The results have been interpreted considering neurophysiological regulation mechanisms. Footwear, masking, and fatigue were interpreted as disturbance parameters, each being a cause for gait pattern variability and complicating the inference of identity of persons in video recordings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Situational Analysis of Engineering Practice

    DEFF Research Database (Denmark)

    Buch, Anders

    STS inspired studies of engineering work practices provide new material for a richer understanding of engineering culture. However, the specific and strictly situated focus of many of these studies threatens to limit discussions of engineering practices to departmental and discrete institutional...... settings. This micro perspective potentially overlooks the inherent and overarching normativities that inform engineering culture. Furthermore, the micro perspective has difficulties in transgressing institutional boundaries in order to investigate the dynamics of cultural reproduction in engineering....... The paper will propose a research agenda that – inspired by George Marcus’ multi-sited ethnographic methodology (Marcus 1998) and Adele Clarke’s situational analysis (Clarke 2005) – analyze (and contrasts) engineering practices in diverse settings (e.g. engineering education and engineering work) in order...

  14. The prefect facing emergency situation

    International Nuclear Information System (INIS)

    Masse, H.

    2006-01-01

    In the field of emergency procedures regarding the protection of life, property and the environment, the 'prefet' of a department is the only public authority both representative of the state and accountable. In France laws and regulations have been in recent years revised in order to modernize emergency situations management. The 'prefet' of the Drome 'department', Henri MASSE, presents a summary of recent developments and explains how his services are organised in order to be able to handle emergency situations. He also focuses on his experience of handling the specific difficulties of nuclear risks, his department sheltering numerous nuclear facilities: EURODIF Pierrelatte nuclear fuel enrichment plant, EDF Tricastin nuclear power plant, AREVA Valence FBFC nuclear fuel manufacturing unit, etc. (author)

  15. Prostate specific antigen - brief update on its clinical use | Heyns ...

    African Journals Online (AJOL)

    Prostate specific antigen - brief update on its clinical use. ... (45 years in those with a family history of prostate cancer and – possibly – African men); ... PSA doubling time (the period it takes for the PSA to double) correlates with the prognosis ...

  16. From situation modelling to a distributed rule-based platform for situation awareness : an ontological framework for disaster management applications

    NARCIS (Netherlands)

    Moreira, João

    2015-01-01

    Situation-aware (SA) applications are particularly useful for disaster management. The complex nature of emergency scenarios presents challenges to the development of collaborative and distributed SA solutions. These challenges concern the whole lifecycle, from specification to implementation

  17. Situativity theory: a perspective on how participants and the environment can interact: AMEE Guide no. 52.

    Science.gov (United States)

    Durning, Steven J; Artino, Anthony R

    2011-01-01

    Situativity theory refers to theoretical frameworks which argue that knowledge, thinking, and learning are situated (or located) in experience. The importance of context to these theories is paramount, including the unique contribution of the environment to knowledge, thinking, and learning; indeed, they argue that knowledge, thinking, and learning cannot be separated from (they are dependent upon) context. Situativity theory includes situated cognition, situated learning, ecological psychology, and distributed cognition. In this Guide, we first outline key tenets of situativity theory and then compare situativity theory to information processing theory; we suspect that the reader may be quite familiar with the latter, which has prevailed in medical education research. Contrasting situativity theory with information processing theory also serves to highlight some unique potential contributions of situativity theory to work in medical education. Further, we discuss each of these situativity theories and then relate the theories to the clinical context. Examples and illustrations for each of the theories are used throughout. We will conclude with some potential considerations for future exploration. Some implications of situativity theory include: a new way of approaching knowledge and how experience and the environment impact knowledge, thinking, and learning; recognizing that the situativity framework can be a useful tool to "diagnose" the teaching or clinical event; the notion that increasing individual responsibility and participation in a community (i.e., increasing "belonging") is essential to learning; understanding that the teaching and clinical environment can be complex (i.e., non-linear and multi-level); recognizing that explicit attention to how participants in a group interact with each other (not only with the teacher) and how the associated learning artifacts, such as computers, can meaningfully impact learning.

  18. [Precision medicine: A major step forward in specific situations, a myth in refractory cancers?

    Science.gov (United States)

    Albin, Nicolas; Mc Leer, Anne; Sakhri, Linda

    2018-04-01

    In recent years, high-throughput sequencing techniques have been developed for cancerology and many clinical trials are currently structured around biomarkers that can guide specific treatment choices. This approach is characteristic of precision medicine, which is actually a concept initiated several decades ago with, for example, retinoic acid in promyelocytic leukemia. This paper will review the different types of molecular alterations and « -omics » biological analyses, bioinformatics tools, coupled drug/biomarkers already validated, the ethical issues of whole genomic sequencing of an individual as part of an inclusion in a clinical trial and finally the first results of precision medicine trials. The AcSé crizotinib program, supported by the Inca (french Cancer National Institute), is emblematic of a success of this personalized medicine illustrated by 4 points: the discovery of a cohort of patients with lung cancer with a ROS1 rearrangement characteristic of a sensitivity to crizotinib, a rapid availability of this innovation through the implementation of a temporary recommendation for use (ANSM), the obtention of a conditional marketing authorization by the pharmaceutical industry and finally, financial assumption of responsibility by French social security (HAS), despite preliminary and non-comparative data. In the case of cancers refractory to standard chemotherapy, and regarding our system of access to drugs illustrated by the PROFILER clinical trial, this approach allows the access to a therapeutic drug targeting specific biomarkers only in 7% of patients included. This does not bode well for efficient treatment and even less for survival. Allowing patients to be included in trials that identify molecular targets by molecular screening, and not being able to propose the drug of interest is a traumatic event for those patients who live in the hope of an immediate future. In refractory disease we must rethink precision medicine in a more humanistic

  19. Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

    Science.gov (United States)

    Ma, Yunbei; Zhou, Xiao-Hua

    2017-02-01

    For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

  20. TU-A-201-02: Treatment Site-Specific Considerations for Clinical IGRT

    Energy Technology Data Exchange (ETDEWEB)

    Wijesooriya, K. [University of Virginia Health Systems (United States)

    2016-06-15

    Recent years have seen a widespread proliferation of available in-room image guidance systems for radiation therapy target localization with many centers having multiple in-room options. In this session, available imaging systems for in-room IGRT will be reviewed highlighting the main differences in workflow efficiency, targeting accuracy and image quality as it relates to target visualization. Decision-making strategies for integrating these tools into clinical image guidance protocols that are tailored to specific disease sites like H&N, lung, pelvis, and spine SBRT will be discussed. Learning Objectives: Major system characteristics of a wide range of available in-room imaging systems for IGRT. Advantages / disadvantages of different systems for site-specific IGRT considerations. Concepts of targeting accuracy and time efficiency in designing clinical imaging protocols.

  1. Lithuanian speaking childrens' bilingualism. language situation and policy

    OpenAIRE

    Paškauskaitė, Ieva

    2017-01-01

    Lithuanian Speaking Childrens' Bilingualism. Language Situation and Policy The purpose of this study is to investigate the language situation of Lithuanian speaking children in Sweden and its causes. This study is specifically concerned with the subjects of bilingualism and family language policy: language strategies and methods. The concept of bilingualism is complex and can be defined in different ways, therefore this study is based on a table which was introduced by T. Skutnabb-Kangas in 1...

  2. Emergency situations; Les situations d'urgence

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The nuclear activities are exercised so as to prevent the accidents. They are subjected to a rule whom application is controlled by the Asn. The risk of grave accident is so limited to a very low level of probability. He cannot be however completely pushed aside. The expression ' radiological emergency situation ' indicates a situation which ensues from an incident or of an accident risking to lead to an emission of radioactive materials or a level of radioactivity susceptible to strike a blow at the public health. The term ' nuclear crisis ' is used for the events which can lead to a radiological emergency situation on a nuclear basic installation or during a transport of radioactive materials. The preparation and the management of emergency situations, that they are of natural, accidental or terrorist origin, became a major concern of our society. We propose you of to know more about it in this file. (N.C.)

  3. Association of Immunological Cell Profiles with Specific Clinical Phenotypes of Scleroderma Disease

    Science.gov (United States)

    Calzada, David; Mayayo, Teodoro; González-Rodríguez, María Luisa; Rabasco, Antonio María; Lahoz, Carlos

    2014-01-01

    This study aimed to search the correlation among immunological profiles and clinical phenotypes of scleroderma in well-characterized groups of scleroderma patients, comparing forty-nine scleroderma patients stratified according to specific clinical phenotypes with forty-nine healthy controls. Five immunological cell subpopulations (B, CD4+ and CD8+ T-cells, NK, and monocytes) and their respective stages of apoptosis and activation were analyzed by flow cytometry, in samples of peripheral blood mononuclear cells (PBMCs). Analyses of results were stratified according to disease stage, time since the diagnosis, and visceral damage (pulmonary fibrosis, pulmonary hypertension, and cardiac affliction) and by time of treatment with corticosteroids. An increase in the percentages of monocytes and a decrease in the B cells were mainly related to the disease progression. A general apoptosis decrease was found in all phenotypes studied, except in localized scleroderma. An increase of B and NK cells activation was found in patients diagnosed more than 10 years ago. Specific cell populations like monocytes, NK, and B cells were associated with the type of affected organ. This study shows how, in a heterogeneous disease, proper patient's stratification according to clinical phenotypes allows finding specific cellular profiles. Our data may lead to improvements in the knowledge of prognosis factors and to aid in the analysis of future specific therapies. PMID:24818126

  4. [Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis].

    Science.gov (United States)

    de Camargo, Kélvia Cristina; Alves, Rosane Ribeiro Figueiredo; Baylão, Luciano Augusto; Ribeiro, Andrea Alves; Araujo, Nadja Lindany Alves de Souza; Tavares, Suelene Brito do Nascimento; dos Santos, Sílvia Helena Rabelo

    2015-05-01

    To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear using the Papanicolaou method. A cross-sectional study of 302 women aged 20 to 87 years, interviewed and submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value (NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was 0.47, 0.23 and 0.28, respectively. CONCLUSION The most common cause of abnormal vaginal secretion was BV. The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis, indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion.

  5. Retinal Diseases Caused by Mutations in Genes Not Specifically Associated with the Clinical Diagnosis.

    Directory of Open Access Journals (Sweden)

    Xia Wang

    Full Text Available When seeking a confirmed molecular diagnosis in the research setting, patients with one descriptive diagnosis of retinal disease could carry pathogenic variants in genes not specifically associated with that description. However, this event has not been evaluated systematically in clinical diagnostic laboratories that validate fully all target genes to minimize false negatives/positives.We performed targeted next-generation sequencing analysis on 207 ocular disease-related genes for 42 patients whose DNA had been tested negative for disease-specific panels of genes known to be associated with retinitis pigmentosa, Leber congenital amaurosis, or exudative vitreoretinopathy.Pathogenic variants, including single nucleotide variations and copy number variations, were identified in 9 patients, including 6 with variants in syndromic retinal disease genes and 3 whose molecular diagnosis could not be distinguished easily from their submitted clinical diagnosis, accounting for 21% (9/42 of the unsolved cases.Our study underscores the clinical and genetic heterogeneity of retinal disorders and provides valuable reference to estimate the fraction of clinical samples whose retinal disorders could be explained by genes not specifically associated with the corresponding clinical diagnosis. Our data suggest that sequencing a larger set of retinal disorder related genes can increase the molecular diagnostic yield, especially for clinically hard-to-distinguish cases.

  6. What specifications for a centre or network of excellence in clinical research?

    Science.gov (United States)

    Diebolt, Vincent; Lang, Marie; Thoby, Frédérique

    2016-02-01

    The Giens 2015 Workshop Round Table entitled "What specifications for a centre or network of excellence in clinical research?" took a viewpoint distinct from earlier work and studies on changes in clinical research activities in France. The purpose of the present work was to identify, starting from concrete examples, the main strengths and advantages of clinical research activity in France related, in part, to the background environment and also to the specific characteristics of the investigation centres considered to be among the most high-performance units in activity. The criteria retained were grouped into a set of specifications that could be used to establish a "label of excellence" upon which the different teams and clinical research centres could model themselves. It was thus considered that belonging to a centre or structured network with at least a national configuration, when this is possible for the medial topic in question, constitutes a real advantage. Four benchmarks were identified: the scientific and clinical expertise of the head investigator, as well as the qualification and operational capacity of the centre's team; definition and measurement of performance using clearly displayed indicators and evaluation procedures; the quality of the overall trial "process" and of each of its component steps; communication, because know-how and promotion go hand in hand, with the main objective of informing the professional and general public about the value of the research centre meeting the above-mentioned criteria, about its networks of competencies, and more generally, about the important assets of the background of clinical research in France. This sector of research is funded by the public authorities via calls for public grants, financial aids for structures supporting clinical research in the University Hospital Centres and other healthcare institutions allowing for a professionalization of the research occupations, and the national public health

  7. [Situational low self-esteem in pregnant women: an analysis of accuracy].

    Science.gov (United States)

    Cavalcante, Joyce Carolle Bezerra; de Sousa, Vanessa Emille Carvalho; Lopes, Marcos Venícios de Oliveira

    2012-01-01

    To investigate the accuracy of defining characteristics of Situational low self-esteem we developed a cross-sectional study, with 52 pregnant women assisted in a family centre. The NANDA-I taxonomy was used as well as the Rosenberg's scale. The diagnosis was present in 32.7% of the sample and all characteristics presented statistical significance, except "Reports verbally situational challenge to its own value". The characteristics "Indecisive behavior" and "Helplessness expressions" had 82.35% of sensitivity. On the other hand, the characteristics "Expression of feelings of worthlessness" and "Reports verbally situational challenge to its own value" were the more specific, with 94.29% of specificity. These results can contribute with the nursing practice because the identification of accurate characteristics is essential to a secure inference.

  8. Grey situation group decision-making method based on prospect theory.

    Science.gov (United States)

    Zhang, Na; Fang, Zhigeng; Liu, Xiaqing

    2014-01-01

    This paper puts forward a grey situation group decision-making method on the basis of prospect theory, in view of the grey situation group decision-making problems that decisions are often made by multiple decision experts and those experts have risk preferences. The method takes the positive and negative ideal situation distance as reference points, defines positive and negative prospect value function, and introduces decision experts' risk preference into grey situation decision-making to make the final decision be more in line with decision experts' psychological behavior. Based on TOPSIS method, this paper determines the weight of each decision expert, sets up comprehensive prospect value matrix for decision experts' evaluation, and finally determines the optimal situation. At last, this paper verifies the effectiveness and feasibility of the method by means of a specific example.

  9. Évolution des classifications et spécifications des huiles pour moteurs (situation en avril 1989 Evolution of Classifications and Specifications for Motor Oils (Situation April 1989

    Directory of Open Access Journals (Sweden)

    Ayel J.

    2006-11-01

    , lubricants for engines meet viscosity and service classifications as well as specifications issuing from national or international agencies such as Society of Automotive Engineers (SAE and American Petroleum Institute (API in the United States or Comité des Constructeurs d'Automobiles du Marché Commun (CCMC in Europe. The aim of these classifications and specifications is to qualify products more specifically. At the same time, engine manufacturers are more and more systematically establishing approval standards for oils to better meet the lubrication requirements of their engines so as to improve their mechanical longevity and reliability while making maintenance more logical. Major users such as armed forces or the leading civil administrations have also developed comprehensive specifications to meet their own needs. All these standards define the limits of physicochemical characteristics as well as the minimum performance levels to be reached during testing in engines and laboratory simulators. With the technological development of gasoline and diesel engines together with the appearance of new legislative, economic and ecological constraints (energy conservation, longer times between oil changes, pollution control, etc. , these specifications have become more and more numerous and more and more complex. Likewise, they are constantly evolving, sometimes at an excessive rate. Despite this, the present article reviews the situation of standards as of the beginning of 1989, analyzes the most important among them, as the case may be, the main phases leading to current specifications and, whenever possible, indicates their foreseeable evolution in the relatively close future.

  10. Domain-specific Knowledge in Lexicography: How It Helps Lexicographers and Users of Accounting Dictionaries Intended for Communicative Usage Situations

    DEFF Research Database (Denmark)

    Nielsen, Sandro

    2013-01-01

    Dictionaries are consulted when translating specialized texts in the global marketplace and when such texts are written in a foreign language. However, studies of translation in e.g. accounting indicate that most dictionaries do not provide the help needed in communicative situations, because...... they do not take into consideration that domain-specific meanings are culture- and structure-dependent. It is proposed that this state of affairs can be improved by studying the relevant types of knowledge required of lexicographers making accounting and other specialized dictionaries: declarative......, procedural and schematic knowledge. These knowledge types are relevant when lexicographers select entry words as well as when they select equivalents and translations. Finally, it is proposed that declarative, procedural and schematic knowledge is needed when writing definitions of terms...

  11. Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group.

    Science.gov (United States)

    Drakulić, Aleksandra Mindoljević

    2011-03-01

    Modern history of short-term group psychotherapy dates back to the late 1950-ies. From then to present day, this psychotherapeutic method has been used in various forms, from dynamic-oriented to cognitive behavioural psychotherapies. Although it has always been considered rather controversial, due its cost-effectiveness, it has been capturing more and more popularity. This paper presents the specificities of first session short-term psychotherapy psychodrama group through session work with two examined groups: a group of 20 adult women who suffer from mild or moderate forms of unipolar depression and a group of 20 students of the School of Medicine in Zagreb without any psychiatric symptomatology. The results indicate the high importance of having structure in first psychodrama session, of relating it with the previously thoroughly conducted, initial, clinical, interviews, and of the clarity and focus in terms of determining the goals of therapy, especially in a clinical context. This study also confirmed assumptions regarding the need for different approaches of warming-up in psychodrama, both in the clinical and in non-clinical samples. A psychodrama psychotherapist should have good time managing skills and capability to convert the time available into an opportunity for directly boosting the group energy and work on therapeutic alliance.

  12. The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: A systematic review.

    Science.gov (United States)

    Maissan, Francois; Pool, Jan; de Raaij, Edwin; Mollema, Jürgen; Ostelo, Raymond; Wittink, Harriet

    2018-06-01

    Primarily to evaluate the completeness of the description of the clinical reasoning process in RCTs with patients with non-specific neck pain with an argued or diagnosed cause i.e. an impairment or activity limitation. Secondly, to determine the association between the completeness of the clinical reasoning process and the degree of risk of bias. Pubmed, Cinahl and PEDro were systematically searched from inception to July 2016. RCTs (n = 122) with patients with non-specific neck pain receiving physiotherapy treatment published in English were included. Data extraction included study characteristics and important features of the clinical reasoning process based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II)]. Thirty-seven studies (30%) had a complete clinical reasoning process of which 8 (6%) had a 'diagnosed cause' and 29 (24%) had an 'argued cause'. The Spearmans rho association between the extent of the clinical reasoning process and the risk of bias was -0.2. In the majority of studies (70%) the described clinical reasoning process was incomplete. A very small proportion (6%) had a 'diagnosed cause'. Therefore, a better methodological quality does not necessarily imply a better described clinical reasoning process. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Gardens of Situations: Learning from the Danish Modern Landscape

    DEFF Research Database (Denmark)

    Boris, Stefan Darlan

    2009-01-01

    of an interlacing of understanding and space.” (Sieverts, 2007) Learning from a series of modern Danish landscape architectural projects by Brandt, Sørensen and Andersson I will define a specific form for gardening – and more importantly a specific form for gathering – which I call „Gardens of Situations...

  14. Exploring Situated Ambiguity in Students' Entrepreneurial Learning

    Science.gov (United States)

    Kubberød, Elin; Pettersen, Inger Beate

    2017-01-01

    Purpose: Building on entrepreneurial learning research, the purpose of this paper is to argue that the students participating in foreign entrepreneurial education programmes can have realistic entrepreneurial learning experiences. This research addresses two specific questions: how situated ambiguity induced by a foreign culture may contribute to…

  15. Clinical reasoning: concept analysis.

    Science.gov (United States)

    Simmons, Barbara

    2010-05-01

    This paper is a report of a concept analysis of clinical reasoning in nursing. Clinical reasoning is an ambiguous term that is often used synonymously with decision-making and clinical judgment. Clinical reasoning has not been clearly defined in the literature. Healthcare settings are increasingly filled with uncertainty, risk and complexity due to increased patient acuity, multiple comorbidities, and enhanced use of technology, all of which require clinical reasoning. Data sources. Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed, PsycINFO, ERIC and OvidMEDLINE, for the years 1980 to 2008. Rodgers's evolutionary method of concept analysis was used because of its applicability to concepts that are still evolving. Multiple terms have been used synonymously to describe the thinking skills that nurses use. Research in the past 20 years has elucidated differences among these terms and identified the cognitive processes that precede judgment and decision-making. Our concept analysis defines one of these terms, 'clinical reasoning,' as a complex process that uses cognition, metacognition, and discipline-specific knowledge to gather and analyse patient information, evaluate its significance, and weigh alternative actions. This concept analysis provides a middle-range descriptive theory of clinical reasoning in nursing that helps clarify meaning and gives direction for future research. Appropriate instruments to operationalize the concept need to be developed. Research is needed to identify additional variables that have an impact on clinical reasoning and what are the consequences of clinical reasoning in specific situations.

  16. A clinical decision-making mechanism for context-aware and patient-specific remote monitoring systems using the correlations of multiple vital signs.

    Science.gov (United States)

    Forkan, Abdur Rahim Mohammad; Khalil, Ibrahim

    2017-02-01

    In home-based context-aware monitoring patient's real-time data of multiple vital signs (e.g. heart rate, blood pressure) are continuously generated from wearable sensors. The changes in such vital parameters are highly correlated. They are also patient-centric and can be either recurrent or can fluctuate. The objective of this study is to develop an intelligent method for personalized monitoring and clinical decision support through early estimation of patient-specific vital sign values, and prediction of anomalies using the interrelation among multiple vital signs. In this paper, multi-label classification algorithms are applied in classifier design to forecast these values and related abnormalities. We proposed a completely new approach of patient-specific vital sign prediction system using their correlations. The developed technique can guide healthcare professionals to make accurate clinical decisions. Moreover, our model can support many patients with various clinical conditions concurrently by utilizing the power of cloud computing technology. The developed method also reduces the rate of false predictions in remote monitoring centres. In the experimental settings, the statistical features and correlations of six vital signs are formulated as multi-label classification problem. Eight multi-label classification algorithms along with three fundamental machine learning algorithms are used and tested on a public dataset of 85 patients. Different multi-label classification evaluation measures such as Hamming score, F1-micro average, and accuracy are used for interpreting the prediction performance of patient-specific situation classifications. We achieved 90-95% Hamming score values across 24 classifier combinations for 85 different patients used in our experiment. The results are compared with single-label classifiers and without considering the correlations among the vitals. The comparisons show that multi-label method is the best technique for this problem

  17. Consequences of contextual factors on clinical reasoning in resident physicians.

    Science.gov (United States)

    McBee, Elexis; Ratcliffe, Temple; Picho, Katherine; Artino, Anthony R; Schuwirth, Lambert; Kelly, William; Masel, Jennifer; van der Vleuten, Cees; Durning, Steven J

    2015-12-01

    Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe what impact the presence of contextual factors have on their clinical reasoning. Participants viewed three video recorded clinical encounters portraying straightforward diagnoses in internal medicine with select patient contextual factors modified. After watching each video recording, participants completed a think-aloud protocol. Transcripts from the think-aloud protocols were analyzed using a constant comparative approach. After iterative coding, utterances were analyzed for emergent themes with utterances grouped into categories, themes and subthemes. Ten residents participated in the study with saturation reached during analysis. Participants universally acknowledged the presence of contextual factors in the video recordings. Four categories emerged as a consequence of the contextual factors: (1) emotional reactions (2) behavioral inferences (3) optimizing the doctor patient relationship and (4) difficulty with closure of the clinical encounter. The presence of contextual factors may impact clinical reasoning performance in resident physicians. When confronted with the presence of contextual factors in a clinical scenario, residents experienced difficulty with closure of the encounter, exhibited as diagnostic uncertainty. This finding raises important questions about the relationship between contextual factors and clinical reasoning activities and how this relationship might influence the cost effectiveness of care. This study also provides insight into how the phenomena of context specificity may be explained using situated cognition theory.

  18. Harm beliefs and coping expectancies in youth with specific phobias.

    Science.gov (United States)

    Ollendick, Thomas H; Öst, Lars-Göran; Ryan, Sarah M; Capriola, Nicole N; Reuterskiöld, Lena

    2017-04-01

    Catastrophic beliefs and lowered coping expectancies are often present in individuals with specific phobias (SPs). The current study examined these beliefs and expectancies in 251 youth who received One Session Treatment for one of the three most common types of SP in youth (animals, natural environment, and situational). We compared the children's subjective beliefs to objective ratings of the likelihood of occurrence and the dangerousness of the feared events. Results revealed pre-treatment differences in the youths' beliefs across phobia types and age. Specifically, children with animal phobias rated their beliefs as more likely to occur than did children with environmental and situational phobias. In addition, older children rated their beliefs as more dangerous than younger children. However, regardless of phobia type or child age, the beliefs improved following treatment. Changes in catastrophic beliefs and coping expectancies were related to changes in clinical severity following treatment but not 6-months following treatment. Moreover, at pre-treatment, children viewed their beliefs as significantly more catastrophic and likely to occur than did independent coders of these beliefs; however, these differences were no longer evident following treatment. Clinical implications are discussed, highlighting how changes in beliefs and expectancies might be associated with treatment outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. [Intraoperative neurophysiological monitoring in Spain: its beginnings, current situation and future prospects].

    Science.gov (United States)

    Cortes-Donate, V E; Perez-Lorensu, P J; Garcia-Garcia, A; Asociacion de Monitorizacion Intraquirurgica Neurofisiologica Espanola Amine, Asociacion de Monitorizacion Intraquirurgica Neurofisiologica Espanola Amine; Sociedad Espanola de Neurofisiologia Clinica Senfc, Sociedad Espanola de Neurofisiologia Clinica Senfc; Grupo de Trabajo de Monitorizacion Neurofisiologica Intraoperatoria de la Senfc, Grupo de Trabajo de Monitorizacion Neurofisiologica Intraoperatoria de la Senfc

    2018-05-01

    Intraoperative neurophysiological monitoring (IONM) is nowadays another tool within the operating room that seeks to avoid neurological sequels derived from the surgical act. The Spanish Neurophysiological Intra-Surgical Monitoring Association (AMINE) in collaboration with the Spanish Society of Clinical Neurophysiology (SENFC), and the IONM Working Group of the SENFC has been collecting data in order to know the current situation of the IONM in Spain by hospitals, autonomous communities including the autonomous cities of Ceuta and Melilla, the opinions of the specialists in clinical neurophysiology involved in this topic and further forecasts regarding IONM. The data was gathered from November 2015 to May 2016 through telephone contact and/or email with specialists in clinical neurophysiology of the public National Health System, and through a computerized survey that also includes private healthcare centers. With the data obtained, from the perspective of AMINE and the SENFC we consider that nowadays the field of medicine covered by IONM is considerably large and it is foreseen that it will continue to grow. Therefore, a greater number of specialists in Clinical Neurophysiology will be required, as well as the need for specific training within the specialty that involves increasing the training period of MIRs based on competencies due to the increase in techniques/procedures, as well as its complexity.

  20. Situational leadership: a management system to increase staff satisfaction.

    Science.gov (United States)

    Zurlinden, J; Bongard, B; Magafas, M

    1990-01-01

    Using the principles of Situational Leadership, nurse managers can deal with people and situations effectively and flexibly--helping to retain nurses on their units. Based on the manager's assessment of the nurse's ability and willingness for a specific task, each nurse falls into one of four readiness quadrants. Each quadrant predicts a corresponding leadership style: telling, selling, participating, or delegating. Nurse managers need to use different combinations of task behavior and relationship behavior for each corresponding leadership style.

  1. The clinical syndrome of specific antibody deficiency in children.

    Science.gov (United States)

    Boyle, R J; Le, C; Balloch, A; Tang, M L-K

    2006-12-01

    Specific antibody deficiency (SAD) is an immune deficiency which has been reported in adults and children with recurrent respiratory tract infections; however, the clinical features of SAD are not well described. This study evaluated formally the clinical syndrome of SAD, by comparing the clinical features of children with SAD and those of children with recurrent infection but normal immune function tests. SAD was defined as an adequate IgG antibody response to less than 50% of 12 pneumococcal serotypes tested following 23-valent unconjugated pneumococcal immunization. An adequate IgG antibody response was defined as a post-immunization titre of >or= 1.3 microg/ml or >or= four times the preimmunization value. Seventy-four children with recurrent infection were evaluated where immune deficiencies other than SAD had been excluded. Eleven (14.9%) of these children had SAD. Clinical features differed between the group with SAD and the group with normal antibody responses. A history of otitis media, particularly in association with chronic otorrhoea was associated with SAD [relative risk (RR) of SAD in those with chronic otorrhoea 4.64 (P = 0.02)]. SAD was associated with allergic disease, particularly allergic rhinitis [RR of SAD in those with allergic rhinitis 3.77 (P = 0.04)]. These two clinical associations of SAD were independent in this study [RR of chronic otorrhoea in those with allergic rhinitis 0.85 (P = 0.28)]. SAD was not an age-related phenomenon in this population. SAD has a distinct clinical phenotype, presenting as recurrent infection associated with chronic otorrhoea and/or allergic disease, and the condition should be sought in children with these features.

  2. A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge.

    Science.gov (United States)

    Hatsek, Avner; Shahar, Yuval; Taieb-Maimon, Meirav; Shalom, Erez; Klimov, Denis; Lunenfeld, Eitan

    2010-01-01

    Clinical guidelines have been shown to improve the quality of medical care and to reduce its costs. However, most guidelines exist in a free-text representation and, without automation, are not sufficiently accessible to clinicians at the point of care. A prerequisite for automated guideline application is a machine-comprehensible representation of the guidelines. In this study, we designed and implemented a scalable architecture to support medical experts and knowledge engineers in specifying and maintaining the procedural and declarative aspects of clinical guideline knowledge, resulting in a machine comprehensible representation. The new framework significantly extends our previous work on the Digital electronic Guidelines Library (DeGeL) The current study designed and implemented a graphical framework for specification of declarative and procedural clinical knowledge, Gesher. We performed three different experiments to evaluate the functionality and usability of the major aspects of the new framework: Specification of procedural clinical knowledge, specification of declarative clinical knowledge, and exploration of a given clinical guideline. The subjects included clinicians and knowledge engineers (overall, 27 participants). The evaluations indicated high levels of completeness and correctness of the guideline specification process by both the clinicians and the knowledge engineers, although the best results, in the case of declarative-knowledge specification, were achieved by teams including a clinician and a knowledge engineer. The usability scores were high as well, although the clinicians' assessment was significantly lower than the assessment of the knowledge engineers.

  3. FOSTERING AND DEVELOPMENT OF MULTICULTURALISM VIA SITUATIVE VOCABULARIES

    Directory of Open Access Journals (Sweden)

    О В Львова

    2017-12-01

    Full Text Available The search for ways and means of fostering and development of multiculturalism is now of great importance for the world community. Situational vocabulary was previously proposed by the author as an ICT tool for fostering and development of communicative competence in foreign language. They contain lexical structures used in specific communicative situations, as well as modern ICT tools (blogs, chats, forums, mail, etc. to supplement already gained data and to discuss the ways and situations of use of various linguistic constructions or meanings of the words. Further study of the possibilities and ways of application of the instrument showed that students are not able to choose a relevant form for certain situations, or they lack or do not know the appropriate words and expressions, both in native and in a foreign language. In addition, the incorrect use of certain words or expressions in the situation may be regarded by representatives of other cultures as rude or disrespectful. The peculiarity of the method offered by the author is based on the idea of using situational vocabularies for gaining information and study of various linguistic and cultural aspects of the host country and other countries. In addition, the interaction in the familiar for learners ICT space motivates them and increase the effectiveness of such activities.

  4. Situated Transgressiveness

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Sullivan, Katie Rose; Rich, Craig

    2016-01-01

    conversations within queer theory, transgender and organization studies by highlighting how situated contexts mediate the political potential of queer bodies at work. By developing the concept ‘situated transgressiveness’, this article challenges notions of transgender as a stable, ideal disruptive category......This study investigates the lived experience of one transwoman, Claire, a public advocate and a manager with client services responsibilities. We examine Claire's story in order to discuss how situated contexts, such as different roles, locales and interactions, shape the way she experiences...

  5. Utilizing Advanced Psychometric Methods in Research on Trait Expression across Situations

    DEFF Research Database (Denmark)

    Lang, Jonas W. B.; Tackett, Jennifer; Zettler, Ingo

    2017-01-01

    Lievens emphasized the extent to which new measurement tools and additional statistics can be used to advance research on trait expression across situations. We suggest that advanced psychometric models represent additional important and complementary building blocks for progress and new insights...... in research on trait expression across situations. Here, we offer two specific examples of this: (1) Item Response Theory modelling of within-person variability simultaneous with estimation of latent trait levels and (2) estimation of latent trait and latent situation factors from a multitrait...

  6. Assessing the viability of situationally driven segmentation opportunities in the health care market.

    Science.gov (United States)

    Gehrt, K C; Pinto, M B

    1993-01-01

    The impact of situational factors has typically been investigated in the context of goods marketing. Very few studies have investigated the influence of situational factors on services marketing. This study demonstrates the importance of situational influence on services marketing by delineating a consumer-based, situationally characterized competitive market structure for health care services. The competitive structure of the health care market is delineated in terms of the similarity/substitutability of the three-factor, situational characterizations of ten health care alternatives. The general marketing implications of the market-structure delineation procedure and the health care-specific implications of the findings are discussed.

  7. Cow-specific risk factors for clinical mastitis in Brazilian dairy cattle

    NARCIS (Netherlands)

    Oliveira, C S F; Hogeveen, H|info:eu-repo/dai/nl/126322864; Botelho, A M; Maia, P V; Coelho, S G; Haddad, J P A

    2015-01-01

    Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which

  8. Is it really not possible to use electronic personal dosimeters in clinical exposure situations?; Sind elektronische Personendosimeter in klinischen Expositionssituationen grundsaetzlich nicht einsetzbar?

    Energy Technology Data Exchange (ETDEWEB)

    Borowski, M. [Klinikum Braunschweig (Germany). Inst. fuer Roentgendiagnostik und Nuklearmedizin; Poppe, B.; Looe, H.K. [Carl von Ossietzky Univ. und Pius-Hospital Oldenburg (Germany). Arbeitsgebiet Medizinische Strahlenphysik; Boetticher, H. von [Klinikum Links der Weser, Bremen (Germany). Inst. fuer Radiologie und Seminar fuer Strahlenschutz

    2010-09-15

    Purpose: Due to significant measuring inaccuracies that can occur under certain conditions, the use of electronic personal dosimeters in statutory measurements in X-ray diagnostics is currently legally restricted. The present study investigates the clinically relevant situations in which measurement errors of more then 20 % can be anticipated. Materials and Methods: Four series of experiments were made, comparing the results of the electronic personal dosimeter EPD Mk2.3 to those of reference dosimeters (TLDs and diagnostic dosimeters). On the one hand, personal doses have been determined in the routine operation of controlled areas in various departments. On the other hand, measurements on phantoms have been conducted in extreme but realistic situations under radiation protection. Experiments were conducted in unweakened scattered radiation as well as in unattenuated and attenuated direct radiation. Results: The tested electronic personal dosimeter type meets the requirements regarding measurement accuracy for 'official' personal dosimeters in all of the examined clinically relevant scattered radiation fields. Only if exposed to radiation directly, an underestimation of the dose can occur and can be greater than 90 %. Conclusion: In the range of scattered radiation of diagnostic X-ray equipment, even in pulsed fields, the use of electronic personal dosimeters is reasonable. Considerable measurement errors can only arise in radiation fields that are not realistic under regular conditions and even in connection with most accidents. (orig.)

  9. Work-related stressors experienced by part-time clinical affiliate nursing faculty in baccalaureate education.

    Science.gov (United States)

    Whalen, Kathleen S

    2009-01-01

    This descriptive and multivariate correlational study identifies work-related situations that were perceived as stressful in a sample of part-time clinical affiliate nursing faculty (n = 91) from a western state who teach in baccalaureate programs. The most stressful conditions include being physically and emotionally drained; working outside regular hours; dealing with the number of role expectations; and receiving inadequate monetary compensation. Subjects reported other specific stressful situations related to their work with clinical agencies, universities, and students. The researcher also examined the relationships between selected background factors (number of years of clinical teaching experience, clinical teacher education, and holding a second job), role stress, and job satisfaction. Even though this sample had a high job satisfaction rating, the variable, role stress, was shown to significantly predict job satisfaction. Lastly, implications for nurse educators in baccalaureate programs are explored.

  10. Do stages of dentistry training affect anxiety provoking situations ...

    African Journals Online (AJOL)

    Getting diagnosis wrong, help in faint episode, not developing radiograph properly and coping with children were the anxiety provoking situations that showed statistically significant difference in the 3 studied training stages of dentistry. Bonferroni post‑hoc analysis significant difference was in the preclinical and clinical ...

  11. Specific Features of Life Situations in Teenagers and Young People, Predisposed to Deviant Behavior

    Science.gov (United States)

    Zotova, Larisa Ed.; Prjazhnikov, Nikolaj S.; Berezhnaja, Marija S.; Ermakov, Vjacheslav A.; Melamud, Marina R.

    2016-01-01

    The importance of the studied problem is determined by the fact that the influence of the deviant environment on society, the spread of its morality, a psychological "exposure" of a less stable part of the population, that is teenagers and young adults, all this is--a reality of the contemporary social situation. The study of problems…

  12. Measurement of the Clinical Usability of a Configurable EHR

    DEFF Research Database (Denmark)

    Møller-Jensen, John; Lund Pedersen, Ivan; Simonsen, Jesper

    2006-01-01

    during a series of workshops with the clinicians after which the XML configuration files were written and deployed. In parallel with this, the participants from the University identified, prioritised and further specified a number of effects related to the clinical practice to be measured. The effects......The objective of the project was to measure the clinical usability of an EHR configured by use of participatory design with clinicians from a neurological stroke unit in order to get input to the County’s future strategy for incremental implementation of EHR. The content of the EHR was defined...... requested by the clinicians focused on improving their overview and assessment of patients as well as on more efficient coordination in three specific and highly cooperative situations, viz. nursing handover, ward round and patient conference. All three situations were measured before (using paper...

  13. An Integrated Agent Model Addressing Situation Awareness and Functional State in Decision Making

    NARCIS (Netherlands)

    Hoogendoorn, M.; van Lambalgen, R.M.; Treur, J.

    2011-01-01

    In this paper, an integrated agent model is introduced addressing mutually interacting Situation Awareness and Functional State dynamics in decision making. This shows how a human's functional state, more specific a human's exhaustion and power, can influence a human's situation awareness, and in

  14. Assessing Operational Situations

    DEFF Research Database (Denmark)

    Zhang, Xinxin

    In spite of the high level of automation commonly applied to today’s engineering system, humans’ skill and knowledge still plays a central role in the systems’ daily operation, critical decision making, and accident management. The complexity of the engineered system poses great challenge for human...... operators to perceive and understand the operational situation. The research domain of situation awareness approaches the operational challenges from the human cognition perspective while the presented thesis aims at supporting situation assessment from the system perspective. The thesis has reviewed...... different perspectives on situation awareness in the human factor studies and uses the knowledge reflectively for system representation and analysis. The human cognitive activities during complex plant operation and how they perceive a situation and what kind of knowledge has to be established in the human...

  15. Emergency situations

    International Nuclear Information System (INIS)

    2007-01-01

    The nuclear activities are exercised so as to prevent the accidents. They are subjected to a rule whom application is controlled by the Asn. The risk of grave accident is so limited to a very low level of probability. He cannot be however completely pushed aside. The expression ' radiological emergency situation ' indicates a situation which ensues from an incident or of an accident risking to lead to an emission of radioactive materials or a level of radioactivity susceptible to strike a blow at the public health. The term ' nuclear crisis ' is used for the events which can lead to a radiological emergency situation on a nuclear basic installation or during a transport of radioactive materials. The preparation and the management of emergency situations, that they are of natural, accidental or terrorist origin, became a major concern of our society. We propose you of to know more about it in this file. (N.C.)

  16. Using Digital Libraries Non-Visually: Understanding the Help-Seeking Situations of Blind Users

    Science.gov (United States)

    Xie, Iris; Babu, Rakesh; Joo, Soohyung; Fuller, Paige

    2015-01-01

    Introduction: This study explores blind users' unique help-seeking situations in interacting with digital libraries. In particular, help-seeking situations were investigated at both the physical and cognitive levels. Method: Fifteen blind participants performed three search tasks, including known- item search, specific information search, and…

  17. Disease-specific clinical pathways - are they feasible in primary care? A mixed-methods study.

    Science.gov (United States)

    Grimsmo, Anders; Løhre, Audhild; Røsstad, Tove; Gjerde, Ingunn; Heiberg, Ina; Steinsbekk, Aslak

    2018-04-12

    To explore the feasibility of disease-specific clinical pathways when used in primary care. A mixed-method sequential exploratory design was used. First, merging and exploring quality interview data across two cases of collaboration between the specialist care and primary care on the introduction of clinical pathways for four selected chronic diseases. Secondly, using quantitative data covering a population of 214,700 to validate and test hypothesis derived from the qualitative findings. Primary care and specialist care collaborating to manage care coordination. Primary-care representatives expressed that their patients often have complex health and social needs that clinical pathways guidelines seldom consider. The representatives experienced that COPD, heart failure, stroke and hip fracture, frequently seen in hospitals, appear in low numbers in primary care. The quantitative study confirmed the extensive complexity among home healthcare nursing patients and demonstrated that, for each of the four selected diagnoses, a homecare nurse on average is responsible for preparing reception of the patient at home after discharge from hospital, less often than every other year. The feasibility of disease-specific pathways in primary care is limited, both from a clinical and organisational perspective, for patients with complex needs. The low prevalence in primary care of patients with important chronic conditions, needing coordinated care after hospital discharge, constricts transferring tasks from specialist care. Generic clinical pathways are likely to be more feasible and efficient for patients in this setting. Key points Clinical pathways in hospitals apply to single-disease guidelines, while more than 90% of the patients discharged to community health care for follow-up have multimorbidity. Primary care has to manage the health care of the patient holistically, with all his or her complex needs. Patients most frequently admitted to hospitals, i.e. patients with COPD

  18. Situated cognition and cognitive apprenticeship: a model for teaching and learning clinical skills in a technologically rich and authentic learning environment.

    Science.gov (United States)

    Woolley, Norman N; Jarvis, Yvonne

    2007-01-01

    The acquisition of a range of diverse clinical skills is a central feature of the pre-registration nursing curriculum. Prior to exposure to clinical practice, it is essential that learners have the opportunity to practise and develop such skills in a safe and controlled environment under the direction and supervision of clinical experts. However, the competing demands of the HE nursing curriculum coupled with an increased number of learners have resulted in a reduced emphasis on traditional apprenticeship learning. This paper presents an alternative model for clinical skills teaching that draws upon the principles of cognitive apprenticeship [Collins, A., Brown, J.S., Newman, S., 1989. Cognitive Apprenticeship: teaching the crafts of reading, writing and mathematics. In: Resnick, L.B. (Ed.) Knowing. Learning and Instruction: Essays in Honor of Robert Glaser. Lawrence Erlbaum Associates, New Jersey, pp. 453-494] and situated cognition within a technologically rich and authentic learning environment. It will show how high quality DVD materials illustrating clinical skills performed by expert practitioners have been produced and used in conjunction with CCTV and digital recording technologies to support learning within a pedagogic framework appropriate to skills acquisition. It is argued that this model not only better prepares the student for the time they will spend in the practice setting, but also lays the foundation for the development of a clinically competent practitioner with the requisite physical and cognitive skills who is fit for purpose [UKCC, 1999. Fitness for Practice: The UKCC Commission for Nursing and Midwifery Education. United Kingdom Central Council for Nursing Midwifery and Health Visiting, London].

  19. [Situational panorama of Mexico against the chikungunya virus pandemic].

    Science.gov (United States)

    Martínez-Sánchez, Abisai; Martínez-Ramos, Ericay Berenice; Chávez-Angeles, Manuel Gerardo

    2015-01-01

    Recent outbreaks of emerging diseases emphasize the vulnerability of health systems, as is the case of chikungunya fever. The wide geographical incidence of the virus in the last years requires alerting systems for the prevention, diagnosis, control and eradication of the disease. Given the ecological, epidemiological and socio-economic characteristic of Mexico, this disease affects directly or indirectly the health of the population and development of agricultural, livestock, industrial, fishing, oil and tourism activities in the country. Due to this situation it is essential to make a brief analysis on the main clinical data, epidemiological and preventive measures with which our country counts with to confront the situation.

  20. Reactivity of Tic Observation Procedures to Situation and Setting

    Science.gov (United States)

    Piacentini, John; Himle, Michael B.; Chang, Susanna; Baruch, David E.; Buzzella, Brian A.; Pearlman, Amanda; Woods, Douglas W.

    2006-01-01

    Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following…

  1. Cow-specific risk factors for clinical mastitis in Brazilian dairy cattle.

    Science.gov (United States)

    Oliveira, C S F; Hogeveen, H; Botelho, A M; Maia, P V; Coelho, S G; Haddad, J P A

    2015-10-01

    Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which risk factors were associated with the occurrence of the most common pathogens involved in Brazilian CM infections. The analyses were based on 65 months of data from 9,789 dairy cows and 12,464 CM cases. Cow-specific risk factors that could easily be measured in standard Brazilian dairy farms were used in the statistical analyses, which included logistic regression and multinomial logistic regression. The first month of lactation, high somatic cell count, rainy season and history of clinical mastitis cases were factors associated with CM for both primiparous and multiparous cows. In addition, parity and breed were also associated risk factors for multiparous cows. Of all CM cases, 54% showed positive bacteriological culturing results from which 57% were classified as environmental pathogens, with a large percentage of coliforms (35%). Coagulase-negative Staphylococcus (16%), Streptococcus uberis (9%), Streptococcus agalactiae (7%) and other Streptococci (9%) were also common pathogens. Among the pathogens analyzed, the association of cow-specific risk factors, such as Zebu breed (OR=5.84, 95%CI 3.77-10.77) and accumulated history of SCC (1.76, 95%CI 1.37-2.27), was different for CM caused by Coagulase-negative Staphylococcus and S. agalactiae in comparison to CM caused by coliforms. Our results suggest that CM control programs in Brazil should specially consider the recent history of clinical mastitis cases and the beginning of the lactations, mainly during the rainy season as important risk factor for mastitis. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Modelling situation awareness relations in a multiagent system

    NARCIS (Netherlands)

    Blom, H.A.P.; Sharpanskykh, A.

    2015-01-01

    There is broad consensus that situation awareness (SA) plays a key role in agent-based modelling of complex sociotechnical systems. However in the social sciences and human factors literature there are different views on what SA is and how it could be modelled. More specifically, one school of

  3. GENDER-SPECIFIC CLINICAL MANIFESTATION OF UNIPOLAR DEPRESSION

    Directory of Open Access Journals (Sweden)

    Olivera Žikić

    2016-06-01

    Full Text Available It is well known that the incidence of depression is twice as often in women than in men. However, data about the clinical picture and the course of the disorder in men and in women are inconsistent. The purpose of our research is to find out if there are any differences in terms of symptomatology and course of unipolar depression in men and in women. The study included 84 subjects affected by unipolar depresson, who were divided in two groups according to the gender: a group of males, comprising 20 subjects and a group of female subjects, that comprised 64 affected persons. We used the general semistructured questionnaire with questions about the course of unipolar depression and sociodemographic data, Patient Health Questionnaire-9, Symptom Checklist-90-Revised (SCL- 90-R, Cambridge Depersonalization Scale (CDS and Beck Anxiety Inventory. Regarding symptoms occurring within unipolar depression, there was no statistically significant gender-specific difference finding. Males tended to somewhat higher frequency of anhedonia and hostility, while females tended to more frequent sleep disturbance and decrease in energy. In terms of the course of disorder, it was found that there was a statistically significant difference in the age at the onset of disorder (M:Ž=43.9:34.72 years and frequency of episodes (males had more frequent episodes. Men and women, affected by unipolar depression differ in terms of the course of unipolar depression, but not in the sense of its clinical manifestation.

  4. Situational Strength Cues from Social Sources at Work: Relative Importance and Mediated Effects.

    Science.gov (United States)

    Alaybek, Balca; Dalal, Reeshad S; Sheng, Zitong; Morris, Alexander G; Tomassetti, Alan J; Holland, Samantha J

    2017-01-01

    Situational strength is considered one of the most important situational forces at work because it can attenuate the personality-performance relationship. Although organizational scholars have studied the consequences of situational strength, they have paid little attention to its antecedents. To address this gap, the current study focused on situational strength cues from different social sources as antecedents of overall situational strength at work. Specifically, we examined how employees combine situational strength cues emanating from three social sources (i.e., coworkers, the immediate supervisor, and top management). Based on field theory, we hypothesized that the effect of situational strength from coworkers and immediate supervisors (i.e., proximal sources of situational strength) on employees' perceptions of overall situational strength on the job would be greater than the effect of situational strength from the top management (i.e., the distal source of situational strength). We also hypothesized that the effect of situational strength from the distal source would be mediated by the effects of situational strength from the proximal sources. Data from 363 full-time employees were collected at two time points with a cross-lagged panel design. The former hypothesis was supported for one of the two situational strength facets studied. The latter hypothesis was fully supported.

  5. Situational Strength Cues from Social Sources at Work: Relative Importance and Mediated Effects

    Directory of Open Access Journals (Sweden)

    Balca Alaybek

    2017-09-01

    Full Text Available Situational strength is considered one of the most important situational forces at work because it can attenuate the personality–performance relationship. Although organizational scholars have studied the consequences of situational strength, they have paid little attention to its antecedents. To address this gap, the current study focused on situational strength cues from different social sources as antecedents of overall situational strength at work. Specifically, we examined how employees combine situational strength cues emanating from three social sources (i.e., coworkers, the immediate supervisor, and top management. Based on field theory, we hypothesized that the effect of situational strength from coworkers and immediate supervisors (i.e., proximal sources of situational strength on employees' perceptions of overall situational strength on the job would be greater than the effect of situational strength from the top management (i.e., the distal source of situational strength. We also hypothesized that the effect of situational strength from the distal source would be mediated by the effects of situational strength from the proximal sources. Data from 363 full-time employees were collected at two time points with a cross-lagged panel design. The former hypothesis was supported for one of the two situational strength facets studied. The latter hypothesis was fully supported.

  6. Promises and Pitfalls of Computer-Supported Mindfulness: Exploring a Situated Mobile Approach

    Directory of Open Access Journals (Sweden)

    Ralph Vacca

    2017-12-01

    Full Text Available Computer-supported mindfulness (CSM is a burgeoning area filled with varied approaches such as mobile apps and EEG headbands. However, many of the approaches focus on providing meditation guidance. The ubiquity of mobile devices may provide new opportunities to support mindfulness practices that are more situated in everyday life. In this paper, a new situated mindfulness approach is explored through a specific mobile app design. Through an experimental design, the approach is compared to traditional audio-based mindfulness meditation, and a mind wandering control, over a one-week period. The study demonstrates the viability for a situated mobile mindfulness approach to induce mindfulness states. However, phenomenological aspects of the situated mobile approach suggest both promises and pitfalls for computer-supported mindfulness using a situated approach.

  7. Transitioning from Clinical to Qualitative Research Interviewing

    Directory of Open Access Journals (Sweden)

    Matthew R. Hunt BSc (PT, PhD

    2011-09-01

    Full Text Available In this paper one aspect of the transition that must be made by experienced clinicians who become involved in conducting qualitative health research is examined, specifically, the differences between clinical and research interviewing. A clinician who is skillful and comfortable carrying out a clinical interview may not initially apprehend the important differences between these categories and contexts of interviewing. This situation can lead to difficulties and diminished quality of data collection because the purpose, techniques and orientation of a qualitative research interview are distinct from those of the clinical interview. Appreciation of these differences between interview contexts and genres, and strategies for addressing challenges associated with these differences, can help clinician researchers to become successful qualitative interviewers.

  8. Infant with a foreign body bronchus: a fishy situation!

    African Journals Online (AJOL)

    which gave him brief respite. However, his situation deteriorated and he was referred to our center, as the suspicion of a foreign body in the bronchus was high by then and the referring physician had become concerned. After a detailed clinical examination in our casualty, we suspected that he might have aspirated a small ...

  9. Clinical implementation of pharmacogenetics.

    Science.gov (United States)

    García-González, Xandra; Cabaleiro, Teresa; Herrero, María José; McLeod, Howard; López-Fernández, Luis A

    2016-03-01

    In the last decade, pharmacogenetic research has been performed in different fields. However, the application of pharmacogenetic findings to clinical practice has not been as fast as desirable. The current situation of clinical implementation of pharmacogenetics is discussed. This review focuses on the advances of pharmacogenomics to individualize cancer treatments, the relationship between pharmacogenetics and pharmacodynamics in the clinical course of transplant patients receiving a combination of immunosuppressive therapy, the needs and barriers facing pharmacogenetic clinical application, and the situation of pharmacogenetic testing in Spain. It is based on lectures presented by speakers of the Clinical Implementation of Pharmacogenetics Symposium at the VII Conference of the Spanish Pharmacogenetics and Pharmacogenomics Society, held in April 20, 2015.

  10. Incorporating uncertainty regarding applicability of evidence from meta-analyses into clinical decision making.

    Science.gov (United States)

    Kriston, Levente; Meister, Ramona

    2014-03-01

    Judging applicability (relevance) of meta-analytical findings to particular clinical decision-making situations remains challenging. We aimed to describe an evidence synthesis method that accounts for possible uncertainty regarding applicability of the evidence. We conceptualized uncertainty regarding applicability of the meta-analytical estimates to a decision-making situation as the result of uncertainty regarding applicability of the findings of the trials that were included in the meta-analysis. This trial-level applicability uncertainty can be directly assessed by the decision maker and allows for the definition of trial inclusion probabilities, which can be used to perform a probabilistic meta-analysis with unequal probability resampling of trials (adaptive meta-analysis). A case study with several fictitious decision-making scenarios was performed to demonstrate the method in practice. We present options to elicit trial inclusion probabilities and perform the calculations. The result of an adaptive meta-analysis is a frequency distribution of the estimated parameters from traditional meta-analysis that provides individually tailored information according to the specific needs and uncertainty of the decision maker. The proposed method offers a direct and formalized combination of research evidence with individual clinical expertise and may aid clinicians in specific decision-making situations. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Further, in certain situations association between rock art and ...

    Indian Academy of Sciences (India)

    Further, in certain situations association between rock art and occupation deposits can be inferred with some amount of certainty. When specific types of art consistently occur with occupation deposits of limited duration it is assumed that the art and occupation are contemporary.

  12. Therapist reactions in self-experienced difficult situations: an exploration

    NARCIS (Netherlands)

    Smith, A.J.M.; Kleijn, W.C.; Hutschemaekers, G.J.M.

    2007-01-01

    This article describes a qualitative study of 63 difficult therapeutic situations described by 26 therapists. The study was part of research on specific reactions of therapists to traumatized clients. The research questions for the current analyses focused on the categorization of difficult

  13. A Survey of the Current Situation of Clinical Biobanks in China.

    Science.gov (United States)

    Li, Haiyan; Ni, Mingyu; Wang, Peng; Wang, Xiaomin

    2017-06-01

    The development of biomedical research urgently needs the support of a large number of high-quality clinical biospecimens. Therefore, human biobanks at different levels have been established successively in China and other countries at a significantly increasing pace in recent years. To better understand the general current state of clinical biobanks in China, we surveyed 42 clinical biobanks based in hospitals and collected information involving their management systems, sharing mechanisms, quality control systems, and informational management systems using closed questionnaire methods. Based on our current information, there has not been such a large-scale survey in China. An understanding of the status and challenges current clinical biobanks face will provide valuable insights for the construction and sustainable development of higher quality clinical biobanks.

  14. The Pedagogical Reflection Model - an educational perspective on clinical decisions

    DEFF Research Database (Denmark)

    Voergaard Poulsen, Bettina; Vibholm Persson, Stine; Skriver, Mette

    Clinical decision-making is important in patient-centred nursing, which is known in nursing education and research (1) The Pedagogical Reflection Model (PRM) can provide a framework that supports students’ decision-making in patient-specific situations. PRM is based on the assumption that clinical......) The aims of this study were to explore how nurse students and clinical supervisors use PRM as method to reflect before, during and after PRM guidance in relation to clinical decisions in the first year of clinical practice...... decision-making needs to take into account; 1) clinical experiences, 2) the perspective of the patient, 3) clinical observations and investigations, 4) knowledge about patients experiences of being a patient and ill, 5) medical knowledge about diseases, and 6) the organizational framework (2,3,4)(Figure 1...

  15. Animal Cruelty Motivations: Assessing Demographic and Situational Influences

    Science.gov (United States)

    Hensley, Christopher; Tallichet, Suzanne E.

    2005-01-01

    Few studies have examined childhood and adolescent animal cruelty motives. Using a sample of 261 inmates surveyed at both medium and maximum security prisons in a southern state, the present study examined the impact of demographic attributes and situational factors relating specifically to a range of animal cruelty motivations. Almost half of the…

  16. Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations.

    Science.gov (United States)

    Schweizer, T Sophie; Schmalenberger, Katja M; Eisenlohr-Moul, Tory A; Mojzisch, Andreas; Kaiser, Stefan; Funke, Joachim

    2016-01-01

    Which factors influence a human being's ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand

  17. Chinanteco children’s silences in different classroom situations

    Directory of Open Access Journals (Sweden)

    Valeria Rebolledo Angulo

    2016-01-01

    Full Text Available This article analyzes, from an ethnographic perspective and a sociocultural framework, the construction of silences in the interaction between students and teachers in a multilingual classroom situation in an indigenous community in méxico. the analysis reveals how the silence of the chinanteco speaking children when asked to answer certain questions in class is not always due to their failure to understand spoken and written spanish that is used in class. their silences are responses taking different meanings in specific situations. the silence of the children can be a way of resisting, a way of hiding, and, sometimes, their voices are silenced.

  18. Clinical Utility of Noninvasive Method to Measure Specific Gravity in the Pediatric Population.

    Science.gov (United States)

    Hall, Jeanine E; Huynh, Pauline P; Mody, Ameer P; Wang, Vincent J

    2018-04-01

    Clinicians rely on any combination of signs and symptoms, clinical scores, or invasive procedures to assess the hydration status in children. Noninvasive tests to evaluate for dehydration in the pediatric population are appealing. The objective of our study is to assess the utility of measuring specific gravity of tears compared to specific gravity of urine and the clinical assessment of dehydration. We conducted a prospective cohort convenience sample study, in a pediatric emergency department at a tertiary care children's hospital. We approached parents/guardians of children aged 6 months to 4 years undergoing transurethral catheterization for evaluation of urinary tract infection for enrollment. We collected tears and urine for measurement of tear specific gravity (TSG) and urine specific gravity (USG), respectively. Treating physicians completed dehydration assessment forms to assess for hydration status. Among the 60 participants included, the mean TSG was 1.0183 (SD = 0.007); the mean USG was 1.0186 (SD = 0.0083). TSG and USG were positively correlated with each other (Pearson Correlation = 0.423, p = 0.001). Clinical dehydration scores ranged from 0 to 3, with 87% assigned a score of 0, by physician assessment. Mean number of episodes of vomiting and diarrhea in a 24-hour period were 2.2 (SD = 3.9) and 1.5 (SD = 3.2), respectively. Sixty-two percent of parents reported decreased oral intake. TSG measurements yielded similar results compared with USG. Further studies are needed to determine if TSG can be used as a noninvasive method of dehydration assessment in children. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Current situation and future usage of anticancer drug databases.

    Science.gov (United States)

    Wang, Hongzhi; Yin, Yuanyuan; Wang, Peiqi; Xiong, Chenyu; Huang, Lingyu; Li, Sijia; Li, Xinyi; Fu, Leilei

    2016-07-01

    Cancer is a deadly disease with increasing incidence and mortality rates and affects the life quality of millions of people per year. The past 15 years have witnessed the rapid development of targeted therapy for cancer treatment, with numerous anticancer drugs, drug targets and related gene mutations been identified. The demand for better anticancer drugs and the advances in database technologies have propelled the development of databases related to anticancer drugs. These databases provide systematic collections of integrative information either directly on anticancer drugs or on a specific type of anticancer drugs with their own emphases on different aspects, such as drug-target interactions, the relationship between mutations in drug targets and drug resistance/sensitivity, drug-drug interactions, natural products with anticancer activity, anticancer peptides, synthetic lethality pairs and histone deacetylase inhibitors. We focus on a holistic view of the current situation and future usage of databases related to anticancer drugs and further discuss their strengths and weaknesses, in the hope of facilitating the discovery of new anticancer drugs with better clinical outcomes.

  20. Tree-connected Peer Group Situations and Peer Group Games

    NARCIS (Netherlands)

    Brânzei, R.; Fragnelli, V.; Tijs, S.H.

    2000-01-01

    A class of cooperative games is introduced which arises from situations in which a set of agents is hierarchically structured and where potential individual economic abilities interfere with the behavioristic rules induced by the organization structure.These games form a cone generated by a specific

  1. Clinical and Phenomenological Characteristics of Patients with Task-Specific Lingual Dystonia: Possible Association with Occupation

    Directory of Open Access Journals (Sweden)

    Kazuya Yoshida

    2017-12-01

    Full Text Available BackgroundLingual dystonia is a subtype of oromandibular dystonia, which is a movement disorder characterized by involuntary sustained or intermittent contraction of the masticatory and/or tongue muscles. Lingual dystonia interferes with important daily activities, such as speaking, chewing, and swallowing, resulting in vocational and social disability.ObjectiveThe aim of this study was to investigate a possible relationship between occupation and the development of lingual dystonia.MethodsPhenomenological and clinical characteristics of 95 patients [53 females (55.8% and 42 males (44.2%, mean age 48.0 years] with task-specific, speech-induced lingual dystonia were analyzed. Structured interviews were carried out to obtain information regarding primary occupation, including overtime work and stress during work. The factors that might have influenced the development of lingual dystonia were estimated using multivariate logistic regression analysis of the 95 patients with lingual dystonia and 95 controls [68 females (71.6% and 27 males (28.4%, mean age 47.2 years] with temporomandibular disorders.ResultsOverall, 84.2% of the patients had regular occupations; 73.8% of the patients with regular occupations reported working overtime more than twice a week, and 63.8% of them experienced stress at the workplace. Furthermore, 82.1% of the patients had engaged in occupations that required them to talk to customers or other people under stressful situations over prolonged periods of time for many years (mean: 15.6 years. The most common occupation was sales representative (17.9%, followed by telephone operator (13.7%, customer service representative (10.5%, health care worker (9.5%, waiter or waitress (5.3%, receptionist (5.3%, and cashier (5.3%. Twenty-nine patients (30.5% had tardive lingual dystonia. Logistic regression analyses revealed that frequent requirements for professional speaking (p = 0.011, odds ratio: 5.66, high stress during work

  2. Current Situations and Countermeasures of Development of Kiwifruit Industry in Guizhou Province

    OpenAIRE

    Huang, Wei; Wan, Ming-chang; Yang, Sheng-jun; Zhang, Xue; Qiao, Rong

    2012-01-01

    On the basis of current development situations of planting, scientific research and processing of kiwifruit industry in Guizhou Province, the paper analyzes main factors restricting development of kiwifruit industry, including lack of unified planning, standardized planting specifications, and backward management of kiwifruit orchard. In accordance with current development situations and restricting factors, the paper presents some countermeasures for development of kiwifruit industry in Guiz...

  3. Real-time PCR for type-specific identification of herpes simplex in clinical samples: evaluation of type-specific results in the context of CNS diseases.

    Science.gov (United States)

    Meylan, Sylvain; Robert, Daniel; Estrade, Christine; Grimbuehler, Valérie; Péter, Olivier; Meylan, Pascal R; Sahli, Roland

    2008-02-01

    HSV-1 and HSV-2 cause CNS infections of dissimilar clinico-pathological characteristics with prognostic and therapeutic implications. To validate a type-specific real-time PCR that uses MGB/LNA Taqman probes and to review the virologico-clinical data of 25 eligible patients with non-neonatal CNS infections. This real-time PCR was evaluated against conventional PCR (26 CSF and 20 quality controls), and LightCycler assay (51 mucocutaneous, 8 CSF and 32 quality controls) and culture/immunofluorescence (75 mucocutaneous) to assess typing with independent methods. Taqman real-time PCR detected 240 HSV genomes per ml CSF, a level appropriate for the management of patients, and provided unambiguous typing for the 104 positive (62 HSV-1 and 42 HSV-2) out the 160 independent clinical samples tested. HSV type diagnosed by Taqman real-time PCR predicted final diagnosis (meningitis versus encephalitis/meningoencephalitis, p<0.001) in 24/25 patients at time of presentation, in contrast to clinical evaluation. Our real-time PCR, as a sensitive and specific means for type-specific HSV diagnosis, provided rapid prognostic information for patient management.

  4. Trait vs. state anxiety in different threatening situations

    Directory of Open Access Journals (Sweden)

    Pollyana Caldeira Leal

    2017-08-01

    Full Text Available Abstract Objective Anxiety as a uni- or multidimensional construct has been under discussion. The unidimensional approach assumes that there is a general trait anxiety, which predisposes the individuals to increases in state anxiety in various threatening situations. In this case, there should be a correlation between state and trait anxiety in any situation of threat. Therefore, the aim of this study was to investigate the correlation between trait and state anxiety in participants exposed to two different anxiogenic situations: interpersonal threat (Video-Monitored Stroop Test – VMST and physical threat (third molar extraction – TME. Methods Participants with various levels of trait anxiety (general trait: State-Trait Anxiety Inventory – STAI, Hospital Anxiety and Depression Scale; specific trait: Social Phobia Inventory, Dental Anxiety Scale had their anxious state evaluated (STAI, self-evaluation of tension level, heart rate, electromyogram activity before, during and after the VMST or the TME. Results In VMST, trait anxiety correlated to state anxiety (psychological parameters in all test phases. However, in TME, the only trait measurement that correlated to state anxiety (psychological parameters was the Dental Anxiety Scale. Conclusion Trait anxiety correlates positively to state anxiety in situations of interpersonal threat, but not of physical threat.

  5. Expression of Panton-Valentine leukocidin mRNA among Staphylococcus aureus isolates associates with specific clinical presentations.

    Directory of Open Access Journals (Sweden)

    Fangyou Yu

    Full Text Available Panton-Valentine leukocidin (PVL; gene designation lukF/S-PV is likely an important virulence factor for Staphylococcus aureus (S. aureus, as qualitative expression of the protein correlates with severity for specific clinical presentations, including skin and soft tissue infections (SSTIs. Development of genetic approaches for risk-assessment of patients with S. aureus infections may prove clinically useful, and whether lukF/S-PV gene expression correlates with specific clinical presentations for S. aureus has been largely unexplored. In the present study, we quantified lukS-PV mRNA among 96 S. aureus isolates to determine whether expression levels correlated with specific clinical presentations in adults and children. Expression level of lukS-PV mRNA among isolates from skin and soft tissue infections (SSTIs was significantly greater than among isolates from blood stream infection (BSIs, and expression level of lukS-PV mRNA among BSI isolates from children was significantly greater than for BSI isolates among adults. Moreover, expression level of lukS-PV mRNA among community-acquired (CA isolates was significantly greater than for hospital-acquired (HA isolates. These data justify additional studies to determine the potential clinical utility for lukS-PV mRNA quantification as a predictive tool for severity of S. aureus infection.

  6. The current situation for gastric cancer in Chile.

    Science.gov (United States)

    Caglevic, Christian; Silva, Shirley; Mahave, Mauricio; Rolfo, Christian; Gallardo, Jorge

    2016-01-01

    Gastric cancer is a neoplasm with a high incidence and mortality rate in Chile where more than 3000 people die every year from this type of cancer. This study shows the clinical and epidemiological considerations of this disease, information about translational research on this pathology in Chile, the contribution of Chilean doctors to the development of gastric cancer management awareness and the general situation of gastric cancer in Chile.

  7. Situation awareness in undergraduate nursing students managing simulated patient deterioration.

    Science.gov (United States)

    McKenna, Lisa; Missen, Karen; Cooper, Simon; Bogossian, Fiona; Bucknall, Tracey; Cant, Robyn

    2014-06-01

    Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. The educational process of FIRST(2)ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Clinical laboratories at each of three participating universities. Ninety-seven nursing students from three Australian universities. Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%). Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  8. The satellite situation center

    International Nuclear Information System (INIS)

    Teague, M.J.; Sawyer, D.M.; Vette, J.I.

    1982-01-01

    Considerations related to the early planning for the International Magnetospheric Study (IMS) took into account the desirability of an establishment of specific entities for generating and disseminating coordination information for both retrospective and predictive periods. The organizations established include the IMS/Satellite Situation Center (IMS/SSC) operated by NASA. The activities of the SSC are related to the preparation of reports on predicted and actually achieved satellite positions, the response to inquiries, the compilation of information on satellite experiments, and the issue of periodic status summaries. Attention is given to high-altitude satellite services, other correlative satellite services, non-IMS activities of the SSC, a summary of the SSC request activity, and post-IMS and future activities

  9. METHODOLOGICAL ELEMENTS OF SITUATIONAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    Tetyana KOVALCHUK

    2016-07-01

    Full Text Available The article deals with the investigation of theoretical and methodological principles of situational analysis. The necessity of situational analysis is proved in modern conditions. The notion “situational analysis” is determined. We have concluded that situational analysis is a continuous system study which purpose is to identify dangerous situation signs, to evaluate comprehensively such signs influenced by a system of objective and subjective factors, to search for motivated targeted actions used to eliminate adverse effects of the exposure of the system to the situation now and in the future and to develop the managerial actions needed to bring the system back to norm. It is developed a methodological approach to the situational analysis, its goal is substantiated, proved the expediency of diagnostic, evaluative and searching functions in the process of situational analysis. The basic methodological elements of the situational analysis are grounded. The substantiation of the principal methodological elements of system analysis will enable the analyst to develop adaptive methods able to take into account the peculiar features of a unique object which is a situation that has emerged in a complex system, to diagnose such situation and subject it to system and in-depth analysis, to identify risks opportunities, to make timely management decisions as required by a particular period.

  10. Clinical validity of a disease-specific health status questionnaire: the peripheral artery questionnaire.

    Science.gov (United States)

    Hoeks, Sanne E; Smolderen, Kim G; Scholte Op Reimer, Wilma J M; Verhagen, Hence J M; Spertus, John A; Poldermans, Don

    2009-02-01

    Measuring patient-centered outcomes is becoming increasingly important in patients with peripheral arterial disease (PAD), both as a means of determining the benefits of treatment and as an aid for disease management. In order to monitor health status in a reliable and sensitive way, the disease-specific measure Peripheral Artery Questionnaire (PAQ) was developed. However, to date, its correlation with traditional clinical indices is unknown. The primary aim of this study was to better establish the clinical validity of the PAQ by examining its association with functional indices related to PAD. Furthermore, we hypothesized that the clinical validity of this disease-specific measure is better as compared with the EuroQol-5-dimensional (EQ-5D), a standardized generic instrument. Data on 711 consecutive PAD patients undergoing surgery were collected from 11 Dutch hospitals in 2004. At 3-year follow-up, questionnaires including the PAQ, EQ-5D, and EuroQol-Visual Analogue Scale (EQ VAS) were completed in 84% of survivors. The PAQ was analyzed according to three domains, as established by a factor analyses in the Dutch population, and the summary score. Baseline clinical indices included the presence and severity of claudication intermittent (CI) and the Lee Cardiac Risk Index. All three PAQ domains (Physical Function, Perceived Disability, and Treatment Satisfaction) were significantly associated with CI symptoms (P values PAQ summary scores as compared with asymptomatic patients (58.6 +/- 27.8 vs 68.6 +/- 27.8, P = PAQ summary score and the subscale scores for Physical Functioning and Perceived Disability demonstrated a clear dose-response relation for walking distance and the Lee Risk Index (P values PAQ proved to be good as the PAQ subscales discriminated well between patients with or without symptomatic PAD and its severity as defined by walking distance. Furthermore, the PAQ subscales were directly proportional to the presence and number of risk factors relevant

  11. A Situational Implementation Method for Business Process Management Systems

    NARCIS (Netherlands)

    R.L. Jansen; J.P.P. Ravensteyn

    For the integrated implementation of Business Process Management and supporting information systems many methods are available. Most of these methods, however, apply a one-size fits all approach and do not take into account the specific situation of the organization in which an information system is

  12. Evaluation of clinical features scoring system as screening tool for influenza A (H1N1 in epidemic situations

    Directory of Open Access Journals (Sweden)

    P Ranjan

    2012-01-01

    Full Text Available Background: Influenza A (H1N1 hit the headlines in recent times and created mass hysteria and general panic. The high cost and non-availability of diagnostic laboratory tests for swine flu, especially in the developing countries underlines the need of having a cheaper, easily available, yet reasonably accurate screening test. Aims: This study was carried out to develop a clinical feature-based scoring system (CFSS for influenza A (H1N1 and to evaluate its suitability as a screening tool when large numbers of influenza-like illness cases are suspect. Settings and Design: Clinical-record based study, carried out retrospectively in post-pandemic period on subject′s case-sheets who had been quarantined at IG International Airport′s quarantine center at Delhi. Materials and Methods: Clinical scoring of each suspected case was done by studying their case record sheet and compared with the results of RT-PCR. RT-PCR was used to confirm the diagnosis (Gold Standard. Statistical Analysis: We calculated sensitivity, specificity, positive and negative predictive values of the clinical feature-based scoring system (the proposed new screening tool at different cut-off values. The most discriminant cut-off value was determined by plotting the ROC curve. Results: Of the 638 suspected cases, 127 (20% were confirmed to have H1N1 by RT-PCR examination. On the basis of ROC, the most discriminant clinical feature score for diagnosing Influenza A was found to be 7, which yielded sensitivity, specificity, positive, and negative predictive values of 86%, 88%, 64%, and 96%, respectively. Conclusion: The clinical features scoring system (CFSS can be used as a valid and cost-effective tool for screening swine flu (influenza A (H1N1 cases from large number of influenza-like illness suspects.

  13. Situational Leadership

    OpenAIRE

    Süttö, Marián

    2016-01-01

    This thesis is focused on field of leadership, particularly situational leadership model by Hersey and Blanchard. Thesis is mostly theoretical framework aimed to offer the possibility for reader to get overview in leadership issues. Theoretical framework of the thesis is focused on leadership definition, the most important leadership theories in the past, and especially to situational leadership approach. The focus of this thesis is to get detailed insight in this model and therefore offer in...

  14. Nephron segment specific microRNA biomarkers of pre-clinical drug-induced renal toxicity: Opportunities and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Nassirpour, Rounak, E-mail: Rounak.nassirpour@pfizer.com [Drug Safety, Pfizer Worldwide Research and Development, 1 Burtt Rd, Andover, MA 01810 (United States); Ramaiah, Shashi K. [Drug Safety, Pfizer Worldwide Research and Development, 610 Main Street, Cambridge, MA 02139 (United States); Whiteley, Laurence O. [Drug Safety, Pfizer Worldwide Research and Development, 1 Burtt Rd, Andover, MA 01810 (United States)

    2016-12-01

    Drug-induced nephrotoxicity is a common drug development complication for pharmaceutical companies. Sensitive, specific, translatable and non-invasive biomarkers of renal toxicity are urgently needed to diagnose nephron segment specific injury. The currently available gold standard biomarkers for nephrotoxicity are not kidney-specific, lack sensitivity for early detection, and are not suitable for renal damage localization (glomerular vs tubulointerstitial injury). MicroRNAs (miRNAs) are increasingly gaining momentum as promising biomarkers of various organ toxicities, including drug induced renal injury. This is mostly due to their stability in easily accessible biofluids, ease of developing nucleic acids detection compared to protein detection assays, as well as their interspecies translatability. Increasing concordance of miRNA findings by standardizing methodology most suitable for their detection and quantitation, as well as characterization of their expression pattern in a cell type specific manner, will accelerate progress toward validation of these miRNAs as biomarkers in pre-clinical, and clinical settings. This review aims to highlight the current pre-clinical findings surrounding miRNAs as biomarkers in two important segments of the nephron, the glomerulus and tubules. - Highlights: • miRNAs are promising biomarkers of drug-induced kidney injury. • Summarized pre-clinical miRNA biomarkers of drug-induced nephrotoxicity. • Described the strengths and challenges associated with miRNAs as biomarkers.

  15. Interactive Purchasing Situations

    NARCIS (Netherlands)

    Groote Schaarsberg, M.; Borm, P.E.M.; Hamers, H.J.M.; Reijnierse, J.H.

    2012-01-01

    Abstract: This paper introduces a new class of interactive cooperative purchasing situations and provides an explicit alternative characterization of the nucleolus of cooperative games, which offers an alternative to Kohlberg (1971). In our cooperative purchasing situation, the unit price of a

  16. Situations of car-to-pedestrian contact.

    Science.gov (United States)

    Matsui, Yasuhiro; Hitosugi, Masahito; Takahashi, Kunio; Doi, Tsutomu

    2013-01-01

    To reduce the severity of injuries and the number of pedestrian deaths in traffic accidents, active safety devices providing pedestrian detection are considered effective countermeasures. The features of car-to-pedestrian collisions need to be known in detail to develop such safety devices. Because information on real-world accidents is limited, this study investigated near-miss situations captured by drive recorders installed in passenger cars. We showed similarities of the contact situation between near-miss incidents and real-world fatal pedestrian accidents in Japan. We analyzed the near-miss incident data via video capturing pedestrians crossing the road in front of forward-moving cars. Using a video frame captured by a drive recorder, the time to collision (TTC) was calculated from the car velocity and the distance between the car and pedestrian at the moment that the pedestrian initially appeared. The average TTC in the cases where pedestrians were not using a pedestrian crossing was shorter than that in the cases where pedestrians were using a pedestrian crossing. The average TTC in the cases where pedestrians emerged from behind obstructions was shorter than that in the cases where drivers had unobstructed views of the pedestrians. We propose that the specifications of the safety device for pedestrian detection and automatic braking should reflect the severe approach situation for a pedestrian and car including the TTC observed for near-miss incidents.

  17. Flooding and Implosive Therapy with Situation Specific and Non-Situation Specific Anxiety.

    Science.gov (United States)

    Boudewyns, Patrick A.

    Two inpatients, one with a circumscribed phobia for dentists and dental offices and another who had been diagnosed as suffering from an anxiety neurosis, were treated with a flooding procedure. A simple flooding technique which dealt with only the symptom contingent cues was sufficient to change behavior in the former case, but for the relatively…

  18. Elective Inactivation of Total Artificial Heart Technology in Non-Futile Situations: Inpatients, Outpatients and Research Participants

    Science.gov (United States)

    Bramstedt, Katrina A.

    2004-01-01

    Total artificial heart technology as a potential clinical therapy raises the issue of elective device inactivation in both futile and non-futile situations. This article explores elective device inactivation in non-futile situations. In reply to such requests for inactivation, the medical team should reflect on the individual's decision-making…

  19. The situated accomplishment (aesthetics) of being a cyranoid

    DEFF Research Database (Denmark)

    Raudaskoski, Pirkko Liisa; Mitchell, Robb

    2013-01-01

    One aim of participatory innovation is to find new ways of engaging people in various situations that result in ideas and suggestions. For a socio- technical system – whether the design process or its implemented result – to work smoothly (aesthetically) as a specific social order, we should...

  20. Study design and rationale for biomedical shirt-based electrocardiography monitoring in relevant clinical situations: ECG-shirt study.

    Science.gov (United States)

    Balsam, Paweł; Lodziński, Piotr; Tymińska, Agata; Ozierański, Krzysztof; Januszkiewicz, Łukasz; Główczyńska, Renata; Wesołowska, Katarzyna; Peller, Michał; Pietrzak, Radosław; Książczyk, Tomasz; Borodzicz, Sonia; Kołtowski, Łukasz; Borkowski, Mariusz; Werner, Bożena; Opolski, Grzegorz; Grabowski, Marcin

    2018-01-01

    Today, the main challenge for researchers is to develop new technologies which may help to improve the diagnoses of cardiovascular disease (CVD), thereby reducing healthcare costs and improving the quality of life for patients. This study aims to show the utility of biomedical shirt-based electrocardiography (ECG) monitoring of patients with CVD in different clinical situations using the Nuubo® ECG (nECG) system. An investigator-initiated, multicenter, prospective observational study was carried out in a cardiology (adult and pediatric) and cardiac rehabilitation wards. ECG monitoring was used with the biomedical shirt in the following four independent groups of patients: 1) 30 patients after pulmonary vein isolation (PVI), 2) 30 cardiac resynchronization therapy (CRT) recipients, 3) 120 patients during cardiac rehabilitation after myocardial infarction, and 4) 40 pediatric patients with supraventricular tachycardia (SVT) before electrophysiology study. Approval for all study groups was obtained from the institutional review board. The biomedical shirt captures the electrocardiographic signal via textile electrodes integrated into a garment. The software allows the visualization and analysis of data such as ECG, heart rate, arrhythmia detecting algorithm and relative position of the body is captured by an electronic device. The major advantages of the nECG system are continuous ECG monitoring during daily activities, high quality of ECG recordings, as well as assurance of a proper adherence due to adequate comfort while wearing the shirt. There are only a few studies that have examined wearable systems, especially in pediatric populations. This study is registered in ClinicalTrials.gov: Identifier NCT03068169. (Cardiol J 2018; 25, 1: 52-59).

  1. Dynamics of Situation Definition

    Science.gov (United States)

    Park, Dongseop; Moro, Yuji

    2006-01-01

    Situation definition is the process and product of actors' interpretive activities toward a given situation. By reviewing a number of psychological studies conducted in experimental settings, we found that the studies have only explicated a part of the situation definition process and have neglected its dynamic aspects. We need to focus on the…

  2. Use of Digital Rectal Examination as an Adjunct to Prostate Specific Antigen in the Detection of Clinically Significant Prostate Cancer.

    Science.gov (United States)

    Halpern, Joshua A; Oromendia, Clara; Shoag, Jonathan E; Mittal, Sameer; Cosiano, Michael F; Ballman, Karla V; Vickers, Andrew J; Hu, Jim C

    2018-04-01

    Guidelines from the NCCN ® (National Comprehensive Cancer Network®) advocate digital rectal examination screening only in men with elevated prostate specific antigen. We investigated the effect of prostate specific antigen on the association of digital rectal examination and clinically significant prostate cancer in a large American cohort. We evaluated the records of the 35,350 men who underwent digital rectal examination in the screening arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial for the development of clinically significant prostate cancer (Gleason 7 or greater). Followup was 343,273 person-years. The primary outcome was the rate of clinically significant prostate cancer among men with vs without suspicious digital rectal examination. We performed competing risks regression to evaluate the interaction between time varying suspicious digital rectal examination and prostate specific antigen. A total of 1,713 clinically significant prostate cancers were detected with a 10-year cumulative incidence of 5.9% (95% CI 5.6-6.2). Higher risk was seen for suspicious vs nonsuspicious digital rectal examination. Increases in absolute risk were small and clinically irrelevant for normal (less than 2 ng/ml) prostate specific antigen (1.5% vs 0.7% risk of clinically significant prostate cancer at 10 years), clinically relevant for elevated (3 ng/ml or greater) prostate specific antigen (23.0% vs 13.7%) and modestly clinically relevant for equivocal (2 to 3 ng/ml) prostate specific antigen (6.5% vs 3.5%). Digital rectal examination demonstrated prognostic usefulness when prostate specific antigen was greater than 3 ng/ml, limited usefulness for less than 2 ng/ml and marginal usefulness for 2 to 3 ng/ml. These findings support the restriction of digital rectal examination to men with higher prostate specific antigen as a reflex test to improve specificity. It should not be used as a primary screening modality to improve sensitivity. Copyright

  3. A clinical challenging situation of Intra oral fibroma mimicking ...

    African Journals Online (AJOL)

    ... bleeds on palpation clinically with histopathological picture of chronic inflammatory infiltrate, endothelial cell proliferation and hyperplastic granulation tissue. Postoperative review was after 1 month with good prognosis thereby facilitating efficient swallowing and tongue movements. Pan African Medical Journal 2015; 22 ...

  4. Core outcome measurement instruments for clinical trials in non-specific low back pain

    NARCIS (Netherlands)

    Chiarotto, Alessandro; Boers, Maarten; Deyo, Richard A; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Christine Lin, Chung-Wei; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Terwee, Caroline B; Ostelo, Raymond W

    2017-01-01

    To standardize outcome reporting in clinical trials of patients with non-specific low back pain (LBP), an international multidisciplinary panel recommended physical functioning, pain intensity, and health-related quality of life (HRQoL) as core outcome domains. Given the lack of consensus on

  5. STRESSFUL SITUATIONS IN TEACHING PROFESSION – CAUSES AND CONSEQUENCES

    Directory of Open Access Journals (Sweden)

    Anna Romanowska-Tołłoczko

    2014-02-01

    Full Text Available Purpose . Determination which areas of teacher’s work are primary sources of stress, denomination of the extent to which disciplinary problems with students were stress inducing, and what was the frequency and intensity of these situations. Material and methods. The study involved 180 teachers from junior high schools, among which two groups were selected: physical education teachers (74 persons and teachers of other subjects (106 persons. The reason for this division was the necessity of identifying the groups of teachers differing in specifics of school subjects, studies which they graduated from, and determine the typical areas of difficulty experienced. The research was based on a diagnostic survey and a questionnaire. Results . Teaching profession is considered as psychologically challenging occupation due to numerous occurrences of stressful situations. Yet it is not equally aggravating for everyone – there are well-functioning teachers who cope easily, but on the other hand, there are cases of serious psychosomatic consequences caused by frequent and prolonged pressures. Abilities of dealing with difficult situations largely depend upon one’s individual predispositions, resistance to stress, way of assessing a situation and resulting type of action. Conclusions . The ability (or lack of it of coping with range of educational activities may determine the intensity of experienced difficulties, and therefore the frequency of occurring stressful situations. Lack of skills in the area of interpersonal relations translates to inability to coping with problematic situations with pupils. This leads the teacher to awareness of own inefficiency and helplessness, which increases the intensity of experienced stress.

  6. From Knowledge Transfer to Situated Innovation

    DEFF Research Database (Denmark)

    Dittrich, Yvonne; Eriksén, Sara; Wessels, Bridgette

    Innovation systems, ‘triple helix’, and similar expressions, are used to conceptualise the growing need for more integrated forms of co-operation between academia and other societal actors, such as governmental agencies and industry, in order to produce knowledge relevant for society. However......, developers and domain experts that form constituencies and where scientific knowledge is confronted by requirements, constraints and possibilities of the specific situation. In this context innovation of, or involving, ICT requires a significant amount of imagination, represents a relatively sharp break...

  7. Leprosy: current situation, clinical and laboratory aspects, treatment history and perspective of the uniform multidrug therapy for all patients.

    Science.gov (United States)

    Cruz, Rossilene Conceição da Silva; Bührer-Sékula, Samira; Penna, Maria Lúcia F; Penna, Gerson Oliveira; Talhari, Sinésio

    2017-01-01

    In this review, the most relevant and current epidemiological data, the main clinical, laboratory and therapeutical aspects of leprosy are presented. Detailed discussion of the main drugs used for leprosy treatment, their most relevant adverse effects, evolution of the therapeutic regimen, from dapsone as a monotherapy to the proposed polychemotherapy by World Health Organization (WHO) can be found in this CME. We specifically highlight the drug acceptability, reduction in treatment duration and the most recent proposal of a single therapeutic regimen, with a fixed six months duration, for all clinical presentations, regardless of their classification.

  8. Elimination of pain improves specificity of clinical diagnostic criteria for adult chronic rhinosinusitis.

    Science.gov (United States)

    Hirsch, Scott D; Reiter, Evan R; DiNardo, Laurence J; Wan, Wen; Schuman, Theodore A

    2017-05-01

    Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis. Retrospective cohort study. History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache. Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, and 34% by either modality. Applying modified RSTF diagnostic criteria, 39% lacked sinonasal inflammation by CT, 38% by endoscopy, and 24% by either modality. Using either abnormal CT or endoscopy as the reference standard, modified diagnostic criteria yielded a statistically significant increase in specificity from 37.1% to 65.1%, with a nonsignificant decrease in sensitivity from 79.2% to 70.3%. Analysis of comorbidities revealed temporomandibular joint disorder, chronic cervical pain, depression/anxiety, and psychiatric medication use to be negatively associated with objective inflammation on CT or endoscopy. Clinical diagnostic criteria overestimate the prevalence of chronic rhinosinusitis. Removing facial pain, ear pain, dental pain, and headache increased specificity without a concordant loss in sensitivity. Given the high prevalence of sinusitis, improved clinical diagnostic criteria may assist primary care providers in more accurately predicting the presence of inflammation, thereby reducing inappropriate antibiotic use or delayed referral for evaluation of primary headache syndromes. 4. Laryngoscope, 127:1011-1016, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  9. 40 CFR 75.58 - General recordkeeping provisions for specific situations.

    Science.gov (United States)

    2010-07-01

    ... data acquisition and handling system, as appropriate to the type of add-on emission controls: (1) For... to a unit that burns such gaseous fuel(s) only during unit startup. (f) Specific SO 2, NO X, and CO 2...

  10. Nursing diagnosis of grieving: content validity in perinatal loss situations.

    Science.gov (United States)

    Paloma-Castro, Olga; Romero-Sánchez, José Manuel; Paramio-Cuevas, Juan Carlos; Pastor-Montero, Sonia María; Castro-Yuste, Cristina; Frandsen, Anna J; Albar-Marín, María Jesús; Bas-Sarmiento, Pilar; Moreno-Corral, Luis Javier

    2014-06-01

    To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation. © 2013 NANDA International.

  11. Precision Oncology Medicine: The Clinical Relevance of Patient-Specific Biomarkers Used to Optimize Cancer Treatment.

    Science.gov (United States)

    Schmidt, Keith T; Chau, Cindy H; Price, Douglas K; Figg, William D

    2016-12-01

    Precision medicine in oncology is the result of an increasing awareness of patient-specific clinical features coupled with the development of genomic-based diagnostics and targeted therapeutics. Companion diagnostics designed for specific drug-target pairs were the first to widely utilize clinically applicable tumor biomarkers (eg, HER2, EGFR), directing treatment for patients whose tumors exhibit a mutation susceptible to an FDA-approved targeted therapy (eg, trastuzumab, erlotinib). Clinically relevant germline mutations in drug-metabolizing enzymes and transporters (eg, TPMT, DPYD) have been shown to impact drug response, providing a rationale for individualized dosing to optimize treatment. The use of multigene expression-based assays to analyze an array of prognostic biomarkers has been shown to help direct treatment decisions, especially in breast cancer (eg, Oncotype DX). More recently, the use of next-generation sequencing to detect many potential "actionable" cancer molecular alterations is further shifting the 1 gene-1 drug paradigm toward a more comprehensive, multigene approach. Currently, many clinical trials (eg, NCI-MATCH, NCI-MPACT) are assessing novel diagnostic tools with a combination of different targeted therapeutics while also examining tumor biomarkers that were previously unexplored in a variety of cancer histologies. Results from ongoing trials such as the NCI-MATCH will help determine the clinical utility and future development of the precision-medicine approach. © 2016, The American College of Clinical Pharmacology.

  12. Puzzle test: A tool for non-analytical clinical reasoning assessment.

    Science.gov (United States)

    Monajemi, Alireza; Yaghmaei, Minoo

    2016-01-01

    Most contemporary clinical reasoning tests typically assess non-automatic thinking. Therefore, a test is needed to measure automatic reasoning or pattern recognition, which has been largely neglected in clinical reasoning tests. The Puzzle Test (PT) is dedicated to assess automatic clinical reasoning in routine situations. This test has been introduced first in 2009 by Monajemi et al in the Olympiad for Medical Sciences Students.PT is an item format that has gained acceptance in medical education, but no detailed guidelines exist for this test's format, construction and scoring. In this article, a format is described and the steps to prepare and administer valid and reliable PTs are presented. PT examines a specific clinical reasoning task: Pattern recognition. PT does not replace other clinical reasoning assessment tools. However, it complements them in strategies for assessing comprehensive clinical reasoning.

  13. Application and evaluation of training for response to emergency situations

    Energy Technology Data Exchange (ETDEWEB)

    Kidwell, M.D.

    1979-01-01

    At Washington Gas Light Co., a magnetic situation-simulation board has become an effective tool for training field personnel in emergency procedures and decisionmaking. Class participants use magnetic disks - symbolizing physical features and components of the distribution system and service equipment - to visually describe the step-by-step procedures applied to specific emergency scenarios. A manually operated clock keeps a running account of the time estimated for each step, emphasizing the need for quick response. Situation-board programs of typical problems, complete with script and drawings, are available to all training foremen to ensure uniform training throughout the department.

  14. Within-Person Analyses of Situational Interest and Boredom: Interactions between Task-Specific Perceptions and Achievement Goals

    Science.gov (United States)

    Tanaka, Ayumi; Murayama, Kou

    2014-01-01

    Despite the increasing number of studies examining the correlates of interest and boredom, surprisingly little research has focused on within-person fluctuations in these emotions, making it difficult to describe their situational nature. To address this gap in the literature, this study conducted repeated measurements (12 times) on a sample of…

  15. Choosing a design to fit the situation: how to improve specificity and positive predictive values using Bayesian lot quality assurance sampling.

    Science.gov (United States)

    Olives, Casey; Pagano, Marcello

    2013-02-01

    Lot Quality Assurance Sampling (LQAS) is a provably useful tool for monitoring health programmes. Although LQAS ensures acceptable Producer and Consumer risks, the literature alleges that the method suffers from poor specificity and positive predictive values (PPVs). We suggest that poor LQAS performance is due, in part, to variation in the true underlying distribution. However, until now the role of the underlying distribution in expected performance has not been adequately examined. We present Bayesian-LQAS (B-LQAS), an approach to incorporating prior information into the choice of the LQAS sample size and decision rule, and explore its properties through a numerical study. Additionally, we analyse vaccination coverage data from UNICEF's State of the World's Children in 1968-1989 and 2008 to exemplify the performance of LQAS and B-LQAS. Results of our numerical study show that the choice of LQAS sample size and decision rule is sensitive to the distribution of prior information, as well as to individual beliefs about the importance of correct classification. Application of the B-LQAS approach to the UNICEF data improves specificity and PPV in both time periods (1968-1989 and 2008) with minimal reductions in sensitivity and negative predictive value. LQAS is shown to be a robust tool that is not necessarily prone to poor specificity and PPV as previously alleged. In situations where prior or historical data are available, B-LQAS can lead to improvements in expected performance.

  16. Dispositional and situational variables related to evacuation at Three Mile Island

    International Nuclear Information System (INIS)

    Miller, I.S.

    1981-01-01

    The purpose of this study was to explore some of the factors influential in local residents' evacuating or remaining in the Three Mile Island area during the nuclear power plant accident of March, 1979. Investigated variables included individuals' behavioral dispositions to attend or to avoid threatening stimuli as well as situational concerns related to demographic characteristics and subjective experience. Investigation of situational variables also probed respondents' concerns about accident-related fears. Two main relationships were investigated. The first hypothesized that positive relationships existed both between dispositional attention to threat and evacuation and between dispositional avoidance of threat and remaining. The second investigation task of the research explored evacuation-related situational variables in regard to individuals' awareness of potential danger at TMI. No support was found for the hypothesized relationships between evacuation and dispositions relative to threat. Situational variables significantly related to evacuation included: specific directives to evacuate the area; disruption of telephone service during the week of the accident; and household proximity to TMI

  17. Mobile, Collaborative Situated Knowledge Creation for Urban Planning

    Directory of Open Access Journals (Sweden)

    Nelson Baloian

    2012-05-01

    Full Text Available Geo-collaboration is an emerging research area in computer sciences studying the way spatial, geographically referenced information and communication technologies can support collaborative activities. Scenarios in which information associated to its physical location are of paramount importance are often referred as Situated Knowledge Creation scenarios. To date there are few computer systems supporting knowledge creation that explicitly incorporate physical context as part of the knowledge being managed in mobile face-to-face scenarios. This work presents a collaborative software application supporting visually-geo-referenced knowledge creation in mobile working scenarios while the users are interacting face-to-face. The system allows to manage data information associated to specific physical locations for knowledge creation processes in the field, such as urban planning, identifying specific physical locations, territorial management, etc.; using Tablet-PCs and GPS in order to geo-reference data and information. It presents a model for developing mobile applications supporting situated knowledge creation in the field, introducing the requirements for such an application and the functionalities it should have in order to fulfill them. The paper also presents the results of utility and usability evaluations.

  18. Marijuana-related problems and social anxiety: the role of marijuana behaviors in social situations.

    Science.gov (United States)

    Buckner, Julia D; Heimberg, Richard G; Matthews, Russell A; Silgado, Jose

    2012-03-01

    Individuals with elevated social anxiety appear particularly vulnerable to marijuana-related problems. In fact, individuals with social anxiety may be more likely to experience marijuana-related impairment than individuals with other types of anxiety. It is therefore important to determine whether constructs particularly relevant to socially anxious individuals play a role in the expression of marijuana-related problems in this vulnerable population. Given that both social avoidance and using marijuana to cope with negative affect broadly have been found to play a role in marijuana-related problems, the current study utilized a new measure designed to simultaneously assess social avoidance and using marijuana to cope in situations previously identified as anxiety-provoking among those with elevated social anxiety. The Marijuana Use to Cope with Social Anxiety Scale (MCSAS) assessed behaviors regarding 24 social situations: marijuana use to cope in social situations (MCSAS-Cope) and avoidance of social situations if marijuana was unavailable. In Study 1, we found preliminary support for the convergent and discriminant validity and internal consistency of the MCSAS scales. In Study 2, we examined if MCSAS scores were related to marijuana problems among those with (n = 44) and without (n = 44) clinically elevated social anxiety. Individuals with clinically meaningful social anxiety were more likely to use marijuana to cope in social situations and to avoid social situations if marijuana was unavailable. Of importance, MCSAS-Cope uniquely mediated the relationship between social anxiety group status and marijuana-related problems. Results highlight the importance of contextual factors in assessing marijuana-related behaviors among high-risk populations. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  19. Clinical anxiety, cortisol and interleukin-6: evidence for specificity in emotion-biology relationships.

    LENUS (Irish Health Repository)

    O'Donovan, Aoife

    2012-02-01

    Anxiety confers increased risk for inflammatory diseases, and elevated inflammatory activity in anxious individuals may contribute to this increased risk. One complication, however, is that anxiety could be associated with inflammatory activity either through a specific anxiety pathway or through a more general negative emotionality pathway. To investigate, we measured levels of the stress hormone cortisol, the pro-inflammatory cytokine interleukin-6 (IL-6), and the systemic inflammatory marker C-reactive protein (CRP), as well as depression and neuroticism, in clinically anxious and non-anxious adults. Compared with non-anxious participants, clinically anxious participants exhibited significantly lower levels of morning cortisol and significantly higher levels of IL-6, independent of age, sex, and depressive symptoms. These group differences were robust when controlling for neuroticism. Conversely, the groups had equivalent levels of CRP in all analyses. Results are indicative of anxiety-specific effects on inflammatory activity, and highlight a pathway by which anxiety may increase risk for inflammatory diseases.

  20. [Predictors of institutionalization of elderly persons in dependency situation in Andalusia].

    Science.gov (United States)

    Pinzón-Pulido, Sandra; Garrido Peña, Francisco; Reyes Alcázar, Víctor; Lima-Rodríguez, Joaquín Salvador; Raposo Triano, María Fernanda; Martínez Domene, Manuel; Alonso Trujillo, Federico

    2016-01-01

    Identifying preferences regarding type of care and risk factors for institutionalization of elderly persons in dependency situations in Andalusia. The data on 200,039 persons registered in the System for Autonomy and Dependency Care over the period 2007-2012 were analysed. The study population was described in terms of: age, dependency situation, preferences, support network and clinical factors at the time of inclusion in the study. Separate analysis was made for men and women. A logistic regression model was designed to determine the risk factors for institutionalization for each sex. 87,4% of women and 85,9% of men expressed their wish to receive care in their own home. The risk of institutionalization is three times higher among men than among women. Among women, the risks of institutionalization are: level of dependency, wishing to move into a residential care home, medium consistency and fragility of support network and being diagnosed with dementia. Among men, the risks are: wishing to move into a residential care home and low or medium consistency of support network. Care in the home is the preferred alternative for elderly persons in dependency situations. The risk of institutionalization is conditioned more by the preferences of the person and their family and the characteristics of the support network than by individual's clinical condition. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  1. CSF Proteomics Identifies Specific and Shared Pathways for Multiple Sclerosis Clinical Subtypes.

    Directory of Open Access Journals (Sweden)

    Timucin Avsar

    Full Text Available Multiple sclerosis (MS is an immune-mediated, neuro-inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS with a heterogeneous clinical presentation and course. There is a remarkable phenotypic heterogeneity in MS, and the molecular mechanisms underlying it remain unknown. We aimed to investigate further the etiopathogenesis related molecular pathways in subclinical types of MS using proteomic and bioinformatics approaches in cerebrospinal fluids of patients with clinically isolated syndrome, relapsing remitting MS and progressive MS (n=179. Comparison of disease groups with controls revealed a total of 151 proteins that are differentially expressed in clinically different MS subtypes. KEGG analysis using PANOGA tool revealed the disease related pathways including aldosterone-regulated sodium reabsorption (p=8.02x10-5 which is important in the immune cell migration, renin-angiotensin (p=6.88x10-5 system that induces Th17 dependent immunity, notch signaling (p=1.83x10-10 pathway indicating the activated remyelination and vitamin digestion and absorption pathways (p=1.73x10-5. An emerging theme from our studies is that whilst all MS clinical forms share common biological pathways, there are also clinical subtypes specific and pathophysiology related pathways which may have further therapeutic implications.

  2. Constructible Assessment for Situation Awareness in a Distributed C2 Environment

    National Research Council Canada - National Science Library

    Seet, Alfred W; Teh, Cheryl A; Soo, John K; Teo, Leonghwee

    2004-01-01

    .... This method is an adaptation of the Situation Awareness Global Assessment Technique (SAGAT) by M. R. Endsley (1995) that takes into account specific constraints for use in a field exercise, such as minimizing the level of intrusiveness...

  3. Knowledge-based driver assistance systems traffic situation description and situation feature relevance

    CERN Document Server

    Huelsen, Michael

    2014-01-01

    The comprehension of a traffic situation plays a major role in driving a vehicle. Interpretable information forms a basis for future projection, decision making and action performing, such as navigating, maneuvering and driving control. Michael Huelsen provides an ontology-based generic traffic situation description capable of supplying various advanced driver assistance systems with relevant information about the current traffic situation of a vehicle and its environment. These systems are enabled to perform reasonable actions and approach visionary goals such as injury and accident free driv

  4. The impact of case specificity and generalisable skills on clinical performance: a correlated traits-correlated methods approach.

    Science.gov (United States)

    Wimmers, Paul F; Fung, Cha-Chi

    2008-06-01

    The finding of case or content specificity in medical problem solving moved the focus of research away from generalisable skills towards the importance of content knowledge. However, controversy about the content dependency of clinical performance and the generalisability of skills remains. This study aimed to explore the relative impact of both perspectives (case specificity and generalisable skills) on different components (history taking, physical examination, communication) of clinical performance within and across cases. Data from a clinical performance examination (CPX) taken by 350 Year 3 students were used in a correlated traits-correlated methods (CTCM) approach using confirmatory factor analysis, whereby 'traits' refers to generalisable skills and 'methods' to individual cases. The baseline CTCM model was analysed and compared with four nested models using structural equation modelling techniques. The CPX consisted of three skills components and five cases. Comparison of the four different models with the least-restricted baseline CTCM model revealed that a model with uncorrelated generalisable skills factors and correlated case-specific knowledge factors represented the data best. The generalisable processes found in history taking, physical examination and communication were responsible for half the explained variance, in comparison with the variance related to case specificity. Conclusions Pure knowledge-based and pure skill-based perspectives on clinical performance both seem too one-dimensional and new evidence supports the idea that a substantial amount of variance contributes to both aspects of performance. It could be concluded that generalisable skills and specialised knowledge go hand in hand: both are essential aspects of clinical performance.

  5. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Neri, E.; Boraschi, P.; Bartolozzi, C. [University of Pisa, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Bali, M.A.; Matos, C. [Hopital Erasme, MRI Clinics, Department of Radiology, Bruxelles (Belgium); Ba-Ssalamah, A. [The General Hospital of the Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Brancatelli, G. [University of Palermo, Department of Radiology, Palermo (Italy); Alves, F.C. [University Hospital of Coimbra, Medical Imaging Department and Faculty of Medicine, Coimbra (Portugal); Grazioli, L. [Spedali Civili di Brescia, Department of Radiology, Brescia (Italy); Helmberger, T. [Academic Teaching Hospital of the Technical University, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Munich (Germany); Lee, J.M. [Seoul National University College of Medicine, Division of Abdominal Imaging, Department of Radiology, Seoul (Korea, Republic of); Manfredi, R. [University of Verona, Department of Radiology, Verona (Italy); Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Area Clinica de Imagen Medica, Valencia (Spain); Merkle, E.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Op De Beeck, B. [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Schima, W. [KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Department of Diagnostic and Interventional Radiology, Vienna (Austria); Skehan, S. [St Vincent' s University Hospital, Department of Radiology, Dublin (Ireland); Vilgrain, V. [Assistance Publique-Hopitaux de Paris, APHP, Hopital Beaujon, Radiology Department, Clichy, Paris (France); Zech, C. [Universitaetsspital Basel, Abteilungsleiter Interventionelle Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)

    2016-04-15

    To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach's statistics were used to rate levels of agreement and internal reliability of the consensus. Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. (orig.)

  6. Conspiracy theories as part of history: The role of societal crisis situations.

    Science.gov (United States)

    van Prooijen, Jan-Willem; Douglas, Karen M

    2017-07-01

    In the present contribution, we examine the link between societal crisis situations and belief in conspiracy theories. Contrary to common assumptions, belief in conspiracy theories has been prevalent throughout human history. We first illustrate historical incidents suggesting that societal crisis situations-defined as impactful and rapid societal change that calls established power structures, norms of conduct, or even the existence of specific people or groups into question-have stimulated belief in conspiracy theories. We then review the psychological literature to explain why this is the case. Evidence suggests that the aversive feelings that people experience when in crisis-fear, uncertainty, and the feeling of being out of control-stimulate a motivation to make sense of the situation, increasing the likelihood of perceiving conspiracies in social situations. We then explain that after being formed, conspiracy theories can become historical narratives that may spread through cultural transmission. We conclude that conspiracy theories originate particularly in crisis situations and may form the basis for how people subsequently remember and mentally represent a historical event.

  7. Thoughts on the Postpartum Situation

    Directory of Open Access Journals (Sweden)

    Jennifer Scuro

    2018-06-01

    Full Text Available The event of childbirth carries with it a dominant narrative: that a pregnant woman happily gives birth to a baby. This appears to be quite a simple formulation—as if a natural fact, as if plain and common sense. Yet, the complexities masked by the mythological and whitewashed quality of this narrative, as I have already argued recently in The Pregnancy ≠ Childbearing Project: A Phenomenology of Miscarriage (Feb 2017, harms and even kills women. In this paper, I expand on the problem of what I term “dismemberment after birth” as it operates invisibly in the “postpartum situation.” The dominant narrative, combined with a pervasive cultural misogynoir— manifesting specifically as an antagonism toward black women and women of color—as medicalized and ableist establishment of care, renders women without resource if they cannot maintain the desires and embodiments required of a contented and successful maternity. The naturalized assumptions about the narrative move from the birth event to “having a baby” are disrupted here with hope of opening up an opportunity to validate and diversify the more non-linear narratives. As an afterthought to these disruptions, I offer an additional challenge to anti-natalist thinking in its limited insight into the postpartum situation.

  8. Reflections on Ethics and Humanity in Pediatric Neurology: the Value of Recognizing Ethical Issues in Common Clinical Practice.

    Science.gov (United States)

    Ronen, Gabriel M; Rosenbaum, Peter L

    2017-05-01

    Our goals in this reflection are to (i) identify the ethical dimensions inherent in any clinical encounter and (ii) bring to the forefront of our pediatric neurology practice the myriad of opportunities to explore and learn from these ethical questions. We highlight specifically Beauchamp and Childress's principles of biomedical ethics. We use the terms ethics in common clinical practice and an ethical lens to remind people of the ubiquity of ethical situations and the usefulness of using existing ethical principles to analyze and resolve difficult situations in clinical practice. We start with a few common situations with which many of us tend to struggle. We describe what we understand as ethics and how and why developments in technology, novel potential interventions, policies, and societal perspectives challenge us to think about and debate ethical issues. Individual patients are not a singular population; each patient has their own unique life situations, culture, goals, and expectations that need to be considered with a good dose of humanity and humility. We believe that using an ethical lens-by which we mean making an explicit effort to identify and consider these issues openly-will help us to achieve this goal in practice, education, and research.

  9. [Current situation of clinical research on impacted premolars].

    Science.gov (United States)

    Liu, Ran-Ran; Tian, Jun

    2018-04-01

    Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

  10. The use of augmented reality in command and control situation ...

    African Journals Online (AJOL)

    This study identifies possible uses of augmented reality in command and control applications with specific attention to situation awareness in the South African context. Applications across the different command and control functions, as well as at the different levels of military operations are considered. The article concludes ...

  11. Clinical use and primary evaluation of tumor marker-free prostate specific antigen

    International Nuclear Information System (INIS)

    Wu Junyuan; Gao Xiuying; Kong Linghua; Su Ping; Guo Xinrong

    2002-01-01

    Free-prostate specific antigen (fPSA)/total prostate specific antigen (tPSA) ratio was evaluated in clinical utility. Serum tPSA and fPSA level were measured by electro-chemo-luminescence (ECL) immunoassay and fPSA/tPSA ratio was calculated. Samples were drawn from 38 patients with Pca, 68 patients with BPH and 43 health men. Results showed serum tPSA > 4.0 μg/L as only cut off for diagnosis Pca, sensitivity and specificity of fPSA/tPSA ratio were 84.2%, 75.0% respectively. But fPSA/tPSA ratio 20.0 μg/L; they were 93.6%, 89.9% when serum tPSA was 2-20 μg/L. fPSA/tPSA ratio may greatly raised accurate rate for diagnosis prostate cancer when tPSA level between 2-20 μg/L and no value to other patients

  12. Situational simulations in interactive video

    Energy Technology Data Exchange (ETDEWEB)

    Smith, L.J.

    1991-07-01

    The Westinghouse Hanford Company Advanced Training Technologies section is using situational simulations in several Interactive Video training courses. Two applications of situational simulations will be discussed. In the first, used in the Hanford General Employee Training course, the student evaluates employee's actions in simulations of possible workplace situations. In the second, used in the Criticality Safety course, students must follow well-defined procedures to complete tasks. Design and incorporation of situational simulations will be discussed. 3 refs.

  13. Situational simulations in interactive video

    International Nuclear Information System (INIS)

    Smith, L.J.

    1991-07-01

    The Westinghouse Hanford Company Advanced Training Technologies section is using situational simulations in several Interactive Video training courses. Two applications of situational simulations will be discussed. In the first, used in the Hanford General Employee Training course, the student evaluates employee's actions in simulations of possible workplace situations. In the second, used in the Criticality Safety course, students must follow well-defined procedures to complete tasks. Design and incorporation of situational simulations will be discussed. 3 refs

  14. Medical Biochemistry – Clinical Cases

    Directory of Open Access Journals (Sweden)

    Gustavo Henrique Cavalcante

    2017-10-01

    Full Text Available The presentation of situations that exemplifies the practical application of the biochemical concepts is one of the main challenges in the development of didactic materials for the teaching of biochemistry. So far, there are a small number of materials, especially in Portuguese language, that present practical situations exemplifying the application of the several biochemical concepts in the area of human health. The Medical Biochemistry-Clinical Cases app/ebook is intended to enable the integrated vision of the basic knowledge in biochemistry and its practical application in day-to-day situations of human health professionals. The biochemical concepts are presented as clinical cases, making possible the exercise of the analytical attitude and decision-making to solve problems based on real situations. The app is available on the internet for free, facilitating both, the access and the use of the material as a supplementary source.

  15. Smoking relapse situations among a community-recruited sample of Spanish daily smokers.

    Science.gov (United States)

    Piñeiro, Bárbara; López-Durán, Ana; Martínez-Vispo, Carmela; Fernández Del Río, Elena; Martínez, Úrsula; Rodríguez-Cano, Rubén; Míguez, M Carmen; Becoña, Elisardo

    2017-12-01

    Relapse is a common factor within the behavior change process. However, there is scarce and limited knowledge of smoking relapse situations in population-based samples. The aim of this study was to identify smoking relapse situations among a sample of Spanish relapsers from the general population. A sample of 775 relapsers was recruited among the general population using a snowball method. Participants completed a survey including sociodemographic, smoking-related and psychopathology variables. Smoking relapse situations were identified through specific questions assessing different aspects related to the last relapse episode. The majority of smoking relapse situations were attributed to positive affect (36.6%) and negative affect (34.3%), followed by lack of control (10.1%), smoking habit (6.7%), craving or nicotine withdrawal (6.3%), and social pressure (5.9%). Being unemployed and having a mental disorder in the past increased the likelihood of relapse in situations of negative affect. Being single and having quit smoking to save money were associated with an increased likelihood of relapse in situations of positive affect. Affect plays a significant role in smoking relapse among a community sample of unassisted Spanish smokers. Relapse may be much more of an affective and situational process than a habit, physiological or social pressure. Findings from this study may help develop tailored community smoking relapse prevention strategies or programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Validation in daily clinical situations of Diascope®, a software developed to help healthcare professionals individualize antidiabetic treatment in type 2 diabetes.

    Science.gov (United States)

    Ampudia-Blasco, Francisco Javier; García-Soidán, Francisco Javier; Rubio Sánchez, Manuela; Phan, Tra-Mi

    2017-03-01

    DiaScope ® is a software to help in individualized prescription of antidiabetic treatment in type 2 diabetes. This study assessed its value and acceptability by different professionals. DiaScope ® was developed based on the ADA-EASD 2012 algorithm and on the recommendation of 12 international diabetes experts using the RAND/UCLA appropriateness method. The current study was performed at a single session. In the first phase, 5 clinical scenarios were evaluated, selecting the most appropriated therapeutic option among 4 possibilities (initial test). In a second phase, the same clinical cases were evaluated with DiaScope ® (final test).Opinion surveys on DiaScope ® were also performed (questionnaire). DiaScope ® changed the selected option 1 or more times in 70.5% of cases. Among 275 evaluated questionnaires, 54.0% strongly agree that DiaScope ® allowed finding easily a similar therapeutic scenario to the corresponding patient, and 52.5 among the obtained answers were clinically plausible. Up to 58.3% will recommend it to a colleague. In particular, primary care physicians with >20 years of professional dedication found with DiaScope ® the most appropriate option for a particular situation against specialists or those with less professional dedication (p17 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Situated teaching improves empathy learning of the students in a BSN program: A quasi-experimental study.

    Science.gov (United States)

    Lee, Kwo-Chen; Yu, Chin-Ching; Hsieh, Pei-Ling; Li, Chin-Ching; Chao, Yann-Fen C

    2018-05-01

    Empathy is an important clinical skill for nursing students, but it is a characteristic difficult to teach and assess. To evaluate the effect of situated teaching on empathy learning among undergraduate nursing students. A cohort study with pre-post-test quasi-experimental design. The 2nd-year students were enrolled from two BSN programs. The teaching program was completed over 4 months on the basis of experiential learning theory which integrated the following four elements: classroom-based role play, self-reflection, situated learning and acting. The Jefferson Scale of Empathy-Health Profession-Student version was administered before and after the program. Objective Structure Clinical Examination (OSCE) was administered at the end of program and a rubrics scale was used to measure empathy. A generalized estimation equation was used to identify the effect of subjective empathy, and an independent t-test was used for the objective assessment between two groups. A total of 103 students were enrolled. The results showed that subjective empathy increased significantly in experimental group. In the Objective Structured Clinical Examination, examiners and standard patients gave significantly higher empathy scores to the situated teaching group than the control group. The present study indicated that situated teaching can improve empathy learning of the nursing students. However different methods of assessment of empathy produce different results. We therefore recommend that multiple measurements from difference perspectives are preferable in the assessment of empathy. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, K. [University of Washington (United States)

    2016-06-15

    Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiation oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.

  19. WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists

    International Nuclear Information System (INIS)

    Hendrickson, K.

    2016-01-01

    Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiation oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.

  20. Improving efficiency of clinical skills training

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Bjørck, Sebastian; Birkvad Rasmussen, Maria

    2013-01-01

    The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation.......The rising number of medical students and the impact this has on students' learning of clinical skills is a matter of concern. Cooperative learning in pairs, called dyad training, might help address this situation....

  1. Evaluations of emotional noninterpersonal situations by patients with borderline personality disorder.

    Science.gov (United States)

    Sieswerda, Simkje; Arntz, Arnoud; Wolfis, Marionne

    2005-09-01

    According to cognitive models of borderline personality disorder (BPD), an important cause for the instability of patients with BPD is dichotomous thinking (DT). Object-relation theories assume that the similar phenomenon of splitting is central in BPD. Previous studies focusing on interpersonal situations found support for DT being prominent in BPD. The aim of this study was to investigate whether patients with BPD also make use of dichotomous and schema-specific evaluations in noninterpersonal situations. An experiment was designed in which a frustrating and rewarding situation was induced by computer games that subjects had to play. Participants evaluated both themselves and the games. Patients with BPD (n=24) were characterized by somewhat more extreme game evaluations in the emotionally negative situations than normal controls (n=25), participants with a cluster C (n=10) or an anti-social personality disorder (ASPD) (n=16). Patients with BPD appeared to be characterized best by a general negative evaluative style, more than by DT or splitting. ASPD participants showed a positivity bias in both conditions.

  2. Radioactivity measurement for emergency or post-accident situations

    International Nuclear Information System (INIS)

    Champion, D.

    2010-01-01

    Specific objectives have to be achieved by radioactivity measurements during emergency or post-accident situations, which are different from those in normal situation. At the beginning of a nuclear emergency, few radioactivity data will be available, mainly from automatic monitoring systems implemented on the site or in its surrounding. Progressively, measurement programmes will be performed, in priority to get information on dose rate, atmospheric radionuclides and surface activities. In order to avoid excessive exposure of the measure teams, these programmes should be optimized. During early post-accident phase, different types of measurements will be done, following two main objectives: 1) to improve the assessment of the environmental contamination and people exposure; 2) for control purpose, to check the contamination of urban places, foodstuff and other products, compared to specific reference levels. The samples measurement in laboratories would be a challenge: usually, the laboratories involved in routine monitoring have to deal with very low level of radioactivity and a poor diversity of artificial radionuclides; after a reactor accident, the environmental samples to be measured would be more active and with a mixture of radionuclides (mainly with short or middle half-life) difficult to be characterized. So theses laboratories have to be trained and organised before any severe accident. (author)

  3. Cognitive and Affective Aspects of Creative Option Generation in Every Day Life Situations

    Directory of Open Access Journals (Sweden)

    T. Sophie Schweizer

    2016-08-01

    Full Text Available Which factors influence a human being’s ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48 generated options for action in 70 shortly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence - and linked these qualities to option generation fluency (speed and number of generated options, situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and

  4. Approaches for Establishing Clinically Relevant Dissolution Specifications for Immediate Release Solid Oral Dosage Forms.

    Science.gov (United States)

    Hermans, Andre; Abend, Andreas M; Kesisoglou, Filippos; Flanagan, Talia; Cohen, Michael J; Diaz, Dorys A; Mao, Y; Zhang, Limin; Webster, Gregory K; Lin, Yiqing; Hahn, David A; Coutant, Carrie A; Grady, Haiyan

    2017-11-01

    This manuscript represents the perspective of the Dissolution Analytical Working Group of the IQ Consortium. The intent of this manuscript is to highlight the challenges of, and to provide a recommendation on, the development of clinically relevant dissolution specifications (CRS) for immediate release (IR) solid oral dosage forms. A roadmap toward the development of CRS for IR products containing active ingredients with a non-narrow therapeutic window is discussed, within the context of mechanistic dissolution understanding, supported by in-human pharmacokinetic (PK) data. Two case studies present potential outcomes of following the CRS roadmap and setting dissolution specifications. These cases reveal some benefits and challenges of pursuing CRS with additional PK data, in light of current regulatory positions, including that of the US Food and Drug Administration (FDA), who generally favor this approach, but with the understanding that both industry and regulatory agency perspectives are still evolving in this relatively new field. The CRS roadmap discussed in this manuscript also describes a way to develop clinically relevant dissolution specifications based primarily on dissolution data for batches used in pivotal clinical studies, acknowledging that not all IR product development efforts need to be supported by additional PK studies, albeit with the associated risk of potentially unnecessarily tight manufacturing controls. Recommendations are provided on what stages during the life cycle investment into in vivo studies may be valuable. Finally, the opportunities for CRS within the context of post-approval changes, Modeling and Simulation (M&S), and the application of biowaivers, are briefly discussed.

  5. Specifications in early conceptual design work

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2007-01-01

    In early conceptual design the design team is working in an uncertain situation, where the understanding of a need is limited and not much is known about the solution space. In this situation the design team has to both analyse need and explore solution space. Thus, the team has to formulate design...... specifications, which express attractive product goals, and has to synthesise the product idea. The authors of this paper see a challenge to enhance and improve our understanding of the nature of design specifications as a means to support the synthesis of a product idea. In this empirical study we analyse...... the structure and content of design specifications during early ideation activities, where initial design specifications are formulated and a product idea is synthesised. We have analysed specification documents of 19 teams of novice designers. Our analysis indicates that a productive product design...

  6. Problem situations in management activity

    OpenAIRE

    N.A. DUBINKO

    2009-01-01

    This article reviews contemporary methodological and theoretical approaches to the problem situations in management activity. Revealed and analyzed the types of problem situations managers dealing with in their activity. Rank correlation of problem situations shows distinctions depending on management work experience. Revealed gender distinctions in the managers' ideas of management problems.

  7. Social class and wise reasoning about interpersonal conflicts across regions, persons and situations.

    Science.gov (United States)

    Brienza, Justin P; Grossmann, Igor

    2017-12-20

    We propose that class is inversely related to a propensity for using wise reasoning (recognizing limits of their knowledge, consider world in flux and change, acknowledges and integrate different perspectives) in interpersonal situations, contrary to established class advantage in abstract cognition. Two studies-an online survey from regions differing in economic affluence ( n = 2 145) and a representative in-lab study with stratified sampling of adults from working and middle-class backgrounds ( n = 299)-tested this proposition, indicating that higher social class consistently related to lower levels of wise reasoning across different levels of analysis, including regional and individual differences, and subjective construal of specific situations. The results held across personal and standardized hypothetical situations, across self-reported and observed wise reasoning, and when controlling for fluid and crystallized cognitive abilities. Consistent with an ecological framework, class differences in wise reasoning were specific to interpersonal (versus societal) conflicts. These findings suggest that higher social class weighs individuals down by providing the ecological constraints that undermine wise reasoning about interpersonal affairs. © 2017 The Authors.

  8. Assessing physician leadership styles: application of the situational leadership model to transitions in patient acuity.

    Science.gov (United States)

    Skog, Alexander; Peyre, Sarah E; Pozner, Charles N; Thorndike, Mary; Hicks, Gloria; Dellaripa, Paul F

    2012-01-01

    The situational leadership model suggests that an effective leader adapts leadership style depending on the followers' level of competency. We assessed the applicability and reliability of the situational leadership model when observing residents in simulated hospital floor-based scenarios. Resident teams engaged in clinical simulated scenarios. Video recordings were divided into clips based on Emergency Severity Index v4 acuity scores. Situational leadership styles were identified in clips by two physicians. Interrater reliability was determined through descriptive statistical data analysis. There were 114 participants recorded in 20 sessions, and 109 clips were reviewed and scored. There was a high level of interrater reliability (weighted kappa r = .81) supporting situational leadership model's applicability to medical teams. A suggestive correlation was found between frequency of changes in leadership style and the ability to effectively lead a medical team. The situational leadership model represents a unique tool to assess medical leadership performance in the context of acuity changes.

  9. Medical student perspective: working toward specific and actionable clinical clerkship feedback.

    Science.gov (United States)

    Moss, Haley A; Derman, Peter B; Clement, R Carter

    2012-01-01

    Feedback on the wards is an important component of medical student education. Medical schools have incorporated formalized feedback mechanisms such as clinical encounter cards and standardized patient encounters into clinical curricula. However, the system could be further improved as medical students frequently feel uncomfortable requesting feedback, and are often dissatisfied with the quality of the feedback they receive. This article explores the shortcomings of the existing medical student feedback system and examines the relevant literature in an effort to shed light on areas in which the system can be enhanced. The discussion focuses on resident-provided feedback but is broadly applicable to delivering feedback in general. A review of the organizational psychology and business administration literature on fostering effective feedback was performed. These insights were then applied to the setting of medical education. Providing effective feedback requires training and forethought. Feedback itself should be specific and actionable. Utilizing these strategies will help medical students and educators get the most out of existing feedback systems.

  10. Control of radiation sources and general regulations for accidental situations

    International Nuclear Information System (INIS)

    Slimani, A.

    1998-01-01

    In order to prevent accidents caused by application of radiation sources the Tunisian O.N.P.C. established straightforward strategy made up of 3 phases: prevention, planning and intervention. Civil Protection conducts prevention studies of all radiation sources by examining normal application conditions as well as possible accidental situations. It keeps up with scientific, technical and statistical aspects of radiation risks, elaborates specific plans and programs for intervention operations and cooperates with administrative and security services as well as international organisations. The O.N.P.C. established a model intervention plan based on observation (according to preliminary information), evaluation of the situation (according to the head of operation) intervention (specialized units) and post intervention (testing of personnel)

  11. Potentials and limits of electronic situation displays

    International Nuclear Information System (INIS)

    Hable, K.; Hoebler, C.; Bieringer, P.

    2007-01-01

    In the field of precautionary radiation protection and disaster response, the amount of information and the number of its sources is steadily increasing. Central compilation and instant availability of information for all involved authorities becomes more and more important. In this context the structured presentation of documents on a web server in terms of an ''Electronic Situation Display'' (ESD) has been established. In Germany, there are several Electronic Situation Display prototypes run by federal and state authorities for various purposes and using different technical approaches. The systems of the federal states focus on workflow management. They provide emergency log books and information on the implementation of countermeasures for disaster response authorities. The Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) tasked the Federal Office for Radiation Protection (BfS) to develop the Federal Electronic Situation Display (ELAN) that is mainly used as an information platform for decision making in case of nuclear emergencies. Documents containing radiological data or results from Decision Support Systems are almost automatically integrated into ELAN. Read and write permissions for users are managed by a concept of specific roles. The federal ESD and the systems of the federal states will be coordinated in order to achieve a better harmonisation. Interfaces for data exchange and data processing must be defined. Authorities of the federal states can use protected areas within the federal ESD where information is kept confidential for internal use before it is distributed to other states and federal authorities. In addition, key information of Electronic Situation Displays from the federal states can automatically be integrated into ELAN. Several task groups of the IAEA are working on the development and realization of a prototype for an information platform harmonising ESDs on international level. (orig.)

  12. Energy situation - Forth quarter 2016. Energy situation October 2016; Energy situation November 2016; Energy situation December 2016

    International Nuclear Information System (INIS)

    Guggemos, Fabien; Misak, Evelyne; Mombel, David; Moreau, Sylvain

    2017-02-01

    This publication presents, first, a quarterly report of the French energy situation: primary energy consumption, energy independence and CO_2 emissions, national production, imports, exports, energy costs, average and spot prices. Data are presented separately for solid mineral fuels, petroleum products, natural gas and electricity. Month-to-month details are summarized in a second part, in the form of tables and graphs

  13. Energy situation - First quarter 2017. Energy situation January 2017; Energy situation February 2017; Energy situation March 2017

    International Nuclear Information System (INIS)

    Guggemos, Fabien; Misak, Evelyne; Mombel, David; Moreau, Sylvain

    2017-05-01

    This publication presents, first, a quarterly report of the French energy situation: primary energy consumption, energy independence and CO_2 emissions, national production, imports, exports, energy costs, average and spot prices. Data are presented separately for solid mineral fuels, petroleum products, natural gas and electricity. Month-to-month details are summarized in a second part, in the form of tables and graphs

  14. Personality and Defense Styles: Clinical Specificities and Predictive Factors of Alcohol Use Disorder in Women.

    Science.gov (United States)

    Ribadier, Aurélien; Dorard, Géraldine; Varescon, Isabelle

    2016-01-01

    This study investigated personality traits and defense styles in order to determine clinical specificities and predictive factors of alcohol use disorders (AUDs) in women. A female sample, composed of AUD outpatients (n = 48) and a control group (n = 50), completed a sociodemographic self-report and questionnaires assessing personality traits (BFI), defense mechanisms and defense styles (DSQ-40). Comparative and correlational analyses, as well as univariate and multivariate logistic regressions, were performed. AUD women presented with higher neuroticism and lower extraversion and conscientiousness. They used less mature and more neurotic and immature defense styles than the control group. Concerning personality traits, high neuroticism and lower conscientiousness were predictive of AUD, as well as low mature, high neurotic, and immature defense styles. Including personality traits and defense styles in a logistic model, high neuroticism was the only AUD predictive factor. AUD women presented clinical specificities and predictive factors in personality traits and defense styles that must be taken into account in AUD studies. Implications for specific treatment for women are discussed.

  15. Stressful situations and factors in students of nursing in clinical practice

    OpenAIRE

    Llapa Rodrigues, Eliana Ofélia; Almeida Marques, Daniel; Lopes Neto, David; López Montesinos, María José; Amado de Oliveira, Adriana Sousa

    2016-01-01

    Objective.To assess the risk factors for stress in undergraduate students of nursing in clinical practice in a public university in the Northeast region of Brazil. Methods. Cross-sectional descriptive study with 116 students from the fifth to the ninth period. The bilingual KEZKAK questionnaire, validated for Portuguese, was used. Stress was considered to be present when the score was equal or superior to 2. Results. The students with stress in clinical practice were 18 to 22 years old (2.82 ...

  16. Red blood cell antibodies in pregnancy and their clinical consequences: synergistic effects of multiple specificities.

    Science.gov (United States)

    Nordvall, Maria; Dziegiel, Morten; Hegaard, Hanne Kristine; Bidstrup, Mogens; Jonsbo, Finn; Christensen, Birgit; Hedegaard, Morten

    2009-10-01

    The objective was to determine clinical consequences of various specificities for the infant/fetus. The population was patients referred between 1998 and 2005 to the tertiary center because of detected red blood cell (RBC) alloimmunization. Altogether 455 infants were delivered by 390 alloimmunized women. This was a retrospective cohort study. Data were obtained from the blood bank register and the obstetric and neonatal database. As indicators of hemolytic activity of the antibodies, the frequency of the therapeutic interventions intrauterine transfusion, exchange transfusion, and simple transfusion was used. Anti-D was the most common antibody (46.6%), followed by anti-K (15.4%). A combination of antibodies was detected in 27%. All three types of therapeutic intervention were significantly more frequent in women with anti-D plus an additional antibody than in women with anti-D as the sole antibody. The anti-D titer closely paralleled the clinical importance of the antibody. One case of anti-s with a titer of 512 required all three types of transfusion. Anti-D was the single most frequent and harmful specificity closely followed by anti-K. Combinations of antibody specificities were more harmful than single specificities, and a potentially synergistic effect should be considered.

  17. Situative Space Tracking within Smart Environments

    DEFF Research Database (Denmark)

    Surie, Dipak; Jäckel, Florian; Janlert, Lars-Erik

    2010-01-01

    This paper describes our efforts in modeling and tracking a human agent’s situation based on his/her possibilities to perceive and act upon objects (both physical and virtual) within smart environments. A Situative Space Model is proposed. WLAN signal-strength-based situative space tracking syste......-laboratory smart home environment where a global precision of 83.4% and a global recall of 88.6% were obtained.......This paper describes our efforts in modeling and tracking a human agent’s situation based on his/her possibilities to perceive and act upon objects (both physical and virtual) within smart environments. A Situative Space Model is proposed. WLAN signal-strength-based situative space tracking system...

  18. Smiling on the Inside: The Social Benefits of Suppressing Positive Emotions in Outperformance Situations.

    Science.gov (United States)

    Schall, Marina; Martiny, Sarah E; Goetz, Thomas; Hall, Nathan C

    2016-05-01

    Although expressing positive emotions is typically socially rewarded, in the present work, we predicted that people suppress positive emotions and thereby experience social benefits when outperformed others are present. We tested our predictions in three experimental studies with high school students. In Studies 1 and 2, we manipulated the type of social situation (outperformance vs. non-outperformance) and assessed suppression of positive emotions. In both studies, individuals reported suppressing positive emotions more in outperformance situations than in non-outperformance situations. In Study 3, we manipulated the social situation (outperformance vs. non-outperformance) as well as the videotaped person's expression of positive emotions (suppression vs. expression). The findings showed that when outperforming others, individuals were indeed evaluated more positively when they suppressed rather than expressed their positive emotions, and demonstrate the importance of the specific social situation with respect to the effects of suppression. © 2016 by the Society for Personality and Social Psychology, Inc.

  19. Rational group decision making in risk situations

    International Nuclear Information System (INIS)

    Yoon, M.H.

    1987-01-01

    Risk management has received increasing attention recently as methods of quantifying risk have been evolving. This is considered a legitimate tendency in the context of the entirety of risk evaluation which connotes both risk quantification and decisions making thereon. A risk-free society does not appear possible; neither could one have zero competing risks or cost versus benefit resulting out of a risk-abatement effort. What further complicates the risk-decision problem is that there exists more than a single decision maker, who claim their own interests associated with risk decision. Furthermore, their risk perceptions are not at all same that the threshold risk levels for a particular actions are varying. In this dissertation, a brief survey on existing action levels for various sort of risk situations including carcinogens, toxic chemicals, etc., is reported on, with emphasis on nuclear risk situation. A decision theoretic approach is then adopted in both individual and group-level risk management. For the purpose of exemplification, multiplicative utility theory is applied for nuclear power risk; attributes derived for this specific purpose are discussed

  20. Congestive heart failure, spouses' support and the couple's sleep situation: a critical incident technique analysis.

    Science.gov (United States)

    Broström, Anders; Strömberg, Anna; Dahlström, Ulf; Fridlund, Bengt

    2003-03-01

    Sleep related breathing disorders are common as well as a poor prognostic sign associated with higher mortality in patients with congestive heart failure (CHF). These patients often have a shorter total duration of sleep, disturbed sleep structure and increased daytime sleepiness, which can negatively affect all dimensions of the life situation. The spouse has an important role in supporting the patient in relation to sleep disorders, but this role may be adversely affected by the sleep situation of the couple. The aim of this study was to describe decisive situations that influence spouses' support to patients with CHF in relation to the couple's sleep situation. A qualitative descriptive design using critical incident technique was employed. Incidents were collected by means of interviews with 25 spouses of patients with CHF, strategically selected from two hospital-based specialist clinics in southern Sweden. Two main areas emerged in the analysis: support stimulating situations and support inhibiting situations. Support stimulating situations described how spouses' support was positively affected by their own adaptation in psychosocial or practical situations, and receiving help from others. Support inhibiting situations described how the spouses' support was negatively affected by sleep disturbances as a result of the patient's symptoms, anxiety in relation to the disease, limitations as a result of the sleeping habits, dissatisfaction with care related to the sleep situation, and being left to cope alone with the problems. An increased understanding of the stimulating and inhibiting situations influencing spouses' support for patients with CHF can guide health care personnel in deciding if an intervention is needed to improve the sleep situation for patient and spouse.

  1. A Situational Maintenance Model

    DEFF Research Database (Denmark)

    Luxhoj, James T.; Thorsteinsson, Uffe; Riis, Jens Ove

    1997-01-01

    An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance.......An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance....

  2. Engagement and practical wisdom in clinical practice: a phenomenological study.

    Science.gov (United States)

    Saraga, Michael; Boudreau, Donald; Fuks, Abraham

    2018-05-08

    In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle's notion of phronesis and Sartre's definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician's situation.

  3. Team performance modeling for HRA in dynamic situations

    International Nuclear Information System (INIS)

    Shu Yufei; Furuta, Kazuo; Kondo, Shunsuke

    2002-01-01

    This paper proposes a team behavior network model that can simulate and analyze response of an operator team to an incident in a dynamic and context-sensitive situation. The model is composed of four sub-models, which describe the context of team performance. They are task model, event model, team model and human-machine interface model. Each operator demonstrates aspects of his/her specific cognitive behavior and interacts with other operators and the environment in order to deal with an incident. Individual human factors, which determine the basis of communication and interaction between individuals, and cognitive process of an operator, such as information acquisition, state-recognition, decision-making and action execution during development of an event scenario are modeled. A case of feed and bleed operation in pressurized water reactor under an emergency situation was studied and the result was compared with an experiment to check the validity of the proposed model

  4. Using Semantic Web technologies for the generation of domain-specific templates to support clinical study metadata standards.

    Science.gov (United States)

    Jiang, Guoqian; Evans, Julie; Endle, Cory M; Solbrig, Harold R; Chute, Christopher G

    2016-01-01

    The Biomedical Research Integrated Domain Group (BRIDG) model is a formal domain analysis model for protocol-driven biomedical research, and serves as a semantic foundation for application and message development in the standards developing organizations (SDOs). The increasing sophistication and complexity of the BRIDG model requires new approaches to the management and utilization of the underlying semantics to harmonize domain-specific standards. The objective of this study is to develop and evaluate a Semantic Web-based approach that integrates the BRIDG model with ISO 21090 data types to generate domain-specific templates to support clinical study metadata standards development. We developed a template generation and visualization system based on an open source Resource Description Framework (RDF) store backend, a SmartGWT-based web user interface, and a "mind map" based tool for the visualization of generated domain-specific templates. We also developed a RESTful Web Service informed by the Clinical Information Modeling Initiative (CIMI) reference model for access to the generated domain-specific templates. A preliminary usability study is performed and all reviewers (n = 3) had very positive responses for the evaluation questions in terms of the usability and the capability of meeting the system requirements (with the average score of 4.6). Semantic Web technologies provide a scalable infrastructure and have great potential to enable computable semantic interoperability of models in the intersection of health care and clinical research.

  5. "Miss! I'm Done!" Finishing Craft Assignments as a Situated Activity System in Preschool

    Science.gov (United States)

    Deunk, Marjolein; Berenst, Jan; de Glopper, Kees

    2010-01-01

    We describe the Situated Activity System of finishing craft assignments in preschool: the specific, routinized way that child and teacher jointly close the child's craft assignment, employing a specific discourse pattern. We analyzed the interactions of 14 Dutch children between 2.1 and 3.10 years old while they were finishing their craft…

  6. Laterally situated sinus pericranii

    International Nuclear Information System (INIS)

    Koshu, K.; Takahashi, S.

    1981-01-01

    Sinus pericranii has been reported to be situated usually along the midline. Two cases of laterally situated sinus pericranii are presented. Venous blood was obtained by puncturing the tumors directly. Injection of contrast medium into the tumors demonstrated a communication between the tumors and the intracranial venous sinuses through marked diploic veins. (orig.)

  7. Specific Phobia among U.S. Adolescents: Phenomenology and Typology

    Science.gov (United States)

    Burstein, Marcy; Georgiades, Katholiki; He, Jian-Ping; Schmitz, Anja; Feig, Emily; Khazanov, Gabriela Kattan; Merikangas, Kathleen

    2014-01-01

    Background Investigators have proposed the diagnostic value of a generalized subtype of specific phobia, with classification based upon the number of phobic fears. However, current and future typologies of specific phobia classify the condition by the nature of phobic fears. This study investigated the clinical relevance of these alternative typologies by: (1) presenting the prevalence and correlates of specific phobia separately by the number and nature of phobia types; and (2) examining the clinical and psychiatric correlates of specific phobia according to these alternative typologies. Methods The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental United States. Results Most adolescents with specific phobia met criteria for more than one type of phobia in their lifetime, however rates were fairly similar across DSM-IV/5 subtypes. Sex differences were consistent across DSM-IV/5 subtypes, but varied by the number of phobic types, with a female predominance observed among those with multiple types of phobias. Adolescents with multiple types of phobias exhibited an early age of onset, elevated severity and impairment, and among the highest rates of other psychiatric disorders. However, certain DSM-IV/5 subtypes (i.e. blood-injection-injury and situational) were also uniquely associated with severity and psychiatric comorbidity. Conclusions Results indicate that both quantitative and DSM-IV/5 typologies of specific phobia demonstrate diagnostic value. Moreover, in addition to certain DSM-IV/5 subtypes, a generalized subtype based on the number of phobias may also characterize youth who are at greatest risk for future difficulties. PMID:23108894

  8. All in a day's work – variability in person-situation interactions in daily life situations

    DEFF Research Database (Denmark)

    Jensen, Lasse Meinert

    effect of persons’ situational concerns and intentions upon fluctuations in quality of experience. This paper will argue that the combination of findings (a) and (b) goes against the interpretation that persons merely “react” to situational features, and instead points to how subjective and agentic...... features of the person shape experience by way of guiding the person’s interaction with the situations of everyday life....

  9. Strategies and methods to study female-specific cardiovascular health and disease: a guide for clinical scientists.

    Science.gov (United States)

    Ouyang, Pamela; Wenger, Nanette K; Taylor, Doris; Rich-Edwards, Janet W; Steiner, Meir; Shaw, Leslee J; Berga, Sarah L; Miller, Virginia M; Merz, Noel Bairey

    2016-01-01

    In 2001, the Institute of Medicine's (IOM) report, "Exploring the Biological Contributions to Human Health: Does Sex Matter?" advocated for better understanding of the differences in human diseases between the sexes, with translation of these differences into clinical practice. Sex differences are well documented in the prevalence of cardiovascular (CV) risk factors, the clinical manifestation and incidence of cardiovascular disease (CVD), and the impact of risk factors on outcomes. There are also physiologic and psychosocial factors unique to women that may affect CVD risk, such as issues related to reproduction. The Society for Women's Health Research (SWHR) CV Network compiled an inventory of sex-specific strategies and methods for the study of women and CV health and disease across the lifespan. References for methods and strategy details are provided to gather and evaluate this information. Some items comprise robust measures; others are in development. To address female-specific CV health and disease in population, physiology, and clinical trial research, data should be collected on reproductive history, psychosocial variables, and other factors that disproportionately affect CVD in women. Variables related to reproductive health include the following: age of menarche, menstrual cycle regularity, hormone levels, oral contraceptive use, pregnancy history/complications, polycystic ovary syndrome (PCOS) components, menopause age, and use and type of menopausal hormone therapy. Other factors that differentially affect women's CV risk include diabetes mellitus, autoimmune inflammatory disease, and autonomic vasomotor control. Sex differences in aging as well as psychosocial variables such as depression and stress should also be considered. Women are frequently not included/enrolled in mixed-sex CVD studies; when they are included, information on these variables is generally not collected. These omissions limit the ability to determine the role of sex-specific

  10. The correlation between anti phospholipase A 2 specific IgE and clinical symptoms after a bee sting in beekeepers

    Directory of Open Access Journals (Sweden)

    Jan Matysiak

    2016-06-01

    Full Text Available Introduction: Beekeepers are a group of people with high exposure to honeybee stings and with a very high risk of allergy to bee venom. Therefore, they are a proper population to study the correlations between clinical symptoms and results of diagnostic tests. Aim: The primary aim of our study was to assess the correlations between total IgE, venom- and phospholipase A 2 -specific IgE and clinical symptoms after a bee sting in beekeepers. The secondary aim was to compare the results of diagnostic tests in beekeepers and in individuals with standard exposure to bees. Material and methods: Fifty-four individuals were divided into two groups: beekeepers and control group. The levels of total IgE (tIgE, venom-specific IgE (venom sIgE, and phospholipase A 2 -specific IgE (phospholipase A 2 sIgE were analyzed. Results: Our study showed no statistically significant correlation between the clinical symptoms after a sting and tIgE in the entire analyzed group. There was also no correlation between venom sIgE level and clinical symptoms either in beekeepers or in the group with standard exposure to bees. We observed a statistically significant correlation between phospholipase A 2 sIgE level and clinical signs after a sting in the group of beekeepers, whereas no such correlation was detected in the control group. Significantly higher venom-specific IgE levels in the beekeepers, as compared to control individuals were shown. Conclusions : In beekeepers, the severity of clinical symptoms after a bee sting correlated better with phospholipase A 2 sIgE than with venom sIgE levels.

  11. Quality evaluation of LC-MS/MS-based E. coli H antigen typing (MS-H) through label-free quantitative data analysis in a clinical sample setup.

    Science.gov (United States)

    Cheng, Keding; Sloan, Angela; McCorrister, Stuart; Peterson, Lorea; Chui, Huixia; Drebot, Mike; Nadon, Celine; Knox, J David; Wang, Gehua

    2014-12-01

    The need for rapid and accurate H typing is evident during Escherichia coli outbreak situations. This study explores the transition of MS-H, a method originally developed for rapid H antigen typing of E. coli using LC-MS/MS of flagella digest of reference strains and some clinical strains, to E. coli isolates in clinical scenario through quantitative analysis and method validation. Motile and nonmotile strains were examined in batches to simulate clinical sample scenario. Various LC-MS/MS batch run procedures and MS-H typing rules were compared and summarized through quantitative analysis of MS-H data output for a standard method development. Label-free quantitative data analysis of MS-H typing was proven very useful for examining the quality of MS-H result and the effects of some sample carryovers from motile E. coli isolates. Based on this, a refined procedure and protein identification rule specific for clinical MS-H typing was established and validated. With LC-MS/MS batch run procedure and database search parameter unique for E. coli MS-H typing, the standard procedure maintained high accuracy and specificity in clinical situations, and its potential to be used in a clinical setting was clearly established. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Environmental management as situated practice

    DEFF Research Database (Denmark)

    Lippert, Ingmar; Krause, Franz; Hartmann, Niklas Klaus

    2015-01-01

    We propose an analysis of environmental management (EM) as work and as practical activity. This approach enables empirical studies of the diverse ways in which professionals, scientists, NGO staffers, and activists achieve the partial manageability of specific “environments”. In this introduction......, we sketch the debates in Human Geography, Management Studies, and Science and Technology Studies to which this special issue contributes. We identify the limits of understanding EM though the framework of ecological modernisation, and show how political ecology and work-place studies provide...... to be assessed, or as simply the implementation of dominant projects and the materialisation of hegemonic discourse. Such a shift renders EM as always messy practices of engagement, critique and improvisation. We conclude that studying the distributed and situated managing agencies, actors and their practices...

  13. Nuclear reactors situation in Japan after the major earthquake of March 11, 2011. March 12, 2011, 8:00 PM status; Situation des reacteurs nucleaires au Japon suite au seisme majeur servenu le 11 mars 2011. Point de situation du 12 mars 2011 a 20 heures

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This situation note is established according to the information gained on March 12, 2011, at 8:00 PM, by the crisis centre of the French institute of radiation protection and nuclear safety (IRSN). The situation of the reactors No. 1, 2 and 3 of the Fukushima I site is briefly presented with the progress of the accident management actions. The operation principles of a BWR-type reactor and of a PWR-type reactor are presented in appendix as well as the confinement principle specific to Mark I-type BWR reactors designed by General Electric. The meteorological forecasts of the day are presented in a figure. (J.S.)

  14. Situated peer coaching and unfolding cases in the fundamentals skills laboratory.

    Science.gov (United States)

    Himes, Deborah O; Ravert, Patricia K

    2012-09-03

    Using unfolding case studies and situated peer coaching for the Fundamentals Skills Laboratory provides students with individualized feedback and creates a realistic clinical learning experience. A quasi-experimental design with pre- and post-intervention data was used to evaluate changes in student ratings of the course. An instrument was used to examine students' self-ratings and student comments about each lab. We found that students' ratings of the lab remained high with the new method and self-evaluations of their performance were higher as the semester progressed. Students appreciated the personalized feedback associated with peer coaching and demonstrated strong motivation and self-regulation in learning. By participating in unfolding case studies with situated peer coaching, students focus on safety issues, practice collaborative communication, and critical thinking in addition to performing psychomotor skills.

  15. Clinical and academic profile of children with specific learning disorder-mixed type: An Indian study

    Directory of Open Access Journals (Sweden)

    Anamika Sahu

    2017-01-01

    Full Text Available Background: Specific learning disorder (SLD in the past decade has gained recognition as a disabling condition among children by parents and teachers in India. However, there are still gaps in knowledge about its clinical presentation and understanding. Therefore, the present study was planned to evaluate the clinical and academic profile of children with SLD. Methods: The sample comprised 30 children with their age range between 7 and 12 years with a diagnosis of SLD-mixed type. All children were assessed through specifically designed structured pro forma for clinical details (i.e., nature of birth, developmental milestones, and comorbidities and academic history (i.e., history of failure, promoted in next class, repetition in the class, school change, etc. and SLD-comprehensive battery. Results: The mean age of the participants was 9.6 years (standard deviation [SD] = 1.5. 76.7% of participants were male and their mean years of education was 4.7 (SD = 1.5. Thirty percent of children had a history of delayed developmental milestones in terms of speech (16.7%, walking (6.7% and in speech and walking (6.7%, 23% of children had comorbid conditions of attention-deficit/hyperactivity disorder/attention-deficit disorder. Thirty percent of children repeated classes in their academic career. Conclusions: A significant number of children had delayed milestones and other problems. Moreover, it is important to understand the clinical and academic profile in the cultural context so that early identification and intervention can be planned.

  16. Genetic associations for pathogen-specific clinical mastitis and patterns of peaks in somatic cell count

    NARCIS (Netherlands)

    Haas, de Y.; Barkema, H.W.; Schukken, Y.H.; Veerkamp, R.F.

    2003-01-01

    Genetic associations were estimated between pathogen-specific cases of clinical mastitis (CM), lactational average somatic cell score (LACSCS), and patterns of peaks in somatic cell count (SCC) which were based on deviations from the typical lactation curve for SCC. The dataset contained test-day

  17. The clinical educator and complexity: a review.

    Science.gov (United States)

    Schoo, Adrian; Kumar, Koshila

    2018-02-08

    Complexity science perspectives have helped in examining fundamental assumptions about learning and teaching in the health professions. The implications of complexity thinking for how we understand the role and development of the clinical educator is less well articulated. This review article outlines: the key principles of complexity science; a conceptual model that situates the clinical educator in a complex system; and the implications for the individual, organisation and the system. Our conceptual model situates the clinical educator at the centre of a complex and dynamic system spanning four domains and multiple levels. The four domains are: personal (encompassing personal/professional needs and expectations); health services (health agencies and their consumers); educational (educational institutions and their health students); and societal (local community/region and government). The system also comprises: micro or individual, meso or organisational, and macro or socio-political levels. Our model highlights that clinical educators are situated within a complex system comprising different agents and connections. It emphasises that individuals, teams and organisations need to recognise and be responsive to the unpredictability, interconnectedness and evolving nature of this system. Importantly, our article also calls for an epistemological shift from faculty development to capacity building in health professions education, aimed at developing individual, team, organisational and system capabilities to work with(in) complexity. Clinical educators are situated within a complex system comprising different agents and connections. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  18. Situating Engagement

    DEFF Research Database (Denmark)

    Korn, Matthias

    Our mobile phone is with us at all times. Habitually, we pick it up in the morning and carry it around on our daily routes and routines. Increasingly, we use it to locate ourselves and the things and people around us. With ubiquitous computing, technology is moving into the very fabric of our....... First, situationally appropriate forms of engagement that align well with citizens’ own conceptions are necessary in order to provide relevance and meaning of issues in the moment. Second, situated engagement requires a technological setup which facilitates the co-location of people, place...... with sophisticated prototypes in the wild. It proposes walkshops as a technique for collaborative exploration within actual outdoor environments and the use of field trials as part of an iterative design process in order to look ahead toward use practices that are still in the making....

  19. Interactive effects of personality and perceptions of the work situation on workplace deviance.

    Science.gov (United States)

    Colbert, Amy E; Mount, Michael K; Harter, James K; Witt, L A; Barrick, Murray R

    2004-08-01

    Previous research on workplace deviance has examined the relationship of either personality or employees' situational perceptions with deviant behavior. In this study, the authors focused on the joint relationship of personality and perceptions of the work situation with deviant behavior. Using 4 samples of employees and multiple operationalizations of the core constructs, the authors found support for the hypothesis that positive perceptions of the work situation are negatively related to workplace deviance. In addition, consistent with hypotheses, the personality traits of conscientiousness, emotional stability, and agreeableness moderated this relationship. Specifically, the relationship between perceptions of the developmental environment and organizational deviance was stronger for employees low in conscientiousness or emotional stability, and the relationship between perceived organizational support and interpersonal deviance was stronger for employees low in agreeableness. (c) 2004 APA

  20. Managing and engineering in complex situations

    CERN Document Server

    Sousa-Poza, Andres

    2013-01-01

    With so many terms available to define the same thing, it would seem nearly irresponsible to introduce yet another term (complex situation) to describe a phenomenological state of such as a system. However, a complex situation infers both a broader meaning and imposes a different perspective. Complex in this context is dependent on understanding and reality rather than observer and knowledge.   Situation imposes a gestalt that cannot be characterized within a singular perspective that relegates paradox to a superior/subordinate hierarchy. This also infers that complex situation has no monotonic definition or each definition is by default incomplete. Therefore the perennial derivations for systems such as complex systems, system of systems, federation of systems is no longer a sufficient descriptor for complex situation.  Ergo system and its genealogy lack the constitution to define complex situations. The books' intent is to explore this pathology through a series of papers written by authors that work in ...

  1. Social Phobia in Youth: The Diagnostic Utility of Feared Social Situations

    Science.gov (United States)

    Puliafico, Anthony C.; Comer, Jonathan S.; Kendall, Philip C.

    2007-01-01

    The present study evaluated the utility of parent- and child-reported social fears for reaching a diagnosis of social phobia in youth. The diagnostic utility of (a) the number of fears and (b) specific feared social situations was examined. The sample included 140 youth and their parents: youth diagnosed with social phobia (n = 50), youth…

  2. Autobiographical memory specificity in response to verbal and pictorial cues in clinical depression.

    Science.gov (United States)

    Ridout, Nathan; Dritschel, Barbara; Matthews, Keith; O'Carroll, Ronan

    2016-06-01

    Depressed individuals have been consistently shown to exhibit problems in accessing specific memories of events from their past and instead tend to retrieve categorical summaries of events. The majority of studies examining autobiographical memory changes associated with psychopathology have tended to use word cues, but only one study to date has used images (with PTSD patients). to determine if using images to cue autobiographical memories would reduce the memory specificity deficit exhibited by patients with depression in comparison to healthy controls. Twenty-five clinically depressed patients and twenty-five healthy controls were assessed on two versions of the autobiographical memory test; cued with emotional words and images. Depressed patients retrieved significantly fewer specific memories, and a greater number of categorical, than did the controls. Controls retrieved a greater proportion of specific memories to images compared to words, whereas depressed patients retrieved a similar proportion of specific memories to both images and words. no information about the presence and severity of past trauma was collected. results suggest that the overgeneral memory style in depression generalises from verbal to pictorial cues. This is important because retrieval to images may provide a more ecologically valid test of everyday memory experiences than word-cued retrieval.. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Geriatric oncology in Spain: survey results and analysis of the current situation.

    Science.gov (United States)

    Gironés, R; Morilla, I; Guillen-Ponce, C; Torregrosa, M D; Paredero, I; Bustamante, E; Del Barco, S; Soler, G; Losada, B; Visa, L; Llabrés, E; Fox, B; Firvida, J L; Blanco, R; Antonio, M; Aparisi, F; Pi-Figueras, M; Gonzalez-Flores, E; Molina-Garrido, M J; Saldaña, J

    2017-12-11

    Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.

  4. Stressful situations and factors in students of nursing in clinical practice

    Directory of Open Access Journals (Sweden)

    Eliana Ofélia Llapa Rodrigues

    Full Text Available Objective.To assess the risk factors for stress in undergraduate students of nursing in clinical practice in a public university in the Northeast region of Brazil. Methods. Cross-sectional descriptive study with 116 students from the fifth to the ninth period. The bilingual KEZKAK questionnaire, validated for Portuguese, was used. Stress was considered to be present when the score was equal or superior to 2. Results. The students with stress in clinical practice were 18 to 22 years old (2.82 ± 0.98, women (2.81 ± 0.96, married (2.80 ± 0.97, and who were permanent contracted employees (2.74 ± 0.94. The factors which were most associated with stress were: Lack of competence (2.99 ± 0.88; Impotence and uncertainty (2.98 ± 0.85; and Patients seeking a closer relationship (2.93 ± 1.01. The students of the sixth period were the most vulnerable to stress (2.85±0.96. Conclusion. The studies showed the main risk factors for stress among students of nursing in their clinical practice. These results could be used in the development of strategies seeking to reduce stress in this context as well as to contribute to promoting mental health.

  5. Situated navigational working memory: the role of positive mood.

    Science.gov (United States)

    Palmiero, Massimiliano; Nori, Raffaella; Rogolino, Carmelo; D'Amico, Simonetta; Piccardi, Laura

    2015-09-01

    The perspective of situated cognition assumes that cognition is not separated from the context. In the present study, the issue if visuospatial memory and navigational working memory are situated was explored by manipulating participants' mood (positive, negative and neutral) while performing two different tasks. College students were randomly assigned to the group of positive, negative or neutral music. Participants filled out the positive and negative affect schedule (PANAS) before and after carrying out the Corsi Test and the Walking Corsi Test. Both tasks were performed forward and backward. Music was played throughout the memory tasks. Firstly, comparing pre-mood induction PANAS scores to post-mood induction PANAS scores, results showed that only positive affects were manipulated: After mood induction, the Positive Music Group produced higher scores, whereas the Negative Music Group produced lower scores than before mood induction; the Neutral Music Group produced no effect. Secondly, the Positive Music Group produced higher scores than Negative and Neutral Music Groups both at the Corsi Test and at the Walking Corsi Test. These results show that situational contexts that induce a specific mood can affect visuospatial memory and navigational working memory, and open to the idea that positive emotions may play a crucial role in enhancing navigational strategies.

  6. Does GEM-Encoding Clinical Practice Guidelines Improve the Quality of Knowledge Bases? A Study with the Rule-Based Formalism

    Science.gov (United States)

    Georg, Gersende; Séroussi, Brigitte; Bouaud, Jacques

    2003-01-01

    The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results. PMID:14728173

  7. Does GEM-encoding clinical practice guidelines improve the quality of knowledge bases? A study with the rule-based formalism.

    Science.gov (United States)

    Georg, Georg; Séroussi, Brigitte; Bouaud, Jacques

    2003-01-01

    The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results.

  8. Social fear and social phobia types among community youth: differential clinical features and vulnerability factors.

    Science.gov (United States)

    Knappe, Susanne; Beesdo-Baum, Katja; Fehm, Lydia; Stein, Murray B; Lieb, Roselind; Wittchen, Hans-Ulrich

    2011-01-01

    To compare different social fears and social phobia subtypes with regard to clinical (age of onset, avoidance, impairment, comorbidities) and vulnerability factors (behavioural inhibition (BI), parental psychopathology and parental rearing) among community youth. Fears of 6 social situations and Social Phobia (SP), along with their clinical features, were assessed using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI) in a population-based sample of N = 3021 14-24 year olds that were followed up for 10 years. BI and parental rearing were assessed using self-report questionnaires. Parental psychopathology was assessed directly in parents via DIA-X/M-CIDI, supplemented by offsprings' family history reports. In the total sample, 20.0%, 11.6%, 11.7% reported fear of 1, 2, 3 or more social situations, respectively; rates were 24.2%, 18.7%, and 57.1% in SP-cases (6.6% of the total sample). Exploring the factorial structure indicated rather unidimensionality of social fears than mutual distinction of social fears by interaction vs. performance situations. Except for fear of taking tests and public speaking, social fears rarely occurred in isolation. Social fears of both interaction and performance situations were associated with severe avoidance (vs. fear of either situation; Odds Ratios, OR = 1.5, 95%CI: 1.1-1.9) and impairment (OR = 3.6, 95%CI: 2.6-4.9), and more comorbid anxiety and depressive disorders (OR range 3.2-5.8, p > .001). Fear of interaction situations was associated with higher BI (vs. performance-related fears, OR range 1.2-2.1, p social fears differ in their clinical and vulnerability factors from performance-related social fears. The current DSM-IV specifier of "generalized" SP may fall short of adequately denoting these differences. Fear of taking tests appears to be conceptually and, possibly, etiologically distinct from other social fears, and may be better placed in another category (e.g., as a type of specific phobia

  9. Sensory Media: Multidisciplinary Approaches in Designing a Situated & Mobile Learning Environment for Past Topics

    Directory of Open Access Journals (Sweden)

    Terje Rasmussen

    2012-07-01

    Full Text Available Handheld digital devices are rapidly increasing their sensory capabilities for registering multiple types of input, such as movement, orientation, position and touch, as well as light and sound. Mobile Augmented Rreality is one of the emerging forms of representation and expression that exploits these sensory media. In the following text we will present and discuss a type of indirect augmented reality, which we call situated simulations. In a situated simulation there is approximate identity between the 3D environment displayed on the screen and the user's real perspective on a given location. This makes it possible to create simulations of relevant objects and environments related to a specific place, for example, interpretations of its past. We present a situated simulation

  10. High-fidelity hybrid simulation of allergic emergencies demonstrates improved preparedness for office emergencies in pediatric allergy clinics.

    Science.gov (United States)

    Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M

    2013-01-01

    Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Learning situation models in a smart home.

    Science.gov (United States)

    Brdiczka, Oliver; Crowley, James L; Reignier, Patrick

    2009-02-01

    This paper addresses the problem of learning situation models for providing context-aware services. Context for modeling human behavior in a smart environment is represented by a situation model describing environment, users, and their activities. A framework for acquiring and evolving different layers of a situation model in a smart environment is proposed. Different learning methods are presented as part of this framework: role detection per entity, unsupervised extraction of situations from multimodal data, supervised learning of situation representations, and evolution of a predefined situation model with feedback. The situation model serves as frame and support for the different methods, permitting to stay in an intuitive declarative framework. The proposed methods have been integrated into a whole system for smart home environment. The implementation is detailed, and two evaluations are conducted in the smart home environment. The obtained results validate the proposed approach.

  12. Situating beyond the social

    DEFF Research Database (Denmark)

    Soffer, Ann Katrine Bønnelykke

    2016-01-01

    Situated learning serves as an analytical framework for learning in a community of practice and has been widely used to understand the learning process that is entailed in becoming a nurse. Yet in this paper, the difficulties encountered with the original notion of situated learning once...... framework. I suggest the notion of multi-configured learning, which captures the heterogeneity and materiality encountered during ethnographic fieldwork at a Danish nursing school....

  13. Break-glass handling exceptional situations in access control

    CERN Document Server

    Petritsch, Helmut

    2014-01-01

    Helmut Petritsch describes the first holistic approach to Break-Glass which covers the whole life-cycle: from access control modeling (pre-access), to logging the security-relevant system state during Break-Glass accesses (at-access), and the automated analysis of Break-Glass accesses (post-access). Break-Glass allows users to override security restrictions in exceptional situations. While several Break-Glass models specific to given access control models have already been discussed in research (e.g., extending RBAC with Break-Glass), the author introduces a generic Break-Glass model. The pres

  14. Strategic governance: Addressing neonatal mortality in situations of political instability and weak governance.

    Science.gov (United States)

    Wise, Paul H; Darmstadt, Gary L

    2015-08-01

    Neonatal mortality is increasingly concentrated globally in situations of conflict and political instability. In 1991, countries with high levels of political instability accounted for approximately 10% of all neonatal deaths worldwide; in 2013, this figure had grown to 31%. This has generated a "grand divergence" between those countries showing progress in neonatal mortality reduction compared to those lagging behind. We present new analyses demonstrating associations of neonatal mortality with political instability (r = 0.55) and poor governance (r = 0.70). However, heterogeneity in these relationships suggests that progress is possible in addressing neonatal mortality even in the midst of political instability and poor governance. In order to address neonatal mortality more effectively in such situations, we must better understand how specific elements of "strategic governance"--the minimal conditions of political stability and governance required for health service implementation--can be leveraged for successful introduction of specific health services. Thus, a more strategic approach to policy and program implementation in situations of conflict and political instability could lead to major accelerations in neonatal mortality reduction globally. However, this will require new cross-disciplinary collaborations among public health professionals, political scientists, and country actors. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. SPECIFICITIES OF THE SUBSET PROFILE OF PERIPHERAL BLOOD IN PATIENTS WITH GLIOBLASTOMA: PATHOGENETIC AND CLINICAL ASSESSMENTS

    Directory of Open Access Journals (Sweden)

    V. A. Chumakov

    2006-01-01

    Full Text Available Abstract. In glioblastoma (GB, it is necessary to take into consideration GB-associated secondary immunodeficiency (SID, so-called syndrome of tumor-associated SID (STASID. Cell subsets having effector and regulatory functions, play an important role in developing STASID, and their proportions in patients with different forms of GB can be of pathogenetic importance and have clinical value for treatment and rehabilitation scheduling as well. The most pathogenically and clinically important features of cell subsets profile of peripheral blood were analyzed in patients with different clinical and morphological types of GB. The patients were divided into three groups, i.e., groups I and II were formed by patients with STASID (marked and slightly marked SID, accordingly; group III – patients with SIDTAS (tumor-associated autoimmune syndrome, associated with SID. Marked suppression of cell immunity is typical of group I - imbalance in T-lymphocytes, in a number of specific subsets, and in subsets clusters, as well as disproportions in the immunoregulatory indexes. In group II, the subset profiles of blood were slightly different from the norm. In patients with SIDTAS, activation of cell immunity was evident, forming SID with signs of autoimmune syndrome, affecting effector and regulatory chains of immunity, and influencing the severity and forecast of the disease. Specific features of the immune status in patients with GB identified can be resulted from different clinicalmorphological types of the tumor; the latter are to be considered in differential diagnostics of clinical course of GB and in scheduling of clinical-immunological efficient anti-tumor pharmacotherapy in pre- and postoperative periods.

  16. Creativity as openness: improvising health and care 'situations'.

    Science.gov (United States)

    Oliver, James

    2009-12-01

    Creativity has become an oft-used word in UK public policy, but perhaps it is also under-imagined. This paper contends that there is an instrumental tendency to narrowly frame creativity as innovation, implying a reproducible product, instead of more openly as improvisation, a situational, embodied and temporal process. This is not a simple dichotomy (innovation and improvisation, product and process, can be mutually informing concepts), nor is it specifically a question of definition; rather, it relates to an ontological orientation, and related to that are issues of epistemological implications. In particular the paper is concerned with the value of the arts in public policy, as situated in the social, and therefore human, spaces of health and care; and more generally the arts in society. The paper brings together a broad discussion from across disciplines, not in an interdisciplinary attempt to solve a problem, or to be reductive in the analysis, but to begin to approach a reorienting of understandings of creativity and the human value and foundation of the arts in society.

  17. Clinical skill center: a review of present situation and importance in medical education curriculum

    Directory of Open Access Journals (Sweden)

    Haleh Talaei

    2002-07-01

    Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

  18. Clinical Profile and Response to Chemotherapeutic Agents in Non-specific Urethritis

    Directory of Open Access Journals (Sweden)

    R K Pandhi

    1984-01-01

    Full Text Available The epidemiological and clinical profile of 159 patients having non-specific iiretbritis is repoed. The majority (67.39o of patients were unm and most (70.4% of the we m re in the age group of 21-30 years. The incubation period in the majority (69.2% of patients was 1-4 weeks. Almost all the (98.1% patients complained of dysuria but urethral discharge was seen only in 48.4% of patients. Out of tetracycline′s doxycline, erythromycin and cotrimoxazole tried in this study, tetracycline′s in the dosage of 2 gm/day for 3 weeks was found to give the best (90.5%′cure rate.

  19. Planning as situated design

    DEFF Research Database (Denmark)

    Axel, Erik

    It is common to associate situated activity with concrete, craftlike or manual activity here and now and to reserve theoretical and abstract thinking for activities like theoretical experimentation and systematic planning. Much work has gone into demonstrating that these activities are concrete...... and situated, too. In this presentation it will be argued that the investigation of systematic planning as conflictual cooperation will help us see that situated activity is not only based on the present conditions, but also relates them to events spread out in time and space, thereby opening up for another...... understanding of theoretical thinking. Some material from the empirical research project developed with Klaus Nielsen on the design and engineering of a house will be presented. On this basis a conception of planning will be unfolded. It will be understood differently from the way it is understood...

  20. Impacts of Situational Factors on Process Attribute Uses for Food Purchases

    DEFF Research Database (Denmark)

    Loebnitz, Natascha; Mueller Loose, Simone; Grunert, Klaus G

    2015-01-01

    Consumer buying decisions for food reflect considerations about food production. However, consumers’ interest in process-related product characteristics does not always translate into buying intentions. The present study investigates how situational factors affect the use of process......-related considerations when consumers select food products. A conjoint study provides estimated part worth utilities for product alternatives that differ on five product attributes (including four process-related factors) across two products (bread and sports drink) that differ on perceived naturalness....... The investigation of the utilities of the process-related attributes features both an internal (priming of environmental values/ value centrality) and an external (time pressure) situational factor. The results indicate that the importance of process-related attributes is product specific and also depends...

  1. The Spatial Power Motivation Scale: a semi-implicit measure of situational power motivation.

    Science.gov (United States)

    Schoel, Christiane; Zimmer, Katharina; Stahlberg, Dagmar

    2015-01-01

    We introduce a new nonverbal and unobtrusive measure to assess power motive activation, the Spatial Power Motivation Scale (SPMS). The unique features of this instrument are that it is (a) very simple and economical, (b) reliable and valid, and (c) sensitive to situational changes. Study 1 demonstrates the instrument's convergent and discriminant validity with explicit measures. Study 2 demonstrates the instrument's responsiveness to situational power motive salience: anticipating and winning competition versus losing competition and watching television. Studies 3 and 4 demonstrate that thoughts of competition result in higher power motivation specifically for individuals with a high dispositional power motive.

  2. Thinking like a nurse: a research-based model of clinical judgment in nursing.

    Science.gov (United States)

    Tanner, Christine A

    2006-06-01

    This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.

  3. Applying Cognitive Fusion to Space Situational Awareness

    Science.gov (United States)

    Ingram, S.; Shaw, M.; Chan, M.

    With recent increases in capability and frequency of rocket launches from countries across the world, maintaining a state-of-the-art Space Situational Awareness model is all the more necessary. We propose a fusion of real-time, natural language processing capability provided by IBM cognitive services with ground-based sensor data of positions and trajectories of satellites in all earth orbits. We believe such insight provided by cognitive services could help determine context to missile launches, help predict when a satellite of interest could be in danger, either by accident or by intent, and could alert interested parties to the perceived threat. We seek to implement an improved Space Situational Awareness model by developing a dynamic factor graph model informed by the fusion of ground-based ”structured” sensor data with ”unstructured” data from the public domain, such as news articles, blogs, and social media, in real time. To this end, we employ IBM’s Cognitive services, specifically, Watson Discovery. Watson Discovery allows real-time natural language processing of text including entity extraction, keyword search, taxonomy classification, concept tagging, relation extraction, sentiment analysis, and emotion analysis. We present various scenarios that demonstrate the utility of this new Space Situational Awareness model, each of which combine past structured information with related open source data. We demonstrate that should the model come to estimate a satellite is ”of interest”, it will indicate it as so, based on the most pertinent data, such as a reading from a sensor or by information available online. We present and discuss the most recent iterations of the model for satellites currently available on Space-Track.org.

  4. How to lead complex situations

    DEFF Research Database (Denmark)

    Hansen, Michael Pingel

    2013-01-01

    The military leader is experiencing increasingly more complex situations, whether it is as leader in a foreign combat environment or in the home-based public administration. Complex situations like these call for a special set of managerial responses and a special way of leading organisations...

  5. Specific determination of clinical and toxicological important substances in biological samples by LC-MS

    International Nuclear Information System (INIS)

    Mitulovic, G.

    2001-02-01

    This thesis of this dissertation is the specific determination of clinical and toxicological important substances in biological samples by LC-MS. Nicotine was determined in serum after application of nicotine plaster and nicotine nasal spray with HPLC-ESI-MS. Cotinine was determined direct in urine with HPLC-ESI-MS. Short time anesthetics were determined in blood and cytostatics were determined in liquor with HPLC-ESI-MS. (botek)

  6. Specificity of interpretation and judgemental biases in social phobia versus depression.

    Science.gov (United States)

    Voncken, M J; Bögels, S M; Peeters, F

    2007-09-01

    A body of studies shows that social phobia is characterized by content specific interpretation and judgmental biases. That is, they show bias in social situations but not in non-social situations. Comorbid depression, one of the major comorbid disorders in social phobia, might account for these biases in social phobia since depression also is characterized by cognitive distortions in social situations. This study hypothesized that, despite comorbid depression, patients with social phobia would suffer from contentspecific biases. Participants filled out the Interpretation and Judgmental Questionnaire (IJQ) to assess interpretation bias (using open-ended responses and forced-interpretations) and judgmental bias in social and non-social situations. Four groups participated: social phobic patients with high (N=38) and low (N=47) depressive symptoms, depressed patients (N=22) and normal controls (N=33). We found both social phobic groups to interpret social situations more negatively and judge social situations as more threatening than non-social situations relative to depressed patients and normal controls. As expected, depressive symptoms related to increased general interpretation and judgmental biases across social and non-social situations. In contrast to expectations, we did not find these patterns for the open-ended measure of interpretation bias. The content-specific biases for social situations distinguished social phobic patients from depressive patients. This speaks for the importance of establishing the primary diagnosis in patients with mixed depression and social anxiety complaints.

  7. Human Factors for Situation Assessment in Grid Operations

    Energy Technology Data Exchange (ETDEWEB)

    Guttromson, Ross T.; Schur, Anne; Greitzer, Frank L.; Paget, Mia L.

    2007-08-08

    Executive Summary Despite advances in technology, power system operators must assimilate overwhelming amounts of data to keep the grid operating. Analyses of recent blackouts have clearly demonstrated the need to enhance the operator’s situation awareness (SA). The long-term objective of this research is to integrate valuable technologies into the grid operator environment that support decision making under normal and abnormal operating conditions and remove non-technical barriers to enable the optimum use of these technologies by individuals working alone and as a team. More specifically, the research aims to identify methods and principles to increase SA of grid operators in the context of system conditions that are representative or common across many operating entities and develop operationally relevant experimental methods for studying technologies and operational practices which contribute to SA. With increasing complexity and interconnectivity of the grid, the scope and complexity of situation awareness have grown. New paradigms are needed to guide research and tool development aimed to enhance and improve operations. In reviewing related research, operating practices, systems, and tools, the present study established a taxonomy that provides a perspective on research and development surrounding power grid situation awareness and clarifies the field of human factors/SA for grid operations. Information sources that we used to identify critical factors underlying SA included interviews with experienced operational personnel, available historical summaries and transcripts of abnormal conditions and outages (e.g., the August 14, 2003 blackout), scientific literature, and operational policies/procedures and other documentation. Our analysis of August 2003 blackout transcripts and interviews adopted a different perspective than previous analyses of this material, and we complemented this analysis with additional interviews. Based on our analysis and a broad

  8. [Analysis of clinical features and allergic status of asthmatic patients with positive serum mycosis-specific IgE].

    Science.gov (United States)

    Mou, Yan; Ye, Ling; Gong, Ying; Zhang, Zhi-feng; Jin, Mei-ling

    2013-08-01

    To improve understanding of the clinical characteristics and diagnosis of allergic bronchopulmonary mycosis (ABPM). We retrospectively analyzed the clinical data, including clinical symptoms, laboratory tests, pulmonary function tests and chest CT imaging of 95 asthmatic patients with positive serum mycosis-specific IgE from January 2010 to September 2012 in Zhongshan Hospital Affiliated to Fudan University. Of the 95 patients, 59 cases met the diagnostic criteria of ABPM. There were 34 males and 25 females, with a mean age of (53 ± 4) years and a duration of asthma for (21 ± 4) years. Thirty-six cases showed mycosis hypersensitivity (MH). There were 10 males and 26 females, with a mean age of (46 ± 6) years and a duration of asthma for (16 ± 5) years. Clinical symptoms such as wheeze (52 vs 21, χ(2) = 11.159, P = 0.001), cough (54 vs 27, χ(2) = 4.859, P = 0.030) and expectoration (43 vs 9, χ(2) = 25.731, P = 0.000) were more common in the ABPM group compared to the MH group.In the ABPM group, 58 were A. fumigatus-specific IgE antibody positive, 34 Penicillium-specific IgE antibody positive and 1 only Penicillium-specific IgE antibody positive.While in the MH group, 15 were A.fumigatus-specific IgE antibody positive, 24 Penicillium-specific IgE antibody positive and 17 only Penicillium-specific IgE antibody positive.In the ABPM group, the percentage of positive fumigatus-specific IgE antibody was higher (58 vs 15, χ(2) = 24.500, P = 0.000), while the percentages of dermatophagoides pteronyssinus(21 vs 20, χ(2) = 3.632, P = 0.045) and Dermatophagoides farinae(17 vs 21, χ(2) = 8.118, P = 0.004) were lower. Total serum IgE [(4395 ± 1437) IU/ml vs (276 ± 133) IU/ml, T = 4.384, P = 0.000], peripheral eosinophil percentage[(12.56 ± 1.20)% vs (1.30 ± 0.15)%, t = 8.175, P = 0.000] and count [(2.09 ± 0.43)×10(9)/L vs (0.19 ± 0.04)×10(9)/L, t = 7.032, P = 0.000] were higher in the ABPM group as compared to the MH group.FEV1% slightly declined in the ABPM

  9. Deep situationality

    DEFF Research Database (Denmark)

    Matejskova, Tatiana

    2014-01-01

    as a Slovak national with immigration experi- ence, a nominal outsider to both the country of research, Germany, and its immigrant subjects, the post-Soviet Russian-speaking migrants. Focusing on the production of time-spaces of proximity as a deeply situational process, I stress in particular the un...

  10. Optimization as a Reasoning Strategy for Dealing with Socioscientific Decision-Making Situations

    Science.gov (United States)

    Papadouris, Nicos

    2012-01-01

    This paper reports on an attempt to help 12-year-old students develop a specific optimization strategy for selecting among possible solutions in socioscientific decision-making situations. We have developed teaching and learning materials for elaborating this strategy, and we have implemented them in two intact classes (N = 48). Prior to and after…

  11. The Didactic Engineering for the Math Olympics Teaching: Olympic Situations with Geogebra’s Support

    Directory of Open Access Journals (Sweden)

    Ana Paula Rodrigues Alves Santos

    2018-01-01

    Full Text Available In this article, we intend to present a partial cut of a master's research, in which we describe, in a specific way, two phases determined by Didactic Engineering - ED in the context of the Mathematical Olympiads. Thus, we have the stages of preliminary analyzes and the construction of Olympic situations/a priori analysis. We emphasize in an Olympic situation that is described/structured with the support of GeoGebra software. Intervention through the proper exploitation of software provides the learner with opportunities to overcome certain difficulties/obstacles to an understanding or even conceptual construction in geometry. In this sense, the mentioned Olympic situation was experienced by students of the ninth year of elementary education II, from a private school in the state of Ceara, Brazil. The Olympic situation described proposes the possibility of the construction of metric relations in the triangle rectangle, content referring to the area of plane geometry. The ED is presented in this research, as a vision of complementarity that uses the theory of didactic situations - TSD. In this way, the described Olympic situation represents an alternative to classes directed to the math Olympics, their indication and structure, describes elements related to didactic mediation during the teaching and learning process, which emphasize details that make it possible to control and predict the possible student’s actions, as well as, to provide the experience of more significant didactic situations for geometry study in the Olympic context.

  12. Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli.

    Science.gov (United States)

    Waters, Allison M; Farrell, Lara J; Zimmer-Gembeck, Melanie J; Milliner, Ella; Tiralongo, Evelin; Donovan, Caroline L; McConnell, Harry; Bradley, Brendan P; Mogg, Karin; Ollendick, Thomas H

    2014-11-01

    This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy ('one-session treatment', OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6-17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger 'dose' of ATP prior to the OST may reveal promising outcomes on clinical measures

  13. Situational and Generalised Conduct Problems and Later Life Outcomes: Evidence from a New Zealand Birth Cohort

    Science.gov (United States)

    Fergusson, David M.; Boden, Joseph M.; Horwood, L. John

    2009-01-01

    Background: There is considerable evidence suggesting that many children show conduct problems that are specific to a given context (home; school). What is less well understood is the extent to which children with situation-specific conduct problems show similar outcomes to those with generalised conduct problems. Methods: Data were gathered as…

  14. Specific responsible environmental behavior among boaters on the Chesapeake Bay: a predictive model part II

    Science.gov (United States)

    Stuart P. Cottrell; Alan R. Graefe

    1995-01-01

    This paper examines predictors of boater behavior in a specific behavior situation, namely the percentage of raw sewage discharged from recreational vessels in a sanitation pumpout facility on the Chesapeake Bay. Results of a multiple regression analysis show knowledge predicts behavior in specific issue situations. In addition, the more specific the...

  15. High sensitivity and specificity in proposed clinical diagnostic criteria for anti-N-methyl-D-aspartate receptor encephalitis.

    Science.gov (United States)

    Ho, Alvin C C; Mohammad, Shekeeb S; Pillai, Sekhar C; Tantsis, Esther; Jones, Hannah; Ho, Reena; Lim, Ming; Hacohen, Yael; Vincent, Angela; Dale, Russell C

    2017-12-01

    To determine the validity of the proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in paediatric patients. The diagnostic criteria for anti-NMDAR encephalitis proposed by Graus et al. (2016) use clinical features and conventional investigations to facilitate early immunotherapy before antibody status is available. The criteria are satisfied if patients develop four out of six symptom groups within 3 months, together with at least one abnormal investigation (electroencephalography/cerebrospinal fluid) and reasonable exclusion of other disorders. We evaluated the validity of the criteria using a retrospective cohort of paediatric patients with encephalitis. Twenty-nine patients with anti-NMDAR encephalitis and 74 comparison children with encephalitis were included. As expected, the percentage of patients with anti-NMDAR encephalitis who fulfilled the clinical criteria increased over time. During the hospital inpatient admission, most patients (26/29, 90%) with anti-NMDAR encephalitis fulfilled the criteria, significantly more than the comparison group (3/74, 4%) (panti-NMDAR encephalitis was 2 weeks from first symptom onset (range 1-6). The sensitivity of the criteria was 90% (95% confidence interval 73-98) and the specificity was 96% (95% confidence interval 89-99). The proposed diagnostic criteria for anti-NMDAR encephalitis have good sensitivity and specificity. Incomplete criteria do not exclude the diagnosis. The proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis by Graus et al. (2016) have high sensitivity and specificity in paediatric patients. The median time of fulfilling the criteria in patients with anti-NMDAR was 2 weeks from first symptom onset. © 2017 Mac Keith Press.

  16. Education as an income situation determinant of a consumer

    Directory of Open Access Journals (Sweden)

    Ladislav Stejskal

    2010-01-01

    Full Text Available The article is focused on an analysis of educational attainment of an individual and income ­situation of their household. At the beginning, a compendious summary of secondary sources is introduced. It resumes data supporting and contradicting the hypothesis about education as a determinant of an income situation. The preliminary theses analysis is performed by results quantification of a project called European Union – Statistics on Income and Living Conditions (EU-SILC. Aim of the paper is to verify the input thesis assumed from secondary resources. The thesis concerns the direct ­proportion between a level of education achieved and level of financial income. An introduction of a methodolo­gy and research summarized data forms a basis for particular analyses which are based on a conjunction of obtained information on household average monthly income and the educational attainment of their leading member. Analyses are sustained by contingency which characteri­zes social groups, i.e. spheres in which leading members are mostly involved with regard to income.Research results proved the validity of the preliminary thesis about correlation, respectively direct proportionality of educational attainment and monthly income amount. Education is consequently identified as one of income situation determinants. The authors anticipate specificity of the selected point of view. Results are therefore presented only as a partial argument and a possible base for further enquiries.

  17. Using the Concept of the "Total Situation" in the Analysis of a Borderline Adolescent

    Science.gov (United States)

    Diem-Wille, Gertraud

    2004-01-01

    The author discusses two concepts of transference: the broader use of transference as the "total situation", as it was called by Melanie Klein and further elaborated by post-Kleinians, and the narrow use of transference in the traditional sense. Using clinical material from the four-times-a-week analysis of a severely disturbed…

  18. Potential clinical usefulness of new glandular and circulating parathyroid peptides illuminated by sequence specific radioimmunoassay

    International Nuclear Information System (INIS)

    Lindall, A.W.; Cecchettin, M.

    1981-01-01

    It is now well known that human PTH peptides constitute a heterogeneous population of fragments of the eighty-four amino acid molecules. Over the years, considerable confusion has resulted from measurements made in both clinical and experimental settings with radioimmunoassays of either undefined or partially-defined specificity for a particular region of the intact molecule. The approach of the authors has been to make use of modern technology to synthesize peptide fragments that mimic portions of native molecules, and to use these fragments in RIA. A more detailed description of a portion of this work will appear in the Journal of Clinical Endocrinology and Metabolism. (Auth.)

  19. Agency in Professional Self-Determination of Adolescentswith Special Social Situations of Development

    Directory of Open Access Journals (Sweden)

    Aron I.S.,

    2017-12-01

    Full Text Available The article explains the importance of agency in professional identity formation as a conscious, independent, active, responsible, professional choice relevant in modern society. Psychological readiness for agency is considered its integral indicator which includes cognitive, activity, motivational, and personality components. The paper presents outcomes of a research on the specifics of psychological readiness to professional self-determination in adolescents with special social situations of development. This research involved 211 adolescents including orphans, teenagers with deviant behavior, and gifted teenagers. A set of techniques used in the research consisted of five standard techniques and a questionnaire developed by the author. The obtained results revealed that there is a lack of readiness for professional self-determination in all adolescent groups: orphans and teenagers with deviant behaviors showed insufficient rates for all four components of readiness, while gifted adolescents showed low rates for activity and personal components. The results of this research may help develop differentiated, person-centered technologies for promoting agency in professional self-determination of adolescents with special social situations of development. The author links the prospects of further investigations with the study of positive characteristics of psychological readiness of young people with special social situations of development to professional self-determination; these characteristics can serve as a compensatory and developmental potential of agency in professional self-determination in the context of specific social contexts and limited agency-based resources of professional self-determination.

  20. Situational interest of high school students who visit an aquarium

    DEFF Research Database (Denmark)

    Dohn, Niels Bonderup

    2011-01-01

    of a combined analytical tool that captures both social and psychological aspects. Qualitative methods were used to generate data: observation, video recording, and interviews. The findings showed that the aquarium visit triggered a lot of situational interest among the students and led to positive emotions...... visits. This study suggests that teachers can find ways to foster students’ involvement in specific content areas and increase levels of academic motivation regardless of prior interest....

  1. Emotions and clinical ethics support. A moral inquiry into emotions in moral case deliberation.

    Science.gov (United States)

    Molewijk, Bert; Kleinlugtenbelt, Dick; Pugh, Scott M; Widdershoven, Guy

    2011-12-01

    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants' conclusion that "compassion" is a more adequate emotion than "sadness". The emotion "sadness" is pointed towards the tragedy that is happening to the woman. The emotion "compassion" is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to

  2. Advanced Situation Awareness Technologies, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Situation Awareness Technologies (ASAT) will facilitate exploration of the moon surface, and other planetary bodies. ASAT will create an Advanced Situation...

  3. Concordance: Design Ideal for Facilitating Situated Negotiations in Out-of-clinic Healthcare

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.; Gronvall, Erik; Sokoler, Tomas

    2014-01-01

    Healthcare HCI research has explored various designs that encourage people to follow prescribed treatments, mostly adopting compliance and adherence as design ideals. However, within the medical sciences the notion of concordance also exists. Concordance promotes negotiation between the patient...... and healthcare professional for forging a therapeutic alliance. However, the HCI community has still not adopted concordance as a design ideal. This paper revisits four old design-cases to explore the role of concordance in out-of-clinic healthcare. We argue that concordance, as a design ideal, can guide new...... designs that promote a more active patient-role both at the clinic and beyond....

  4. Emergency situations in SMEs : Are entrepreneurs prepared?

    NARCIS (Netherlands)

    Kleijn, E.; Montfort, van K.; Masurel, E.

    2012-01-01

    The article examines how entrepreneurs prepare for emergency situations in small and medium-sized enterprises (SMEs) in the Netherlands. It identifies the characteristics of SMEs and the theory related to emergency situations and the preparations for such situations. It also provides a detailed

  5. Nursing students' assessment of the learning environment in different clinical settings.

    Science.gov (United States)

    Bisholt, Birgitta; Ohlsson, Ulla; Engström, Agneta Kullén; Johansson, Annelie Sundler; Gustafsson, Margareta

    2014-05-01

    Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. A cross-sectional study with comparative design was conducted. Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Poor and distressed, but happy: situational and cultural moderators of the relationship between wealth and happiness

    OpenAIRE

    Borrero, Silvio; Bolena Escobar, Ana; Cortés, Aura María; Maya, Luis Carlos

    2013-01-01

    Evidence on the relationship between wealth and happiness is mixed, hinting that there are situational or individual factors that account for the variability in results. This paper contends that wealth is in fact related to happiness. More specifically, it is proposed that poverty - as well as other adverse situations- has an undermining effect on happiness, and that this effect is attenuated by a collectivist orientation. Analyses of variance (ANOVAs) using data on happiness, wealth and cult...

  7. Identification and analysis of unsatisfactory psychosocial work situations: a participatory approach employing video-computer interaction.

    Science.gov (United States)

    Hanse, J J; Forsman, M

    2001-02-01

    A method for psychosocial evaluation of potentially stressful or unsatisfactory situations in manual work was developed. It focuses on subjective responses regarding specific situations and is based on interactive worker assessment when viewing video recordings of oneself. The worker is first video-recorded during work. The video is then displayed on the computer terminal, and the filmed worker clicks on virtual controls on the screen whenever an unsatisfactory psychosocial situation appears; a window of questions regarding psychological demands, mental strain and job control is then opened. A library with pictorial information and comments on the selected situations is formed in the computer. The evaluation system, called PSIDAR, was applied in two case studies, one of manual materials handling in an automotive workshop and one of a group of workers producing and testing instrument panels. The findings indicate that PSIDAR can provide data that are useful in a participatory ergonomic process of change.

  8. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    , and single clinics. Accordingly, there is an urgent need to improve this situation. Guidelines for Good Clinical (Research) Practice, conduct of more trials as multicentre trials, The Consort Statement, and The Cochrane Collaboration may all help in the application of the best research evidence in clinical......Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....

  9. Normalization and Personalization of Learning Situation: NPLS

    Directory of Open Access Journals (Sweden)

    Mounia Abik

    2009-06-01

    Full Text Available The personalization of learning is a major pedagogical challenge solicited by pedagogues and didacts. There are several projects about the production of personalizable learning situations such as Reload-LDE and Alfanet. These projects are interested in producing new standardized and personalizable learning situations. However, on the Web, an important number of learning situations exist. These situations are rich in information but don't consider all the characteristics of participants taking part in the learning, nor their technical environments. In this paper we suggest a help system that can transform an existing learning situation to another structure standardized and personalizable depending on the context of learning personalization that we have defined.

  10. Situational leadership and persons with disabilities.

    Science.gov (United States)

    Cubero, Christopher G

    2007-01-01

    Does situational leadership style impact workers with disabilities? Situational leadership as a model and style of organizational management is defined. With a concentration on workers with disabilities, employer and employee perceptions of the workplace environment are analyzed as a contributing factor to the choice of leadership styles. Leadership style and its potential impact on workers with disabilities are included. Advantages of situational leadership style as an organizational model for managers that matches the intricate needs of workers with disabilities are argued. Methods for increasing awareness of the needs of persons with disabilities in the workplace and improving leadership models are discussed. Implications and potential outcomes for workers with disabilities based on the use of situational leadership by managers are discussed.

  11. External Beam Radiotherapy for Clinically Localized Hormone-Refractory Prostate Cancer: Clinical Significance of Nadir Prostate-Specific Antigen Value Within 12 Months

    International Nuclear Information System (INIS)

    Ogawa, Kazuhiko; Nakamura, Katsumasa; Sasaki, Tomonari; Onishi, Hiroshi; Koizumi, Masahiko; Shioyama, Yoshiyuki; Araya, Masayuki; Mukumoto, Nobutaka M.S.; Mitsumori, Michihide; Teshima, Teruki

    2009-01-01

    Purpose: To analyze retrospectively the results of external beam radiotherapy for clinically localized hormone-refractory prostate cancer and investigate the clinical significance of nadir prostate-specific antigen (PSA) value within 12 months (nPSA12) as an early estimate of clinical outcomes after radiotherapy. Methods and Materials: Eighty-four patients with localized hormone-refractory prostate cancer treated with external beam radiotherapy were retrospectively reviewed. The total radiation doses ranged from 30 to 76 Gy (median, 66 Gy), and the median follow-up period for all 84 patients was 26.9 months (range, 2.7-77.3 months). Results: The 3-year actuarial overall survival, progression-free survival (PFS), and local control rates in all 84 patients after radiotherapy were 67%, 61%, and 93%, respectively. Although distant metastases and/or regional lymph node metastases developed in 34 patients (40%) after radiotherapy, local progression was observed in only 5 patients (6%). Of all 84 patients, the median nPSA12 in patients with clinical failure and in patients without clinical failure was 3.1 ng/mL and 0.5 ng/mL, respectively. When dividing patients according to low (<0.5 ng/mL) and high (≥0.5 ng/mL) nPSA12 levels, the 3-year PFS rate in patients with low nPSA12 and in those with high nPSA12 was 96% and 44%, respectively (p < 0.0001). In univariate analysis, nPSA12 and pretreatment PSA value had a significant impact on PFS, and in multivariate analysis nPSA12 alone was an independent prognostic factor for PFS after radiotherapy. Conclusions: External beam radiotherapy had an excellent local control rate for clinically localized hormone-refractory prostate cancer, and nPSA12 was predictive of clinical outcomes after radiotherapy.

  12. Hospital Nurses' Competencies in Disaster Situations: A Qualitative Study in the South of Brazil.

    Science.gov (United States)

    Marin, Sandra M; Witt, Regina R

    2015-12-01

    Introduction Hospital nurses play a key role in the aftermath of the occurrence of disasters and need specific competencies to work in these situations. From a global perspective, few models exist that focus on disaster nursing. This study aimed to identify hospital nurses' competencies in disaster situations. A qualitative, descriptive, exploratory study was developed using focus groups as a method of data collection. Three meetings were held from June through September 2012 with nurses who worked at a hospital used as reference for disaster situations in the South of Brazil. Thematic analysis of collected data generated the competencies. For statement standardization, a format consistent with a verb, a noun, and a complement was adopted. The group validated 17 competencies, which were organized according to the phases of emergency management described by the World Health Organization (WHO) and classified in domain areas of management, health care, communication, and education. The competencies identified in this study can contribute to the education and practice of nurses in the hospital ambience, strengthening its capacity to face disaster situations.

  13. Old and in pain: Enduring and situational effects of cultural aging stereotypes on older people's pain experiences.

    Science.gov (United States)

    Bernardes, S F; Marques, S; Matos, M

    2015-08-01

    This study aimed to investigate the interplay between enduring and situational aging stereotype (AS) effects in older adults' self-reports of clinical and experimentally induced pain. We expected that, as compared with the situational activation of positive AS or a neutral condition, the activation of negative AS would lead to more severe self-reports of clinical pain (H1, hypothesis 1), higher cold pressor task (CPT) pain threshold (H2) and lower CPT pain tolerance (H3), especially among older adults who more strongly endorsed AS. This was a prospective study across two moments in time. At time 1 (T1), 52 older adults (Mage  = 74.7; 51.9% women) filled out measures of cultural AS endorsement, clinical pain severity and interference. Three months afterwards (T2), some of these participants collaborated in an experimental study on the effects of AS activation on reported clinical pain (n = 40) and experimentally induced (using CPT) pain threshold and tolerance (n = 35). Our results supported H2, i.e., as compared with the activation of positive AS or a neutral condition, when negative AS were activated older adults showed higher CPT pain thresholds, but this effect was more salient among those who more strongly endorsed AS at T1. This study stresses the influence of cultural AS in older adults' pain experiences showing that the situational activation of negative AS greatly increases experimentally induced pain thresholds of elders who more strongly endorse those stereotypes. It also highlights the relevance of interventions at the level of the physical and/or social environments surrounding elders in pain. © 2014 European Pain Federation - EFIC®

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

    Directory of Open Access Journals (Sweden)

    A Obarisiagbon

    2013-01-01

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

  15. [Economic analysis of multinational clinical trials in oncology].

    Science.gov (United States)

    Lejeune, Catherine; Lueza, Béranger; Bonastre, Julia

    2018-02-01

    In oncology, as in other fields of medicine, international multicentre clinical trials came into being so as to include a sufficient number of subjects to investigate a clinical situation. The existence of tight budgetary constraints and the desire to make the best use of the resources available have resulted in the development of economic evaluations associated with these trials, which, thanks to their level of evidence and their size, provide particularly relevant material. Nonetheless, economic evaluations alongside international clinical trials raise specific questions of methodology with regard to both the design and the analysis of the results. Indeed, the costs of goods and services consumed, the types and quantities of resources, and medical practices vary from one country to another and within an individual country. Economic data from the different countries involved must be available so as to study and to take into account this variability, and appropriate techniques for cost estimations and analysis must be implemented to aggregate the results from several countries. From a review of the literature, the aim of this work was to provide an overview of the specific methodological features of economic evaluations alongside international clinical trials: analysis of efficacy data from several countries, collection of resources and real costs, methods to establish the monetary value of resources, methods to aggregate results accounting for the trial effect. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  16. Ethiopia - energy situation 1983/84

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    After a few short remarks on the energy situation, the most important figures referring to the production and consumption of electricity, petroleum, and petroleum products from 1978 to 1982 are compared in tabular form. The situation on the energy market, especially the petroleum and natural gas market, is described. Finally, some figures concerning the foreign trade are given.

  17. A Simulation and Modeling Framework for Space Situational Awareness

    International Nuclear Information System (INIS)

    Olivier, S.S.

    2008-01-01

    This paper describes the development and initial demonstration of a new, integrated modeling and simulation framework, encompassing the space situational awareness enterprise, for quantitatively assessing the benefit of specific sensor systems, technologies and data analysis techniques. The framework is based on a flexible, scalable architecture to enable efficient, physics-based simulation of the current SSA enterprise, and to accommodate future advancements in SSA systems. In particular, the code is designed to take advantage of massively parallel computer systems available, for example, at Lawrence Livermore National Laboratory. The details of the modeling and simulation framework are described, including hydrodynamic models of satellite intercept and debris generation, orbital propagation algorithms, radar cross section calculations, optical brightness calculations, generic radar system models, generic optical system models, specific Space Surveillance Network models, object detection algorithms, orbit determination algorithms, and visualization tools. The use of this integrated simulation and modeling framework on a specific scenario involving space debris is demonstrated

  18. Clinical dosimetry using mosfets

    International Nuclear Information System (INIS)

    Ramani, Ramaseshan; Russell, Stephen; O'Brien, Peter

    1997-01-01

    Purpose: The use of metal oxide-silicon field effect transistors (MOSFETs) as clinical dosimeters is demonstrated for a number of patients with targets at different clinical sites. Methods and Materials: Commercially available MOSFETs were characterized for energy response, angular dependency of response, and effect of accumulated dose on sensitivity and some inherent properties of MOSFETs. The doses determined both by thermoluminescence dosimetry (TLD) and MOSFETs in clinical situation were evaluated and compared to expected doses determined by calculation. Results: It was observed that a standard calibration of 0.01 Gy/mV gave MOSFET determined doses which agreed with expected doses to within 5% at the 95% confidence limit for photon beams from 6 to 25 MV and electron beams from 5 to 14 MeV. An energy-dependent variation in response of up to 28% was observed between two orientations of a MOSFET. The MOSFET doses compared very well with the doses estimated by TLDs, and the patients tolerated MOSFETs very well. A standard deviation of 3.9% between expected dose and MOSFET determined dose was observed, while for TLDs the standard deviation was 5.1%. The advantages and disadvantages of using MOSFETs for clinical dosimetry are discussed in detail. Conclusion: It was concluded that MOSFETs can be used as clinical dosimeters and can be a good alternative to TLDs. However, they have limitations under certain clinical situations

  19. School and Situated Knowledge: Travel or Tourism?

    Science.gov (United States)

    Damarin, Suzanne K.

    1993-01-01

    Examines issues related to situated cognition and learning, both in the classroom and in the world. Topics discussed include educational theories; the situated nature of knowledge; the perception of experts; and the role of technology in situated learning, including virtual reality, hypertext, and telecommunications. (26 references) (LRW)

  20. Connecting Classroom, Clinic, and Context: Clinical Reasoning Strategies for Clinical Instructors and Academic Faculty.

    Science.gov (United States)

    Furze, Jennifer; Kenyon, Lisa K; Jensen, Gail M

    2015-01-01

    Clinical reasoning is an essential skill in pediatric physical therapist (PT) practice. As such, explicit instruction in clinical reasoning should be emphasized in PT education. This article provides academic faculty and clinical instructors with an overview of strategies to develop and expand the clinical reasoning capacity of PT students within the scope of pediatric PT practice. Achieving a balance between deductive reasoning strategies that provide a framework for thinking and inductive reasoning strategies that emphasize patient factors and the context of the clinical situation is an important variable in educational pedagogy. Consideration should be given to implementing various teaching and learning approaches across the curriculum that reflect the developmental level of the student(s). Deductive strategies may be helpful early in the curriculum, whereas inductive strategies are often advantageous after patient interactions; however, exposure to both is necessary to fully develop the learner's clinical reasoning abilities. For more insights from the authors, see Supplemental Digital Content 1, available at http://links.lww.com/PPT/A87.

  1. The situation of radiation oncology patients' relatives. A stocktaking; Die Situation der Angehoerigen von Strahlentherapiepatienten. Eine Bestandsaufnahme

    Energy Technology Data Exchange (ETDEWEB)

    Momm, Felix; Lingg, Sabine; Adebahr, Sonja; Grosu, Anca-Ligia [Klinik fuer Strahlenheilkunde, Univ. Freiburg (Germany); Xander, Carola; Becker, Gerhild [Palliativeinheit, Univ. Freiburg (Germany)

    2010-06-15

    Background and Purpose: Recent studies have shown a very high importance of relatives in decisions about medical interventions. Therefore, the situation of this group was investigated in the sense of a stocktaking by interviewing the closest relatives of radiotherapy patients. Interviewed Persons and Methods: In a defined span of time (6 weeks), a total of 470 relatives (evaluable: n = 287, 61%) of radiotherapy patients were interviewed by a newly developed questionnaire about their contentment with their inclusion in the therapy course. Further, they gave information about specific needs of relatives as well as proposals for direct improvements in the context of a radiation therapy. Results: In total, the relatives were satisfied with their inclusion in the radiotherapy course and with the patient care. As an example, more than 95% of the relatives agreed with the statement ''Here in the hospital my ill relative is cared for well.'' Nevertheless, direct possibilities for improvements were found in the interdisciplinary information about oncologic topics and in the organization of the therapy course. Conclusion: In the stocktaking the situation of radiotherapy patients' relatives was generally satisfactory. Further improvements for the future can be expected mainly from interdisciplinary cancer centers having the best suppositions to care for the relatives, if necessary. Structures known from palliative care can be used as a model. (orig.)

  2. Distributed sensor management for space situational awareness via a negotiation game

    Science.gov (United States)

    Jia, Bin; Shen, Dan; Pham, Khanh; Blasch, Erik; Chen, Genshe

    2015-05-01

    Space situational awareness (SSA) is critical to many space missions serving weather analysis, communications, and navigation. However, the number of sensors used in space situational awareness is limited which hinders collision avoidance prediction, debris assessment, and efficient routing. Hence, it is critical to use such sensor resources efficiently. In addition, it is desired to develop the SSA sensor management algorithm in a distributed manner. In this paper, a distributed sensor management approach using the negotiation game (NG-DSM) is proposed for the SSA. Specifically, the proposed negotiation game is played by each sensor and its neighboring sensors. The bargaining strategies are developed for each sensor based on negotiating for accurately tracking desired targets (e.g., satellite, debris, etc.) . The proposed NG-DSM method is tested in a scenario which includes eight space objects and three different sensor modalities which include a space based optical sensor, a ground radar, or a ground Electro-Optic sensor. The geometric relation between the sensor, the Sun, and the space object is also considered. The simulation results demonstrate the effectiveness of the proposed NG-DSM sensor management methods, which facilitates an application of multiple-sensor multiple-target tracking for space situational awareness.

  3. Income situation of households as a social status indicator

    Directory of Open Access Journals (Sweden)

    Jana Stávková

    2013-01-01

    Full Text Available The net financial income of households plays a crucial role in assessing their living standard. It determines of which social class they are members and, thus, their social status as well. In order to monitor their income situation, this paper uses survey data of the European Union Statistics on Income and Living Conditions (EU SILC. An abundance of identification data, such as economic activity, industrial classification or sector of economic activity, level of education, age, number of household members, place of residence, household type and others, makes it possible to identify factors that demonstrably influence the household income level. On this basis, it is possible not only to determine the commonly available social class definitions using income intervals, but also to identify specific causes affecting household income and, thus, link a particular household to a given social class. The goal of this article is to establish which factors influence the income level of households. The authors of this paper focused on four factors: social group membership, occupation classified according to the national economy sectors, the highest level of education attained by the household leader and their age. To analyse the influence of selected factors including their interaction and impact on the income situation of households, the authors applied the method of analysing variance between groups (ANOVA using STATA statistical software. The Scheffe’s method of contrasts was used to determine specific differences between factor levels.

  4. Source of learning basic clinical skills by medical interns Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Meshkani Z

    2004-07-01

    Full Text Available Background: Effective clinical teaching is a major objective in general practitioner’s education at medical schools. Purpose: To identify the sources of clinical skills learning that medical student experience Methods: In this cross sectional study, interns of Tehran medical university who spent at least 12 months of their internship answered a questionnaire on the sources of clinical skills training. Chi2 test was used to examine the association of source of learning and students,’ specification such as sex, score of pre –internship exam, and marital status. Results: All 250 interns who were eligible participated. Over all 46.60% interns learned their clinical skills from residents or clinical teachers, 29.61% observed others performing the procedures, 16.25 learned the skills from hospital staff or nurses, 7.54% practiced their knowledge when confronted to an emergency situation Conclusion: Our results warrant a more attentive approach to clinical skills (specially procedural skills training Key words: LEARNING RESOURCES

  5. Burnout Syndrome and Demotivation Among Health Care Personnel. Managing Stressful Situations: The Importance of Teamwork.

    Science.gov (United States)

    García-Campayo, J; Puebla-Guedea, M; Herrera-Mercadal, P; Daudén, E

    2016-06-01

    Almost one-third of our lives is spent in the workplace, where much of our interaction with others takes place and where we are exposed to stressful situations. Work-related stress has consequences for the individual's physical and mental health. Stress and professional burnout syndrome are the main consequences of work situations characterized by a constant state of tension. Stress is the second leading cause of absenteeism in the European Union, and around 12% of European workers are currently affected by burnout syndrome. It is therefore vital to identify demotivated and stressed staff in both large organizations (hospitals and clinics) and smaller centers (private practices) so as to facilitate preventive measures and ensure early intervention in situations of stress, with a view to improving the performance of work teams. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  6. 21 CFR 290.10 - Definition of emergency situation.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Definition of emergency situation. 290.10 Section...) DRUGS: GENERAL CONTROLLED DRUGS General Provisions § 290.10 Definition of emergency situation. For the... Controlled Substances Act, the term emergency situation means those situations in which the prescribing...

  7. Informing physicians using a situated decision support system: Disease management for the smart city

    Directory of Open Access Journals (Sweden)

    Raafat George Saade

    2014-12-01

    Full Text Available We are in the midst of a healthcare paradigm shift driven by the wide adoption of ubiquitous computing and various modes of information communications technologies. As a result, cities worldwide are undergoing a major process of urbanization with ever increasing wealth of sensing capabilities – hence the Internet of Things (IoT. These trends impose great pressure on how healthcare is done. This paper describes the design and implementation of a situated clinical decision support (SCDSS system, most appropriate for smart cities. The SCDSS was prototyped and enhanced in a clinic. The SCDSS was then used in a clinic as well as in a university hospital centre. In this article, the system’s architecture, subcomponents and integrated workflow are described. The systems’ design was the result of a knowledge acquisition process involving interviews with five specialists and testing with 50 patients. The reports (specialist consultation report generated by the SCDSS were shown to general practitioners who were not able to distinguish them from human specialist reports. We propose a context-aware CDSS and assess its effectiveness in managing a wide medical range of patients. Five different patient cases were identified for analysis. The SCDSS was used to produce draft electronic specialist consultations, which were then compared to the original specialists’ consultations. It was found that the SCDSS-generated consults were of better quality for a number of reasons discussed herein. SCDSSs have great promise for their use in the clinical environment of smart cities. Valuable insights into the integration and use of situated clinical decision support systems are highlighted and suggestions for future research are given.

  8. The role of matching job resources in different demanding work situations : a vignette study

    NARCIS (Netherlands)

    Tooren, van den M.; Jonge, de J.

    2010-01-01

    This study examines human service employees' beliefs about the availability, relevance, and use of specific types of job resources (i.e. cognitive, emotional, and physical) in similar types of demanding situations at work. To gain a better understanding of these intra-psychic processes assumed to

  9. Crisis Situations in Engineering Product Development

    DEFF Research Database (Denmark)

    Muenzberg, Christopher; Hammer, Jens; Brem, Alexander

    2016-01-01

    approaches reduce the problem identification time and increase the efficiency of crisis management. The goal of this research is to identify methods which are able to support the crisis management process successfully. Therefore, a literature-based analysis of developing methods, especially TRIZ is conducted......Crisis situations are special situations during the development process. They are characterized by time and handling pressure. Therefore, it is necessary to identify and apply a methodical problem solving approach to overcome these situations. Due to their prescriptive character, problem solving...

  10. Social Situation of Development: Parents Perspectives on Infants-Toddlers' Concept Formation in Science

    Science.gov (United States)

    Sikder, Shukla

    2015-01-01

    The social situation of development (SSD) specific to each age determines regularly the whole picture of the child's life. Therefore, we need to learn about the whole context surrounding children relevant to their development. The focus of the study is to understand parent's views on infant-toddler's science concept formation in the family…

  11. Is the person-situation debate important for agent-based modeling and vice-versa?

    Directory of Open Access Journals (Sweden)

    Katarzyna Sznajd-Weron

    Full Text Available Agent-based models (ABM are believed to be a very powerful tool in the social sciences, sometimes even treated as a substitute for social experiments. When building an ABM we have to define the agents and the rules governing the artificial society. Given the complexity and our limited understanding of the human nature, we face the problem of assuming that either personal traits, the situation or both have impact on the social behavior of agents. However, as the long-standing person-situation debate in psychology shows, there is no consensus as to the underlying psychological mechanism and the important question that arises is whether the modeling assumptions we make will have a substantial influence on the simulated behavior of the system as a whole or not.Studying two variants of the same agent-based model of opinion formation, we show that the decision to choose either personal traits or the situation as the primary factor driving social interactions is of critical importance. Using Monte Carlo simulations (for Barabasi-Albert networks and analytic calculations (for a complete graph we provide evidence that assuming a person-specific response to social influence at the microscopic level generally leads to a completely different and less realistic aggregate or macroscopic behavior than an assumption of a situation-specific response; a result that has been reported by social psychologists for a range of experimental setups, but has been downplayed or ignored in the opinion dynamics literature.This sensitivity to modeling assumptions has far reaching consequences also beyond opinion dynamics, since agent-based models are becoming a popular tool among economists and policy makers and are often used as substitutes of real social experiments.

  12. A Prospective Study on the Clinical and Microbiological Spectrum of Endophthalmitis in a Specific Region in Denmark

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Hamoudi, Hassan; Friis-Møller, Alice

    2016-01-01

    PURPOSE: To study the clinical and microbiological spectrum of endophthalmitis with emphasis on clinical features, visual outcomes and risks of surgical complications. METHODS: A prospective observational study was conducted between 2012 and 2013 in a specific region in Denmark. Patients were...... clinically examined before, during and after surgical intervention for endophthalmitis. RESULTS: Fifty eyes with endophthalmitis were included. Endophthalmitis after cataract surgery (post-cataract), anti-VEGF (vascular endothelial growth factor) intravitreal injections (post-injection) and cases...... of endogenous endophthalmitis were responsible for 40, 28 and 18% of all cases, respectively. There was no difference in the microbiological spectrum in post-cataract patients and post-injection patients, but patients with post-cataract endophthalmitis presented statistically significantly more frequently...

  13. Situation Awareness with Systems of Systems

    NARCIS (Netherlands)

    Laar, P. van de; Tretmans, J.; Borth, M.

    2013-01-01

    This book discusses various aspects, challenges, and solutions for developing systems-of-systems for situation awareness, using applications in the domain of maritime safety and security. Topics include advanced, multi-objective visualization methods for situation awareness, stochastic outlier

  14. Vulnerability Situations associated with Flash Flood Casualties in the United States

    Science.gov (United States)

    Terti, G.; Ruin, I.; Anquetin, S.; Gourley, J. J.

    2015-12-01

    In the United States (U.S.) flash flooding (FF hereafter) is one of the leading cause of weather-related deaths. Because FF events can be distinguished from riverine floods by their fast response to rainfall and resulting impacts signature, analyzing FF-specific impact datasets seems a good way to identify the juxtaposition of social and physical circumstances leading to those impacts. This communication focuses on conceptual and methodological developments allowing testing hypotheses on FF-specific vulnerability factors through the analysis of human impact datasets. We hypothesize that the intersection of the spatio-temporal context of the FF phenomena with the distribution of people and their characteristics across space and time reveals various paths of vulnerability through the expression of different accidents' circumstances (i.e., vehicle-related, inside buildings, open-air, campsites). We argue that vulnerability and the resulting impacts vary dynamically throughout the day according to the location/situation under concern. In order to test FF-specific contextual vulnerability factors at the scale of the continental US, 1075 fatalities reported between 1996 and 2014 in the Storm Data publication of the U.S. National Climatic Data Center (NCDC) are analyzed to statistically explore the timing, the duration and the location of the FF event, and the age and gender of the victims and the circumstance (i.e. location/activity) of their death. In this objective, a re-classification of the individual fatality circumstances and a discretization of the time in qualitative time-steps are performed to obtain possible trends and patterns in the occurrence of fatalities in certain circumstances and time (e.g., day vs night). The findings highlight the importance of situation-specific assessment of FF fatalities to guide the development of FF-specific vulnerability and impacts prediction modeling. Such analysis can provide valuable knowledge when the National Weather

  15. A Domain-Specific Terminology for Retinopathy of Prematurity and Its Applications in Clinical Settings.

    Science.gov (United States)

    Zhang, Yinsheng; Zhang, Guoming

    2018-01-01

    A terminology (or coding system) is a formal set of controlled vocabulary in a specific domain. With a well-defined terminology, each concept in the target domain is assigned with a unique code, which can be identified and processed across different medical systems in an unambiguous way. Though there are lots of well-known biomedical terminologies, there is currently no domain-specific terminology for ROP (retinopathy of prematurity). Based on a collection of historical ROP patients' data in the electronic medical record system, we extracted the most frequent terms in the domain and organized them into a hierarchical coding system-ROP Minimal Standard Terminology, which contains 62 core concepts in 4 categories. This terminology has been successfully used to provide highly structured and semantic-rich clinical data in several ROP-related applications.

  16. A Domain-Specific Terminology for Retinopathy of Prematurity and Its Applications in Clinical Settings

    Directory of Open Access Journals (Sweden)

    Yinsheng Zhang

    2018-01-01

    Full Text Available A terminology (or coding system is a formal set of controlled vocabulary in a specific domain. With a well-defined terminology, each concept in the target domain is assigned with a unique code, which can be identified and processed across different medical systems in an unambiguous way. Though there are lots of well-known biomedical terminologies, there is currently no domain-specific terminology for ROP (retinopathy of prematurity. Based on a collection of historical ROP patients’ data in the electronic medical record system, we extracted the most frequent terms in the domain and organized them into a hierarchical coding system—ROP Minimal Standard Terminology, which contains 62 core concepts in 4 categories. This terminology has been successfully used to provide highly structured and semantic-rich clinical data in several ROP-related applications.

  17. Zur wirtschaftlichen Situation georgischer Landwirtschaftsbetriebe

    OpenAIRE

    Schulze, Eberhard; Tillack, Peter; Mosashwili, Nodar

    2003-01-01

    Dieser Forschungsbericht beinhaltet die Ergebnisse einer Untersuchung von 200 Familienbetrieben im Osten Georgiens im Distrikt Sighnagi in der Kakheti-Region Ende 2001/Anfang 2002. Sie dienten dem Ziel, Erkenntnisse über die wirtschaftliche Situation georgischer Familienbetriebe sowie zum Teil der sozialen Situation in Bauernfamilien nach zehn Jahren Transformationsprozess in der Landwirtschaft zu gewinnen. Die Untersuchungen schlossen die Befragung der Betriebsleiter nach dem Alter, der Daue...

  18. Women-specific mental disorders in DSM-V: are we failing again?

    Science.gov (United States)

    Wittchen, Hans-Ulrich

    2010-02-01

    Despite a wealth of studies on differences regarding the biobehavioral and social-psychological bases of mental disorders in men and women and repeated calls for increased attention, women-specific issues have so far not been comprehensively addressed in past diagnostic classification systems of mental disorders. There is also increasing evidence that this situation will not change significantly in the upcoming revisions of ICD-11 and DSM-V. This paper explores reasons for this continued failure, highlighting three major barriers: the fragmentation of the field of women's mental health research, lack of emphasis on diagnostic classificatory issues beyond a few selected clinical conditions, and finally, the "current rules of game" used by the current DSM-V Task Forces in the revision process of DSM-V. The paper calls for concerted efforts of researchers, clinicians, and other stakeholders within a more coherent and comprehensive framework aiming at broader coverage of women-specific diagnostic classificatory issues in future diagnostic systems.

  19. [Study on commercial specification of atractylodes based on Delphi method].

    Science.gov (United States)

    Wang, Hao; Chen, Li-Xiao; Huang, Lu-Qi; Zhang, Tian-Tian; Li, Ying; Zheng, Yu-Guang

    2016-03-01

    This research adopts "Delphi method" to evaluate atractylodes traditional traits and rank correlation. By using methods of mathematical statistics the relationship of the traditional identification indicators and atractylodes goods rank correlation was analyzed, It is found that the main characteristics affectingatractylodes commodity specifications and grades of main characters wereoil points of transaction,color of transaction,color of surface,grain of transaction,texture of transaction andspoilage. The study points out that the original "seventy-six kinds of medicinal materials commodity specification standards of atractylodes differentiate commodity specification" is not in conformity with the actual market situation, we need to formulate corresponding atractylodes medicinal products specifications and grades.This study combined with experimental results "Delphi method" and the market actual situation, proposed the new draft atractylodes commodity specifications and grades, as the new atractylodes commodity specifications and grades standards. It provides a reference and theoretical basis. Copyright© by the Chinese Pharmaceutical Association.

  20. Sonification of network traffic flow for monitoring and situational awareness

    Science.gov (United States)

    2018-01-01

    Maintaining situational awareness of what is happening within a computer network is challenging, not only because the behaviour happens within machines, but also because data traffic speeds and volumes are beyond human ability to process. Visualisation techniques are widely used to present information about network traffic dynamics. Although they provide operators with an overall view and specific information about particular traffic or attacks on the network, they often still fail to represent the events in an understandable way. Also, because they require visual attention they are not well suited to continuous monitoring scenarios in which network administrators must carry out other tasks. Here we present SoNSTAR (Sonification of Networks for SiTuational AwaReness), a real-time sonification system for monitoring computer networks to support network administrators’ situational awareness. SoNSTAR provides an auditory representation of all the TCP/IP traffic within a network based on the different traffic flows between between network hosts. A user study showed that SoNSTAR raises situational awareness levels by enabling operators to understand network behaviour and with the benefit of lower workload demands (as measured by the NASA TLX method) than visual techniques. SoNSTAR identifies network traffic features by inspecting the status flags of TCP/IP packet headers. Combinations of these features define particular traffic events which are mapped to recorded sounds to generate a soundscape that represents the real-time status of the network traffic environment. The sequence, timing, and loudness of the different sounds allow the network to be monitored and anomalous behaviour to be detected without the need to continuously watch a monitor screen. PMID:29672543

  1. Sonification of network traffic flow for monitoring and situational awareness.

    Science.gov (United States)

    Debashi, Mohamed; Vickers, Paul

    2018-01-01

    Maintaining situational awareness of what is happening within a computer network is challenging, not only because the behaviour happens within machines, but also because data traffic speeds and volumes are beyond human ability to process. Visualisation techniques are widely used to present information about network traffic dynamics. Although they provide operators with an overall view and specific information about particular traffic or attacks on the network, they often still fail to represent the events in an understandable way. Also, because they require visual attention they are not well suited to continuous monitoring scenarios in which network administrators must carry out other tasks. Here we present SoNSTAR (Sonification of Networks for SiTuational AwaReness), a real-time sonification system for monitoring computer networks to support network administrators' situational awareness. SoNSTAR provides an auditory representation of all the TCP/IP traffic within a network based on the different traffic flows between between network hosts. A user study showed that SoNSTAR raises situational awareness levels by enabling operators to understand network behaviour and with the benefit of lower workload demands (as measured by the NASA TLX method) than visual techniques. SoNSTAR identifies network traffic features by inspecting the status flags of TCP/IP packet headers. Combinations of these features define particular traffic events which are mapped to recorded sounds to generate a soundscape that represents the real-time status of the network traffic environment. The sequence, timing, and loudness of the different sounds allow the network to be monitored and anomalous behaviour to be detected without the need to continuously watch a monitor screen.

  2. Personality-situation transactions from adolescence to old age.

    Science.gov (United States)

    Wrzus, Cornelia; Wagner, Gert G; Riediger, Michaela

    2016-05-01

    People presumably choose and create their daily environments according to their personality. Prior research shows that, for example, more extraverted people engage more often in social situations, and more conscientious people engage more often in work-related activities compared with less extraverted or less conscientious people, respectively. The current study examined such personality-situation transactions in people's daily life. Based on the assumption that older people know themselves and their personality better than younger people, we investigated whether momentary and proximate personality-situation associations (i.e., changing from 1 type of situation into another) increase with older age. Three-hundred and 78 people aged 14 to 82 years described their Big Five traits and took part in a 3-week experience-sampling phase. Using mobile-phone based assessments in daily life, participants reported on average 55 times on their momentary situation. Multilevel modeling results showed that personality-situation associations varied with the age of participants. Some of the "established" personality-situation associations, such as for extraversion and time spent with friends or conscientiousness and time spent with work activities, were only observed in adolescence and young adulthood. In contrast, other personality-situation associations appeared only in late adulthood, such as for openness and time spent with friends. Yet most personality-situation associations did not vary significantly with people's age. In addition, personality traits predicted maintaining or entering personality-congruent situations. The latter results point to the active role of personality in shaping one's environment. The findings imply that some personality-situation transactions may be largely similarly across the life span. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Modern principles of public administration of pharmaceutical supply for the population in emergency situations

    Directory of Open Access Journals (Sweden)

    P. V. Olіynуk

    2015-08-01

    Full Text Available In conditions of the emergency situations’ amount increasing the readiness of the state to provide affected people and all other segments of the population with full pharmaceutical provision is important. The aim of research is an analysis of the state of the legislative and regulatory framework of governmental administration by pharmaceutical provision of the population in the conditions of emergency situations. Materials and methods. We used methods of observation and synthesis, generalization and formalization, analysis of content. The object of the study were regulations, government pharmaceutical providing of population in emergency situations. Results. Studies show the need to develop methods and principles of public administration process to ensure people with pharmaceutical and specific methodological approaches in emergency situations. Conclusions. It has been established, that it is necessary to develop scientifically based methods of governance by the process of pharmaceutical providing the affected population.

  4. [Scientific concepts in clinical medicine].

    Science.gov (United States)

    Rogler, G

    2003-11-28

    The understanding of the scientific basis and the theory of knowledge are surprisingly heterogeneous in practical and clinical medicine. It is frequently influenced or based on the philosophical theory of critical rationalism founded by Sir Karl Popper. Because the theory of knowledge and the understanding of scientific truth is the central basis for cautious and good clinical practise it is necessary to discuss both points to avoid unscientific auto-immunisation against critique in a type of medicine that regards herself as science-based. Evidence-based medicine would not be possible without interpretation and explanation of existing data into the individual treatment context. Besides an inductive or deductive logic the historical and situative side-conditions of the gathering of knowledge and of experiments are of central importance for their interpretation and their relevance in clinical practice. This historical and situative context warrants reflection but must also be paid attention to in the reflections on medical ethics.

  5. Spacio-temporal situation assessment for mobile robots

    DEFF Research Database (Denmark)

    Beck, Anders Billesø; Risager, Claus; Andersen, Nils Axel

    2011-01-01

    chains are used to model the situation states and sequence, where stream clustering is used for state matching and dealing with noise. In experiments using simulated and real data, we show that we are able to learn a situation sequence for a mobile robot passing through a narrow passage. After learning......In this paper, we present a framework for situation modeling and assessment for mobile robot applications. We consider situations as data patterns that characterize unique circumstances for the robot, and represented not only by the data but also its temporal and spacial sequence. Dynamic Markov...

  6. Prostate-specific membrane antigen-based imaging in prostate cancer: impact on clinical decision making process.

    Science.gov (United States)

    Demirkol, Mehmet Onur; Acar, Ömer; Uçar, Burcu; Ramazanoğlu, Sultan Rana; Sağlıcan, Yeşim; Esen, Tarık

    2015-05-01

    There is an ongoing need for an accurate imaging modality which can be used for staging purposes, metastatic evaluation, predicting biologic aggresiveness and investigating recurrent disease in prostate cancer. Prostate specific membrane antigen, given its favorable molecular characteristics, holds a promise as an ideal target for prostate cancer-specific nuclear imaging. In this study, we evaluated our initial results of PSMA based PET/CT imaging in prostate cancer. A total of 22 patients with a median age and serum PSA level of 68 years and 4.15 ng/ml, respectively underwent Ga-68 PSMA PET/CT in our hospital between Februrary and August 2014. Their charts were retrospectively reviewed in order to document the clinical characteristics, the indications for and the results of PSMA based imaging and the impact of Ga-68 PSMA PET/CT findings on disease management. The most common indications were rising PSA after local ± adjuvant treatment followed by staging and metastatic evaluation before definitive or salvage treatment. All except 2 patients had prostatic ± extraprostatic PSMA positive lesions. For those who had a positive result; treatment strategies were tailored accordingly. Above the PSA level of 2 ng/ml, none of the PSMA based nuclear imaging studies revealed negative results. PSMA based nuclear imaging has significantly impacted our way of handling patients with prostate cancer. Its preliminary performance in different clinical scenarios and ability to detect lesions even in low PSA values seems fairly promising and deserves to be supplemented with further clinical studies. © 2015 Wiley Periodicals, Inc.

  7. [Suicidal behavior: a psychiatric emergency situation, suicide prevention: a psychiatric obligation].

    Science.gov (United States)

    Wolfersdorf, M; Schneider, B; Schmidtke, A

    2015-09-01

    In German psychiatry suicidal behavior is seen as sign of a psychiatric crisis in a person in the context of psychopathology, psychodynamics and psychosocial situation. Psychiatric disorders are found in up to 90% of people who commit suicide and the time span following the decision to commit suicide is often very short, within 24 h. Suicide prevention is a central duty and obligation in psychiatry and psychotherapy. This article gives an overview on the current state of knowledge on suicide from a clinical point of view.

  8. Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program.

    Science.gov (United States)

    Amor, Antonio J; Cabrer, Maria; Giménez, Marga; Vinagre, Irene; Ortega, Emilio; Conget, Ignacio

    2016-01-01

    The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program. A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A P value 153 (53.6% women; mean age 46.6±8.6 years; age at onset 23.3±8.8 years; disease duration, 23.3±2.6 years) continued to attend our diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD. Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Current situation and existing problems of acupuncture for primary hypertension].

    Science.gov (United States)

    Zhang, Lili; Wei, Pengfei; Chen, Shaozong

    2018-03-12

    To analyze the present situation and existing problems of acupuncture for primary hypertension (PH) based on clinical research literature in recent 20 years. The clinical research literature regarding acupuncture for PH were searched from China National Knowledge Infrastructure (CNKI), VIP data network (VIP) and Wanfang database from 1997 through 2016; a total of 218 papers met the inclusive criteria. Microsoft Excel and Apriori algorithm of SPSS Clementine software were applied to analyze the data. The main acupoints of acupuncture for PH were Taichong (LR 3), Quchi (LI 11), Zusanli (ST 36) and Hegu (LI 4), but its support degree was only 12.21%. 127 papers were randomized controlled trials, accounting for 58.26%. 158 papers had clear diagnostic criteria, accounting for 72.48%. 138 papers had clear efficacy evaluation criteria, accounting for 63.30%. Only 5.05% of the papers were classified as high-quality literature by using Jadad scale. In recent 20 years, some rules existed in acupoint selection for PH, but the support degree was low so it could not accurately guide clinical treatment. Although the clinical literature quality of acupuncture for PH was gradually increasing, the proportion of high-quality literature was low, therefore modern medical research model and foreign similar research should be followed to design a more rigorous trial protocol. As a result, the quality of clinical research is increased to provide reference for future clinical treatment.

  10. Situation-Based Contingencies Underlying Wisdom-Content Manifestations: Examining Intellectual Humility in Daily Life.

    Science.gov (United States)

    Zachry, Corinne E; Phan, Le Vy; Blackie, Laura E R; Jayawickreme, Eranda

    2018-02-21

    Existing assessments of intellectual humility (IH)-a key component of wisdom-do not examine its manifestation in daily life while sufficiently focusing on the core idea of the construct: owning up to one's intellectual shortcomings. The present research sought to examine situational contingencies underlying daily manifestations of IH-relevant characteristics. We developed a trait version of the State-Trait IH Scale in two studies and subsequently examined daily manifestations of IH-relevant characteristics utilizing a contextualized state version of the State-Trait IH Scale in a 21-day experience sampling study. Here we tested how specific situational contingencies (associated with the context and the personality of the individual with whom participants engaged) influenced the manifestation of IH-relevant qualities. We found strong evidence for the validity of both versions of the scale. Specifically, the state measure exhibited high within-person variability, and aggregated state assessments were strongly correlated with the trait measure. Additionally, morality positively predicted manifestation of IH, while disagreeableness negatively predicted manifestation of IH. These results offer new directions for research on the expression of wisdom-related characteristics in daily life.

  11. Detection of braking intention in diverse situations during simulated driving based on EEG feature combination.

    Science.gov (United States)

    Kim, Il-Hwa; Kim, Jeong-Woo; Haufe, Stefan; Lee, Seong-Whan

    2015-02-01

    We developed a simulated driving environment for studying neural correlates of emergency braking in diversified driving situations. We further investigated to what extent these neural correlates can be used to detect a participant's braking intention prior to the behavioral response. We measured electroencephalographic (EEG) and electromyographic signals during simulated driving. Fifteen participants drove a virtual vehicle and were exposed to several kinds of traffic situations in a simulator system, while EEG signals were measured. After that, we extracted characteristic features to categorize whether the driver intended to brake or not. Our system shows excellent detection performance in a broad range of possible emergency situations. In particular, we were able to distinguish three different kinds of emergency situations (sudden stop of a preceding vehicle, sudden cutting-in of a vehicle from the side and unexpected appearance of a pedestrian) from non-emergency (soft) braking situations, as well as from situations in which no braking was required, but the sensory stimulation was similar to stimulations inducing an emergency situation (e.g., the sudden stop of a vehicle on a neighboring lane). We proposed a novel feature combination comprising movement-related potentials such as the readiness potential, event-related desynchronization features besides the event-related potentials (ERP) features used in a previous study. The performance of predicting braking intention based on our proposed feature combination was superior compared to using only ERP features. Our study suggests that emergency situations are characterized by specific neural patterns of sensory perception and processing, as well as motor preparation and execution, which can be utilized by neurotechnology based braking assistance systems.

  12. Detection of braking intention in diverse situations during simulated driving based on EEG feature combination

    Science.gov (United States)

    Kim, Il-Hwa; Kim, Jeong-Woo; Haufe, Stefan; Lee, Seong-Whan

    2015-02-01

    Objective. We developed a simulated driving environment for studying neural correlates of emergency braking in diversified driving situations. We further investigated to what extent these neural correlates can be used to detect a participant's braking intention prior to the behavioral response. Approach. We measured electroencephalographic (EEG) and electromyographic signals during simulated driving. Fifteen participants drove a virtual vehicle and were exposed to several kinds of traffic situations in a simulator system, while EEG signals were measured. After that, we extracted characteristic features to categorize whether the driver intended to brake or not. Main results. Our system shows excellent detection performance in a broad range of possible emergency situations. In particular, we were able to distinguish three different kinds of emergency situations (sudden stop of a preceding vehicle, sudden cutting-in of a vehicle from the side and unexpected appearance of a pedestrian) from non-emergency (soft) braking situations, as well as from situations in which no braking was required, but the sensory stimulation was similar to stimulations inducing an emergency situation (e.g., the sudden stop of a vehicle on a neighboring lane). Significance. We proposed a novel feature combination comprising movement-related potentials such as the readiness potential, event-related desynchronization features besides the event-related potentials (ERP) features used in a previous study. The performance of predicting braking intention based on our proposed feature combination was superior compared to using only ERP features. Our study suggests that emergency situations are characterized by specific neural patterns of sensory perception and processing, as well as motor preparation and execution, which can be utilized by neurotechnology based braking assistance systems.

  13. Virus-specific immune response in HBeAg-negative chronic hepatitis B: relationship with clinical profile and HBsAg serum levels.

    Directory of Open Access Journals (Sweden)

    Elisabetta Loggi

    Full Text Available BACKGROUND AIMS: The immune impairment characterizing chronic hepatitis B (cHBV infection is thought to be the consequence of persistent exposure to viral antigens. However, the immune correlates of different clinical stages of cHBV and their relation with different levels of HBsAg have not been investigated. The aim of the present study was to evaluate the relationship between HBV-specific T cells response and the degree of in vivo HBV control and HBsAg serum levels in HBeAg-HBeAb+ cHBV. METHODS: Peripheral blood mononuclear cells from 42 patients with different clinical profiles (treatment-suppressed, inactive carriers and active hepatitis of cHBV, 6 patients with resolved HBV infection and 10 HBV-uninfected individuals were tested with overlapping peptides spanning the entire HBV proteome. The frequency and magnitude of HBV-specific T cell responses was assessed by IFNγ ELISPOT assay. Serum HBsAg was quantified with a chemiluminescent immunoassay. RESULTS: The total breadth and magnitude of HBV-specific T cell responses did not differ significantly between the four groups. However, inactive carriers targeted preferentially the core region. In untreated patients, the breadth of the anti-core specific T cell response was inversely correlated with serum HBsAg concentrations as well as HBV-DNA and ALT levels and was significantly different in patients with HBsAg levels either above or below 1000 IU/mL. The same inverse association between anti-core T cell response and HBsAg levels was found in treated patients. CONCLUSIONS: Different clinical outcomes of cHBV infection are associated with the magnitude, breadth and specificity of the HBV-specific T cell response. Especially, robust anti-core T cell responses were found in the presence of reduced HBsAg serum levels, suggesting that core-specific T cell responses can mediate a protective effect on HBV control.

  14. Changes in the job situation due to telemedicine.

    Science.gov (United States)

    Aas, I H Monrad

    2002-01-01

    Little is known either about how telemedicine changes the job situation or about how the working environment might be improved for those involved in telemedicine. To investigate these issues, qualitative interviews were carried out with 30 people in Norway working with telepsychiatry (12 respondents), teledermatology (six respondents), a telepathology frozen-section service (10 respondents) and tele-otolaryngology (two respondents). The median annual number of remote consultations in telepsychiatry was nine, in teledermatology 81 and in the telepathology frozen-section service nine. The positive aspects of working with telemedicine included less travelling, which gave more time for other work, less need to travel in poor weather, new contacts, an increased sense of professional security (because support was readily available) and the satisfaction of seeing partners in communication. At its present volume, telemedicine generally fits into daily work patterns quite well. Problems do occur, but they can be solved by appropriate organizational measures. Long-term scheduling of telemedical sessions may be important. Many telemedicine workers want to have the equipment in their own office. Working with telemedicine can be tiring and those interviewed wanted to limit the number of hours per week. A solution may be to use large clinics, such as university clinics, where the telemedical work could be distributed between several specialists. Large telemedicine clinics with a full-time dedicated staff would need careful consideration of working practices.

  15. Tangible and Intangible Rewards and Employee Creativity: The Mediating Role of Situational Extrinsic Motivation

    Science.gov (United States)

    Yoon, Hye Jung; Sung, Sun Young; Choi, Jin Nam; Lee, Kyungmook; Kim, Seongsu

    2015-01-01

    This study examined the effects of tangible and intangible forms of creativity-contingent rewards on employee creativity. Situation-specific intrinsic and extrinsic motivations were proposed as mediators of the reward-creativity link. Based on data collected from 271 employees and their supervisors, results revealed the following: (a) intangible…

  16. Problematic Social Situations for Peer-Rejected Students in the First Year of Elementary School

    Directory of Open Access Journals (Sweden)

    Luis Jorge Martín-Antón

    2016-12-01

    Full Text Available This study examined the social situations that are problematic for peer-rejected students in the first year of elementary school. For this purpose, exploratory and confirmatory factor analyses were conducted on the Taxonomy of Problematic Social Situations for Children (TOPS, Dodge et al., 1985 in 169 rejected pupils, identified from a sample of 1457 first-grade students (ages 5-7 enrolled in 62 classrooms of elementary school. For each rejected student, another student of average sociometric status of the same gender was selected at random from the same classroom (naverage = 169. The model for the rejected students showed a good fit, and was also invariant in the group of average students. Four types of situations were identified in which rejected students have significantly more difficulties than average students. They are, in descending order: (a respect for authority and rules, (b being disadvantaged, (c prosocial and empathic behavior, and (d response to own success. Rejected boys have more problems in situations of prosociability and empathy than girls. The implications concerning the design of specific programs to prevent and reduce early childhood rejection in the classroom are discussed.

  17. Multi-Robot Interfaces and Operator Situational Awareness: Study of the Impact of Immersion and Prediction.

    Science.gov (United States)

    Roldán, Juan Jesús; Peña-Tapia, Elena; Martín-Barrio, Andrés; Olivares-Méndez, Miguel A; Del Cerro, Jaime; Barrientos, Antonio

    2017-07-27

    Multi-robot missions are a challenge for operators in terms of workload and situational awareness. These operators have to receive data from the robots, extract information, understand the situation properly, make decisions, generate the adequate commands, and send them to the robots. The consequences of excessive workload and lack of awareness can vary from inefficiencies to accidents. This work focuses on the study of future operator interfaces of multi-robot systems, taking into account relevant issues such as multimodal interactions, immersive devices, predictive capabilities and adaptive displays. Specifically, four interfaces have been designed and developed: a conventional, a predictive conventional, a virtual reality and a predictive virtual reality interface. The four interfaces have been validated by the performance of twenty-four operators that supervised eight multi-robot missions of fire surveillance and extinguishing. The results of the workload and situational awareness tests show that virtual reality improves the situational awareness without increasing the workload of operators, whereas the effects of predictive components are not significant and depend on their implementation.

  18. Multi-Robot Interfaces and Operator Situational Awareness: Study of the Impact of Immersion and Prediction

    Science.gov (United States)

    Peña-Tapia, Elena; Martín-Barrio, Andrés; Olivares-Méndez, Miguel A.

    2017-01-01

    Multi-robot missions are a challenge for operators in terms of workload and situational awareness. These operators have to receive data from the robots, extract information, understand the situation properly, make decisions, generate the adequate commands, and send them to the robots. The consequences of excessive workload and lack of awareness can vary from inefficiencies to accidents. This work focuses on the study of future operator interfaces of multi-robot systems, taking into account relevant issues such as multimodal interactions, immersive devices, predictive capabilities and adaptive displays. Specifically, four interfaces have been designed and developed: a conventional, a predictive conventional, a virtual reality and a predictive virtual reality interface. The four interfaces have been validated by the performance of twenty-four operators that supervised eight multi-robot missions of fire surveillance and extinguishing. The results of the workload and situational awareness tests show that virtual reality improves the situational awareness without increasing the workload of operators, whereas the effects of predictive components are not significant and depend on their implementation. PMID:28749407

  19. Multi-Robot Interfaces and Operator Situational Awareness: Study of the Impact of Immersion and Prediction

    Directory of Open Access Journals (Sweden)

    Juan Jesús Roldán

    2017-07-01

    Full Text Available Multi-robot missions are a challenge for operators in terms of workload and situational awareness. These operators have to receive data from the robots, extract information, understand the situation properly, make decisions, generate the adequate commands, and send them to the robots. The consequences of excessive workload and lack of awareness can vary from inefficiencies to accidents. This work focuses on the study of future operator interfaces of multi-robot systems, taking into account relevant issues such as multimodal interactions, immersive devices, predictive capabilities and adaptive displays. Specifically, four interfaces have been designed and developed: a conventional, a predictive conventional, a virtual reality and a predictive virtual reality interface. The four interfaces have been validated by the performance of twenty-four operators that supervised eight multi-robot missions of fire surveillance and extinguishing. The results of the workload and situational awareness tests show that virtual reality improves the situational awareness without increasing the workload of operators, whereas the effects of predictive components are not significant and depend on their implementation.

  20. Development and validation of Burkholderia pseudomallei-specific real-time PCR assays for clinical, environmental or forensic detection applications.

    Directory of Open Access Journals (Sweden)

    Erin P Price

    Full Text Available The bacterium Burkholderia pseudomallei causes melioidosis, a rare but serious illness that can be fatal if untreated or misdiagnosed. Species-specific PCR assays provide a technically simple method for differentiating B. pseudomallei from near-neighbor species. However, substantial genetic diversity and high levels of recombination within this species reduce the likelihood that molecular signatures will differentiate all B. pseudomallei from other Burkholderiaceae. Currently available molecular assays for B. pseudomallei detection lack rigorous validation across large in silico datasets and isolate collections to test for specificity, and none have been subjected to stringent quality control criteria (accuracy, precision, selectivity, limit of quantitation (LoQ, limit of detection (LoD, linearity, ruggedness and robustness to determine their suitability for environmental, clinical or forensic investigations. In this study, we developed two novel B. pseudomallei specific assays, 122018 and 266152, using a dual-probe approach to differentiate B. pseudomallei from B. thailandensis, B. oklahomensis and B. thailandensis-like species; other species failed to amplify. Species specificity was validated across a large DNA panel (>2,300 samples comprising Burkholderia spp. and non-Burkholderia bacterial and fungal species of clinical and environmental relevance. Comparison of assay specificity to two previously published B. pseudomallei-specific assays, BurkDiff and TTS1, demonstrated comparable performance of all assays, providing between 99.7 and 100% specificity against our isolate panel. Last, we subjected 122018 and 266152 to rigorous quality control analyses, thus providing quantitative limits of assay performance. Using B. pseudomallei as a model, our study provides a framework for comprehensive quantitative validation of molecular assays and provides additional, highly validated B. pseudomallei assays for the scientific research community.

  1. Broad-range (pan) Salmonella and Salmonella serotype typhi-specific real-time PCR assays: potential tools for the clinical microbiologist.

    Science.gov (United States)

    Farrell, John J; Doyle, Laura J; Addison, Rachel M; Reller, L Barth; Hall, Geraldine S; Procop, Gary W

    2005-03-01

    We describe broad-range salmonellae (ie, Salmonella) and Salmonella serotype Typhi-specific LightCycler (Roche Diagnostics, Indianapolis, IN) real-time polymerase chain reaction assays. We validated these with a battery of 280 bacteria, 108 of which were salmonellae representing 20 serotypes. In addition, 298 isolates from 170 clinical specimens that were suspected to possibly represent Salmonella were tested with the pan- Salmonella assay. Finally, the pan-Salmonella assay also was used to test DNA extracts from 101 archived, frozen stool specimens, 55 of which were culture-positive for salmonellae. Both assays were 100% sensitive and specific when cultured isolates of the battery were tested. The pan- Salmonella assay also characterized correctly all salmonellae on the primary isolation agar and was 96% sensitive (53/55) and 96% specific (49/51) when nucleic acid extracts from direct stool specimens were tested. These assays represent potential tools the clinical microbiologist could use to screen suspect isolates or stool specimens for Salmonella.

  2. Use of oral antineoplastic in special situations in a third level hospital: real life results

    Directory of Open Access Journals (Sweden)

    José Miguel Ferrari-Piquero

    2018-01-01

    Full Text Available Objective: To analyse the effectiveness and safety of oral antineoplastic drugs (ANEOs that are authorized in special situations in a third-level hospital and to compare the results obtained with the clinical evidence used for this authorization. Method: Descriptive observational and retrospective study. We included all adult patients who started treatment with ANEO in special situations during the year 2016. We collected demographic, treatment-related and clinical variables (overall survival (OS, progression-free survival (PFS. Adverse reactions and detected interactions were collected. An unadjusted comparison was made between the results of the available evidence and those of the study patients. Results: 34 patients were treated, 50% were men, the median age was 58 years (38-80 and they presented ECOG 1 in 64.7%. Most of the treated patients were diagnosed with advanced colorectal cancer, treated with trifluridine-tipiracil, followed by palbociclib in breast cancer, obtaining results similar to those of the evidence. The median PFS was 2.8 months (95% CI 0.8- 4.8 and the 8-month SG (95% CI 3.4-12.5 for all patients. 26% of patients required dose reduction because of treatment toxicity. We found 13 interactions, which affected 15 patients, only two of category X. Conclusions: The effectiveness of ANEO in special situations in our center is similar to that of available evidence. The impact on survival is low and adverse effects are common.

  3. The France energy situation; La situation energetique de la France

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This analysis of the french energy situation provides information and key data on some key facts about the energy in France, the France energy supply and demand, the major principles of energy policy, the challenges of french energy policy and the DGEMP (general directorate for energy and raw materials). (A.L.B.)

  4. Modeling of Communication in a Computational Situation Assessment Model

    International Nuclear Information System (INIS)

    Lee, Hyun Chul; Seong, Poong Hyun

    2009-01-01

    Operators in nuclear power plants have to acquire information from human system interfaces (HSIs) and the environment in order to create, update, and confirm their understanding of a plant state, or situation awareness, because failures of situation assessment may result in wrong decisions for process control and finally errors of commission in nuclear power plants. Quantitative or prescriptive models to predict operator's situation assessment in a situation, the results of situation assessment, provide many benefits such as HSI design solutions, human performance data, and human reliability. Unfortunately, a few computational situation assessment models for NPP operators have been proposed and those insufficiently embed human cognitive characteristics. Thus we proposed a new computational situation assessment model of nuclear power plant operators. The proposed model incorporating significant cognitive factors uses a Bayesian belief network (BBN) as model architecture. It is believed that communication between nuclear power plant operators affects operators' situation assessment and its result, situation awareness. We tried to verify that the proposed model represent the effects of communication on situation assessment. As the result, the proposed model succeeded in representing the operators' behavior and this paper shows the details

  5. Story of a Mediation in the Clinical Setting.

    Science.gov (United States)

    Morreim, Haavi

    2016-01-01

    Conflicts in the clinical setting can spiral downward with remarkable speed, as parties become ever more incensed and entrenched in their positions. Productive conversations seem unlikely at best. Nevertheless, such situations can sometimes be turned into collaborative problem solving with equally remarkable speed. For this to happen, those providing conflict-resolution services such as mediation need to bring, not just a set of skills, but also some key norms: the process must be voluntary for all; the mediator must abjure giving advice or taking sides, and must honor the privacy of privately offered thoughts. This article describes a conflict that had reached the point of a hospital's requesting judicial coercion. However, a conflict-resolution process was then initiated that, in the end, led to amicable resolution and mended relationships, obviating the need for court orders. This article describes that conflict and the resolution process in detail, along the way annotating specific strategies that are often highly effective. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

  6. [The specific microbiological and clinical features of acute otitis media].

    Science.gov (United States)

    Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

    The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

  7. 14 CFR 99.5 - Emergency situations.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Emergency situations. 99.5 Section 99.5 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SECURITY CONTROL OF AIR TRAFFIC General § 99.5 Emergency situations. In an...

  8. Enhancing Evacuation Plans with a Situation Awareness System Based on End-User Knowledge Provision

    Directory of Open Access Journals (Sweden)

    Augusto Morales

    2014-06-01

    Full Text Available Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating.

  9. Preferred information sources for clinical decision making: critical care nurses' perceptions of information accessibility and usefulness.

    Science.gov (United States)

    Marshall, Andrea P; West, Sandra H; Aitken, Leanne M

    2011-12-01

    Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access

  10. An exploration of the applicability of situational segmentation in the health care market: development of a situational taxonomy.

    Science.gov (United States)

    Gehrt, K C; Pinto, M B

    1990-01-01

    Competition in the health care market has intensified in recent years. Health care providers are increasingly adopting innovative marketing techniques to secure their positions in the marketplace. This paper examines an innovative marketing technique, situational segmentation, and assesses its applicability to the health care market. Situational segmentation has proven useful in many consumer goods markets but has received little attention in the context of health care marketing. A two-stage research process is used to develop a taxonomy of situational factors pertinent to health care choice. In stage one, focus group interviews are used to gather information which is instrumental to questionnaire development. In stage two, the responses of 151 subjects to a 51 item questionnaire are factor analyzed. The results demonstrate that situational segmentation is a viable strategy in the health care market.

  11. Sensitivity, specificity and predictive value of blood cultures from cattle clinically suspected of bacterial endocarditis

    DEFF Research Database (Denmark)

    Houe, Hans; Eriksen, L.; Jungersen, Gregers

    1993-01-01

    This study investigated the number of blood culture-positive cattle among 215 animals clinically suspected of having bacterial endocarditis. For animals that were necropsied, the sensitivity, specificity and predictive value of the diagnosis of endocarditis were calculated on the basis...... of the isolation of the causative bacteria from blood. Furthermore, it was investigated whether the glutaraldehyde coagulation time, total leucocyte count, per cent neutrophil granulocytes, pulse rate and duration of disease could help to discriminate endocarditis from other diseases. Among 138 animals necropsied...... the sensitivity, specificity and predictive value of blood cultivation were 70.7 per cent, 93.8 per cent and 89.1 per cent, respectively. None of the other measurements could be used to discriminate between endocarditis and non-endocarditis cases....

  12. [Support psychotherapy in traumatic situations].

    Science.gov (United States)

    Pérez-Sales, Pau; Vázquez Valverde, Carmelo

    2003-12-01

    It seems that a certain consensus exists to speak about a traumatic situation as an experience which is made up of a threat on the physical or psychological integrity of a person and against which one responds with fear, desperation and intensive horror. Different psychological phenomena are involved with the manner through which a human being confronts his/her past. In particular, the response to traumatic situations, mourning, and blame share their characteristic of being an irreversible living reality related to facts, loss or past impacts and it is necessary to integrate these in one's life in order to advance; these comprise a triangle frequently coexisting and interconnected. Aid for these three situations has, therefore, as common elements, two premises: an active task is required by the person who suffers this situation; this person must, in some form, desire to move ahead. One can not toil in mourning, in a traumatic experience, or in a life of blame if these have a positive symbolic value for this person; for example, mourning as a manner not to treason the dead person by forgetting that person, the reliving a trauma as an attempt to provide some sense to the actions which occurred, or blame as a desire to not forget an error or as a final punishment of this active task; the final objective of this active task is not usually to forget but to integrate in order to live. If a person does not perceive this clearly, this person may not become actively involved in the task to overcome a traumatic situation and to move ahead, nor will that person accept that a person who tries to help questions this person's realities or experiences.

  13. Diagnostic imaging in polytrauma: comparison of radiation exposure from whole-body MSCT and conventional radiography with organ-specific CT

    International Nuclear Information System (INIS)

    Wedegaertner, U.; Lorenzen, M.; Weber, C.; Adam, G.; Nagel, H.D.

    2004-01-01

    Purpose: To compare the radiation dose of whole-body multislice CT (MSCT) and conventional radiography with organ-specific CT in polytrauma. Materials and Methods: The whole-body MSCT encompassing brain, neck and midface, chest, abdomen and pelvis was performed on a Somatom Volume Zoom (Siemens). Conventional radiography consisted of chest and cervical, thoracic and lumbar spine in two views as well as pelvis. Polymat, Siemens. Three combinations of organ specific CT were chosen: CT examination of (1) head and cervical spine, (2) head, cervical spine and chest, (3) head, cervical spine and abdomen. The effective doses of whole-body MSCT and conventional radiography with organ-specific CT were calculated. Results: Effective doses were 20 mSv for whole-body MSCT, 2 mSv for conventional x-ray, and 5 mSv for combination (1), 8 mSv for combination (2) and (3) 16 mSv for combination (3) of the organ-specific CT. The ratio of radiation dose between whole-body MSCT and radiography was 10: 1. This ratio was reduced to 3: 1, 2: 1 and 1: 1 when a combination of radiography and CT was performed. Conclusions: Whole-body MSCT in polytrauma compared to conventional radiography with organ-specific CT induces a threefold increased dose in unfavorable situations and no increased dose in favorable situations. Nevertheless, routine use of whole-body MSCT should be critically evaluated and should be adapted to the clinical benefit. (orig.) [de

  14. Recent developments in the clinical pharmacology of rolapitant: subanalyses in specific populations

    Directory of Open Access Journals (Sweden)

    Rapoport BL

    2017-09-01

    Full Text Available Bernardo Leon Rapoport,1 Matti Aapro,2 Martin R Chasen,3 Karin Jordan,4 Rudolph M Navari,5 Ian Schnadig,6 Lee Schwartzberg7 1The Medical Oncology Centre of Rosebank, Johannesburg, South Africa; 2Breast Center, Genolier Cancer Center, Genolier, Switzerland; 3Palliative Care, William Osler Health Services, Brampton, ON, Canada; 4Department of Medicine V, University of Heidelberg, Heidelberg, Germany; 5Division of Hematology Oncology, University of Alabama School of Medicine, Birmingham, AL, USA; 6Compass Oncology, US Oncology Research, Tualatin, OR, USA; 7West Clinic, Memphis, TN, USA Abstract: Knowledge of the involvement of the neurokinin substance P in emesis has led to the development of the neurokinin-1 receptor antagonists (NK-1 RAs for control of chemotherapy-induced nausea and vomiting (CINV, in combination with serotonin type 3 receptor antagonists and corticosteroids. The NK-1 RA rolapitant, recently approved in oral formulation, has nanomolar affinity for the NK-1 receptor, as do the other commercially available NK-1 RAs, aprepitant and netupitant. Rolapitant is rapidly absorbed and has a long half-life in comparison to aprepitant and netupitant. All three NK-1 RAs undergo metabolism by cytochrome P450 (CYP 3A4, necessitating caution with the concomitant use of CYP3A4 inhibitors, but in contrast to aprepitant and netupitant, rolapitant does not inhibit or induce CYP3A4. However, rolapitant is a moderate inhibitor of CYP2D6, and concomitant use with CYP2D6 substrates with narrow therapeutic indices should be avoided. Aprepitant, netupitant, and rolapitant have all demonstrated efficacy in the control of delayed CINV in patients receiving moderately and highly emetogenic chemotherapy in randomized controlled trials, including over multiple cycles of chemotherapy. We reviewed recent post hoc analyses of clinical trial data demonstrating that rolapitant is efficacious in the control of CINV in patient populations with specific tumor types

  15. HRM in a highly uncertain strategic situation: The case of the electronuclear industry

    Energy Technology Data Exchange (ETDEWEB)

    Corbel, P. [University of Versailles Saint-Quentin-en-Yvelines, LAREQUOI, Management Research Centre, 47 boulevard Vauban, F-78047 Guyancourt (France)]. E-mail: Pascal.Corbel@quoi.uvsq.fr

    2004-07-01

    The nuclear industry has some specific strategic features that result in a very high level of uncertainty. The demand for new reactors has been declining for more than twenty years, and gains in performance have slowed down during the same period. As a result, at first sight, this technology should be classified as declining in terms of demand and maturing in terms of technological life cycle. This situation has important consequences on HRM inside this industry. In particular, power plant constructors have had to considerably reduce their personnel numbers. However, this industry also expects a strong revival of demand, which means that it has to preserve its key competences. This paper deals with the management of this paradoxical situation. (author)

  16. HRM in a highly uncertain strategic situation: The case of the electronuclear industry

    International Nuclear Information System (INIS)

    Corbel, P.

    2004-01-01

    The nuclear industry has some specific strategic features that result in a very high level of uncertainty. The demand for new reactors has been declining for more than twenty years, and gains in performance have slowed down during the same period. As a result, at first sight, this technology should be classified as declining in terms of demand and maturing in terms of technological life cycle. This situation has important consequences on HRM inside this industry. In particular, power plant constructors have had to considerably reduce their personnel numbers. However, this industry also expects a strong revival of demand, which means that it has to preserve its key competences. This paper deals with the management of this paradoxical situation. (author)

  17. Exploring schema-driven differences in situation awareness between road users: an on-road study of driver, cyclist and motorcyclist situation awareness.

    Science.gov (United States)

    Salmon, Paul M; Lenne, Michael G; Walker, Guy H; Stanton, Neville A; Filtness, Ashleigh

    2014-01-01

    Collisions between different road users make a substantial contribution to road trauma. Although evidence suggests that different road users interpret the same road situations differently, it is not clear how road users' situation awareness differs, nor is it clear which differences might lead to conflicts. This article presents the findings from an on-road study conducted to examine driver, motorcyclist and cyclist situation awareness in different road environments. The findings suggest that, in addition to minor differences in the structure of different road users' situation awareness (i.e. amount of information and how it is integrated), the actual content of situation awareness in terms of road user schemata, the resulting interaction with the world and the information underpinning situation awareness is markedly different. Further examination indicates that the differences are likely to be compatible along arterial roads, shopping strips and at roundabouts, but that they may create conflicts between different road users at intersections. Interventions designed to support compatible situation awareness and behaviour between different road users are discussed.

  18. Assessment of radiation damage - the need for a multi-parametric and integrative approach with the help of both clinical and biological dosimetry

    International Nuclear Information System (INIS)

    Meineke, Viktor

    2008-01-01

    Full text: Accidental exposure to ionising radiation leads to a damage on different levels of the biological organization of the organism. Depending on exposure conditions, such as nature of radiation, time and affected organs and organ systems, the clinical endpoint of radiation damage and the resulting acute and chronic radiation syndromes may vary to a great extent. Exposure situations range from pure localised radiation scenarios and partial body exposures up to whole body exposures. Therefore clinical pictures vary from localized radiation injuries up to the extreme situation of a radiation-induced multi-organ involvement and failure requiring immediate, intensive and interdisciplinary medical treatment. These total different and complex clinical situations not only show up most different clinical diagnostic and therapeutic aspects but necessarily due to different levels of the underlying biological damage, biological indicators of effects may vary to a wide extent. This fact means that an exact assessment of the extent of radiation damage within individual patients can only be performed when taking into consideration both clinical signs and symptoms as well as different biological indicators. Among the clinical indicators, routine laboratory parameters such as blood counts and the documentation of clinical signs and symptoms (such as the METREPOL system) are the key parameters, whereas the dicentric assay, the gold standard for biological dosimetry, but also methods under development such as the gamma-H2Ax focus assay or the estimation of variations of gene expression have to be taken into account. Each method provides best results in different situations, or in other words, there are methods that work better in a specific exposure condition or at a given time of examination (e.g. time after exposure) than others. Some methods show up results immediately, others require days to weeks until results are available for clinical decision making. Therefore to

  19. Use of the Menopause-Specific Quality of Life (MENQOL) questionnaire in research and clinical practice: a comprehensive scoping review.

    Science.gov (United States)

    Sydora, Beate C; Fast, Hilary; Campbell, Sandy; Yuksel, Nese; Lewis, Jacqueline E; Ross, Sue

    2016-09-01

    The Menopause-Specific Quality of Life (MENQOL) questionnaire was developed as a validated research tool to measure condition-specific QOL in early postmenopausal women. We conducted a comprehensive scoping review to explore the extent of MENQOL's use in research and clinical practice to assess its value in providing effective, adequate, and comparable participant assessment information. Thirteen biomedical and clinical databases were systematically searched with "menqol" as a search term to find articles using MENQOL or its validated derivative MENQOL-Intervention as investigative or clinical tools from 1996 to November 2014 inclusive. Review articles, conference abstracts, proceedings, dissertations, and incomplete trials were excluded. Additional articles were collected from references within key articles. Three independent reviewers extracted data reflecting study design, intervention, sample characteristics, MENQOL questionnaire version, modifications and language, recall period, and analysis detail. Data analyses included categorization and descriptive statistics. The review included 220 eligible papers of various study designs, covering 39 countries worldwide and using MENQOL translated into more than 25 languages. A variety of modifications to the original questionnaire were identified, including omission or addition of items and alterations to the validated methodological analysis. No papers were found that described MENQOL's use in clinical practice. Our study found an extensive and steadily increasing use of MENQOL in clinical and epidemiological research over 18 years postpublication. Our results stress the importance of proper reporting and validation of translations and variations to ensure outcome comparison and transparency of MENQOL's use. The value of MENQOL in clinical practice remains unknown.

  20. Alcohol-related memory associations in positive and negative affect situations: drinking motives, working memory capacity, and prospective drinking.

    Science.gov (United States)

    Salemink, Elske; Wiers, Reinout W

    2014-03-01

    Although studies on explicit alcohol cognitions have identified positive and negative reinforcing drinking motives that are differentially related to drinking indices, such a distinction has received less attention in studies on implicit cognitions. An alcohol-related Word-Sentence Association Task was used to assess implicit alcohol-related memory associations in positive and negative affect situations in 92 participants. Results revealed that enhancement motives were specifically associated with the endorsement of alcohol words in positive affect situations and coping motives were associated with the endorsement of alcohol words in negative affect situations. Furthermore, alcohol associations in positive affect situations predicted prospective alcohol use and number of binges, depending on levels of working memory capacity. The current findings shed more light on the underpinnings of alcohol use and suggest that implicit memory processes and working memory capacity might be important targets for intervention.

  1. [Leadership Experience of Clinical Nurses: Applying Focus Group Interviews].

    Science.gov (United States)

    Lee, Byoung Sook; Eo, Yong Sook; Lee, Mi Aie

    2015-10-01

    The purpose of this study was to understand and describe the leadership experience of clinical nurses. During 2014, data were collected using focus group interviews. Three focus group interviews were held with a total of 20 clinical nurses participating. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Fifteen categories emerged from the five main themes. 1) Thoughts on the leadership category: to lead others, to cope with problem situations adequately and to serve as a shield against difficulties. 2) Situations requiring leadership: situation that requires correct judgement, coping and situations that need coordination and cooperation. 3-1) Leadership behaviors: other-oriented approach and self-oriented approach. 3-2) Leadership behavior consequences: relevant compensation and unfair termination. 4-1) Facilitators of leadership: confidence and passion for nursing and external support and resources. 4-2) Barriers to leadership: non-supportive organization culture and deficiency in own leadership competencies. 5) Strategies of leadership development: strengthen leadership through self-development and organizational leadership development. In conclusion, the results indicate that it is necessary to enhance clinical nurses' leadership role in healthcare. Enhancement can be achieved through leadership programs focused on enlarging leadership experience, constant self-development, leadership training, and development of leadership competencies suited to the nursing environment.

  2. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia

    Science.gov (United States)

    Rofes, L; Arreola, V; Mukherjee, R; Clavé, P

    2014-01-01

    Background Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD. Methods We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values. Key Results According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations. Conclusions & Inferences Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. PMID:24909661

  3. Pedagogical and conflict situations of teacher of physical training

    Directory of Open Access Journals (Sweden)

    Pechko O.M.

    2011-02-01

    Full Text Available The article reveals the essence of pedagogical and conflict situations between teacher and student. Considered ways of solving and preventing pedagogical and conflict situations in school. Principal reasons of conflict situations are selected, situations of activity, conduct and relations. The receptions of influence of teacher of physical culture are separated on personality of schoolchildren. It is well-proven that the profession of teacher of physical culture supposes possibility of conflict situations.

  4. The layperson in emergency situations

    OpenAIRE

    Pergola, AM; Araujo, IEM

    2008-01-01

    The layperson's qualification to provide early care in emergency situations and basic life support (BLS) is fundamental to save lives and prevent sequels. The objective was to identify the level of knowledge of lay people about approaching an emergency victim. Structured interviews in non-technical language were used with a 385-subject sample, average age 35.4 (+/- 14.55) years, with more than 50% having a high school or university education. Over 55% of these observed situations with loss of...

  5. Zika virus infection in Asian island countries in Indian Ocean:Present situation

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2016-01-01

    Zika virus infection is the present global problem. The infection is widely seen in tropical Latin and South American countries and results in several problems in that area. In addition, the previous big outbreak in many island countries in Pacific region brings attention to the further expansion of the infection worldwide. The specific situation of the infection in island countries is very interesting. Here, the current situation (in 2016) of Zika virus infection in Asian island countries in Indian Ocean is summarized and presented. Although there is still no current problem in the Asian island countries in Indian Ocean, the appearance of infection in the sea resorts of countries lining Indian Ocean is a big concern. Due to the high volume of traveler to sea resorts, emergence of the new disease in Asian island countries in Indian Ocean can be expected.

  6. 'Translation' and 'transformation' in the analytic situation: Freud-Bion-Laplanche.

    Science.gov (United States)

    Heenen-Wolff, Susann

    2013-06-01

    Following a short introduction to the core theses of Jean Laplanche's theory of a 'general seduction' the author presents the resultant clinical position of the analyst. In the same way that an adult sends 'enigmatic messages' to the child, it is the analyst's task to reopen this primal situation so that the patient can find new 'translations' for these messages. Laplanche distinguishes between the function of the analytic frame--which represents and supports attachment--and the 'sexual'--which is the repressed and constitutes the unconscious. Only the focus on this unconscious facilitates the deconstruction of 'incorrect' translations. Accordingly, the analyst, says Laplanche, should not take part in construction--this is a self-construction of the patient--but only in reconstruction. The author compares this clinical model with Freud's notions and the 'transformation processes' through the alpha function as described by Bion. She illustrates Laplanche's model and the interpretation strategy with case material. Copyright © 2013 Institute of Psychoanalysis.

  7. Characteristics of specific reading disability in children from a neuropsychological clinic in Mexico City

    Directory of Open Access Journals (Sweden)

    Poblano Adrián

    2002-01-01

    Full Text Available Objective. This report describes the main clinical features associated with specific reading disability (RD in a group of 778 school-age children studied in a Neuropsychological Clinic in Mexico City. Material and Methods. The study was performed retrospectively, using data abstracted from clinical records of subjects seen in 1995-1996. Children were mainly from low and middle economic strata and aged between 6 to 12 years. The following data were collected: age, gender, diagnosis, school grade, food intake, maternal complications during pregnancy, perinatal and postnatal neurological risk factors, and neurological signs and handedness. Results. Subjects with RD had a mean age of 102.9 months, were predominantly male (male female ratio, 2:1. Among the study group, 49.1% of the children were diagnosed with RD of a visuo-sensory-motor type, and 75.1% were from early school years (1st to 3rd grades; 27.6% showed evidence of malnutrition. A previous history of language disorders (49.2%, and a high frequency of perinatal risk factors and neurological soft signs were also found. Conclusions. This study shows that variables such as gender, food intake, and genetic and neurological risk factors, were associated with reading disabilities in school children.

  8. Reactor Safety Assessment System--A situation assessment aid for USNRC emergency response

    International Nuclear Information System (INIS)

    Bray, M.A.; Sebo, D.E.; Dixon, B.W.

    1985-01-01

    The Reactor Safety Assessment System (RSAS) is an expert system under development for the United States Nuclear Regulatory Commission (USNRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. The system uses plant parameter data and status information from the power plant. It has a rule base that uses the parametric values, the known operator actions, and the time sequence information in the data to generate situation assessment conclusions for use by the NRC Reactor Safety Team. RSAS rules currently cover one specific reactor type and use setpoints specific to one power plant

  9. Reactor Safety Assessment System: a situation assessment aid for USNRC emergency response

    International Nuclear Information System (INIS)

    Bray, M.A.; Sebo, D.E.; Dixon, B.W.

    1985-04-01

    The Reactor Safety Assessment System is an expert system under development for the United States Nuclear Regulatory Commission (NRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. The system uses plant parameter data and status information from the power plant. It has a rule base which uses the parametric values, the known operator actions and the time sequence information in the data to generate situation assessment conclusions for use by the NRC Reactor Safety Team. RSAS rules currently cover one specific reactor type and use setpoints specific to one power plant. 5 figs

  10. Situation awareness with systems of systems

    CERN Document Server

    Tretmans, Jan; Borth, Michael

    2013-01-01

    This book discusses various aspects, challenges, and solutions for developing systems-of-systems for situation awareness, using applications in the domain of maritime safety and security.  Topics include advanced, multi-objective visualization methods for situation awareness, stochastic outlier selection, rule-based anomaly detection, an ontology-based event model for semantic reasoning, new methods for semi-automatic generation of adapters bridging communication gaps, security policies for systems-of-systems, trust assessment, and methods to deal with the dynamics of systems-of-systems in run-time monitoring, testing, and diagnosis. Architectural considerations for designing information-centric systems-of-systems such as situation awareness systems, and an integrated demonstrator implementing many of the investigated aspects, complete the book.

  11. Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy.

    Science.gov (United States)

    Shakir, Nabeel A; George, Arvin K; Siddiqui, M Minhaj; Rothwax, Jason T; Rais-Bahrami, Soroush; Stamatakis, Lambros; Su, Daniel; Okoro, Chinonyerem; Raskolnikov, Dima; Walton-Diaz, Annerleim; Simon, Richard; Turkbey, Baris; Choyke, Peter L; Merino, Maria J; Wood, Bradford J; Pinto, Peter A

    2014-12-01

    Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. We reviewed the records of all patients enrolled in a prospective trial who underwent 12-core transrectal ultrasound and magnetic resonance imaging/ultrasound targeted biopsies from August 2007 through February 2014. Patients were stratified by each of 4 prostate specific antigen cutoffs. The greatest Gleason score using either biopsy method was compared in and across groups as well as across the population prostate specific antigen range. Clinically significant prostate cancer was defined as Gleason 7 (4 + 3) or greater. Univariate and multivariate analyses were performed. A total of 1,003 targeted and 12-core transrectal ultrasound biopsies were performed, of which 564 diagnosed prostate cancer for a 56.2% detection rate. Targeted biopsy led to significantly more upgrading to clinically significant disease compared to 12-core biopsy. This trend increased more with increasing prostate specific antigen, specifically in patients with prostate specific antigen 4 to 10 and greater than 10 ng/ml. Prostate specific antigen 5.2 ng/ml or greater captured 90% of upgrading by targeted biopsy, corresponding to 64% of patients who underwent multiparametric magnetic resonance imaging and subsequent fusion biopsy. Conversely a greater proportion of clinically insignificant disease was detected by 12-core vs targeted biopsy overall. These differences persisted when controlling for potential confounders on multivariate analysis. Prostate cancer upgrading with targeted biopsy increases

  12. Rapid detection of Corynebacterium pseudotuberculosis in clinical samples from sheep.

    Science.gov (United States)

    Kumar, Jyoti; Tripathi, Bhupendra Nath; Kumar, Rajiv; Sonawane, Ganesh Gangaram; Dixit, Shivendra Kumar

    2013-08-01

    Corynebacterium pseudotuberculosis, a Gram-positive bacterium is the causative agent of caseous lymphadenitis (CLA), a chronic disease of sheep, goats and other warm blooded animals. In the present study, a total of 1,080 sheep reared under semi-intensive system on organized farms situated in the semi arid tropical region of Rajasthan, India, was clinically examined. Pus samples from superficial lymph nodes of 25 (2.31%) adult sheep showing clinical lesions similar to CLA were collected for laboratory analyses. On the basis of morphological, cultural and biochemical characteristics 12 (48%) bacterial isolates from pus identified it as C. pseudotuberculosis. A polymerase chain reaction (PCR) assay targeting Putative oligopeptide/dipeptide ABC transporter, nicotinamide adenine dinucleotide phosphate (NADP) oxidoreductase coenzyme F420-dependent and proline iminopeptidase (PIP) genes of C. pseudotuberculosis was developed that showed 14 pus samples as positive. All C. pseudotuberculosis isolates were also found positive for these genes in the PCR. The specificity of the PCR products was confirmed by sequencing of the amplified products that showed 98-100% homology with published sequences available in the NCBI database. The present study shows the incidence of CLA as 2.31%, 1.1% and 1.29% based on clinical, bacterial culture and direct pus PCR assay, respectively. The PCR assay was rapid, specific and as significant as bacterial culture in detecting bacteria directly in the clinical pus samples. The PCR assay developed in the study can be applied for the diagnosis and control of CLA. Furthermore, the assay can also be applied to detect C. pseudotuberculosis in various clinical samples.

  13. Construction of ethics in clinical research: clinical trials registration

    Directory of Open Access Journals (Sweden)

    C. A. Caramori

    2007-01-01

    Full Text Available Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials and scientific publications (selective, manipulated and with wrong conclusions led to an inappropriate clinical practice, favoring the involved economic aspect. In 2005, the International Committee of Medical Journal Editors (ICMJE, supported by the World Association of Medical Editors, started demanding as a requisite for publication that all clinical trials be registered at the database ClinicalTrials.gov. In 2006, the World Health Organization (WHO created the International Clinical Trial Registry Platform (ICTRP, which gathers several registry centers from all over the world, and required that all researchers and pharmaceutical industries register clinical trials. Such obligatory registration has progressed and will extend to all scientific journals indexed in all worldwide databases. Registration of clinical trials means another step of clinical research towards transparency, ethics and impartiality, resulting in real evidence to the forthcoming changes in clinical practice as well as in the health situation.

  14. Project management in crisis situations

    Directory of Open Access Journals (Sweden)

    Agnieszka Goździewska-Nowicka

    2017-05-01

    Full Text Available In today’s methodologies of project management attention is increasingly paid to the crises-related issues. Modern economy and the turbulent environment cause that an emergingcrisis can pose a serious threat to the implementation of any undertaking. This article focuses on the presentation of the conditions and causes of crisis situations, the essence of projects, and their effective management. The major objective of the paper, however, is to demonstrate how companies implementing projects cope with the occurrence of a crisis situation.

  15. When is it OK to be drunk? Situational and cultural variations in the acceptability of visible intoxication in the UK and Norway.

    Science.gov (United States)

    Fjær, Eivind Grip; Pedersen, Willy; von Soest, Tilmann; Gray, Paul

    2016-03-01

    Research on norms regulating drunken behaviour has tended to focus on differences between different countries and cultures rather than variations within them. Here, we examine whether there are: (i) situation-specific differences in the acceptability of visible intoxication among students in the UK and Norway; (ii) whether there are situation-specific and overall differences in this regard between the two countries; and finally (iii) to what degree possible differences reflect individual characteristics such as use of alcohol, perceived harm of alcohol consumption, and broader value orientation. Students at one British (n=473) and one Norwegian (n=472) university responded to a survey including a battery of questions assessing the acceptability of visible intoxication in different situations, such as with friends, with work colleagues, with family members, and situations where children are present. Data were also collected regarding alcohol consumption, perceived harms of alcohol consumption, and value orientation. Analyses of covariance were performed to assess patterns in the acceptability of visible intoxication across different situations, and the relative contributions of country, alcohol consumption, perceived harm of alcohol consumption and human values. In both countries, visible intoxication was rated as most acceptable in situations involving friends and colleagues. Students from both countries rated visible intoxication least acceptable in situations where children are present. However, both overall, and in situations where children or family members are present, acceptability of visible intoxication scores were higher in the UK than Norway. These differences persisted after control for other variables. The study demonstrates large situational variation in acceptability of drunken behaviour, pointing to a fine-meshed set of norms regulating alcohol use and drunken behaviour within the two cultures, with the UK standing out as a more alcohol

  16. Cow-specific treatment of clinical mastitis: an economic approach.

    Science.gov (United States)

    Steeneveld, W; van Werven, T; Barkema, H W; Hogeveen, H

    2011-01-01

    Under Dutch circumstances, most clinical mastitis (CM) cases of cows on dairy farms are treated with a standard intramammary antimicrobial treatment. Several antimicrobial treatments are available for CM, differing in antimicrobial compound, route of application, duration, and cost. Because cow factors (e.g., parity, stage of lactation, and somatic cell count history) and the causal pathogen influence the probability of cure, cow-specific treatment of CM is often recommended. The objective of this study was to determine if cow-specific treatment of CM is economically beneficial. Using a stochastic Monte Carlo simulation model, 20,000 CM cases were simulated. These CM cases were caused by Streptococcus uberis and Streptococcus dysgalactiae (40%), Staphylococcus aureus (30%), or Escherichia coli (30%). For each simulated CM case, the consequences of using different antimicrobial treatment regimens (standard 3-d intramammary, extended 5-d intramammary, combination 3-d intramammary+systemic, combination 3-d intramammary+systemic+1-d nonsteroidal antiinflammatory drugs, and combination extended 5-d intramammary+systemic) were simulated simultaneously. Finally, total costs of the 5 antimicrobial treatment regimens were compared. Some inputs for the model were based on literature information and assumptions made by the authors were used if no information was available. Bacteriological cure for each individual cow depended on the antimicrobial treatment regimen, the causal pathogen, and the cow factors parity, stage of lactation, somatic cell count history, CM history, and whether the cow was systemically ill. Total costs for each case depended on treatment costs for the initial CM case (including costs for antibiotics, milk withdrawal, and labor), treatment costs for follow-up CM cases, costs for milk production losses, and costs for culling. Average total costs for CM using the 5 treatments were (US) $224, $247, $253, $260, and $275, respectively. Average probabilities

  17. Identifying compensatory driving behavior among older adults using the situational avoidance questionnaire.

    Science.gov (United States)

    Davis, Jessica J; Conlon, Elizabeth G

    2017-12-01

    Driving self-regulation is considered a means through which older drivers can compensate for perceived declines in driving skill or more general feelings of discomfort on the road. One form of driving self-regulation is situational avoidance, the purposeful avoidance of situations perceived as challenging or potentially hazardous. This study aimed to validate the Situational Avoidance Questionnaire (SAQ, Davis, Conlon, Ownsworth, & Morrissey, 2016) and identify the point on the scale at which drivers practicing compensatory avoidance behavior could be distinguished from those whose driving is unrestricted, or who are avoiding situations for other, non-compensatory reasons (e.g., time or convenience). Seventy-nine Australian drivers (M age =71.48, SD=7.16, range: 55 to 86years) completed the SAQ and were classified as a compensatory-restricted or a non-restricted driver based on a semi-structured interview designed to assess the motivations underlying avoidance behavior reported on the SAQ. Using receiver-operator characteristic (ROC) analysis, the SAQ was found to have high diagnostic accuracy (sensitivity: 85%, specificity: 82%) in correctly classifying the driver groups. Group comparisons confirmed that compensatory-restricted drivers were self-regulating their driving behavior to reduce the perceived demands of the driving task. This group had, on average, slower hazard perception reaction times, and reported greater difficulty with driving, more discomfort when driving due to difficulty with hazard perception skills, and greater changes in cognition over the past five years. The SAQ is a psychometrically sound measure of situational avoidance for drivers in baby boomer and older adult generations. Use of validated measures of driving self-regulation that distinguish between compensatory and non-compensatory behavior, such as the SAQ, will advance our understanding of the driving self-regulation construct and its potential safety benefits for older road users

  18. Site-specific mouth rinsing can improve oral odor by altering bacterial counts. Blind crossover clinical study.

    Science.gov (United States)

    Alqumber, Mohammed A; Arafa, Khaled A

    2014-11-01

    To determine whether site-specific mouth rinsing with oral disinfectants can improve oral odor beyond the traditional panoral mouth disinfection with mouth rinses by targeting specifically oral malodor implicated anaerobic bacteria. Twenty healthy fasting subjects volunteered for a blinded prospective, descriptive correlational crossover cross-section clinical trial conducted during the month of Ramadan between July and August 2013 in Albaha province in Saudi Arabia involving the application of Listerine Cool Mint mouth rinse by either the traditional panoral rinsing method, or a site-specific disinfection method targeting the subgingival and supragingival plaque and the posterior third of the tongue dorsum, while avoiding the remaining locations within the oral cavity. The viable anaerobic and aerobic bacterial counts, volatile sulfur compounds (VSCs) levels, organoleptic assessment of oral odor, and the tongue-coating index were compared at baseline, one, 5, and 9 hours after the treatment. The site-specific disinfection method reduced the VSCs and anaerobic bacterial loads while keeping the aerobic bacterial numbers higher than the traditional panoral rinsing method. Site-specific disinfection can more effectively maintain a healthy oral cavity by predominantly disinfecting the niches of anaerobic bacteria within the oral cavity.

  19. Knowledge-based public health situation awareness

    Science.gov (United States)

    Mirhaji, Parsa; Zhang, Jiajie; Srinivasan, Arunkumar; Richesson, Rachel L.; Smith, Jack W.

    2004-09-01

    There have been numerous efforts to create comprehensive databases from multiple sources to monitor the dynamics of public health and most specifically to detect the potential threats of bioterrorism before widespread dissemination. But there are not many evidences for the assertion that these systems are timely and dependable, or can reliably identify man made from natural incident. One must evaluate the value of so called 'syndromic surveillance systems' along with the costs involved in design, development, implementation and maintenance of such systems and the costs involved in investigation of the inevitable false alarms1. In this article we will introduce a new perspective to the problem domain with a shift in paradigm from 'surveillance' toward 'awareness'. As we conceptualize a rather different approach to tackle the problem, we will introduce a different methodology in application of information science, computer science, cognitive science and human-computer interaction concepts in design and development of so called 'public health situation awareness systems'. We will share some of our design and implementation concepts for the prototype system that is under development in the Center for Biosecurity and Public Health Informatics Research, in the University of Texas Health Science Center at Houston. The system is based on a knowledgebase containing ontologies with different layers of abstraction, from multiple domains, that provide the context for information integration, knowledge discovery, interactive data mining, information visualization, information sharing and communications. The modular design of the knowledgebase and its knowledge representation formalism enables incremental evolution of the system from a partial system to a comprehensive knowledgebase of 'public health situation awareness' as it acquires new knowledge through interactions with domain experts or automatic discovery of new knowledge.

  20. CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

    OpenAIRE

    Maria-Madalina SALOMIA

    2012-01-01

    In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space. From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups tha...

  1. Ethically-based clinical decision-making in physical therapy: process and issues.

    Science.gov (United States)

    Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

    2005-01-01

    The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

  2. Microbeams, microdosimetry and specific dose

    International Nuclear Information System (INIS)

    Randers-Pehrson, H.

    2002-01-01

    Dose and its usefulness as a single parameter to describe the amount of radiation absorbed are well established for most situations. The conditions where the concept of dose starts to break down are well known, mostly from the study of microdosimetry. For low doses of high LET radiation it is noted that the process of taking the limiting value of the energy absorbed within a test volume divided by the mass within that volume yields either zero or a relatively large value. The problem is further exacerbated with microbeam irradiations where the uniformity of the energy deposition is experimentally manipulated on the spatial scale of cells being irradiated. Booz introduced a quantity to deal with these problems: the unfortunately named 'mean specific energy in affected volumes'. This quantity multiplied by the probability that a test volume has received an energy deposit is equal to dose (in situations where dose can be defined). I propose that Booz's quantity be renamed 'specific dose', that is the mean energy deposited divided by the mass within a specified volume. If we believe for instance that the nucleus of a cell is the critical volume for biological effects, we can refer to the nuclear specific dose. A microbeam experiment wherein 10 per cent of the cell nuclei were targeted with 10 alpha particles would be described as delivering a nuclear specific dose of 1.6 Gy to 10 per cent of the population. (author)

  3. Learning in Context: Technology Integration in a Teacher Preparation Program Informed by Situated Learning Theory

    Science.gov (United States)

    Bell, Randy L.; Maeng, Jennifer L.; Binns, Ian C.

    2013-01-01

    This investigation explores the effectiveness of a teacher preparation program aligned with situated learning theory on preservice science teachers' use of technology during their student teaching experiences. Participants included 26 preservice science teachers enrolled in a 2-year Master of Teaching program. A specific program goal was to…

  4. Health goal priming as a situated intervention tool: how to benefit from nonconscious motivational routes to health behaviour.

    Science.gov (United States)

    Papies, Esther K

    2016-12-01

    Recent research has shown the limited effects of intentions on behaviour, so that novel methods to facilitate behaviour change are needed that do not rely on conscious intentions. Here, it is argued that nonintentional effects on health behaviour, such as the effects of habits, impulses, and nonconscious goals, occur through the activation of cognitive structures by specific situations. Interventions should therefore be situated to change these effects, either by changing the critical cognitive structures (training interventions), or by changing which cognitive structures get activated (cueing interventions). The current article presents this framework for situated interventions, as well as examples of interventions of each type. Then, it introduces goal priming as a cueing intervention tool to activate health goals and thus facilitate healthier behaviour, even in tempting situations that typically activate short-term hedonic goals. Following a review of empirical evidence, five principles for the effective application of health goal primes are proposed, namely (1) to target individuals who value the primed goals, (2) by activating their specific motivation, (3) through effective cues (4) that attract attention at the right time. Finally, (5) an effective goal-directed behaviour needs to be known and accessible to the primed individual. These principles are illustrated with examples of different health behaviours in order to facilitate their application for successful behaviour change.

  5. CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

    Directory of Open Access Journals (Sweden)

    Maria-Madalina, Salomia

    2012-01-01

    Full Text Available In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space.From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups that present opinions, knowledge and divergent interests such as:managers, investors, financial creditors, commercial creditors, clients, suppliers, employees, the government and its institutions, bankers, financial analysts, the public, the business community and other entities who base themselves on the objectivity and integrity of the financial situations audited.

  6. Current Perspectives in Teaching English for Specific Purposes

    Science.gov (United States)

    Garcia Laborda, Jesus; Litzler, Mary Frances

    2015-01-01

    Interest in Languages for Specific Purposes (LSP)courses has grown in recent years (Harding, 2007). For this reason a paper on the current situation in the field is of relevance. The present article provides a discussion of English for Specific Purposes and it does so by reviewing the history and background of this area of teaching, proposing a…

  7. Evolutionistic or revolutionary paths? A PACS maturity model for strategic situational planning.

    Science.gov (United States)

    van de Wetering, Rogier; Batenburg, Ronald; Lederman, Reeva

    2010-07-01

    While many hospitals are re-evaluating their current Picture Archiving and Communication System (PACS), few have a mature strategy for PACS deployment. Furthermore, strategies for implementation, strategic and situational planning methods for the evolution of PACS maturity are scarce in the scientific literature. Consequently, in this paper we propose a strategic planning method for PACS deployment. This method builds upon a PACS maturity model (PMM), based on the elaboration of the strategic alignment concept and the maturity growth path concept previously developed in the PACS domain. First, we review the literature on strategic planning for information systems and information technology and PACS maturity. Secondly, the PMM is extended by applying four different strategic perspectives of the Strategic Alignment Framework whereupon two types of growth paths (evolutionistic and revolutionary) are applied that focus on a roadmap for PMM. This roadmap builds a path to get from one level of maturity and evolve to the next. An extended method for PACS strategic planning is developed. This method defines eight distinctive strategies for PACS strategic situational planning that allow decision-makers in hospitals to decide which approach best suits their hospitals' current situation and future ambition and what in principle is needed to evolve through the different maturity levels. The proposed method allows hospitals to strategically plan for PACS maturation. It is situational in that the required investments and activities depend on the alignment between the hospital strategy and the selected growth path. The inclusion of both strategic alignment and maturity growth path concepts make the planning method rigorous, and provide a framework for further empirical research and clinical practice.

  8. Volumes of radionuclide into the basins of water while the accident at the Chernobyl nuclear power station and a specifics of radiation situation development in the post-accidents periods

    International Nuclear Information System (INIS)

    Standritchuk, O.Z.; Maksin, V.I.; Goncharuk, V.V.

    1996-01-01

    There was stated total content of radionuclide pollution, rejected to the environment in consequence of the accident at the Chernobyl nuclear power station, specifics of qualitative and quantitative change which supposes the division of post-accident period into five conventional post-accident periods. There were given the data about the levels of main fragmentation radionuclide activity in river water, atmospheric precipitation and sewage of the objects of sanitary treatment in May 1986. According to these data there were estimated the volumes of radioactive pollution rejection to the Kiev basins of water (1.56 centre dot 10 10 Ku, that is equal to 144,57 kg of radionuclides or 3,67 % of their mass in reactor) and their going into the Dnieper river. There was shown an interconnection of all season state of water basins which are near to Chernobyl nuclear power station, with specific development of radiation situation in them after the accident. There was proposed a probated variant of improvement of the traditional technology of drinking water preparation from the open water source within 1-2 post-accident periods

  9. Clinical trials recruitment planning: A proposed framework from the Clinical Trials Transformation Initiative.

    Science.gov (United States)

    Huang, Grant D; Bull, Jonca; Johnston McKee, Kelly; Mahon, Elizabeth; Harper, Beth; Roberts, Jamie N

    2018-03-01

    Patient recruitment is widely recognized as a key determinant of success for clinical trials. Yet a substantial number of trials fail to reach recruitment goals-a situation that has important scientific, financial, ethical, and policy implications. Further, there are important effects on stakeholders who directly contribute to the trial including investigators, sponsors, and study participants. Despite efforts over multiple decades to identify and address barriers, recruitment challenges persist. To advance a more comprehensive approach to trial recruitment, the Clinical Trials Transformation Initiative (CTTI) convened a project team to examine the challenges and to issue actionable, evidence-based recommendations for improving recruitment planning that extend beyond common study-specific strategies. We describe our multi-stakeholder effort to develop a framework that delineates three areas essential to strategic recruitment planning efforts: (1) trial design and protocol development, (2) trial feasibility and site selection, and (3) communication. Our recommendations propose an upstream approach to recruitment planning that has the potential to produce greater impact and reduce downstream barriers. Additionally, we offer tools to help facilitate adoption of the recommendations. We hope that our framework and recommendations will serve as a guide for initial efforts in clinical trial recruitment planning irrespective of disease or intervention focus, provide a common basis for discussions in this area and generate targets for further analysis and continual improvement. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Clinical professional governance for detailed clinical models.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  11. Clinical assessment of transthoracic echocardiography skills: a generalizability study

    DEFF Research Database (Denmark)

    Nielsen, Dorte Guldbrand; O'Neill, Lotte; Jensen, Signe

    2015-01-01

    Context: Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice. An objec......Context: Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice....... An objective assessment instrument for TTE technical proficiency including a global rating score and a checklist score has previously been shown reliability and validity in a standardised setting. Objectives: As clinical test situations typically have several sources of error giving rise to variance in scores......, a more thorough examination of the generalizability of the test scores is needed. Methods Nine physicians performed a TTE scan on the same three patients. Then, two raters rated all 27 TTE scans using the TTE technical assessment in a fully crossed generalizability study. Estimated variance components...

  12. Partial Diversity Generates Effector Immunity Specificity of the Bac41-Like Bacteriocins of Enterococcus faecalis Clinical Strains.

    Science.gov (United States)

    Kurushima, Jun; Ike, Yasuyoshi; Tomita, Haruyoshi

    2016-09-01

    Bacteriocin 41 (Bac41) is the plasmid-encoded bacteriocin produced by the opportunistic pathogen Enterococcus faecalis Its genetic determinant consists of bacL1 (effector), bacL2 (regulator), bacA (effector), and bacI (immunity). The secreted effectors BacL1 and BacA coordinate to induce the lytic cell death of E. faecalis Meanwhile, the immunity factor BacI provides self-resistance to the Bac41 producer, E. faecalis, against the action of BacL1 and BacA. In this study, we demonstrated that more than half of the 327 clinical strains of E. faecalis screened had functional Bac41 genes. Analysis of the genetic structure of the Bac41 genes in the DNA sequences of the E. faecalis strains revealed that the Bac41-like genes consist of a relatively conserved region and a variable region located downstream from bacA Based on similarities in the variable region, the Bac41-like genes could be classified into type I, type IIa, and type IIb. Interestingly, the distinct Bac41 types had specific immunity factors for self-resistance, BacI1 or BacI2, and did not show cross-immunity to the other type of effector. We also demonstrated experimentally that the specificity of the immunity was determined by the combination of the C-terminal region of BacA and the presence of the unique BacI1 or BacI2 factor. These observations suggested that Bac41-like bacteriocin genes are extensively disseminated among E. faecalis strains in the clinical environment and can be grouped into at least three types. It was also indicated that the partial diversity results in specificity of self-resistance which may offer these strains a competitive advantage. Bacteriocins are antibacterial effectors produced by bacteria. In general, a bacteriocin-coding gene is accompanied by a cognate immunity gene that confers self-resistance on the bacteriocin-producing bacterium itself. We demonstrated that one of the bacteriocins, Bac41, is disseminated among E. faecalis clinical strains and the Bac41 subtypes with

  13. Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians.

    Science.gov (United States)

    McBee, Elexis; Ratcliffe, Temple; Picho, Katherine; Schuwirth, Lambert; Artino, Anthony R; Yepes-Rios, Ana Monica; Masel, Jennifer; van der Vleuten, Cees; Durning, Steven J

    2017-11-15

    The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual "stimulus" to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine. We explicitly modified the context to assess its impact on performance (patient and physician contextual factors). Patient contextual factors, including English as a second language and emotional volatility, were portrayed in the videos. Physician participant contextual factors were self-rated sleepiness and burnout.. The accuracy of diagnostic and therapeutic reasoning was compared with covariates using Fisher Exact, Mann-Whitney U tests and Spearman Rho's correlations as appropriate. Fifteen board certified internists and 10 resident physicians participated from 2013 to 2014. Accuracy of diagnostic and therapeutic reasoning did not differ between groups despite residents reporting significantly higher rates of sleepiness (mean rank 20.45 vs 8.03, U = 0.5, p reasoning performance. Further, the processes of diagnostic and therapeutic reasoning, although related, may not be interchangeable. This raises important questions about the impact that contextual factors have on clinical reasoning and provides insight into how clinical reasoning processes in more authentic settings may be explained by situated cognition theory.

  14. Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

    DEFF Research Database (Denmark)

    Gadegaard Jensen, Anders; Callesen, T; Hagemo, J S

    2010-01-01

    Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care...... Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high-grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients...... breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre-oxygenation in the obese patients should be performed in the head-up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor...

  15. [Health care activity in a headache-specific clinic].

    Science.gov (United States)

    Garcia-Escrivà, A; Asensio-Asensio, M; López-Hernández, N; González-Aznar, O J; Oliver-Navarrete, C; Alvarez-Saúco, M; Pampliega-Pérez, A

    It is reckoned that headaches affect, at least once a year, around 90% of the population. The socioeconomic repercussion occasioned by this malady justifies the appearance in recent years of headache units. To conduct a descriptive epidemiological and health care study of the activity carried out in a headache-specific clinic. All the relevant points from the histories of patients who visited our surgery over a period of two years were collected prospectively and consecutively. The different types of headaches were classified according to the 1988 IHS criteria. Both the symptomatic and the preventive treatment were analysed. In all, a total of 866 patients were found; 691 (79.8%) were females and the mean age was 39.8 +/- 15.9 years (range: 6-90 years); 208 (24%) had a history of migraine in the family; 399 (49.9%) were diagnosed as suffering from migraine: 256 (64.2%) had migraine without aura, 152 (19%) were diagnosed as having tension-type headache, and 218 (27.3%) presented chronic daily headache (CDH). The most frequently used symptomatic treatments were NSAI drugs (36.7%) and triptanes (28.4%). Amitriptyline (47.7%), beta-blockers (14.5%) and calcium antagonists (11.3%) were the main drugs used as preventive treatment. After several years' operation of our Headache Unit, we thought there was a need to analyse the population seen in the visits. The fact that the majority of our patients were middle-aged females matched our expectations. Although most of the patients were diagnosed as suffering from M, we also want to highlight the high proportion of cases of CDH, above all associated with the abuse of analgesics.

  16. About Stressful Situations

    Science.gov (United States)

    ... make a new friend — plus catch up in social studies. Get support. Find someone to talk to about your situation. Ask for help or advice. Be with people who believe in you, make you laugh, and help you feel good about yourself. Sometimes just a listening ear helps a lot. It helps you know ...

  17. Problems and opportunity of personality inventories in clinical - psychological practice

    Directory of Open Access Journals (Sweden)

    Emil Benedik

    2002-12-01

    Full Text Available The article deals with possibilities and problems of usage of personality inventories in psychological diagnostic of persons with "heavy pathology", from aspect of validity and applicability in the first place. Personality inventories are usually designed for health population. By their usage in clinical psychology we often meet problems like specific tendencies when answering defined questions. This could be the result of situational factors but also the impact of their disorders and personality. The possibilities of classical interpretation of results are in this way limited. Do we have the opportunity of development of the diagnostic instruments that we could, not only recognise, but use such deformations (which represent cognitive style or defence of person in diagnostic purpose? The MMPI-2, most famous inventory in this field, offer us great aid, especially because its items are selected empirically. By the analysis of its items from aspect of sensing and localisation of subjects problems, we found differences between clinical scales which represent patients of different clinical groups. These differences are in accordance with psychoanalytical assumptions about characteristics of sensing self and other people.

  18. My Vocational Situation (MVS): Case Example and Psychometric Review.

    Science.gov (United States)

    Nitsch, Kristian P; Pedersen, Jessica; Miliotto, Alexandra; Petersen, Brett; Robbins, Samantha; Garcia, Ana; Hoisington, Molly Ansel; The, Kimberly J; Smiley, Jill; Janikowski, Timothy

    This case report provides an overview of the psychometric properties and clinical utility of the My Vocational Situation (MVS) instrument. The accompanying hypothetical case description illustrates how clinicians could use the MVS to evaluate vocational preferences and outcomes and how the MVS can be used to inform treatment planning and rehabilitation decision making. The information contained in this report is intended to familiarize clinicians with the administration and scoring of the MVS, the psychometric information necessary to interpret results obtained from the MVS, and how the results could be used to provide comprehensive, patient-centered care. It is important to note that the information provided represents only a sample of the available research literature on the MVS. Copyright © 2017 by the American Occupational Therapy Association, Inc.

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

    Directory of Open Access Journals (Sweden)

    T.V. Simanova

    2010-01-01

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

  20. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus).

    Science.gov (United States)

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R

    2015-07-01

    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions.

  1. Interactive effects of specific fine particulate matter compositions and airborne pollen on frequency of clinic visits for pollinosis in Fukuoka, Japan.

    Science.gov (United States)

    Phosri, Arthit; Ueda, Kayo; Tasmin, Saira; Kishikawa, Reiko; Hayashi, Masahiko; Hara, Keiichiro; Uehara, Yamato; Phung, Vera Ling Hui; Yasukouchi, Shusuke; Konishi, Shoko; Honda, Akiko; Takano, Hirohisa

    2017-07-01

    Previous studies have revealed the interactive effects of airborne pollen and particulate matter on the daily consultations for pollinosis, but it is uncertain which compositions are responsible. This study aimed to investigate the interactive effects of specific PM 2.5 compositions and airborne pollen on the daily number of clinic visits for pollinosis in Fukuoka. We obtained daily data on pollen concentrations, PM 2.5 compositions, PM 2.5 mass, gaseous pollutants (SO 2 , NO 2 , CO, and O 3 ), and weather variables monitored in Fukuoka between February and April, 2002-2012. In total, 73,995 clinic visits for pollinosis were made at 10 clinics in Fukuoka Prefecture during the study period. A time-stratified case-crossover design was applied to examine the interactive effects. The concentrations of PM 2.5 and its compositions were stratified into low (85th percentile) levels, and the association between airborne pollen and daily clinic visits for pollinosis was analyzed within each level. We found a significant interaction between specific PM 2.5 compositions and airborne pollen. Specifically, the odds ratio of daily clinic visits for pollinosis per interquartile increase in pollen concentration (39.8 grains/cm 2 ) at the average cumulative lag of 0 and 2 days during high levels of non-sea-salt Ca 2+ was 1.446 (95% CI: 1.323-1.581), compared to 1.075 (95% CI: 1.067-1.083) when only moderate levels were observed. This result remained significant when other air pollutants were incorporated into the model and was fairly persistent even when different percentile cut-off points were used. A similar interaction was found when we stratified the data according to non-sea-salt SO 4 2- levels. This finding differed from estimates made according to PM 2.5 and NO 3 - levels, which predicted that the effects of pollen were strongest in the lower levels. Associations between airborne pollen and daily clinic visits for pollinosis could be enhanced by high levels of specific PM 2

  2. Towards a Food Safety Knowledge Base Applicable in Crisis Situations and Beyond.

    Science.gov (United States)

    Falenski, Alexander; Weiser, Armin A; Thöns, Christian; Appel, Bernd; Käsbohrer, Annemarie; Filter, Matthias

    2015-01-01

    In case of contamination in the food chain, fast action is required in order to reduce the numbers of affected people. In such situations, being able to predict the fate of agents in foods would help risk assessors and decision makers in assessing the potential effects of a specific contamination event and thus enable them to deduce the appropriate mitigation measures. One efficient strategy supporting this is using model based simulations. However, application in crisis situations requires ready-to-use and easy-to-adapt models to be available from the so-called food safety knowledge bases. Here, we illustrate this concept and its benefits by applying the modular open source software tools PMM-Lab and FoodProcess-Lab. As a fictitious sample scenario, an intentional ricin contamination at a beef salami production facility was modelled. Predictive models describing the inactivation of ricin were reviewed, relevant models were implemented with PMM-Lab, and simulations on residual toxin amounts in the final product were performed with FoodProcess-Lab. Due to the generic and modular modelling concept implemented in these tools, they can be applied to simulate virtually any food safety contamination scenario. Apart from the application in crisis situations, the food safety knowledge base concept will also be useful in food quality and safety investigations.

  3. Esophageal stent implantation for the treatment of esophageal strictures: its current situation and research progress

    International Nuclear Information System (INIS)

    Zhu Haidong; Guo Jinhe; Teng Gaojun

    2011-01-01

    Esophageal stent implantation has been the most common therapy for the treatment of malignant and benign esophageal stenosis. At present, this technique is widely used in treating advanced esophageal cancerous stricture, refractory esophageal benign stricture and all kinds of esophageal fistulae or perforation. This paper aims to make a comprehensive review of the current situation and research progress of the esophageal stent implantation in clinical practice. (authors)

  4. Knowledge mobilized by a critical thinking process deployed by nursing students in practical care situations: a qualitative study.

    Science.gov (United States)

    Lechasseur, Kathleen; Lazure, Ginette; Guilbert, Louise

    2011-09-01

    This paper is a report of a qualitative study of mobilization of knowledge within the critical thinking process deployed by female undergraduate nursing students in practical care situations. Holistic practice is based on variety of knowledge mobilized by a critical thinking process. Novices and, more specifically, students experience many difficulties in this regard. Therefore, a better understanding of the knowledge they mobilize in their practice is important for nurse educators. A qualitative study, guided by grounded theory, was carried out. Sixteen nursing students, registered in an undergraduate programme in an Eastern Canadian university, were recruited. Descriptions of practical care situations were obtained through explicitation interviews in 2007. A sociodemographic questionnaire, semi-structured interviews and field notes were also used. Data were analysed using an approach based on grounded theory. An additional stage of analysis involved data condensation. Various types of knowledge guide nursing students' practice. These include intrapersonal, interpersonal, perceptual, moral/ethical, experiential, practical, scientific and contextual knowledge. The mobilization of these types of knowledge is only possible when the process of critical thinking has attained a higher level, giving rise to a new knowledge that we have termed combinational constructive knowledge rather than aesthetic knowledge. Clarification of the types of knowledge guiding the practice of student nurses and of the role of critical thinking in their mobilization could lead to innovative educational strategies. The findings provide guidance for the revision and development of both academic and clinical training programmes. © 2011 Blackwell Publishing Ltd.

  5. Epidemiological and clinical aspects of ear nose and throat ...

    African Journals Online (AJOL)

    Introduction: sensorineural emergencies (SNE) are rare clinical situations. Few patients consult early explaining subsequent difficulty in having accurate data and management. Three clinical conditions are considered SNE in otolaryngology; they include sudden sensorineural hearing loss (SSHL), Bell's palsy and acute ...

  6. Applying OR to problem situations within community organisations

    DEFF Research Database (Denmark)

    Tavella, Elena; Papadopoulos, Thanos

    2017-01-01

    This paper focuses on how the use of Community OR (COR), specifically Systems Thinking (ST) and the Viable System Model (VSM) can help in addressing complex and uncertain problem situations within community organisations, in particular Alternative Food Networks (AFNs). Literature has highlighted...... within a member-driven food cooperative in Copenhagen, Denmark, and the changes in decision making and the organisational structure of the cooperative. We illustrate the application of the VSM and in particular the methodology for organisational self-transformation within ‘localist green communitarianism......’ and ‘nonprofit management’ to tackle issues, enhance democratic and participative decision making, and changes in the organisational structure that foster coordination and cohesion. The implications for COR and Soft OR, limitations and future research directions are also provided....

  7. Review of the Empirical and Clinical Support for Group Therapy Specific to Sexual Abusers.

    Science.gov (United States)

    Jennings, Jerry L; Deming, Adam

    2017-12-01

    This review compiles 48 empirical studies and 55 clinical/practice articles specific to group therapy with sex offenders. Historically, group therapy has always been the predominant modality in sex offender-specific treatment. In the first decades of the field, treatment applied a psychoanalytic methodology that, although not empirically supported, fully appreciated the primary therapeutic importance of the group modality. Conversely, since the early 1980s, treatment has applied a cognitive behavioral method, but the field has largely neglected the therapeutic value of interpersonal group dynamics. The past decade has seen a growing re-appreciation of general therapeutic processes and more holistic approaches in sex offender treatment, and there is an emerging body of empirical research which, although often indirectly concerned with group, has yielded three definitive conclusions. First, the therapeutic qualities of the group therapist-specifically warmth, empathy, encouragement, and guidance-can strongly affect outcomes. Second, the quality of group cohesion can profoundly affect the effectiveness of treatment. Third, confrontational approaches in group therapy are ineffective, if not counter-therapeutic, and overwhelmingly rated as not helpful by sex offenders themselves. Additional conclusions are less strongly supported, but include compelling evidence that sex offenders generally prefer group therapy over individual therapy, that group therapy appears equally effective to individual therapy, and that mixing or separating groups by offense type is not important to therapeutic climate. Other group techniques and approaches specific to sexual abuse treatment are also summarized.

  8. France energy situation

    International Nuclear Information System (INIS)

    1991-01-01

    The monthly (May 1991) energy situation analysis in France is presented: the energy consumption rise is lowered and especially, oil imports have fallen from -3.1 pc; natural gas imports and domestic electric power production have risen. The energy import dependence rate have very slightly risen, around 50 pc. Diagrams for 1989, 1990, 1991 are presented [fr

  9. Using Twitter and other social media platforms to provide situational awareness during an incident.

    Science.gov (United States)

    Tobias, Ed

    2011-10-01

    The recent use of social media by protesters in Iran, Egypt, Yemen and elsewhere has focused new attention on this communications medium. Government agencies and businesses, as well, are using social media to push information to their stakeholders. Those who are on the front lines of this information revolution, however, realise that social media is most effective when the communication is two-way. Unlike other media, social media allows information sharing. This, in turn, provides emergency managers with new situational-awareness resources when trying to mitigate an incident. As Federal Emergency Management Agency (FEMA) Administrator Craig Fugate told Information Week on January 19th, 2011: 'We can adjust much quicker if we can figure out how to have (a) two-way conversation and if we can look at the public as a resource. The public is putting out better situational awareness than many of our own agencies can.' This paper provides examples of how social media can be used as a situational-awareness resource and specific 'tools' that can be used to assist with this task.

  10. Core outcome domains for clinical trials in non-specific low back pain.

    Science.gov (United States)

    Chiarotto, Alessandro; Deyo, Richard A; Terwee, Caroline B; Boers, Maarten; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Lin, Chung-Wei Christine; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Ostelo, Raymond W

    2015-06-01

    Inconsistent reporting of outcomes in clinical trials of patients with non-specific low back pain (NSLBP) hinders comparison of findings and the reliability of systematic reviews. A core outcome set (COS) can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials. In 1998, Deyo et al. recommended a standardized set of outcomes for LBP clinical research. The aim of this study was to update these recommendations by determining which outcome domains should be included in a COS for clinical trials in NSLBP. An International Steering Committee established the methodology to develop this COS. The OMERACT Filter 2.0 framework was used to draw a list of potential core domains that were presented in a Delphi study. Researchers, care providers and patients were invited to participate in three Delphi rounds and were asked to judge which domains were core. A priori criteria for consensus were established before each round and were analysed together with arguments provided by panellists on importance, overlap, aggregation and/or addition of potential core domains. The Steering Committee discussed the final results and made final decisions. A set of 280 experts was invited to participate in the Delphi; response rates in the three rounds were 52, 50 and 45%. Of 41 potential core domains presented in the first round, 13 had sufficient support to be presented for rating in the third round. Overall consensus was reached for the inclusion of three domains in this COS: 'physical functioning', 'pain intensity' and 'health-related quality of life'. Consensus on 'physical functioning' and 'pain intensity' was consistent across all stakeholders, 'health-related quality of life' was not supported by the patients, and all the other domains were not supported by two or more groups of stakeholders. Weighting all possible argumentations, the Steering Committee decided to include in the COS the three domains that reached overall consensus and

  11. Understanding situation awareness and its importance in patient safety.

    Science.gov (United States)

    Gluyas, Heather; Harris, Sarah-Jane

    2016-04-20

    Situation awareness describes an individual's perception, comprehension and subsequent projection of what is going on in the environment around them. The concept of situation awareness sits within the group of non-technical skills that include teamwork, communication and managing hierarchical lines of communication. The importance of non-technical skills has been recognised in safety-critical industries such as aviation, the military, nuclear, and oil and gas. However, health care has been slow to embrace the role of non-technical skills such as situation awareness in improving outcomes and minimising the risk of error. This article explores the concept of situation awareness and the cognitive processes involved in maintaining it. In addition, factors that lead to a loss of situation awareness and strategies to improve situation awareness are discussed.

  12. First year clinical tutorials: students’ learning experience

    Directory of Open Access Journals (Sweden)

    Burgess A

    2014-11-01

    Full Text Available Annette Burgess,1 Kim Oates,2 Kerry Goulston,2 Craig Mellis1 1Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; 2Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Background: Bedside teaching lies at the heart of medical education. The learning environment afforded to students during clinical tutorials contributes substantially to their knowledge, thinking, and learning. Situated cognition theory posits that the depth and breadth of the students' learning experience is dependent upon the attitude of the clinical teacher, the structure of the tutorial, and the understanding of tutorial and learning objectives. This theory provides a useful framework to conceptualize how students' experience within their clinical tutorials impacts their knowledge, thinking, and learning. Methods: The study was conducted with one cohort (n=301 of students who had completed year 1 of the medical program at Sydney Medical School in 2013. All students were asked to complete a three-part questionnaire regarding their perceptions of their clinical tutor's attributes, the consistency of the tutor, and the best features of the tutorials and need for improvement. Both quantitative and qualitative data were collected and analyzed using descriptive statistics. Results: The response rate to the questionnaire was 88% (265/301. Students perceived that their tutors displayed good communication skills and enthusiasm, encouraged their learning, and were empathetic toward patients. Fifty-two percent of students reported having the same communications tutor for the entire year, and 28% reported having the same physical examination tutor for the entire year. Students would like increased patient contact, greater structure within their tutorials, and greater alignment of teaching with the curriculum. Conclusion: Situated cognition theory provides a valuable lens to view students' experience of learning within the

  13. Analysis of PSA-Specific T-Cell Responses of Prostate Cancer Patients Given a PSA-Based Vaccine on a Clinical Trial

    National Research Council Canada - National Science Library

    Gulley, James

    2003-01-01

    .... This randomized, phase II clinical trial was designed to determine if a PSA-based vaccine could induce a specific immune response when combined with radiotherapy in patients with localized prostate cancer...

  14. Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards

    Directory of Open Access Journals (Sweden)

    Valkenhoef Gert

    2012-09-01

    Full Text Available Abstract Background Decisions concerning drug safety and efficacy are generally based on pivotal evidence provided by clinical trials. Unfortunately, finding the relevant clinical trials is difficult and their results are only available in text-based reports. Systematic reviews aim to provide a comprehensive overview of the evidence in a specific area, but may not provide the data required for decision making. Methods We review and analyze the existing information systems and standards for aggregate level clinical trials information from the perspective of systematic review and evidence-based decision making. Results The technology currently used has major shortcomings, which cause deficiencies in the transfer, traceability and availability of clinical trials information. Specifically, data available to decision makers is insufficiently structured, and consequently the decisions cannot be properly traced back to the underlying evidence. Regulatory submission, trial publication, trial registration, and systematic review produce unstructured datasets that are insufficient for supporting evidence-based decision making. Conclusions The current situation is a hindrance to policy decision makers as it prevents fully transparent decision making and the development of more advanced decision support systems. Addressing the identified deficiencies would enable more efficient, informed, and transparent evidence-based medical decision making.

  15. Association of Escherichia coli J5-specific serum antibody responses with clinical mastitis outcome for J5 vaccinate and control dairy cattle.

    Science.gov (United States)

    Wilson, David J; Mallard, Bonnie A; Burton, Jeanne L; Schukken, Ynte H; Grohn, Yrjo T

    2009-02-01

    Dairy cattle in two commercial Holstein herds were randomly selected to be vaccinated twice with J5, at approximately 60 days and 28 days before the expected calving date, or to be untreated controls. Based on whether milk production changed following clinical mastitis or whether cows were culled or died within 30 days after onset, 51 mastitis cases were classified as severe or mild. J5-specific antibody responses were evaluated by enzyme-linked immunosorbent assay of all 32 severe and 19 mild cases. The amounts of J5-specific immunoglobulin M (IgM), IgG1, and IgG2 antibodies in sera from the 27 J5 vaccinates were compared with those of the 24 controls. At drying off (before J5 vaccination), all cows had similar amounts of J5-specific antibody. Immediately after calving (approximately 28 days after the second vaccination), J5 vaccinates had significantly higher production of J5-specific IgG1 and IgG2 than controls. When cows were tested following clinical mastitis, none of the three antibody classes differed significantly between the controls and the vaccinates. Vaccinates that contracted Escherichia coli mastitis had 75% less milk loss than controls. The cows that contracted clinical mastitis later in lactation, the unvaccinated controls, and those infected with E. coli had more milk loss following mastitis. The hazards of being culled for all reasons and of being culled for mastitis were significantly lower for J5 vaccinates. Vaccination with J5 was associated with protection against milk production loss and culling following clinical mastitis, and it was also significantly associated with changes in J5-specific IgM, IgG1, and IgG2 antibodies in sera of vaccinated cows.

  16. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association.

    Science.gov (United States)

    Garber, Jeffrey R; Cobin, Rhoda H; Gharib, Hossein; Hennessey, James V; Klein, Irwin; Mechanick, Jeffrey I; Pessah-Pollack, Rachel; Singer, Peter A; Woeber, Kenneth A

    2012-12-01

    Hypothyroidism has multiple etiologies and manifestations. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions. This paper describes evidence-based clinical guidelines for the clinical management of hypothyroidism in ambulatory patients. The development of these guidelines was commissioned by the American Association of Clinical Endocrinologists (AACE) in association with American Thyroid Association (ATA). AACE and the ATA assembled a task force of expert clinicians who authored this article. The authors examined relevant literature and took an evidence-based medicine approach that incorporated their knowledge and experience to develop a series of specific recommendations and the rationale for these recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach outlined in the American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Guidelines-2010 update. Topics addressed include the etiology, epidemiology, clinical and laboratory evaluation, management, and consequences of hypothyroidism. Screening, treatment of subclinical hypothyroidism, pregnancy, and areas for future research are also covered. Fifty-two evidence-based recommendations and subrecommendations were developed to aid in the care of patients with hypothyroidism and to share what the authors believe is current, rational, and optimal medical practice for the diagnosis and care of hypothyroidism. A serum thyrotropin is the single best screening test for primary thyroid dysfunction for the vast majority of outpatient clinical situations. The standard treatment is replacement with L-thyroxine. The decision to treat subclinical hypothyroidism when the serum thyrotropin is less than 10 mIU/L should be tailored to the individual patient.

  17. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie D'intervention).

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines. © 2015 by The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery.

  18. Representing and reasoning about program in situation calculus

    Science.gov (United States)

    Yang, Bo; Zhang, Ming-yi; Wu, Mao-nian; Xie, Gang

    2011-12-01

    Situation calculus is an expressive tool for modeling dynamical system in artificial intelligence, changes in a dynamical world is represented naturally by the notions of action, situation and fluent in situation calculus. Program can be viewed as a discrete dynamical system, so it is possible to model program with situation calculus. To model program written in a smaller core programming language CL, notion of fluent is expanded for representing value of expression. Together with some functions returning concerned objects from expressions, a basic action theory of CL programming is constructed. Under such a theory, some properties of program, such as correctness and termination can be reasoned about.

  19. Clinical leadership in mental health nursing: the importance of a calm and confident approach.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry

    2015-01-01

    Explore the perceptions of nurses working in mental health of effective clinical leadership. In-depth interviews were conducted with registered nurses employed in a mental health setting. Qualitative research using grounded theory. Remaining calm and confident in times of crisis and uncertainty was identified as one attribute of clinical leadership. Participants noted clinical leaders' demeanor during stressful or crisis situations, and their ability to manage unpredictable or unexpected clinical situations as contributing positively to clinical practice. Understanding these characteristics and how they can influence positive outcomes for clients is crucial in addressing the recruitment and retention challenges for the nursing workforce. © 2014 Wiley Periodicals, Inc.

  20. Teaching Foreign Languages to Pupils with Specific Learning Disability

    OpenAIRE

    VOLDÁNOVÁ, Veronika

    2015-01-01

    This diploma thesis deals with the topic of specific learning disability. In the theoretical part I define the term specific learning disability and I mention the related terms. I deal with the history, types and causes of specific learning disability, further I describe the possibilities of diagnostics and re-education concerning specific learning disability. I also attend to the situation of a pupil in the family and school background. The main attention is especially paid to teaching forei...

  1. A safety-critical decision support system evaluation using situation awareness and workload measures

    International Nuclear Information System (INIS)

    Naderpour, Mohsen; Lu, Jie; Zhang, Guangquan

    2016-01-01

    To ensure the safety of operations in safety-critical systems, it is necessary to maintain operators' situation awareness (SA) at a high level. A situation awareness support system (SASS) has therefore been developed to handle uncertain situations [1]. This paper aims to systematically evaluate the enhancement of SA in SASS by applying a multi-perspective approach. The approach consists of two SA metrics, SAGAT and SART, and one workload metric, NASA-TLX. The first two metrics are used for the direct objective and subjective measurement of SA, while the third is used to estimate operator workload. The approach is applied in a safety-critical environment called residue treater, located at a chemical plant in which a poor human-system interface reduced the operator's SA and caused one of the worst accidents in US history. A counterbalanced within-subjects experiment is performed using a virtual environment interface with and without the support of SASS. The results indicate that SASS improves operators' SA, and specifically has benefits for SA levels 2 and 3. In addition, it is concluded that SASS reduces operator workload, although further investigations in different environments with a larger number of participants have been suggested. - Highlights: • The suitability of a cognitive decision support system is investigated. • An evaluation approach considering situation awareness and workload measures is proposed. • A computerized system based on the proposed approach is implemented. • The implemented system is used in a safety-critical environment.

  2. Articular dysfunction patterns in patients with mechanical low back pain: A clinical algorithm to guide specific mobilization and manipulation techniques.

    Science.gov (United States)

    Dewitte, V; Cagnie, B; Barbe, T; Beernaert, A; Vanthillo, B; Danneels, L

    2015-06-01

    Recent systematic reviews have demonstrated reasonable evidence that lumbar mobilization and manipulation techniques are beneficial. However, knowledge on optimal techniques and doses, and its clinical reasoning is currently lacking. To address this, a clinical algorithm is presented so as to guide therapists in their clinical reasoning to identify patients who are likely to respond to lumbar mobilization and/or manipulation and to direct appropriate technique selection. Key features in subjective and clinical examination suggestive of mechanical nociceptive pain probably arising from articular structures, can categorize patients into distinct articular dysfunction patterns. Based on these patterns, specific mobilization and manipulation techniques are suggested. This clinical algorithm is merely based on empirical clinical expertise and complemented through knowledge exchange between international colleagues. The added value of the proposed articular dysfunction patterns should be considered within a broader perspective. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. EMDR therapy for specific fears and phobias: the phobia protocol

    NARCIS (Netherlands)

    de Jongh, A.; Luber, M.

    2016-01-01

    This chapter illustrates how EMDR Therapy can be applied in the treatment of fears and specific phobias. These conditions are highly prevalent in the general population, and are characterized by an unreasonable and severe fear related to exposure to specific objects or situations, which tend to

  4. Pragmatically Framed Cross-Situational Noun Learning Using Computational Reinforcement Models.

    Science.gov (United States)

    Najnin, Shamima; Banerjee, Bonny

    2018-01-01

    Cross-situational learning and social pragmatic theories are prominent mechanisms for learning word meanings (i.e., word-object pairs). In this paper, the role of reinforcement is investigated for early word-learning by an artificial agent. When exposed to a group of speakers, the agent comes to understand an initial set of vocabulary items belonging to the language used by the group. Both cross-situational learning and social pragmatic theory are taken into account. As social cues, joint attention and prosodic cues in caregiver's speech are considered. During agent-caregiver interaction, the agent selects a word from the caregiver's utterance and learns the relations between that word and the objects in its visual environment. The "novel words to novel objects" language-specific constraint is assumed for computing rewards. The models are learned by maximizing the expected reward using reinforcement learning algorithms [i.e., table-based algorithms: Q-learning, SARSA, SARSA-λ, and neural network-based algorithms: Q-learning for neural network (Q-NN), neural-fitted Q-network (NFQ), and deep Q-network (DQN)]. Neural network-based reinforcement learning models are chosen over table-based models for better generalization and quicker convergence. Simulations are carried out using mother-infant interaction CHILDES dataset for learning word-object pairings. Reinforcement is modeled in two cross-situational learning cases: (1) with joint attention (Attentional models), and (2) with joint attention and prosodic cues (Attentional-prosodic models). Attentional-prosodic models manifest superior performance to Attentional ones for the task of word-learning. The Attentional-prosodic DQN outperforms existing word-learning models for the same task.

  5. Why do we laugh at misfortunes? An electrophysiological exploration of comic situation processing.

    Science.gov (United States)

    Manfredi, Mirella; Adorni, Roberta; Proverbio, Alice Mado; Proverbio, Alice

    2014-08-01

    The goal of the present study was to shed some light on a particular kind of humour, called slapstick, by measuring brain bioelectrical activity during the perception of funny vs. non-funny pictures involving misfortunate circumstances. According to our hypothesis, the element mostly providing a comic feature in a misfortunate situation is the facial expression of the victims: the observer׳s reaction will usually be laughing only if the victims will show a funny bewilderment face and not a painful or anger expression. Several coloured photographs depicting people involved in misfortunate situations were presented to 30 Italian healthy volunteers, while their EEG was recorded. Three different situations were considered: people showing a painful or an angry expression (Affective); people showing a bewilderment expression and, so, a comic look (Comic); people engaged in similar misfortunate situations but with no face visible (No Face). Results showed that the mean amplitude of both the posterior N170 and anterior N220 components was much larger in amplitude to comic pictures, than the other stimuli. This early response could be considered the first identification of a comic element and evidence of the compelling and automatic response that usually characterizes people amused reaction during a misfortune. In addition, we observed a larger P300 amplitude in response to comic than affective pictures, probably reflecting a more conscious processing of the comic element. Finally, no face pictures elicited an anteriorly distributed N400, which might reflect the effort to comprehend the nature of the situation displayed without any affective facial information, and a late positivity, possibly indexing a re-analysis processing of the unintelligible misfortunate situation (comic or unhappy) depicted in the No Face stimuli. These data support the hypothesis that the facial expression of the victims acts as a specific trigger for the amused feeling that observers usually

  6. Cross-situational consistency of trait expressions and injunctive norms among Asian Canadian and European Canadian undergraduates.

    Science.gov (United States)

    Locke, Kenneth D; Sadler, Pamela; McDonald, Kelly

    2018-06-14

    In the current paper, we sought to clarify when and why Asian Americans/Canadians and European Americans/Canadians differ in self-consistency (the consistency of personality traits across situations). European Canadian (n = 220) and second-generation Asian Canadian (n = 166) undergraduates (Mage = 19 years) described the traits they expressed and the traits others wanted them to express (i.e., injunctive norms, or injunctions) in four different social situations (i.e., with parents, with friends, with siblings, and with professors). Self-consistency was greater among European Canadians than Asian Canadians, but only when comparing behavior with parents versus with peers (i.e., friends and siblings). The same pattern was found for injunctive consistency (cross-situational consistency of trait injunctions). Injunctions strongly predicted the behavior of both Asian and European Canadians, but because the injunctions from parents versus peers diverged more for Asian Canadians, so did their behaviors. Controlling for the effect of inconsistent injunctions across situations eliminated the ethnic difference in self-consistency. Finally, Asian Canadians who perceived their immigrant parents as embracing a Canadian identity were as cross-situationally consistent as European Canadians because they tended to behave-and believe their parents approved of their behaving-with parents similarly to how they behaved with peers (e.g., more carefree and outspoken). Contrary to previous theorizing, cultural influences on broad cognitive or motivational dispositions (e.g., dialecticism, collectivism) alone cannot explain the observed pattern of ethnic differences in consistency. To understand when bicultural individuals are less consistent across situations also requires an understanding of the specific situations across which they tend to encounter divergent social norms. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  7. Automated classification of eligibility criteria in clinical trials to facilitate patient-trial matching for specific patient populations.

    Science.gov (United States)

    Zhang, Kevin; Demner-Fushman, Dina

    2017-07-01

    To develop automated classification methods for eligibility criteria in ClinicalTrials.gov to facilitate patient-trial matching for specific populations such as persons living with HIV or pregnant women. We annotated 891 interventional cancer trials from ClinicalTrials.gov based on their eligibility for human immunodeficiency virus (HIV)-positive patients using their eligibility criteria. These annotations were used to develop classifiers based on regular expressions and machine learning (ML). After evaluating classification of cancer trials for eligibility of HIV-positive patients, we sought to evaluate the generalizability of our approach to more general diseases and conditions. We annotated the eligibility criteria for 1570 of the most recent interventional trials from ClinicalTrials.gov for HIV-positive and pregnancy eligibility, and the classifiers were retrained and reevaluated using these data. On the cancer-HIV dataset, the baseline regex model, the bag-of-words ML classifier, and the ML classifier with named entity recognition (NER) achieved macro-averaged F2 scores of 0.77, 0.87, and 0.87, respectively; the addition of NER did not result in a significant performance improvement. On the general dataset, ML + NER achieved macro-averaged F2 scores of 0.91 and 0.85 for HIV and pregnancy, respectively. The eligibility status of specific patient populations, such as persons living with HIV and pregnant women, for clinical trials is of interest to both patients and clinicians. We show that it is feasible to develop a high-performing, automated trial classification system for eligibility status that can be integrated into consumer-facing search engines as well as patient-trial matching systems. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  8. Situational Script Management of Business Processes with Changeable Structure

    OpenAIRE

    Chaliy, Sergey; Chala, Oksana

    2008-01-01

    In the presented work the problem of management business-processes with changeable structure is considered and situational based approach to its decision is offered. The approach is based on situational model of management business-process according to which process is represented as a set of situations. The script defining necessary actions is connected with each situation. Management of process is carried out by means of the rules formalizing functional requirements to processes.

  9. Inheritance of Properties in NTU Communication Situations

    NARCIS (Netherlands)

    Hendrickx, R.L.P.

    2002-01-01

    In this paper we consider communication situations in which utility is nontransferable. We compare this model with the more familiar model of transferable utility communication situations and point out an odd feature of the latter. We mainly focus on the inheritance of properties of the underlying

  10. Towards ontology-driven situation-aware disaster management

    NARCIS (Netherlands)

    Moreira, João; Ferreira Pires, Luis; van Sinderen, Marten J.; Dockhorn Costa, P.

    2015-01-01

    Over the last years, numerous ICT applications with mechanisms to detect situations have been developed to support disaster management (DM), which is a field of a great societal and economic importance. Those applications are termed situation-aware (SA) because they try, in near real-time, to

  11. Narrative Construction, Social Perceptions, and the Situation Model.

    Science.gov (United States)

    Costabile, Kristi A

    2016-05-01

    The present investigation examined how three salient features of narrative thinking (situation model construction, linguistic concreteness, and perspective-taking) influenced the social inference process. Results of four experiments indicated that compared with those given other objectives, perceivers given narrative objectives were: (a) more likely to make situation rather than trait attributions for observed behaviors (Experiment 1), (b) less likely to make implicit trait inferences (Experiment 2), and (c) less likely to rely on behavior valence when making evaluative judgments (Experiment 4). Linguistic analyses indicated that narrative construction consistently entailed the creation of situation models of events and linguistic concreteness, but only situation model creation mediated the relationship between narrative and inferences. Experiment 3 confirmed the mediating role of situation models: Perceivers with narrative objectives made trait inferences only when behaviors were inconsistent with contextual information. The role of these core narrative features on social perceptions is discussed. © 2016 by the Society for Personality and Social Psychology, Inc.

  12. Representing Operational Modes for Situation Awareness

    DEFF Research Database (Denmark)

    Kirchhübel, Denis; Lind, Morten; Ravn, Ole

    2017-01-01

    reasonable reactions to abnormal situations. Intelligent computational support tools can make the operator's task easier, but they require knowledge about the overall system in form of some model. While tools used for fault-tolerant control design based on physical principles and relations are valuable tools...... for designing robust systems, the models become too complex when considering the interactions on a plant-wide level. The alarm systems meant to support human operators in the diagnosis of the plant-wide situation on the other hand fail regularly in situations where these interactions of systems lead to many...... the interconnected systems can be inferred and alarm floods can potentially be reduced to their root-cause. However, the desired behaviour of a complex system changes due to operating procedures that require more than one physical and functional configuration. In this paper a consistent representation of possible...

  13. A improved Network Security Situation Awareness Model

    Directory of Open Access Journals (Sweden)

    Li Fangwei

    2015-08-01

    Full Text Available In order to reflect the situation of network security assessment performance fully and accurately, a new network security situation awareness model based on information fusion was proposed. Network security situation is the result of fusion three aspects evaluation. In terms of attack, to improve the accuracy of evaluation, a situation assessment method of DDoS attack based on the information of data packet was proposed. In terms of vulnerability, a improved Common Vulnerability Scoring System (CVSS was raised and maked the assessment more comprehensive. In terms of node weights, the method of calculating the combined weights and optimizing the result by Sequence Quadratic Program (SQP algorithm which reduced the uncertainty of fusion was raised. To verify the validity and necessity of the method, a testing platform was built and used to test through evaluating 2000 DAPRA data sets. Experiments show that the method can improve the accuracy of evaluation results.

  14. Situated learning and interacting with/through technologies

    DEFF Research Database (Denmark)

    Raudaskoski, Pirkko Liisa

    2006-01-01

    There is a growing interest within social and humanistic sciences towards understanding practice theoretically and analytically. Lave and Wenger’s concept “situated learning” describes the process of newcomers moving toward full participation in a community. Wenger later refined his approach in h...... practices. The interdisciplinary interaction analysis (IA) is suggested as the best way to study the various aspects of situated learning in technology-intensive interactions.......There is a growing interest within social and humanistic sciences towards understanding practice theoretically and analytically. Lave and Wenger’s concept “situated learning” describes the process of newcomers moving toward full participation in a community. Wenger later refined his approach in his...... book ‘Communities of practice: Learning, meaning and identity’. Situated learning is equalled with social order: instead of understanding learning as a separate practice from everyday life, learning is seen as a more mundane phenomenon. It is sometimes difficult to operationalize Lave and Wenger...

  15. Diagnostic orientation in control of disturbance situations

    International Nuclear Information System (INIS)

    Hukki, K.; Norros, L.

    1993-01-01

    The object of the study is diagnostic judgement in the control of dynamic processes. The starting point was the known difficulty process operators have in utilizing knowledge of process dynamics in disturbance situations that require both diagnostic and prognostic actions. A model of the diagnostic judgement process as a construction of coherent interpretation of the situation is outlined, and comprehensive data from simulated disturbance handling by 6 crews of a PWR type nuclear power plant was analysed. The phase of analysis included evaluation of the adequacy of task performance, utilization of available process information, and evaluation of the interpretation of disturbance situations. The results suggest that a functional orientation towards task performance allows a more coherent and comprehensive interpretation of the situation and more adequate task performance. Coherence of interpretation seems to be reflected in a higher subjective certainty compared with crews with an incoherent interpretation. (author). 15 refs, 2 figs, 2 tabs

  16. Continuous measures of situation awareness and workload

    International Nuclear Information System (INIS)

    Droeivoldsmo, Asgeir; Skraaning, Gyrd jr.; Sverrbo, Mona; Dalen, Joergen; Grimstad, Tone; Andresen, Gisle

    1998-03-01

    This report presents methods for continuous measures for Situation Awareness and Workload. The objective has been to identify, develop and test the new measures, and compare them to instruments that require interruptions of scenarios. The new measures are: (1) the Visual Indicator of Situation Awareness (VISA); where Situation Awareness is scored from predefined areas of visual interest critical for solving scenarios. Visual monitoring of areas was recorded by eye-movement tracking. (2) Workload scores reflected by Extended Dwell Time (EDT) and the operator Activity Level. EDT was calculated from eye-movement data files, and the activity level was estimated from simulator logs. Using experimental data from the 1996 CASH NRC Alarm study and the 1997 Human Error Analysis Project/ Human-Centred Automation study, the new measurement techniques have been tested and evaluated on a preliminary basis. The results showed promising relationships between the new continuous measures of situation awareness and workload, and established instruments based upon scenario interruptions. (author)

  17. Sci-Thur AM: YIS – 04: Stopping power-to-Cherenkov power ratios and beam quality specification for clinical Cherenkov emission dosimetry of electrons: beam-specific effects and experimental validation

    International Nuclear Information System (INIS)

    Zlateva, Yana; Seuntjens, Jan; El Naqa, Issam

    2016-01-01

    Purpose: To advance towards clinical Cherenkov emission (CE)-based dosimetry by investigating beam-specific effects on Monte Carlo-calculated electron-beam stopping power-to-CE power ratios (SCRs), addressing electron beam quality specification in terms of CE, and validating simulations with measurements. Methods: The EGSnrc user code SPRRZnrc, used to calculate Spencer-Attix stopping-power ratios, was modified to instead calculate SCRs. SCRs were calculated for 6- to 22-MeV clinical electron beams from Varian TrueBeam, Clinac 21EX, and Clinac 2100C/D accelerators. Experiments were performed with a 20-MeV electron beam from a Varian TrueBeam accelerator, using a diffraction grating spectrometer with optical fiber input and a cooled back-illuminated CCD. A fluorophore was dissolved in the water to remove CE signal anisotropy. Results: It was found that angular spread of the incident beam has little effect on the SCR (≤ 0.3% at d max ), while both the electron spectrum and photon contamination increase the SCR at shallow depths and decrease it at large depths. A universal data fit of R 50 in terms of C 50 (50% CE depth) revealed a strong linear dependence (R 2 > 0.9999). The SCR was fit with a Burns-type equation (R 2 = 0.9974, NRMSD = 0.5%). Below-threshold incident radiation was found to have minimal effect on beam quality specification (< 0.1%). Experiments and simulations were in good agreement. Conclusions: Our findings confirm the feasibility of the proposed CE dosimetry method, contingent on computation of SCRs from additional accelerators and on further experimental validation. This work constitutes an important step towards clinical high-resolution out-of-beam CE dosimetry.

  18. Accelerated production of antigen-specific T-cells for pre-clinical and clinical applications using Gas-permeable Rapid Expansion cultureware (G-Rex)

    Science.gov (United States)

    Vera, Juan F.; Brenner, Lara J.; Gerdemann, Ulrike; Ngo, Minhtran C.; Sili, Uluhan; Liu, Hao; Wilson, John; Dotti, Gianpietro; Heslop, Helen E.; Leen, Ann M.; Rooney, Cliona M.

    2009-01-01

    The clinical manufacture of antigen-specific cytotoxic T lymphocytes (CTL) for adoptive immunotherapy is limited by the complexity and time required to produce large numbers with the desired function and specificity. The culture conditions required are rigorous, and in some cases only achieved in 2cm2 wells in which cell growth is limited by gas exchange, nutrients and waste accumulation. Bioreactors developed to overcome these issues tend to be complex, expensive and not always conducive to CTL growth. We observed that antigen-specific CTL undergo seven to ten divisions post-stimulation. However the expected CTL numbers were achieved only in the first week of culture. By recreating the culture conditions present during this first week - low frequency of antigen-specific T-cells and high frequency of feeder cells - we were able to increase CTL expansion to expected levels which could be sustained for several weeks without affecting phenotype or function. However, the number of 24-well plates needed was excessive and cultures required frequent media changes, increasing complexity and manufacturing costs. Therefore, we evaluated novel gas-permeable culture devices (G-Rex) with a silicone membrane at the base allowing gas exchange to occur uninhibited by depth of medium above. This system effectively supports the expansion of CTL and actually increases output by up to 20-fold while decreasing required technician time. Importantly, this amplified cell expansion is not due to more cell divisions but to reduced cell death. This bioprocess optimization increased T-cell output while decreasing the complexity and cost of CTL manufacture, making cell therapy more accessible. PMID:20445351

  19. The Situated Nature of Preschool Children's Conflict Strategies

    OpenAIRE

    Thornberg, Robert

    2006-01-01

    The purpose of this study was to examine whether the peer conflict strategies of preschool children are situated and therefore vary across different conflict situations. Hypothetical conflict interviews were administered through a series of puppet shows. Participants were 178 preschool children. Results indicate that preschool children's conflict management skills are situated in peer conflict, because their strategies are to a greater or lesser degree influenced by the opponent's strategies....

  20. A Critical Systems Metamethodology for Problem Situation Structuring

    OpenAIRE

    Slavica P. Petrovic

    2012-01-01

    The increasing complexity and diversity of management problem situations in organizations, as well as the increasing variety of theories, methodologies, methods, techniques, and models that can be employed in problem situation structuring and solving, must be considered as relevant aspects of management process in contemporary circumstances. Creative holism in management problem situations in organizations is enabled by means of Critical Systems Thinking (CST) as well as Critical Systems Prac...

  1. Recognition of risk situations based on endoscopic instrument tracking and knowledge based situation modeling

    Science.gov (United States)

    Speidel, Stefanie; Sudra, Gunther; Senemaud, Julien; Drentschew, Maximilian; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

    2008-03-01

    Minimally invasive surgery has gained significantly in importance over the last decade due to the numerous advantages on patient-side. The surgeon has to adapt special operation-techniques and deal with difficulties like the complex hand-eye coordination, limited field of view and restricted mobility. To alleviate these constraints we propose to enhance the surgeon's capabilities by providing a context-aware assistance using augmented reality (AR) techniques. In order to generate a context-aware assistance it is necessary to recognize the current state of the intervention using intraoperatively gained sensor data and a model of the surgical intervention. In this paper we present the recognition of risk situations, the system warns the surgeon if an instrument gets too close to a risk structure. The context-aware assistance system starts with an image-based analysis to retrieve information from the endoscopic images. This information is classified and a semantic description is generated. The description is used to recognize the current state and launch an appropriate AR visualization. In detail we present an automatic vision-based instrument tracking to obtain the positions of the instruments. Situation recognition is performed using a knowledge representation based on a description logic system. Two augmented reality visualization programs are realized to warn the surgeon if a risk situation occurs.

  2. A situated didactics of the philosophy a model to attend the estrangement of the teachers

    Directory of Open Access Journals (Sweden)

    Laura Susana Morales

    2013-01-01

    Full Text Available Training for Philosophy teachers, in the deductive curriculum frames, generates strangeness in those who carry on their internship and their first labor practices, when they come back to school. How to attend this estrangement from a specific didactics of the philosophy without denying the tension among technical, practical and experiential foregrounds? For this, a model denominated as Philosophy’s specific situated didactics is suggested. Such didactics has in its basis, besides the consideration that education is constituted by the tension of the above mentioned foregrounds, a conception of the philosophy referred to as philosophizing Philosophy, which takes into consideration both the subject of the philosophical activity and the disciplinary object, and is opposed to the academism from a perspective that nourishes itself in the situated thought as a philosophic category and in the experience understood as the transformation of subject. That’s why the mentioned didactical model breaks with the explanation, as the university teaching axis, and relies on the narration as the contact point for those involved in the training of trainers and those who begin in Philosophy teaching.

  3. Use of oral antineoplastic in special situations in a third level hospital: real life results.

    Science.gov (United States)

    Garcia-Muñoz, Carmen; Rodriguez-Quesada, Pedro Pablo; Ferrari-Piquero, José Miguel

    2018-01-01

    To analyse the effectiveness and safety of oral antineoplastic drugs  (ANEOs) that are authorized in special situations in a third-level hospital and to  compare the results obtained with the clinical evidence used for this  authorization. Descriptive observational and retrospective study. We included all  adult patients who started treatment with ANEO in special situations during the  year 2016. We collected demographic, treatment-related and clinical variables  (overall survival (OS), progression-free survival (PFS)). Adverse reactions and  detected interactions were collected. An unadjusted comparison was made  between the results of the available evidence and those of the study patients. 34 patients were treated, 50% were men, the median age was 58  years (38-80) and they presented ECOG 1 in 64.7%. Most of the treated  patients were diagnosed with advanced colorectal cancer, treated with  trifluridine-tipiracil, followed by palbociclib in breast cancer, obtaining results  similar to those of the evidence. The median PFS was 2.8 months (95% CI 0.8- 4.8) and the 8-month SG (95% CI 3.4-12.5) for all patients. 26% of patients  required dose reduction because of treatment toxicity. We found 13 interactions,  which affected 15 patients, only two of category X. The effectiveness of ANEO in special situations in our center is  similar to that of available evidence. The impact on survival is low and adverse  effects are common. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  4. The influence of situation awareness training on nurses' confidence about patient safety skills: A prospective cohort study.

    Science.gov (United States)

    Stomski, Norman; Gluyas, Heather; Andrus, Prue; Williams, Anne; Hopkins, Martin; Walters, Jennifer; Sandy, Martinique; Morrison, Paul

    2018-04-01

    Several studies report that patient safety skills, especially non-technical skills, receive scant attention in nursing curricula. Hence, there is a compelling reason to incorporate material that enhances non-technical skills, such as situation awareness, in nursing curricula in order to assist in the reduction of healthcare related adverse events. The objectives of this study were to: 1) understand final year nursing students' confidence in their patient safety skills; and 2) examine the impact of situation awareness training on final year nursing students' confidence in their patient safety skills. Participants were enrolled from a convenience sample comprising final year nursing students at a Western Australia university. Self-reported confidence in patient safety skills was assessed with the Health Professional in Patient Safety Survey before and after the delivery of a situation awareness educational intervention. Pre/post educational intervention differences were examined by repeated measures ANOVA. No significant differences in confidence about patient safety skills were identified within settings (class/clinical). However, confidence in patient safety skills significantly decreased between settings i.e. nursing students lost confidence after clinical placements. The educational intervention delivered in this study did not seem to improve confidence in patient safety skills, but substantial ceiling effects may have confounded the identification of such improvement. Further studies are required to establish whether the findings of this study can be generalised to other university nursing cohorts. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Situation-based social anxiety enhances the neural processing of faces: evidence from an intergroup context

    Science.gov (United States)

    Ofan, Renana H.; Rubin, Nava

    2014-01-01

    Social anxiety is the intense fear of negative evaluation by others, and it emerges uniquely from a social situation. Given its social origin, we asked whether an anxiety-inducing social situation could enhance the processing of faces linked to the situational threat. While past research has focused on how individual differences in social anxiety relate to face processing, we tested the effect of manipulated social anxiety in the context of anxiety about appearing racially prejudiced in front of a peer. Visual processing of faces was indexed by the N170 component of the event-related potential. Participants viewed faces of Black and White males, along with nonfaces, either in private or while being monitored by the experimenter for signs of prejudice in a ‘public’ condition. Results revealed a difference in the N170 response to Black and Whites faces that emerged only in the public condition and only among participants high in dispositional social anxiety. These results provide new evidence that anxiety arising from the social situation modulates the earliest stages of face processing in a way that is specific to a social threat, and they shed new light on how anxiety effects on perception may contribute to the regulation of intergroup responses. PMID:23709354

  6. Cooperative Games arising from Information Sharing Situations

    NARCIS (Netherlands)

    Brânzei, R.; Tijs, S.H.; Timmer, J.B.

    2000-01-01

    Relations are established between information sharing (IS) situations and IS-games on one hand and information collecting (IC) situations and IC-games on the other hand. It is shown that IC-games can be obtained as convex combinations of so-called local games. Properties are described which IC-games

  7. Situational Influences on Reactions to Observed Violence.

    Science.gov (United States)

    Berkowitz, Leonard

    1986-01-01

    Examines data on what situational factors influence people's desire to view violent television programming. Surveys research on the effects on viewer's behavior of the presence of other observers, the nature of the available target, situational features operating as retrieval cues, the viewers' interpretations of the violent scenes, and the…

  8. Management by Grid Principles or Situationalism: Which?

    Science.gov (United States)

    Blake, Robert R.; Mouton, Jane S.

    1981-01-01

    Attempts to resolve the leadership theory controversy between situationalism and the one-best-way approach. Indicates the validity of the latter and the lack of predictive value of the former. Results indicated administrators chose the 9,9 alternative and rejected situationally prescribed answers, reflecting a management by principles (behavioral…

  9. Imaging, virtual planning, design, and production of patient-specific implants and clinical validation in craniomaxillofacial surgery.

    Science.gov (United States)

    Dérand, Per; Rännar, Lars-Erik; Hirsch, Jan-M

    2012-09-01

    The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes(®), Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and

  10. Appraisals and impression management opportunities: person and situation influences on cardiovascular reactivity.

    Science.gov (United States)

    Heffner, Kathi L; Ginsburg, G P; Hartley, Terry R

    2002-05-01

    This study examined how threat and coping appraisals and impression management opportunities influenced cardiovascular reactivity within a self-presentation context. Participants were videotaped performing a speech that they believed might be evaluated. Participants' physiological responses were recorded 1 week later while: (a) watching their speech, indicating which portions they wished to re-shoot before it was evaluated,;(b) simply watching their speech; or (c) watching an architectural videotape and indicating which portions should be reshot, and also watching their own speech, but without evaluation concerns. Cardiovascular reactivity was influenced by the presence or absence of the impression management opportunity, but more variance in reactivity was explained when participants' threat and coping appraisals were also taken into account. The specific cardiovascular responses pertinent to goal-relevant action within each condition were the only responses related to appraisals. These findings emphasize the importance of considering both the situation and the state of the individual in that situation when attempting to understand social psychological influences on physiological reactivity.

  11. Towards an ethical theory in disaster situations.

    Science.gov (United States)

    Mallia, Pierre

    2015-02-01

    Health Care professionals working in disaster situations have to face urgent choices which diverge from their normal deontological ethos and are more utilitarian. Such is the triage system used to choose whom to treat. Instead of entering a crisis these professionals should be thought that ethics is not harmonizable to all situations and that there are situations in which saving as many lives as possible mean sacrificing others. This calls for defining a perimeter zone in which such choices occur, and a time frame (a space-time niche) in which it ought to be considered ethical and legitimate to use such value laden choices.

  12. Clinical effect of deep water running on non-specific low back pain: A randomised trial

    Directory of Open Access Journals (Sweden)

    A.I. Cuesta-Vargas

    2009-01-01

    Full Text Available Objectives: To evaluate clinical effect of deep water running(DW R on non-specific low back pain. Outcome measures were pain, disability,general health and physical fitness.  Materials and methods: Experimental, randomized,  controlled trial involving 46 persons with CLBP over 15 weekswith two experimental processes, each three times a week. Evidence-basedProgram (EBP, personalized physical exercise program, manual therapy andhealth educa tion was the common process to which was added 20 minutes ofpersonalized intensity DW R at the aerobic threshold. Measurements were made at the beginning and end of the studyof pain, disability, general health and physical fitness.  R esults: The pain of CLBP were homogeneous at baseline.Significant changes between group were don’t found for pain in favour of the EBP+DW R group (p<0.3. The within-group differences were highly significant for all clinical and functional variables. The effect was clinically relevant forpain in the EBP+DW R group (0.70 and in the EBP group (0.58, and for disability degree it was also relevant in theEBP+DW R group (0.48 and relevant for the EBP group (0.36. Conclusion: Significant improvement was seen inCLBP when EBP was complemented with the high-intensity exercise of DW R.

  13. Fundamental situations in teaching biology: The case of parthenogenesis

    Directory of Open Access Journals (Sweden)

    Robert Evans

    2012-06-01

    Full Text Available This theoretical paper considers the notion of fundamental situation in the sense of Brousseau’s theory of didactical situations. It introduces some precise elements of this theory in which a teacher provides an environment for student work that aims to enable students, through constructive inquiry, to acquire well defined pieces of scientific knowledge. Situations become fundamental if they not only allow, but force students to construct the target knowledge. A classical example from mathematics is presented, where the target knowledge is a theorem of plane geometry presented as a puzzle. Then a new fundamental situation in biology is described for parthenogenetic reproduction, which has recently turned out to occur in Komodo dragons. An explicit demand to generate and test hypotheses that could explain the given example of dragon reproduction, using authentic DNA data, is given to students. The paper concludes with an analysis of the extent to which this fundamental situation in biology is authentic to the theory of didactical situations.

  14. A situational approach to the measurement of safety culture

    International Nuclear Information System (INIS)

    Semmer, N.; Regennass, A.

    1997-01-01

    Values and social norms are the main target of most approaches to the study of safety culture and many existing survey methodologies directly ask for these norms and values. However, a number of considerations point to the dangers of limiting the evaluation of safety culture to the analysis of these responses. Therefore the necessity is stressed to also consider how actual situations activate norms and behaviours. This relates to the fact that in any given situation both aspects of the appraisal of reality are present: the objective definition of the situation and its personal evaluation. The latter not only reflects the ''official'' norms and values but also ''basic underlying assumptions''. The situational approach introduced in this paper confronts people with situations which contain a dilemma with conflicting social norms and where various costs and benefits are associated with different types of behaviour. In addition, the prerequisites and limitations of the situational approach are discussed. (author). 9 refs, 1 fig

  15. [Development, problems and results of specialty-specific genetic counseling at the Neurology Clinic of the Karl Marx University].

    Science.gov (United States)

    Bachmann, H

    1987-11-01

    Genetic counselling for inherited neurological diseases has been established at the Clinic for Neurology of Karl Marx University. Comprehensive experiences have been got with the specific and sometimes markedly different problems and aims of counselling in Wilsons disease, X-linked recessive muscular dystrophies, myotonic dystrophy and other neuromuscular disorders, Huntingtons chorea and hereditary ataxias.

  16. Using pathology-specific laboratory profiles in Clinical Pathology to reduce inappropriate test requesting: two completed audit cycles

    Science.gov (United States)

    2012-01-01

    Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the

  17. An experience in the clinical use of specific immunoglobulin from horse blood serum for prophylaxis of Ebola haemorrhagic fever.

    Science.gov (United States)

    Borisevich, I V; Chemikova, Natalya K; Markov, V I; Krasnianskiy, V P; Borisevich, S V; Rozhdestvenskiy, E V

    The aim of this work was to estimate the efficacy and safety of single intramuscular introduction of specific heterologous immunoglobulin as prophylactic drug against Ebola hemorrhagic fever. Materials and methods. The specific heterologous immunoglobulin was introduced as a special prophylactic drug to 28 patients in epidemic situations, after skin hurt with infectious materials or contact with infectious blood. Clinico-laboratory observation was performed in 24 subjects after single intramuscular introduction of heterologous immunoglobulin Ebola. The samples of blood serum were investigated for immunoglobulin Ebola and antibodies to horse gamma-globulin on the 30th and 60th days after prophylaxis. Results. None of the subjects of the study contracted Ebola fever. There were no anaphylactic reactions after special prophylaxis with specific heterologous immunoglobulin. Among the subjects with normal allergic state 31% responded with local reactions; 13%, with a general reaction (mild case of the serum disease). Almost no reaction was observed in patients with unfavorable allergic state subjected to desensitizing therapy; in the absence of desensitizing therapy, 50% of patients with unfavorable allergic state exhibited local reactions; 17%, mild cases of the serum disease; 33%, moderate cases of the serum disease. In summary, if the tactics of immunoglobulin application was right, the quantity of local allergic reactions was 28%; of wide spread reactions, 6%. Weak serum disease was observed in 11% of the subjects. The prognostic period of resistance to Ebola fever was less than 30 days. Conclusion. The prophylactic use of specific immunoglobulin from horse blood serum against hemorrhagic Ebola fever is effective and relatively safe in patients subjected to desensitizing therapy.

  18. Energy situation november 2002

    International Nuclear Information System (INIS)

    2002-12-01

    The monthly situation analysis in France is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

  19. Energy situation August 2002

    International Nuclear Information System (INIS)

    2002-09-01

    The monthly situation analysis in France is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

  20. Existential vulnerability: toward a psychopathology of limit situations.

    Science.gov (United States)

    Fuchs, Thomas

    2013-01-01

    Jaspers' concept of limit situations seems particularly appropriate not only to elucidate outstanding existential situations in general, but also basic preconditions for the occurrence of mental disorders. For this purpose, the concept is first explained in Jaspers' sense and then related to an 'existential vulnerability' of mentally ill persons that makes them experience even inconspicuous events as distressing limit situations. In such situations, an otherwise hidden fundamental condition of existence becomes manifest for them, e.g. the fragility of one's own body, the inevitability of freedom, or the finiteness of life. This fundamental condition is found unbearable and, as a reaction, gives rise to mental illness. This concept of existential vulnerability is illustrated by some psychopathological examples. © 2013 S. Karger AG, Basel.

  1. Situational Awareness and Logistics Division

    Data.gov (United States)

    Federal Laboratory Consortium — Volpe's Situational Awareness and Logistics Division researches, develops, implements, and analyzes advanced systems to protect, enhance, and ensure resilienceof the...

  2. Investigating Situational Interest in Primary Science Lessons

    Science.gov (United States)

    Loukomies, Anni; Juuti, Kalle; Lavonen, Jari

    2015-01-01

    Pupils' interest has been one of the major concerns in science education research because it can be seen as a gateway to more personalised forms of interest and motivation. However, methods to investigate situational interest in science teaching and learning are not broadly examined. This study compares the pupils' observed situational interest…

  3. Practicing discernment: pastoral care in crisis situations.

    Science.gov (United States)

    Landes, Scott D

    2010-01-01

    This article correlates a particular experience of providing pastoral care for a person in a crisis situation with a particular understanding of the practice of pastoral care. Through engaging in correlative practical theology, it highlights the need for practicing discernment when providing pastoral care for persons utilizing narratives to work through crisis situations.

  4. A Goal-Function Approach to Analysis of Control Situations

    DEFF Research Database (Denmark)

    Lind, Morten

    2010-01-01

    The concept of situations plays a central role in all theories of meaning and context. and serve to frame or group events and other occurrences into coherent meaningful wholes. Situations are typed, may be interconnected and organized into higher level structures. In operation of industrial...... processes situations should identify operational aspects relevant for control agent’s decision making in plant supervision and control. Control situations can be understood as recurrent and interconnected patterns of control with important implications for control and HMI design. Goal-Function approaches...

  5. Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe.

    Directory of Open Access Journals (Sweden)

    Francisco A Rojo-Vazquez

    Full Text Available Cystic echinococcosis (CE remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians.

  6. Cystic Echinococcosis in Spain: Current Situation and Relevance for Other Endemic Areas in Europe

    Science.gov (United States)

    Rojo-Vazquez, Francisco A.; Pardo-Lledias, Javier; Francos-Von Hunefeld, Marcelo; Cordero-Sanchez, Miguel; Alamo-Sanz, Rufino; Hernandez-Gonzalez, Ana; Brunetti, Enrico; Siles-Lucas, Mar

    2011-01-01

    Cystic echinococcosis (CE) remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians. PMID:21283615

  7. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    Directory of Open Access Journals (Sweden)

    Shahar eAyal

    2015-07-01

    Full Text Available A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

  8. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    Science.gov (United States)

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. PMID:26284011

  9. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors.

    Science.gov (United States)

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

  10. Face processing in chronic alcoholism: a specific deficit for emotional features.

    Science.gov (United States)

    Maurage, P; Campanella, S; Philippot, P; Martin, S; de Timary, P

    2008-04-01

    It is well established that chronic alcoholism is associated with a deficit in the decoding of emotional facial expression (EFE). Nevertheless, it is still unclear whether this deficit is specifically for emotions or due to a more general impairment in visual or facial processing. This study was designed to clarify this issue using multiple control tasks and the subtraction method. Eighteen patients suffering from chronic alcoholism and 18 matched healthy control subjects were asked to perform several tasks evaluating (1) Basic visuo-spatial and facial identity processing; (2) Simple reaction times; (3) Complex facial features identification (namely age, emotion, gender, and race). Accuracy and reaction times were recorded. Alcoholic patients had a preserved performance for visuo-spatial and facial identity processing, but their performance was impaired for visuo-motor abilities and for the detection of complex facial aspects. More importantly, the subtraction method showed that alcoholism is associated with a specific EFE decoding deficit, still present when visuo-motor slowing down is controlled for. These results offer a post hoc confirmation of earlier data showing an EFE decoding deficit in alcoholism by strongly suggesting a specificity of this deficit for emotions. This may have implications for clinical situations, where emotional impairments are frequently observed among alcoholic subjects.

  11. Ego-location and situational awareness in semistructured environments

    Science.gov (United States)

    Goodsell, Thomas G.; Snorrason, Magnus S.; Stevens, Mark R.; Stube, Brian; McBride, Jonah

    2003-09-01

    The success of any potential application for mobile robots depends largely on the specific environment where the application takes place. Practical applications are rarely found in highly structured environments, but unstructured environments (such as natural terrain) pose major challenges to any mobile robot. We believe that semi-structured environments-such as parking lots-provide a good opportunity for successful mobile robot applications. Parking lots tend to be flat and smooth, and cars can be uniquely identified by their license plates. Our scenario is a parking lot where only known vehicles are supposed to park. The robot looks for vehicles that do not belong in the parking lot. It checks both license plates and vehicle types, in case the plate is stolen from an approved vehicle. It operates autonomously, but reports back to a guard who verifies its performance. Our interest is in developing the robot's vision system, which we call Scene Estimation & Situational Awareness Mapping Engine (SESAME). In this paper, we present initial results from the development of two SESAME subsystems, the ego-location and license plate detection systems. While their ultimate goals are obviously quite different, our design demonstrates that by sharing intermediate results, both tasks can be significantly simplified. The inspiration for this design approach comes from the basic tenets of Situational Awareness (SA), where the benefits of holistic perception are clearly demonstrated over the more typical designs that attempt to solve each sensing/perception problem in isolation.

  12. The Farm Credit Situation: Implications for Agricultural Policy.

    Science.gov (United States)

    Bullock, J. Bruce

    1986-01-01

    Examines issues regarding current farm finance situation from a public policy perspective: origins and causes of current situation, available policy options for dealing with the problems, and impacts of policy options. (NEC)

  13. Towards a Food Safety Knowledge Base Applicable in Crisis Situations and Beyond

    Directory of Open Access Journals (Sweden)

    Alexander Falenski

    2015-01-01

    Full Text Available In case of contamination in the food chain, fast action is required in order to reduce the numbers of affected people. In such situations, being able to predict the fate of agents in foods would help risk assessors and decision makers in assessing the potential effects of a specific contamination event and thus enable them to deduce the appropriate mitigation measures. One efficient strategy supporting this is using model based simulations. However, application in crisis situations requires ready-to-use and easy-to-adapt models to be available from the so-called food safety knowledge bases. Here, we illustrate this concept and its benefits by applying the modular open source software tools PMM-Lab and FoodProcess-Lab. As a fictitious sample scenario, an intentional ricin contamination at a beef salami production facility was modelled. Predictive models describing the inactivation of ricin were reviewed, relevant models were implemented with PMM-Lab, and simulations on residual toxin amounts in the final product were performed with FoodProcess-Lab. Due to the generic and modular modelling concept implemented in these tools, they can be applied to simulate virtually any food safety contamination scenario. Apart from the application in crisis situations, the food safety knowledge base concept will also be useful in food quality and safety investigations.

  14. [Nostalgia as a state of mind and as a clinical form].

    Science.gov (United States)

    Borgna, E

    2001-01-01

    Psychiatry, as human science, necessarily concerns emotions too and, among these, nostalgia. Nostalgia is not only a mind condition but also a psychopathological and clinical state which can be defined nostalgic depression form. At the beginning of this work, on the base of a clinical case-report, we describe the phenomenological and space-temporal aspects of nostalgia, we analyse some psychopathological situations that, marked by nostalgic emotions, come from moving house, exile and rooting out. Each of these situations go with depression models thematically different, that are explained in the work.

  15. Hippocampal frequency shifts in different behavioural situations

    NARCIS (Netherlands)

    Kamp, A.; Lopes da Silva, F.H.; Storm van Leeuwen, W.

    1971-01-01

    Electrical activity of the dog's hippocampus was recorded in (a) an operant behaviour situation, and (b) a field situation by a radio-telemetering system. The dominant frequency of the theta rhythm shifted consistently from 4–5 c/sec to 6–7 c/sec when a dog (a) withdrew from a pedal after being

  16. Study on dynamic team performance evaluation methodology based on team situation awareness model

    International Nuclear Information System (INIS)

    Kim, Suk Chul

    2005-02-01

    The purpose of this thesis is to provide a theoretical framework and its evaluation methodology of team dynamic task performance of operating team at nuclear power plant under the dynamic and tactical environment such as radiological accident. This thesis suggested a team dynamic task performance evaluation model so called team crystallization model stemmed from Endsely's situation awareness model being comprised of four elements: state, information, organization, and orientation and its quantification methods using system dynamics approach and a communication process model based on a receding horizon control approach. The team crystallization model is a holistic approach for evaluating the team dynamic task performance in conjunction with team situation awareness considering physical system dynamics and team behavioral dynamics for a tactical and dynamic task at nuclear power plant. This model provides a systematic measure to evaluate time-dependent team effectiveness or performance affected by multi-agents such as plant states, communication quality in terms of transferring situation-specific information and strategies for achieving the team task goal at given time, and organizational factors. To demonstrate the applicability of the proposed model and its quantification method, the case study was carried out using the data obtained from a full-scope power plant simulator for 1,000MWe pressurized water reactors with four on-the-job operating groups and one expert group who knows accident sequences. Simulated results team dynamic task performance with reference key plant parameters behavior and team-specific organizational center of gravity and cue-and-response matrix illustrated good symmetry with observed value. The team crystallization model will be useful and effective tool for evaluating team effectiveness in terms of recruiting new operating team for new plant as cost-benefit manner. Also, this model can be utilized as a systematic analysis tool for

  17. Study on dynamic team performance evaluation methodology based on team situation awareness model

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Suk Chul

    2005-02-15

    The purpose of this thesis is to provide a theoretical framework and its evaluation methodology of team dynamic task performance of operating team at nuclear power plant under the dynamic and tactical environment such as radiological accident. This thesis suggested a team dynamic task performance evaluation model so called team crystallization model stemmed from Endsely's situation awareness model being comprised of four elements: state, information, organization, and orientation and its quantification methods using system dynamics approach and a communication process model based on a receding horizon control approach. The team crystallization model is a holistic approach for evaluating the team dynamic task performance in conjunction with team situation awareness considering physical system dynamics and team behavioral dynamics for a tactical and dynamic task at nuclear power plant. This model provides a systematic measure to evaluate time-dependent team effectiveness or performance affected by multi-agents such as plant states, communication quality in terms of transferring situation-specific information and strategies for achieving the team task goal at given time, and organizational factors. To demonstrate the applicability of the proposed model and its quantification method, the case study was carried out using the data obtained from a full-scope power plant simulator for 1,000MWe pressurized water reactors with four on-the-job operating groups and one expert group who knows accident sequences. Simulated results team dynamic task performance with reference key plant parameters behavior and team-specific organizational center of gravity and cue-and-response matrix illustrated good symmetry with observed value. The team crystallization model will be useful and effective tool for evaluating team effectiveness in terms of recruiting new operating team for new plant as cost-benefit manner. Also, this model can be utilized as a systematic analysis tool for

  18. Radiation. Basics, influences, contamination situation, and countermeasures

    International Nuclear Information System (INIS)

    Baba, Mamoru; Nomura, Kiyoshi

    2012-01-01

    Fukushima Daiichi Nuclear Accident resulted in the contamination of a large area, and by now the situation of contamination and exposure has gradually clarified, and a lot of information has been being accumulated. Toward reconstruction of Fukushima prefecture from the current circumstance that the residents still live under continuing fear, this article discusses how to clarify the current situation and deal with the contamination, which the residents are concerned about. First, radiation, basic properties of radiation, and so on are introduced. Regarding the influence on human bodies, the mechanism and the degree of influence by radiation, especially on children, women, and pregnant women are explained. Next, regarding the measurements of radiation and radioactivity, the properties of measurement methods and the detectors are explained. Regarding the current situation of contamination and exposure, mainly addressing the area around Koriyama city, various topics are covered including: (1) situation of contamination and radiation monitoring, (2) countermeasures for radioactivity contamination, (3) internal exposure dose, (4) exposed dose from water and food, as well as (5) safety standards. (S.K.)

  19. Conflict Resolution Automation and Pilot Situation Awareness

    Science.gov (United States)

    Dao, Arik-Quang V.; Brandt, Summer L.; Bacon, Paige; Kraut, Josh; Nguyen, Jimmy; Minakata, Katsumi; Raza, Hamzah; Rozovski, David; Johnson, Walter W.

    2010-01-01

    This study compared pilot situation awareness across three traffic management concepts. The Concepts varied in terms of the allocation of traffic avoidance responsibility between the pilot on the flight deck, the air traffic controllers, and a conflict resolution automation system. In Concept 1, the flight deck was equipped with conflict resolution tools that enable them to fully handle the responsibility of weather avoidance and maintaining separation between ownship and surrounding traffic. In Concept 2, pilots were not responsible for traffic separation, but were provided tools for weather and traffic avoidance. In Concept 3, flight deck tools allowed pilots to deviate for weather, but conflict detection tools were disabled. In this concept pilots were dependent on ground based automation for conflict detection and resolution. Situation awareness of the pilots was measured using online probes. Results showed that individual situation awareness was highest in Concept 1, where the pilots were most engaged, and lowest in Concept 3, where automation was heavily used. These findings suggest that for conflict resolution tasks, situation awareness is improved when pilots remain in the decision-making loop.

  20. Enriching Mental Health Mobile Assessment and Intervention with Situation Awareness.

    Science.gov (United States)

    Soares Teles, Ariel; Rocha, Artur; José da Silva E Silva, Francisco; Correia Lopes, João; O'Sullivan, Donal; Van de Ven, Pepijn; Endler, Markus

    2017-01-10

    Current mobile devices allow the execution of sophisticated applications with the capacity for identifying the user situation, which can be helpful in treatments of mental disorders. In this paper, we present SituMan , a solution that provides situation awareness to MoodBuster , an ecological momentary assessment and intervention mobile application used to request self-assessments from patients in depression treatments. SituMan has a fuzzy inference engine to identify patient situations using context data gathered from the sensors embedded in mobile devices. Situations are specified jointly by the patient and mental health professional, and they can represent the patient's daily routine (e.g., "studying", "at work", "working out"). MoodBuster requests mental status self-assessments from patients at adequate moments using situation awareness. In addition, SituMan saves and displays patient situations in a summary, delivering them for consultation by mental health professionals. A first experimental evaluation was performed to assess the user satisfaction with the approaches to define and identify situations. This experiment showed that SituMan was well evaluated in both criteria. A second experiment was performed to assess the accuracy of the fuzzy engine to infer situations. Results from the second experiment showed that the fuzzy inference engine has a good accuracy to identify situations.