WorldWideScience

Sample records for syringe access programs

  1. Injection drug users report good access to pharmacy sale of syringes.

    Science.gov (United States)

    Reich, Wendy; Compton, Wilson M; Horton, Joeseph C; Cottler, Linda B; Cunningham-Williams, Renee M; Booth, Robert; Singer, Merrill; Leukefeld, Carl; Fink, Joseph; Stopka, Tom J; Corsi, Karen Fortuin; Tindall, Michelle Staton

    2002-01-01

    To examine injection drug users (IDUs) opinions and behavior regarding purchase of sterile syringes from pharmacies. Focus groups. Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri. Eight focus groups, with 4 to 15 IDU participants per group. Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of the software program NUD*IST. Knowledge of human immunodeficiency virus (HIV), pharmacy use, barriers to access from pharmacies, high-risk and risk-reducing behavior, and rural/urban difference. Almost all participants knew the importance of using sterile syringes for disease prevention and reported buying syringes from pharmacies more than from any other source. Two IDUs believed pharmacists knew the syringes were being used for injecting drugs and perceived pharmacists' sales of syringes to be an attempt to contribute to HIV prevention. Most IDUs reported that sterile syringes were relativity easy to buy from pharmacies, but most also reported barriers to access, such as having to buy in packs of 50 or 100, being made to sign a book, having to make up a story about being diabetic, or having the feeling that the pharmacists were demeaning them. While the majority of IDUs reported properly cleaning or not sharing syringes and safely disposing of them, others reported inadequate cleaning of syringes and instances of sharing syringes or of improper disposal. There were few differences in IDUs' reported ability to buy syringes among states or between urban and rural sites, although the data suggest that IDUs could buy syringes more easily in the urban settings. For the most part, participants understood the need for sterile syringes in order to protect themselves from HIV, hepatitis B virus, and hepatitis C virus and saw pharmacies as the best source of sterile syringes. Although these data are not generalizable, they suggest that pharmacists can and do serve as HIV-prevention service providers in

  2. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    Science.gov (United States)

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  3. Commentary on Vorobjov et al., "Comparison of injection drug users who obtain syringes from pharmacies and syringe exchange programs in Tallinn, Estonia"

    Directory of Open Access Journals (Sweden)

    Werb Daniel

    2009-01-01

    Full Text Available Abstract Recent data suggest that globally, between 5% and 10% of all new HIV cases are the result of unsafe injecting practices, and experts agree that reducing these practices is key to tackling the spread of HIV. And yet, despite the overwhelming evidence that providing sterile syringes to injection drug users (IDU through syringe exchange programs (SEPs or other means is an effective way of reducing HIV transmission among high-risk subpopulations, IDU in most settings still do not have access to sterile injecting equipment or if they do, access remains too restricted to effectively reduce the risk of HIV transmission. Vorobjov and colleagues have presented in this journal an interesting and timely study from Estonia comparing individuals who obtain syringes from SEPs and those who obtain syringes from pharmacies. As the authors point out, Estonia faces an unacceptably high HIV incidence rate of 50 new HIV cases per 100,000, this rate driven primarily by injection drug use. As such, the authors argue that Estonia's SEP network does not have the capacity to serve a growing IDU population at risk of transmitting HIV and pharmacy dispensation of clean syringes may be one potential approach to decreasing syringe sharing among high-risk injectors. It may be overly optimistic to consider the impact of higher threshold interventions such as pharmacy-based SEPs, given that IDU populations that engage in HIV risk behaviours such as syringe sharing are often hidden or hard to reach. Despite the need for a cautious approach, however, the findings presented by Vorobjov et al. may chart one potential course towards a more comprehensive societal response to reducing the health harms associated with injection drug use.

  4. Access to sterile syringes for injecting drug users in New York City: politics and perception (1984-2010).

    Science.gov (United States)

    Heller, Daliah; Paone, Denise

    2011-01-01

    In the United States, political and social environments have shaped public health response to injecting drug use, and New York City represents a salient example. The history of "harm reduction" in New York City is characterized within changing historical periods and in relation to the actions of stakeholders. The expansion is traced over four periods: (i) 1984-1989: emergence, activism, and science; (ii) 1990-1994 reckoning: syringe exchange legislation and consolidation; (iii) 1995-1999: bureaucratization, opposition, and challenges to institutional control; and (iv) 2000-2010 revitalization: expansion of syringe access and harm reduction. It is clear from this review that the leadership of activism and the work of advocates catalyzed syringe access policy and practice. Without this "push," it is unlikely that New York City would have experienced the dramatic decline in HIV infection among drug injectors in the 1990s. Second, successful arguments for expanding syringe access in New York City were based on the high HIV/AIDS infection rates. Thus, program developments were advocated as HIV prevention interventions, rather than as expanded services for addressing broader health and social issues of injecting drug use.

  5. Unstable housing as a factor for increased injection risk behavior at US syringe exchange programs.

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    Des Jarlais, Don C; Braine, Naomi; Friedmann, Patricia

    2007-11-01

    To assess variation in injection risk behavior among unstably housed/homeless injecting drug users (IDUs) across programs in a national sample of US syringe exchange programs. About 23 syringe exchange programs were selected through stratified random sampling of moderate to very large US syringe exchange programs operating in 2001-2005. Subjects at each program were randomly sampled. Risk behavior interviews were collected using audio-computer assisted self-interviewing (A-CASI). "Unstable housing/homelessness" was operationally defined as having lived "on the street or in a shanty" or "living in a shelter or single room occupancy hotel (SRO)" at any time in the 6 months prior to the interview. "Receptive sharing" was operationally defined as having injected with a needle or syringe that "had been used by someone else" in the 30 days prior to the interview. Six very large and nine moderate-to-large programs had at least 50 subjects who reported unstable housing, and these 15 programs were used in the analyses. There was considerable variation among the 15 programs in the percentages of unstably housed participants (range from 35 to 74%, P lack of significant variation in the odds ratios for increased injection risk suggests that none of the programs were "better" or "worse" at reducing injection risk behavior among unstably housed participants. Reduction in injecting risk behavior among syringe exchange participants may require greater efforts to provide stable housing or the development of dramatically new interventions to reduce injecting risk behavior among IDUs with persistent unstable housing.

  6. HIV Risk Behavior among Amphetamine Injectors at U.S. Syringe Exchange Programs

    Science.gov (United States)

    Braine, Naomi; Des Jarlais, Don C.; Goldblatt, Cullen; Zadoretzky, Cathy; Turner, Charles

    2005-01-01

    The goal of this study was to compare HIV risk behaviors of amphetamine and non-amphetamine injectors at syringe exchange programs (SEP) in the United States and to identify factors associated with injection risk. This analysis is based on data from a random cross-section of participants at 13 SEPs in different parts of the country. All interviews…

  7. Housing Instability among People Who Inject Drugs: Results from the Australian Needle and Syringe Program Survey

    OpenAIRE

    Topp, Libby; Iversen, Jenny; Baldry, Eileen; Maher, Lisa

    2012-01-01

    High rates of substance dependence are consistently documented among homeless people, and are associated with a broad range of negative outcomes among this population. Investigations of homelessness among drug users are less readily available. This study examined the prevalence and correlates of housing instability among clients of needle syringe programs (NSPs) via the Australian NSP Survey, annual cross-sectional seroprevalence studies among NSP attendees. Following self-completion of a bri...

  8. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

    Science.gov (United States)

    Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

    2016-12-01

    This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.

  9. Negotiating access: Social barriers to purchasing syringes at pharmacies in Tijuana, Mexico

    Science.gov (United States)

    Davidson, Peter J.; Lozada, Remedios; Rosen, Perth C.; Macias, Armando; Gallardo, Manuel; Pollini, Robin A.

    2012-01-01

    Background One common public health response to the emergence of HIV has been the provision of sterile syringes to people who inject drugs. In Mexico specialized syringe exchanges are rare, and the sale of needles through pharmacies is often the only way people who inject drugs can obtain sterile syringes. However, people who inject drugs in Tijuana, Mexico report considerable social barriers to successfully purchasing syringes at pharmacies. Methods Between October 2008 and March 2009 we conducted seven in-depth focus groups with 47 people who inject drugs in Tijuana, Mexico. Focus group transcripts were analysed using a descriptive and thematic approach rooted in grounded theory. Results We found that injectors offered a number of explanations for why pharmacies were reluctant to sell them syringes, including fear of police; attitudes toward drug use; fear of stereotypical drug user behaviour such as petty theft, violence, or distressing behaviour; and related fears that an obvious drug using clientèle would drive away other customers. Injectors described a range of ways of attempting to re-frame or negotiate interactions with pharmacy staff so that these and related concerns were ameliorated. These included tactics as simple as borrowing cleaner clothing, through to strategies for becoming ‘known’ to pharmacy staff as an individual rather than as a member of a stigmatized group. Conclusion Increasing the ability of pharmacy staff and people who inject drugs to successfully negotiate syringe sales are highly desirable. Interventions designed to improve this likelihood need to capitalize on existing solutions developed ad-hoc by people who inject drugs and pharmacy staff, and should focus on broadening the range of ‘identities’ which pharmacy staff are able to accept as legitimate customers. Approaches to achieve this end might include sensitizing pharmacy staff to the needs of people who inject drugs; facilitating individual drug users meeting individual

  10. Social marketing of low dead space syringes in Vietnam: findings from a 1-year pilot program in Hanoi, Thai Nguyen, and Ho Chi Minh City.

    Science.gov (United States)

    Huong, Ngo Thi Thanh; Mundy, Gary; Neukom, Josselyn; Zule, William; Tuan, Nguyen Minh; Tam, Nguyen Minh

    2015-05-30

    Although a growing body of evidence suggests that low dead space syringes may reduce the risk of human immunodeficiency virus (HIV) and Hepatitis C virus infection associated with sharing syringes among people who inject drugs, there is little evidence of effective approaches to motivate people who inject drugs (PWID) to shift from high to low dead space syringes. Using a mix of consumer and trade marketing approaches, informed by rapid assessments of both the syringe market and PWID preferences, practices, and behaviors in Hanoi and Ho Chi Minh City, Population Services International (PSI) Vietnam piloted an intervention to increase the use of low dead space syringes (LDSS) in the three provinces of Hanoi, Ho Chi Minh City, and Thai Nguyen, where an estimated 31% of PWID are HIV positive and 58% are living with hepatitis C virus (HCV). This paper provides a summary of the social marketing activities implemented and results achieved by PSI Vietnam during an initial 1-year pilot period from December 2012 to December 2013 in these three provinces to explore their effectiveness in motivating PWID to use low dead space syringes. We found major increases in sales of LDSS accompanied by increases in reported use and consistent use of LDSS among PWID in the three provinces included in the pilot program and a positive and independent association (odds ratio (OR) 21.08; 95% confidence interval (CI) 10.6-27.3) between LDSS use and exposure to social marketing activities. We also found that LDSS use had a stronger association with perceptions of LDSS product quality than with perceptions regarding LDSS potential to reduce HIV transmission risk and use. We conclude that social marketing interventions have an important role to play in widening access to and the use of LDSS for PWID, as they address the need for PWID to find LDSS when and where they need them and also promote the benefits of LDSS use to PWID. High coverage of these activities among PWID appears to be the key in

  11. Needle and syringe programs in Yunnan, China yield health and financial return

    Directory of Open Access Journals (Sweden)

    Xun Zhuang

    2011-04-01

    Full Text Available Abstract Background As a harm reduction strategy in response to HIV epidemics needle and syringes programs (NSPs were initiated throughout China in 2002. The effectiveness of NSPs in reducing the spread of infection in such an established epidemic is unknown. In this study we use data from Yunnan province, the province most affected by HIV in China, to (1 estimate the population benefits in terms of infections prevented due to the programs; (2 calculate the cost-effectiveness of NSPs. Methods We developed a mathematical transmission model, informed by detailed behavioral and program data, which accurately reflected the unique HIV epidemiology among Yunnan injecting drug users (IDUs in the presence of NSPs. We then used the model to estimate the likely epidemiological and clinical outcomes without NSPs and conducted a health economics analysis to determine the cost-effectiveness of the program. Results It is estimated that NSPs in Yunnan have averted approximately 16-20% (5,200-7,500 infections of the expected HIV cases since 2002 and led to gains of 1,300-1,900 DALYs. The total $1.04 million spending on NSPs from 2002 to 2008 has resulted in an estimated cost-saving over this period of $1.38-$1.97 million due to the prevention of HIV and the associated costs of care and management. Conclusion NSPs are not only cost-effective but cost-saving in Yunnan. Significant scale-up of NSPs interventions across China and removal of the societal and political barriers that compromise the effects of NSPs should be a health priority of the Chinese government.

  12. Syringe sociology.

    Science.gov (United States)

    Vitellone, Nicole

    2015-06-01

    In this article I consider the impact of social epistemologies for understanding the object of the syringe. My aim is to examine the process through which the syringe transforms from an injecting device to a tool of social and political inquiry. Paying particular attention to the uses of Foucault, Becker, Bourdieu, Freud and Latour in empirical studies of injecting heroin use, I examine the sociology of the syringe through the lens of habit and habitus, discourse and deviance, mourning and melancholia, attachment and agencement. In pursuing the theory behind the object my goal is to address a sociological object in the making. In so doing I show how the syringe has been significant for social research, social theory, and sociology. It is the difference the object makes that this article seeks to describe. In tracing the epistemology of the syringe I show how the object is important not just for knowledge of addiction but sociology itself. © London School of Economics and Political Science 2015.

  13. Housing instability among people who inject drugs: results from the Australian needle and syringe program survey.

    Science.gov (United States)

    Topp, Libby; Iversen, Jenny; Baldry, Eileen; Maher, Lisa

    2013-08-01

    High rates of substance dependence are consistently documented among homeless people, and are associated with a broad range of negative outcomes among this population. Investigations of homelessness among drug users are less readily available. This study examined the prevalence and correlates of housing instability among clients of needle syringe programs (NSPs) via the Australian NSP Survey, annual cross-sectional seroprevalence studies among NSP attendees. Following self-completion of a brief, anonymous survey and provision of a capillary blood sample by 2,396 NSP clients, multivariate logistic regressions identified the variables independently associated with housing instability. Nineteen percent of ANSPS participants reported current unstable housing, with primary ('sleeping rough'; 5 %), secondary (staying with friends/relatives or in specialist homelessness services; 8 %), and tertiary (residential arrangements involving neither secure lease nor private facilities; 6 %) homelessness all evident. Extensive histories of housing instability were apparent among the sample: 66 % reported at least one period of sleeping rough, while 77 % had shifted between friends/relatives (73 %) and/or resided in crisis accommodation (52 %). Participants with a history of homelessness had cycled in and out of homelessness over an average of 10 years; and one third reported first being homeless before age 15. Compared to their stably housed counterparts, unstably housed participants were younger, more likely to be male, of Indigenous Australian descent, and to report previous incarceration; they also reported higher rates of key risk behaviors including public injecting and receptive sharing of injecting equipment. The high prevalence of both historical and current housing instability among this group, particularly when considered in the light of other research documenting the many adverse outcomes associated with this particular form of disadvantage, highlights the need

  14. Effects of an Intensive Street-Level Police Intervention on Syringe Exchange Program Use in Philadelphia, Pa

    Science.gov (United States)

    Davis, Corey S.; Burris, Scott; Kraut-Becher, Julie; Lynch, Kevin G.; Metzger, David

    2005-01-01

    Repeated measurements and mixed-effects models were used to analyze the effects of an intensive long-term street-level police intervention on syringe exchange program use. Utilization data for 9 months before and after the beginning of the intervention were analyzed. Use fell across all categories and time periods studied, with significant declines in use among total participants, male participants, and Black participants. Declines in use among Black and male participants were much more pronounced than decreases among White and female participants. PMID:15671455

  15. Decomposition of Economic Inequality in Needle and Syringe Programs Utilization to its Determinants among Men Who Inject Drugs in Tehran using Blinder-Oaxaca Decomposition Method.

    Science.gov (United States)

    Noroozi, Mehdi; Rahimi, Ebrahim; Ghisvand, Hessam; Qorbani, Mostafa; Sharifi, Hamid; Noroozi, Alireza; Farhoudian, Ali; Marshall, Brandon D L; Jorjoran Shoshtari, Zahra; Karimi, Salah Eddin; Rezaei, Omid; Armoon, Bahram

    2017-11-22

    According to latest available data there are more of 300,000 people injects drug users (PWID) in Iran. In this study, we used a Blinder-Oaxaca (BO) decomposition to explore the relative contributions of inequality in utilization of NSPs and to decompose it to its determinants in Teheran. We used data from a cross-sectional survey using snowball sampling to recruit 500 PWID from June to July 2016 in Tehran. Participants were reported injecting drug use in the past month, were able to speak and comprehend Farsi enough to respond to survey questions, and were able to provide informed consent to complete the interview. We used a BO method to decompose the role of economic inequality on utilization of needle and syringe programs. A total 520 of clients participated in the study of which data was fully complete for 500. The selected predictor variables (age, education level, marital status, homelessness, HIV risk perception, and HIV knowledge) together explain 54% (8.5% out of 16%) of total inequality in utilization of needle and syringe programs and the remaining 46% constitute the unexplained residual. HIV risk perception status contributed about 38% (3.3% out of 8.5%) to the total health inequality, followed by HIV knowledge (26%) and education level were contributed 20% each, respectively. The results showed that contribution of economic inequalities in utilization of NSPs was primarily explained by the differential effects of HIV risk perception and HIV knowledge among PWID. Reducing HIV risk perception and increasing HIV knowledge might be essential to efforts to eliminate inequalities in access to NSPs among PWID.

  16. Professional Access 2013 programming

    CERN Document Server

    Hennig, Teresa; Hepworth, George; Yudovich, Dagi (Doug)

    2013-01-01

    Authoritative and comprehensive coverage for building Access 2013 Solutions Access, the most popular database system in the world, just opened a new frontier in the Cloud. Access 2013 provides significant new features for building robust line-of-business solutions for web, client and integrated environments.  This book was written by a team of Microsoft Access MVPs, with consulting and editing by Access experts, MVPs and members of the Microsoft Access team. It gives you the information and examples to expand your areas of expertise and immediately start to develop and upgrade projects. Exp

  17. The effect of on-site and outreach-based needle and syringe programs in people who inject drugs in Kermanshah, Iran.

    Science.gov (United States)

    Nazari, Seyed Saeed Hashemi; Noroozi, Mehdi; Soori, Hamid; Noroozi, Alireza; Mehrabi, Yadollah; Hajebi, Ahmad; Sharifi, Hamid; Higgs, Peter; Mirzazadeh, Ali

    2016-01-01

    Needle and syringe programs (NSPs) are widely used to reduce harms associated with drug injecting. This study assessed the effect of facility-based (on-site services at drop-in centre) and outreach models of NSP on injection risk behaviours. Self-reported data from 455 people who injected drugs (PWID) during 2014 in Kermanshah, Iran, were examined to measure demographic characteristics and risk behaviors. Self-reported and program data were also assessed to identify their main source of injection equipment. Participants were divided into three sub-groups: facility-based NSP users, outreach NSP users and non-users (comparison group). Coarsened exact matching was used to make the three groups statistically equivalent based on age, place of residence, education and income, and groups were compared regarding the proportion of borrowing or lending of syringes/cookers, reusing syringes and recent HIV testing. Overall, 76% of participants reported any NSP service use during the two months prior to interview. Only 23% (95%CI: 17-27) reported outreach NSP as their main source of syringes. Using facility-based NSP significantly decreased recent syringe borrowing (OR: 0.27, 95%CI: 0.10-0.70), recent syringe reuse (OR: 0.38, 95%CI: 0.23-0.68) and increased recent HIV testing (OR: 2.60, 95%CI: 1.48-4.56). Similar effects were observed among outreach NSP users; in addition, the outreach NSP model significantly reduced the chance of lending syringes (OR: 0.31, 95%CI: 0.15-0.60), compared to facility-based NSP (OR: 1.25, 95%CI: 0.74-2.17). These findings suggest that the outreach NSP model is as effective as facility-based NSP in reducing injection risk behaviours and increasing the rate of HIV testing. Outreach NSP was even more effective than facility-based in reducing the lending of syringes to others. Scaling up outreach NSP is an effective intervention to further reduce transmission of HIV via needle sharing. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

    Science.gov (United States)

    Strike, Carol; Miskovic, Miroslav

    2018-02-08

    Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts

  19. Do needle and syringe programs reduce risky behaviours among people who inject drugs in Kermanshah City, Iran? A coarsened exact matching approach.

    Science.gov (United States)

    Noroozi, Mehdi; Marshall, Brandon D L; Noroozi, Alireza; Armoon, Bahram; Sharifi, Hamid; Farhoudian, Ali; Ghiasvand, Hesam; Vameghi, Meroe; Rezaei, Omid; Sayadnasiri, Mohammad; Pouya, Rokhsane Hosseini

    2017-12-21

    In this study, we used a 'coarsened exact matching' method to evaluate the relationship between two levels of needle and syringe program (NSP) utilisation and HIV-related risk behaviours among people who inject drugs (PWID). Using snowball sampling, we recruited 500 PWID (all male) in Kermanshah City, Iran between September and December 2014 in a cross-sectional survey. We categorised participants into two groups, including high (i.e. receiving 60% or more of their syringes from an NSP) and low (i.e. receiving less than 60% of their syringes from NSP) NSP users. Then, we applied coarsened exact matching to match the two groups based on confounding covariates (age, place of residence, income, receiving methadone maintenance treatment) and made statistically equivalent comparison groups to estimate the effect of the NSP on injection risk behaviours. Participants with low NSP use were more likely to report borrowing syringes in past 2 months (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.30, 1.86; P Kermanshah, Iran. Expanded coverage of high-quality NSPs is recommended. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  20. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

    Directory of Open Access Journals (Sweden)

    Glickman Andrea

    2010-01-01

    Full Text Available Abstract Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

  1. AVLIS industrial access program

    International Nuclear Information System (INIS)

    1984-01-01

    This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures

  2. AVLIS industrial access program

    Energy Technology Data Exchange (ETDEWEB)

    1984-11-15

    This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures.

  3. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    Energy Technology Data Exchange (ETDEWEB)

    Santos, J.A.M. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)], E-mail: a.miranda@portugalmail.pt; Carrasco, M.F. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Lencart, J. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Bastos, A.L. [Servico de Medicina Nuclear, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)

    2009-06-15

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for {sup 99m}Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  4. Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

    Science.gov (United States)

    Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

    2017-06-29

    Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

  5. High coverage needle/syringe programs for people who inject drugs in low and middle income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Des Jarlais Don C

    2013-01-01

    Full Text Available Abstract Background Persons who inject drugs (PWID are at an elevated risk for human immunodeficiency virus (HIV and hepatitis C virus (HCV infection. In many high-income countries, needle and syringe exchange programs (NSP have been associated with reductions in blood-borne infections. However, we do not have a good understanding of the effectiveness of NSP in low/middle-income and transitional-economy countries. Methods A systematic literature review based on PRISMA guidelines was utilized to collect primary study data on coverage of NSP programs and changes in HIV and HCV infection over time among PWID in low-and middle-income and transitional countries (LMICs. Included studies reported laboratory measures of either HIV or HCV and at least 50% coverage of the local injecting population (through direct use or through secondary exchange. We also included national reports on newly reported HIV cases for countries that had national level data for PWID in conjunction with NSP scale-up and implementation. Results Studies of 11 NSPs with high-coverage from Bangladesh, Brazil, China, Estonia, Iran, Lithuania, Taiwan, Thailand and Vietnam were included in the review. In five studies HIV prevalence decreased (range −3% to −15% and in three studies HCV prevalence decreased (range −4.2% to −10.2%. In two studies HIV prevalence increased (range +5.6% to +14.8%. HCV incidence remained stable in one study. Of the four national reports of newly reported HIV cases, three reported decreases during NSP expansion, ranging from −30% to −93.3%, while one national report documented an increase in cases (+37.6%. Estimated incidence among new injectors decreased in three studies, with reductions ranging from −11/100 person years at risk to −16/100 person years at risk. Conclusions While not fully consistent, the data generally support the effectiveness of NSP in reducing HIV and HCV infection in low/middle-income and transitional-economy countries. If

  6. 77 FR 66052 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... delivered, cable-affiliated RSNs in the 2010 Program Access Order. 3. With respect to the first element (the... exclusive contract involving a cable-affiliated RSN is an ``unfair act.'' In the 2010 Program Access Order... Agreements 18. ACA also urges the Commission to revise the program access rules to prohibit cable-affiliated...

  7. A Multi-Center Randomized Controlled Trial of Adding Brief Skill-Based Psychoeducation to Primary Needle and Syringe Programs to prevent Human Immunodeficiency Virus: Study Protocol.

    Directory of Open Access Journals (Sweden)

    Morteza Naserbakht

    2014-09-01

    Full Text Available Our objective was to design an RCT in order to assess the effects of adding a brief skill-based psychoeducation (PE to routine Needle and Syringe Programs to reduce injection and high risk sexual behaviors associated with Human Immunodeficiency Virus (HIV infection among referrals of Drop-in Centers (DICs.This was a randomized control trial with the primary hypothesis that adding skill-based PE to the routine needle syringe program (NSP provided in the DICs would be more effective in reducing injection and high risk sexual behaviors associated with HIV infection compared to the routine programs. We intended to randomly allocate 60 patients per group after obtaining informed written consent,. The intervention group receive a combination of brief psychoeducation consisting two individual sessions of skill-based education concerning blood borne viral infection, specifically HIV. The control group received the routine primary NSP services provided in DIC. Study assessments were undertaken by a psychologist at baseline, 1 and 3 months after recruitment. The primary outcome measure was the comparison of the trend of alterations in high risk sexual and injection behaviors associated with HIV infection during 3 months after the initiation of the intervention between the two groups. Secondary outcome measures included the comparison of HIV/AIDS related knowledge and client satisfaction in the participants.This paper presents a protocol for an RCT of brief skill-based PE by a trained psychologist to reduce the sexual and injection related high risk behaviors among drug users who received primary NSP services in DIC. This trial tried to investigate the efficacy of the intervention on increasing HIV/AIDS related knowledge and client satisfaction. The results of different indicators of high risk behaviors will be discussed.

  8. Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

    Science.gov (United States)

    Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M

    2013-09-01

    Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

  9. Lower syringe sharing and re-use after syringe legalization in Rhode Island.

    Science.gov (United States)

    Rich, Josiah D; Hogan, Joseph W; Wolf, Francis; DeLong, Allison; Zaller, Nickolas D; Mehrotra, Meenakshi; Reinert, Steven

    2007-07-10

    Increased access to sterile syringes reduces the transmission of HIV, viral hepatitis and other infectious diseases, without increasing injection drug use. In Rhode Island, in 2000, syringes were legalized to reduce spread of disease but remained outlawed in Massachusetts until 2006. Drug users undergoing inpatient detoxification in Rhode Island and Massachusetts were surveyed about their syringe usage between October 2001 and August 2003. Two hundred forty-seven Rhode Island, and 226 Massachusetts inpatients completed surveys. Of these, 61% (n=151) from Rhode Island and 46% (n=105) from Massachusetts reported injecting within 6 months. Respondents from Rhode Island reported reusing a syringe in the last 30 days less often than Massachusetts respondents (0.35 versus 0.50; 95% CI on difference 0.01-0.29). Syringe re-use and sharing among drug injectors in Rhode Island was markedly lower than in Massachusetts. This difference is attributed at least in part to the legalization of non-prescription sterile syringes in Rhode Island in 2000. Laws and policies that increase legal syringe availability can decrease injection related transmission of HIV and other infectious diseases.

  10. Safer Disposable Syringe

    OpenAIRE

    Swann, David

    2013-01-01

    Injections are one of the most common healthcare procedures performed in the world and the most deadly. Each year 16 billion injections are delivered using a pre-used syringe. This action kills 1.3 million patients and accounts for 26-million life years lost and 32% of all new Hepatitis B cases. To prevent such violations the auto-destruct syringe was introduced in 1986. This device has since become a prerequisite tool for immunization programmes (95%) but only used for 5% of all curative inj...

  11. 77 FR 66025 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... 76 Program Access Rules; Final Rule and Proposed Rule #0;#0;Federal Register / Vol. 77 , No. 211... 47 CFR Part 76 [MB Docket Nos. 12-68; 07-18; 05-192; 07-29; FCC 12-123] Program Access Rules AGENCY... to extend the prohibition on exclusive contracts involving satellite-delivered, cable-affiliated...

  12. Charter Halibut Limited Access Program

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in area 2C and 3A. NMFS issues a charter...

  13. Patient Safety Threat - Syringe Reuse

    Science.gov (United States)

    ... to Prevent HAIs HICPAC One & Only Campaign A Patient Safety Threat – Syringe Reuse Recommend on Facebook Tweet Share Compartir Important ... due to syringe reuse by your healthcare provider. Patients need to be aware of a very serious ...

  14. Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

    Science.gov (United States)

    Koo, Fung Kuen; Chen, Xi; Chow, Eric P F; Jing, Jun; Zheng, Jun; Zhao, Junshi; Zhang, Lei

    2015-01-01

    This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

  15. Environmental Research Division's Data Access Program (ERDDAP)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — ERDDAP (the Environmental Research Division's Data Access Program) is a data server that gives you a simple, consistent way to download subsets of scientific...

  16. Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001.

    Science.gov (United States)

    Des Jarlais, Don C; McKnight, Courtney; Friedmann, Patricia

    2002-01-01

    To assess preliminary results of the Expanded Syringe Access Demonstration Program (ESAP) in New York City. Temporal trends of pharmacy use among injection drug users (IDUs) in Brooklyn and Queens were analyzed from December 2000 through December 2001. Brooklyn and Queens, New York City. PARTIPANTS: IDUs. Attempts to purchase syringes from pharmacies and success in doing so. Of the 1,072 IDUs interviewed from December 2000 through December 2001, the majority were daily heroin injectors, but there was also substantial speedball and cocaine injection. There was a clear increase over time in both the percentage of subjects who attempted to purchase syringes in pharmacies and in the percentage who successfully purchased syringes. Among IDUs interviewed 4 or more months after ESAP began, large majorities of those who attempted to purchase syringes were successful in doing so. No differences in use of ESAP by IDUs were identified in Brooklyn versus Queens: 27% of IDUs interviewed in Queens reported that they had attempted to purchase syringes in pharmacies versus 28% in Brooklyn. Persons who reported injecting on a daily or more frequent basis were more likely to have attempted pharmacy purchases than persons who reported injecting less frequently, 32% versus 21%. The ESAP program has led to an increase in the use of pharmacies as sources of sterile injection equipment among IDUs in New York City. The extent to which pharmacies become an important source of sterile injection equipment and the effect of legal pharmacy sales on risk behaviors for human immunodeficiency virus (HIV) infection remain to be determined.

  17. Syringe-injectable electronics.

    Science.gov (United States)

    Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M

    2015-07-01

    Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

  18. Syringe injectable electronics

    Science.gov (United States)

    Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

    2015-01-01

    Seamless and minimally-invasive three-dimensional (3D) interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating syringe injection and subsequent unfolding of submicrometer-thick, centimeter-scale macroporous mesh electronics through needles with a diameter as small as 100 micrometers. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with > 90% device yield. We demonstrate several applications of syringe injectable electronics as a general approach for interpenetrating flexible electronics with 3D structures, including (i) monitoring of internal mechanical strains in polymer cavities, (ii) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (iii) in vivo multiplexed neural recording. Moreover, syringe injection enables delivery of flexible electronics through a rigid shell, delivery of large volume flexible electronics that can fill internal cavities and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics. PMID:26053995

  19. Options for reducing HIV transmission related to the dead space in needles and syringes.

    Science.gov (United States)

    Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

    2018-01-15

    When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

  20. The impact of harm reduction programs and police interventions on the number of syringes collected from public spaces. A time series analysis in Barcelona, 2004-2014.

    Science.gov (United States)

    Espelt, A; Villalbí, J R; Bosque-Prous, M; Parés-Badell, O; Mari-Dell'Olmo, M; Brugal, M T

    2017-12-01

    To estimate the effect of opening two services for people who use drugs and three police interventions on the number of discarded syringes collected from public spaces in Barcelona between 2004 and 2014. We conducted an interrupted time-series analysis of the monthly number of syringes collected from public spaces during this period. The dependent variable was the number of syringes collected per month. The main independent variables were month and five dummy variables (the opening of two facilities with safe consumption rooms, and three police interventions). To examine which interventions affected the number of syringes collected, we performed an interrupted time-series analysis using a quasi-Poisson regression model, obtaining relative risks (RR) and 95% confidence intervals (CIs). The number of syringes collected per month in Barcelona decreased from 13,800 in 2004 to 1655 in 2014 after several interventions. For example, following the closure of an open drug scene in District A of the city, we observed a decreasing trend in the number of syringes collected [RR=0.88 (95% CI: 0.82-0.95)], but an increasing trend in the remaining districts [RR=1.11 (95% CI: 1.05-1.17) and 1.08 (95% CI: 0.99-1.18) for districts B and C, respectively]. Following the opening of a harm reduction facility in District C, we observed an initial increase in the number collected in this district [RR=2.72 (95% CI: 1.57-4.71)] and stabilization of the trend thereafter [RR=0.97 (95% CI: 0.91-1.03)]. The overall number of discarded syringes collected from public spaces has decreased consistently in parallel with a combination of police interventions and the opening of harm reduction facilities. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Aquagenic syringeal acrokeratoderma

    Directory of Open Access Journals (Sweden)

    Belkiz Uyar

    2014-01-01

    Full Text Available Aquagenic syringeal acrokeratoderma is a rare, transient, and usually bilaterally symmetric, palmoplantar keratoderma. Patients complain of tingling and pain in the hands starting a few minutes after exposure to water and lasting for 20-30 minutes after removal. Clinically, there is marked wrinkling with edematous white papules on the palms or, less often, the soles. We present the case of a 21-year-old woman who used spironolactone for polycystic ovary syndrome and had similar clinical features 2 weeks later, after withdrawing the drug.

  2. Needle and syringe sharing among Iranian drug injectors

    Directory of Open Access Journals (Sweden)

    Roshanpajouh Mohsen

    2009-07-01

    Full Text Available Abstract Objective The role of needle and syringe sharing behavior of injection drug users (IDUs in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8% reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs.

  3. Experiments with Disposable Hypodermic Syringes.

    Science.gov (United States)

    Clayton, G. T.; And Others

    1988-01-01

    Lists five experiments or demonstrations involving hypodermic syringes. The titles of experiments are Boyle's Law, Charles' Law, Atmospheric Pressure, Expansion of Gases, and Boiling at Reduced Pressure. Provides a list of materials, the typical data, and graphs where appropriate. (YP)

  4. Stellar Atmospheric Modelling for the ACCESS Program

    Science.gov (United States)

    Morris, Matthew; Kaiser, Mary Elizabeth; Bohlin, Ralph; Kurucz, Robert; ACCESS Team

    2018-01-01

    A goal of the ACCESS program (Absolute Color Calibration Experiment for Standard Stars) is to enable greater discrimination between theoretical astrophysical models and observations, where the comparison is limited by systematic errors associated with the relative flux calibration of the targets. To achieve these goals, ACCESS has been designed as a sub-orbital rocket borne payload and ground calibration program, to establish absolute flux calibration of stellar targets at high resolution spectra in addition to the HST/CALSPEC data, we have generated stellar atmosphere models for ACCESS flight candidates, as well as a selection of A and G stars from the CALSPEC database. Stellar atmosphere models were generated using Atlas 9 and Atlas 12 Kurucz stellar atmosphere software. The effective temperature, log(g), metallicity, and redenning were varied and the chi-squared statistic was minimized to obtain a best-fit model. A comparison of these models and the results from interpolation between grids of existing models will be presented. The impact of the flexibility of the Atlas 12 input parameters (e.g. solar metallicity fraction, abundances, microturbulent velocity) is being explored.

  5. The evidence does not speak for itself: The role of research evidence in shaping policy change for the implementation of publicly funded syringe exchange programs in three US cities.

    Science.gov (United States)

    Allen, Sean T; Ruiz, Monica S; O'Rourke, Allison

    2015-07-01

    A breadth of literature exists that explores the utilization of research evidence in policy change processes. From this work, a number of studies suggest research evidence is applied to change processes by policy change stakeholders primarily through instrumental, conceptual, and/or symbolic applications, or is not used at all. Despite the expansiveness of research on policy change processes, a deficit exists in understanding the role of research evidence during change processes related to the implementation of structural interventions for HIV prevention among injection drug users (IDU). This study examined the role of research evidence in policy change processes for the implementation of publicly funded syringe exchange services in three US cities: Baltimore, MD, Philadelphia, PA, and Washington, DC. In-depth qualitative interviews were conducted with key stakeholders (n=29) from each of the study cities. Stakeholders were asked about the historical, social, political, and scientific contexts in their city during the policy change process. Interviews were transcribed and analyzed for common themes pertaining to applications of research evidence. In Baltimore and Philadelphia, the typological approaches (instrumental and symbolic/conceptual, respectively) to the applications of research evidence used by harm reduction proponents contributed to the momentum for securing policy change for the implementation of syringe exchange services. Applications of research evidence were less successful in DC because policymakers had differing ideas about the implications of syringe exchange program implementation and because opponents of policy change used evidence incorrectly or not at all in policy change discussions. Typological applications of research evidence are useful for understanding policy change processes, but their efficacy falls short when sociopolitical factors complicate legislative processes. Advocates for harm reduction may benefit from understanding how to

  6. 77 FR 24301 - Revision of the Commission's Program Access Rules

    Science.gov (United States)

    2012-04-23

    ...-delivered, cable-affiliated programming; and (ii) potential revisions to our program access rules to better... Revision of the Commission's Program Access Rules; Proposed Rule #0;#0;Federal Register / Vol. 77 , No. 78... Part 76 [MB Docket Nos. 12-68, 07-18, and 05-192; FCC 12-30] Revision of the Commission's Program...

  7. 76 FR 56091 - Expansion of 911 Access; Telecommunications Loan Program

    Science.gov (United States)

    2011-09-12

    ... Access; Telecommunications Loan Program AGENCY: Rural Utilities Service, USDA. ACTION: Interim rule with... the Telecommunications Loan Program. DATES: This rule is effective on September 12, 2011. Comments... INFORMATION CONTACT: David Villano, Assistant Administrator, Telecommunications Program, USDA--Rural Utilities...

  8. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  9. Syringe exchange programs in Brazil: preliminary assessment of 45 programs Programas de redução de danos causados pelo uso de drogas no Brasil: caracterização preliminar de 45 programas

    Directory of Open Access Journals (Sweden)

    Elize Massard da Fonseca

    2006-04-01

    Full Text Available The present study aims to evaluate the current operation of Brazilian syringe exchange programs (SEP. After consulting national and regional networks of people working in projects/ programs aiming to reduce drug-related harm, we identified 134 potential participant programs. Unfortunately, only 45 SEPs answered a survey, even after repeated attempts. The survey addressed: coverage, funding, procurement of basic supplies, managerial capacity, and the local political environment. Findings were triangulated with in-depth interviews with key informants. The main findings included: satisfactory adherence to the initiatives and adequate documentation, but deficiencies in terms of coverage and monitoring, and uneven procurement of resources. Program personnel work mostly on a provisional basis, despite the efforts of local coordinators. Most programs are funded by the National STDs/AIDS Program. A comprehensive agenda aiming to improve current operations should include: concerted efforts to improve local and regional databanks, incentives/sanctions toward full accountability of initiatives carried by the programs, and a genuine culture of monitoring and evaluation.O presente estudo buscou avaliar a operação cotidiana dos programas de troca de seringas brasileiros (conhecidos, no país, como PRD. Foram identificados 134 PRD, com base na compilação de informações das redes que atuam na área. Por intermédio de uma pesquisa, avaliou-se a cobertura dos programas, o seu financiamento, o controle de insumos, a sua capacidade organizacional e o contexto político local. Os achados, referentes a 45 programas (que, de fato, responderam à pesquisa, após repetidos contatos, foram triangulados com entrevistas com informantes-chave. Foi identificada adesão satisfatória às ações e adequada documentação e registro, mas deficiências de cobertura e monitoramento, além de descontinuidades quanto aos insumos. Os profissionais que atuam nos programas t

  10. 13 CFR 136.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 136.149 Section 136.149 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... BUSINESS ADMINISTRATION § 136.149 Program accessibility: Discrimination prohibited. Except as otherwise...

  11. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

    ... Training Corps, and Officer Candidate School. Three areas are covered: historical patterns in officer accessions and historical changes in Navy pre-commissioning training and education philosophy and policy...

  12. 77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2012-02-07

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

  13. Characterizing expanded access and compassionate use programs for experimental drugs.

    Science.gov (United States)

    Miller, Jennifer E; Ross, Joseph S; Moch, Kenneth I; Caplan, Arthur L

    2017-07-28

    We sought to determine the characteristics of "expanded access" and "compassionate use" programs registered in ClinicalTrials.gov and to determine the percentage of drugs provided through these programs that ultimately received FDA marketing approval. We identified 398 expanded access and compassionate use programs (hereafter referred to as expanded access programs) registered on ClinicalTrials.gov. Industry funded 61% (n = 241) of programs individually or collaboratively, while NIH and the US Federal Government rarely funded programs (3% [n = 11] and 2% [n = 6], respectively). Most programs provided access to drugs (71% [n = 282]), 11% to biologics (n = 43), and 10% to medical devices (n = 40). These programs covered 460 unique conditions, the most common being HIV (n = 26), leukemia (22), and multiple myeloma (n = 14). Only 2% of programs reported results in ClinicalTrials.gov. Most programs (82%) were open to enrolling adults and seniors (n = 326). These programs provided access to 210 unique experimental drugs, of which 76% have received FDA approval.

  14. 77 FR 29473 - Market Access Program

    Science.gov (United States)

    2012-05-17

    ... regulation to mean only U.S. agricultural cooperatives that are ``participating in the MAP brand promotion of... all programs.) Persons with disabilities who require alternative means for communication of program... expenditures are not reimbursable for brand promotion activities. The comments regarding E-ticketing and...

  15. 77 FR 41885 - Market Access Program

    Science.gov (United States)

    2012-07-17

    ... Agricultural Service, Office of Trade Programs, Program Operations Division; or by phone: (202) 720- 4327; or.... List of Subjects in 7 CFR Part 1485 Agricultural commodities, Exports. Accordingly, 7 CFR Part 1485 is... particular situation will depend on a number of factors, such as, for example, the Participant's history of...

  16. 75 FR 9691 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-03-03

    ... pursue program access claims involving terrestrially delivered, cable-affiliated programming similar to... have filed three program access complaints involving terrestrially delivered, cable-affiliated... program suppliers had the incentive and ability to favor their affiliated cable operators over other MVPDs...

  17. The development of accessibility indicators for distance learning programs

    Directory of Open Access Journals (Sweden)

    Sheryl Burgstahler

    2006-12-01

    Full Text Available A study was undertaken to explore program policies and practices related to the accessibility of American distance learning courses to qualified students with disabilities. A literature review was conducted, a draft list of accessibility indicators was created, examples of applications of the indicators in existing distance learning programs were collected, the indicators were systematically applied to one distance learning program, input from a variety of distance learning programs was used to further refine the indicators, and these programs were encouraged to adopt the indicators and make use of resources provided by the project. Results of this exploratory work suggest that incorporating accessibility considerations into policies, procedures and communications of a program requires consideration of the unique needs of students, course designers, instructors and evaluators; involves approval and implementation at a variety of administrative levels; and is an ongoing process that may be implemented in incremental steps.

  18. Embedded Systems Programming: Accessing Databases from Esterel

    Directory of Open Access Journals (Sweden)

    2009-03-01

    Full Text Available A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel’s synchrony hypothesis, or remotely along several of Esterel’s execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel’s facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs’ utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot’s controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse’s floor layout into account, both of which are stored in a MySQL database.

  19. Embedded Systems Programming: Accessing Databases from Esterel

    Directory of Open Access Journals (Sweden)

    White David

    2008-01-01

    Full Text Available Abstract A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel's synchrony hypothesis, or remotely along several of Esterel's execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel's facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs' utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot's controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse's floor layout into account, both of which are stored in a MySQL database.

  20. 32 CFR 154.17 - Special access programs.

    Science.gov (United States)

    2010-07-01

    ... service, DoD civilian employment, or access to classified information under the Industrial Security... National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEPARTMENT OF DEFENSE PERSONNEL SECURITY PROGRAM REGULATION Personnel Security Investigative Requirements § 154.17 Special access...

  1. Hypertensive Crisis During Norepinephrine Syringe Exchange

    NARCIS (Netherlands)

    Snijder, Roland A; Knape, Johannes T A; Egberts, Toine C G|info:eu-repo/dai/nl/162850050; Timmerman, Annemoon M D E

    2017-01-01

    A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and

  2. Hypertensive Crisis During Norepinephrine Syringe Exchange

    NARCIS (Netherlands)

    Snijder, Roland A; Knape, Johannes T A|info:eu-repo/dai/nl/071757481; Egberts, Toine C G|info:eu-repo/dai/nl/162850050; Timmerman, Annemoon M D E

    A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and

  3. Notified Access: Extending Remote Memory Access Programming Models for Producer-Consumer Synchronization

    KAUST Repository

    Belli, Roberto

    2015-05-01

    Remote Memory Access (RMA) programming enables direct access to low-level hardware features to achieve high performance for distributed-memory programs. However, the design of RMA programming schemes focuses on the memory access and less on the synchronization. For example, in contemporary RMA programming systems, the widely used producer-consumer pattern can only be implemented inefficiently, incurring in an overhead of an additional round-trip message. We propose Notified Access, a scheme where the target process of an access can receive a completion notification. This scheme enables direct and efficient synchronization with a minimum number of messages. We implement our scheme in an open source MPI-3 RMA library and demonstrate lower overheads (two cache misses) than other point-to-point synchronization mechanisms for each notification. We also evaluate our implementation on three real-world benchmarks, a stencil computation, a tree computation, and a Colicky factorization implemented with tasks. Our scheme always performs better than traditional message passing and other existing RMA synchronization schemes, providing up to 50% speedup on small messages. Our analysis shows that Notified Access is a valuable primitive for any RMA system. Furthermore, we provide guidance for the design of low-level network interfaces to support Notified Access efficiently.

  4. 22 CFR 711.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ....150 Section 711.150 Foreign Relations OVERSEAS PRIVATE INVESTMENT CORPORATION ADMINISTRATIVE... THE OVERSEAS PRIVATE INVESTMENT CORPORATION § 711.150 Program accessibility: Existing facilities. (a... result in a fundamental alteration in the nature of a program or activity or in undue financial and...

  5. 5 CFR 1636.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... facilities. 1636.150 Section 1636.150 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD... RETIREMENT THRIFT INVESTMENT BOARD § 1636.150 Program accessibility: Existing facilities. (a) General. The... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

  6. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  7. A novel IPTV program multiplex access system to EPON

    Science.gov (United States)

    Xu, Xian; Liu, Deming; He, Wei; Lu, Xi

    2007-11-01

    With the rapid development of high speed networks, such as Ethernet Passive Optical Network (EPON), traffic patterns in access networks have evolved from traditional text-oriented service to the mixed text-, voice- and video- based services, leading to so called "Triple Play". For supporting IPTV service in EPON access network infrastructure, in this article we propose a novel IPTV program multiplex access system to EPON, which enables multiple IPTV program source servers to seamlessly access to IPTV service access port of optical line terminal (OLT) in EPON. There are two multiplex schemes, namely static multiplex scheme and dynamic multiplex scheme, in implementing the program multiplexing. Static multiplex scheme is to multiplex all the IPTV programs and forward them to the OLT, regardless of the need of end-users. While dynamic multiplex scheme can dynamically multiplex and forward IPTV programs according to what the end-users actually demand and those watched by no end-user would not be multiplexed. By comparing these two schemes, a reduced traffic of EPON can be achieved by using dynamic multiplex scheme, especially when most end-users are watching the same few IPTV programs. Both schemes are implemented in our system, with their hardware and software designs described.

  8. JASPAR RESTful API: accessing JASPAR data from any programming language.

    Science.gov (United States)

    Khan, Aziz; Mathelier, Anthony

    2017-12-15

    JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. aziz.khan@ncmm.uio.no, anthony.mathelier@ncmm.uio.no. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  9. Access to Investigational Drugs: FDA Expanded Access Programs or “Right‐to‐Try” Legislation?

    Science.gov (United States)

    Berglund, Jelena P.; Weatherwax, Kevin; Gerber, David E.; Adamo, Joan E.

    2015-01-01

    Abstract Purpose The Food and Drug Administration Expanded Access (EA) program and “Right‐to‐Try” legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. Methods FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. Results The FDA EA program includes Single Patient‐Investigational New Drug (SP‐IND), Emergency SP‐IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. “Right‐to‐Try” legislation bypasses some of these steps, but provides no regulatory or safety oversight. Conclusion The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP‐IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. PMID:25588691

  10. Access to Investigational Drugs: FDA Expanded Access Programs or "Right-to-Try" Legislation?

    Science.gov (United States)

    Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E

    2015-10-01

    The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.

  11. 76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-09-19

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... programming, and the interoperability and user interface of the equipment used to deliver video programming...

  12. Adrenaline in cardiac arrest: Prefilled syringes are faster.

    Science.gov (United States)

    Helm, Claire; Gillett, Mark

    2015-08-01

    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  13. Benefits of concurrent syringe exchange and substance abuse treatment participation.

    Science.gov (United States)

    Kidorf, Michael; King, Van L; Peirce, Jessica; Pierce, Jessica; Kolodner, Ken; Brooner, Robert K

    2011-04-01

    Participation in syringe exchange programs (SEPs) is associated with many individual and public health benefits but may have little impact on reducing drug use without concurrent treatment engagement. This study evaluated rates of drug use, other risk behaviors, and illegal activities in newly registered SEP participants (N = 240) enrolled versus not enrolled in substance abuse treatment over a 4-month observation window and examined the effect of days in treatment on these outcomes. After controlling for baseline differences, SEP registrants enrolled in treatment (n = 113) reported less days of opioid and cocaine use, injection drug use, illegal activities, and incarceration than those not enrolled in treatment (n = 127). For those enrolled in treatment, days of treatment was strongly correlated with each of these outcomes. These findings provide good evidence for a dose-response effect of treatment in syringe exchangers and suggest that substance abuse treatment significantly expands the harm reduction benefits of SEP participation. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. 17 CFR 200.649 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-04-01

    ...: Discrimination prohibited. 200.649 Section 200.649 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Enforcement of Nondiscrimination on... § 200.649 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 200.650...

  15. 76 FR 66089 - Access Authorization Program for Nuclear Power Plants

    Science.gov (United States)

    2011-10-25

    ... Plants AGENCY: Nuclear Regulatory Commission. ACTION: Regulatory guide; issuance. SUMMARY: The U.S... Program for Nuclear Power Plants.'' This guide describes a method that NRC staff considers acceptable to... Regulations (10 CFR), section 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants...

  16. Syringe siliconization process investigation and optimization.

    Science.gov (United States)

    Chan, Edwin; Hubbard, Aaron; Sane, Samir; Maa, Yuh-Fun

    2012-01-01

    The interior barrel of the prefilled syringe is often lubricated/siliconized by the syringe supplier or at the syringe filling site. Syringe siliconization is a complex process demanding automation with a high degree of precision; this information is often deemed "know-how" and is rarely published. The purpose of this study is to give a detailed account of developing and optimizing a bench-top siliconization unit with nozzle diving capabilities. This unit comprises a liquid dispense pump unit and a nozzle integrated with a Robo-cylinder linear actuator. The amount of coated silicone was determined by weighing the syringe before and after siliconization, and silicone distribution was visually inspected by glass powder coating or characterized by glide force testing. Nozzle spray range, nozzle retraction speed, silicone-coated amount, and air-to-nozzle pressure were found to be the key parameters affecting silicone distribution uniformity. Distribution uniformity is particularly sensitive to low-target silicone amount where the lack of silicone coating on the barrel near the needle side often caused the syringes to fail the glide force test or stall when using an autoinjector. In this bench-top unit we identified optimum coating conditions for a low silicone dose, which were also applicable to a pilot-scale siliconization system. The pilot unit outperformed the bench-top unit in a tighter control (standard deviation) in coated silicone amount due to the elimination of tubing flex. Tubing flex caused random nozzle mis-sprays and was prominent in the bench-top unit, while the inherent design of the pilot system substantially limited tubing flux. In summary, this bench-top coating unit demonstrated successful siliconization of the 1 mL long syringe with ∼0.2 mg of silicone oil using a spraying cycle also applicable to larger-scale siliconization. Syringe siliconization can be considered a well-established manufacturing process and has been implemented by numerous

  17. 76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-04-07

    ... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The meeting will address the provision of closed captioning of Internet programming previously captioned on...

  18. Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures

    International Nuclear Information System (INIS)

    Haseler, Luke J.; Sibbitt, Randy R.; Sibbitt, Wilmer L.; Michael, Adrian A.; Gasparovic, Charles M.; Bankhurst, Arthur D.

    2011-01-01

    Purpose: Syringes are used for diagnostic fluid aspiration and fine-needle aspiration biopsy in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods: Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device, were studied. Twenty operators performed aspiration procedures with the following outcomes measured: (1) vacuum (torr), (2) time to vacuum (s), (3) hand force to generate vacuum (torr-cm 2 ), (4) operator difficulty during aspiration, (5) biopsy yield (mg), and (6) operator control of the needle tip position (mm). Results: Vacuum increased tissue biopsy yield at all needle diameters (P < 0.002). Twenty-milliliter syringes achieved a vacuum of −517 torr but required far more strength to aspirate, and resulted in significant loss of needle control (P < 0.002). The 10-ml syringe generated only 15% less vacuum (−435 torr) than the 20-ml device and required much less hand strength. The mechanical syringe generated identical vacuum at all syringe sizes with less hand force (P < 0.002) and provided significantly enhanced needle control (P < 0.002). Conclusions: To optimize patient safety and control of the needle, and to maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered.

  19. An accessible interface for programming an assistive robot

    Directory of Open Access Journals (Sweden)

    Juan G Victores

    2014-09-01

    Full Text Available In this paper, we present an accessible interface in the context of our work on bringing advanced robotics closer to everyday domestic users. This interface allows inexperienced users to be capable of programming an assistive robotic arm to perform a specific desired task in a household environment. The programming process is performed through the developed Web Browsable interface, within which a Task Creator Wizard plays an essential role. The robot's open architecture enables flexible multi-modal interaction. In addition to the touch buttons provided by the Web Browsable interface when presented on a touch screen, voice commands and the use of the Wii RemoteTM controller for intuitive robotic movement have also been enabled. The Web Browsable interface has been designed to provide high accessibility while taking aesthetic details into account, in order to prevent distraction caused by boredom of the user.

  20. Object oriented programming techniques applied to device access and control

    International Nuclear Information System (INIS)

    Goetz, A.; Klotz, W.D.; Meyer, J.

    1992-01-01

    In this paper a model, called the device server model, has been presented for solving the problem of device access and control faced by all control systems. Object Oriented Programming techniques were used to achieve a powerful yet flexible solution. The model provides a solution to the problem which hides device dependancies. It defines a software framework which has to be respected by implementors of device classes - this is very useful for developing groupware. The decision to implement remote access in the root class means that device servers can be easily integrated in a distributed control system. A lot of the advantages and features of the device server model are due to the adoption of OOP techniques. The main conclusion that can be drawn from this paper is that 1. the device access and control problem is adapted to being solved with OOP techniques, 2. OOP techniques offer a distinct advantage over traditional programming techniques for solving the device access problem. (J.P.N.)

  1. How to start a minimal access mitral valve program

    OpenAIRE

    Hunter, Steven

    2013-01-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate t...

  2. Radiation safety shield for a syringe

    International Nuclear Information System (INIS)

    Tipton, H.W.

    1976-01-01

    Safety apparatus for use in administering radioactive serums by a syringe, without endangering the health and safety of the medical operators is described. The apparatus consists of a sheath and a shield which can be retracted into the sheath to assay the radioactive serum in an assay well. The shield can be moved from the retracted position into an extended position when the serum is to be injected into the patient. To protect the operator, the shield can be constructed of tantalum or any like high density substance to attenuate the radiation, emanating from the radioactive serums contained in the syringe, from passing to the atmosphere. A lead glass window is provided so that the operator can determine the exact quantity of the radioactive serum which is contained in the syringe

  3. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Harmer Andrew

    2011-07-01

    Full Text Available Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs. Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84, service providers (Ukraine n = 138, Kyrgyzstan n = 58 and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86. Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater

  4. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  5. Successful program maintenance when federal demonstration dollars stop: the ACCESS program for homeless mentally ill persons.

    Science.gov (United States)

    Steadman, Henry J; Cocozza, Joseph J; Dennis, Deborah L; Lassiter, Margaret G; Randolph, Frances L; Goldman, Howard; Blasinsky, Margaret

    2002-07-01

    A major issue that has long dogged federal human services demonstration programs is the perception that when federal dollars end, the programs end-regardless of any proven successes. Access to Community Care and Effective Services and Supports (ACCESS) was a 5-year federal demonstration project to foster partnerships between service providers for homeless people with serious mental illness and co-occurring substance abuse disorders; and to identify effective, replicable systems integration strategies. After federal funding ended, research teams visited the ACCESS sites to determine which project elements remained and which strategies were used by the sites to continue ACCESS. This article describes ACCESS services and systems integration activities retained by the sites, new funding streams, and strategies used to obtain continued funding.

  6. Structure of the syringeal muscles in jungle crow (Corvus macrorhynchos).

    Science.gov (United States)

    Tsukahara, Naoki; Yang, Qian; Sugita, Shoei

    2008-09-01

    Birds' vocalizations are produced by the syrinx, which is located between the trachea and the two primary bronchi. Oscine birds have multiple pairs of syringeal muscles in the syrinx. To determine the detailed structure of the syringeal muscle in jungle crows, an oscine bird, a histological study and gross examination of the syrinx were performed. In the histological study, sections of the syrinxes from four jungle crows were stained with Azan and observed. Each syringeal muscle was classified by the limit of the fascia from neighbor fascicules. From the gross examination a 3-D image of the structure of the syringeal muscles was generated. The combined histological and anatomical results show that there are seven pairs of syringeal muscles in jungle crows. Muscle fusions were observed in some of the syringeal muscles. It is likely that each syringeal muscle has a specific role. Jungle crows may be able to generate various calls because they have several pairs of syringeal muscles.

  7. Combination syringe provides air-free blood samples

    Science.gov (United States)

    Pool, S. L.

    1970-01-01

    Standard syringe and spinal needle are combined in unique manner to secure air-free blood samples. Combination syringe obtains air free samples because air bubbles become insignificant when samples greater than 1 cc are drawn.

  8. Syringe irrigation: blending endodontics and fluid dynamics

    NARCIS (Netherlands)

    Boutsioukis, C.; van der Sluis, L.W.M.; Basrani, B.

    2015-01-01

    Syringe irrigation remains a widely used irrigant delivery method during root canal treatment. An interdisciplinary approach involving well-established methods from the field of fluid dynamics can provide new insights into the mechanisms involved in cleaning and disinfection of the root canal system

  9. Open-Source Syringe Pump Library

    Science.gov (United States)

    Wijnen, Bas; Hunt, Emily J.; Anzalone, Gerald C.; Pearce, Joshua M.

    2014-01-01

    This article explores a new open-source method for developing and manufacturing high-quality scientific equipment suitable for use in virtually any laboratory. A syringe pump was designed using freely available open-source computer aided design (CAD) software and manufactured using an open-source RepRap 3-D printer and readily available parts. The design, bill of materials and assembly instructions are globally available to anyone wishing to use them. Details are provided covering the use of the CAD software and the RepRap 3-D printer. The use of an open-source Rasberry Pi computer as a wireless control device is also illustrated. Performance of the syringe pump was assessed and the methods used for assessment are detailed. The cost of the entire system, including the controller and web-based control interface, is on the order of 5% or less than one would expect to pay for a commercial syringe pump having similar performance. The design should suit the needs of a given research activity requiring a syringe pump including carefully controlled dosing of reagents, pharmaceuticals, and delivery of viscous 3-D printer media among other applications. PMID:25229451

  10. Aspects of syringeal mechanics in avian phonation

    NARCIS (Netherlands)

    Larsen, O.N.; Goller, F.; Leeuwen, van J.L.

    2006-01-01

    The vocal organ of birds, the syrinx, is formed by modified cartilages of the trachea and bronchi. Recently, the use of thin, flexible endoscopes has made direct observation of the syrinx possible in situ. The effects of direct muscle stimulation on the syringeal aperture identified adductor and

  11. Insulin Syringe: A Gimmick in Pediatric Dentistry.

    Science.gov (United States)

    Kour, Gurpreet; Masih, Updesh; Singh, Chanchal; Srivastava, Manvi; Yadav, Priti; Kushwah, Jagriti

    2017-01-01

    The management of pain and anxiety in dentistry encompasses a number of procedural issues, including the delivery of anesthetic solution. One of the most important ways to manage the behavior of children is pain control. Trypanophobia is very common among dental patients and the most important goal of guidelines on behavior guidance for pediatric dental patient is to ease fear and anxiety in dental procedures in children. For the stated reasons, the purpose of the present study was to record child's pain sensation both objectively and subjectively while receiving dental local anesthesia using conventional syringes and diabetic needles. Twenty children of age group 6 to 12 years undergoing routine dental procedures participated in the study. Every child acted as one's own control, while receiving treatment on the opposite side of the same arch. Each patient was randomly assigned to receive the injection either with conventional syringe or diabetic needle for the first visit, while the injection with the other needle was administered during the second visit. Rating scales were used for objective and subjective evaluations. Statistical analysis of the measurements were made using Wilcoxon signed U test and Mann-Whitney U test which showed the mean sound, eye, motor (SEM) score difference using insulin syringe. The outcome was statistically significant when compared using the mean ranks between male and female patients with that of control group. It can be concluded that diabetic syringes exhibit clinical advantage and its use in pediatric dentistry for local anesthetics (LA) infiltration can prove beneficial. How to cite this article: Kour G, Masih U, Singh C, Srivastava M, Yadav P, Kushwah J. Insulin Syringe: A Gimmick in Pediatric Dentistry. Int J Clin Pediatr Dent 2017;10(4):319-323.

  12. Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

    Directory of Open Access Journals (Sweden)

    Islam Md Mofizul

    2007-10-01

    Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

  13. An Accessible User Interface for Geoscience and Programming

    Science.gov (United States)

    Sevre, E. O.; Lee, S.

    2012-12-01

    The goal of this research is to develop an interface that will simplify user interaction with software for scientists. The motivating factor of the research is to develop tools that assist scientists with limited motor skills with the efficient generation and use of software tools. Reliance on computers and programming is increasing in the world of geology, and it is increasingly important for geologists and geophysicists to have the computational resources to use advanced software and edit programs for their research. I have developed a prototype of a program to help geophysicists write programs using a simple interface that requires only simple single-mouse-clicks to input code. It is my goal to minimize the amount of typing necessary to create simple programs and scripts to increase accessibility for people with disabilities limiting fine motor skills. This interface can be adapted for various programming and scripting languages. Using this interface will simplify development of code for C/C++, Java, and GMT, and can be expanded to support any other text based programming language. The interface is designed around the concept of maximizing the amount of code that can be written using a minimum number of clicks and typing. The screen is split into two sections: a list of click-commands is on the left hand side, and a text area is on the right hand side. When the user clicks on a command on the left hand side the applicable code is automatically inserted at the insertion point in the text area. Currently in the C/C++ interface, there are commands for common code segments that are often used, such as for loops, comments, print statements, and structured code creation. The primary goal is to provide an interface that will work across many devices for developing code. A simple prototype has been developed for the iPad. Due to the limited number of devices that an iOS application can be used with, the code has been re-written in Java to run on a wider range of devices

  14. Accessibility Landscapes of Supplemental Nutrition Assistance Program-Authorized Stores.

    Science.gov (United States)

    Racine, Elizabeth F; Delmelle, Eric; Major, Elizabeth; Solomon, Corliss A

    2018-01-20

    The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Participants receive electronic benefits that are redeemable at a variety of food stores. Previous research notes that low-income neighborhoods often lack supermarkets with high-quality, affordable food. The first aim of this study was to explore the number and spatial distribution of SNAP stores by type and to assess how SNAP benefit redemption is linked to store type in North Carolina in 2015. The second aim was to compare the demographics of populations living in areas with a high concentration of SNAP participants vs areas with a lower concentration of SNAP participants. The third aim was to test for disparities in the availability of and access to SNAP-authorized stores in areas with high vs low concentration of SNAP participants stratified by rural/urban status. US Department of Agriculture and US Census data were used to explore the spatial distribution of SNAP stores at the census block group level utilizing a Geographic Information System. The 9,556 North Carolina SNAP stores in 2015 categorized into full-variety and limited-variety stores. Proximity to limited-variety SNAP food stores and full-variety SNAP food stores within access range (1 mile in urban areas and 10 miles in rural areas). Wilcoxon rank sum and χ 2 tests are used to compare the distance to and concentration of SNAP stores by rurality and SNAP participant concentration at census block group scale. Among the SNAP stores in North Carolina, 83% are limited-variety stores and 17% are full-variety stores. There are disparities in the demographics of individuals living in census block groups with a high proportion of SNAP participants compared to census block groups with a lower proportion of SNAP participants. More households in higher SNAP participant census block groups were non-white, did not have a car, and had children compared to census block groups with lower SNAP

  15. Development of Syringe/Bottle Hybrids for Sampling Slurries

    International Nuclear Information System (INIS)

    Coleman, C.J.

    1998-01-01

    A convenient and effective sample bottle system based on simple modifications of disposable plastic syringes and bottles has been devised and tested for slurry samples. Syringe/ bottle hybrids (hereafter referred to as syringe bottles) have the convenience of regular flat-bottom bottles with screw cap closures. In addition, the syringe imparts a sliding and adjustable bottom to the bottle that forces the entire contents from the bottle. The system was designed especially to collect samples for high temperature work-ups of DWPF slurry samples. The syringe bottles together with fixed-bottom sample vial inserts would provide the DWPF with convenient and reliable methods for dealing with slurry samples

  16. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

    Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.

  17. The impact of citrate introduction at UK syringe exchange programmes: a retrospective cohort study in Cheshire and Merseyside, UK

    Directory of Open Access Journals (Sweden)

    Wareing Michelle

    2007-12-01

    Full Text Available Abstract Background In 2003, it became legal in the UK for syringe exchange programmes (SEPs to provide citrate to injecting drug users to solubilise heroin. Little work has been undertaken on the effect of policy change on SEP function. Here, we examine whether the introduction of citrate in Cheshire and Merseyside SEPs has altered the number of heroin/crack injectors accessing SEPs, the frequency at which heroin/crack injectors visited SEPs and the number of syringes dispensed. Methods Eleven SEPs in Cheshire and Merseyside commenced citrate provision in 2003. SEP-specific data for the six months before and six months after citrate was introduced were extracted from routine monitoring systems relating to heroin and crack injectors. Analyses compared all individuals attending pre and post citrate and matched analyses only those individuals attending in both periods (defined as 'longitudinal attenders'. Non-parametric tests were used throughout. Results Neither new (first seen in either six months period nor established clients visited SEPs more frequently post citrate. New clients collected significantly less syringes per visit post citrate, than pre citrate (14.5,10.0; z = 1.992, P Conclusion The introduction of citrate did not negatively affect SEP attendance. 'Longitudinal attenders' visited SEPs more frequently post citrate, providing staff with greater opportunity for intervention and referral. As the number of syringes they collected each visit remained unchanged the total number of clean syringes made available to this group of injectors increased very slightly between the pre and post citrate periods. However, new clients collected significantly less syringes post citrate than pre citrate, possibly due to staff concerns regarding the amount of citrate (and thus syringes to dispense safely to new clients. These concerns should not be allowed to negatively impact on the number of syringes dispensed.

  18. Survey of Airport Access Analysis Techniques - Models, Data and a Research Program

    Science.gov (United States)

    1972-06-01

    The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research program is proposed which would ge...

  19. 77 FR 27178 - Notice of Funds Availability; Inviting Applications for the Market Access Program; Correction

    Science.gov (United States)

    2012-05-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Commodity Credit Corporation Notice of Funds Availability; Inviting Applications for the Market Access... 23, 2012, concerning funds availability and inviting applications for the Market Access Program (MAP...

  20. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Science.gov (United States)

    2010-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... 47 Telecommunication 4 2010-10-01 2010-10-01 false Applicability of program access rules to common carriers and affiliates. 76.1004 Section 76.1004 Telecommunication FEDERAL COMMUNICATIONS COMMISSION...

  1. A study of gross morphological and histological syringeal features of ...

    African Journals Online (AJOL)

    A study of gross morphological and histological syringeal features of true francolins (Galliformes: Francolinus, Scleroptila, Peliperdix and Dendroperdix spp.) and spurfowls ( Pternistis spp.) in a phylogenetic context.

  2. Massachusetts Child Psychiatry Access Project 2.0: A Case Study in Child Psychiatry Access Program Redesign.

    Science.gov (United States)

    Sarvet, Barry D; Ravech, Marcy; Straus, John H

    2017-10-01

    The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign. The redesign process is described, moving from an initial strategic assessment of program and the planning of structural and functional changes, through transition and implementation. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Peláez, Sarah S; Mahler, Hanns-Christian; Matter, Anja; Koulov, Atanas; Singh, Satish K; Germershaus, Oliver; Mathaes, Roman

    2018-04-04

    Prefilled syringes (PFSs) are increasingly preferred over vials as container closure systems (CCSs) for injectable drug products when facilitated or self-administration is required. However, PFSs are more complex compared to CCSs consisting of vial, rubber stopper and crimp cap. Container closure integrity (CCI) assurance and verification has been a specific challenge for PFSs as they feature several sealing areas. A comprehensive understanding of the CCS is necessary for an appropriate CCI assessment as well as for packaging development and qualification. A comprehensive CCI assessment of six different PFSs from three different manufacturers (including one polymeric PFS) was conducted using helium leak testing. PFS components were manipulated to systematically assess the contribution of the different sealing areas to CCI, namely rigid needle shield (RNS)/needle, RNS/tip cone and the individual ribs of a syringe plunger. The polymeric PFS required an equilibrium measurement for accurate CCIT. The different sealing areas and a single plunger rib were shown to provide adequate CCI. Acceptable tip cap movement until the point of CCI failure was estimated. The assessment of acceptable tip cap movement demonstrated the importance of considering the RNS/tip cone seal design to ensure CCI of the PFS upon post assembly possesses and shipment. Copyright © 2018. Published by Elsevier Inc.

  4. Home Delivery Medicament Program: access, inactivity and cardiovascular risk.

    Science.gov (United States)

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-10-10

    to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion

  5. International Education Programs: Access to the World and Its Languages

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The International Education Programs Service (IEPS) administers 14 education programs. These programs are complementary in nature and designed to benefit a variety of audiences through training programs, research, start-up or enhancement projects, and fellowships. This paper provides brief descriptions of these programs.

  6. Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

    Directory of Open Access Journals (Sweden)

    M Kamal Pasa

    Full Text Available Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID, examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV and hepatitis in a region where these dual epidemics are likely to expand.We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software.We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms.Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle-syringe

  7. 41 CFR 105-8.152 - Program accessibility: Assignment of space.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program accessibility: Assignment of space. 105-8.152 Section 105-8.152 Public Contracts and Property Management Federal Property...-8.152 Program accessibility: Assignment of space. (a) When GSA assigns or reassigns space to an...

  8. 77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2012-02-08

    ... Commercial Access; Development of Competition and Diversity in Video Programming Distribution and Carriage... contained in the Second Report and Order, FCC 11-119, pertaining to carriage of video programming vendors by multichannel video programming distributors (program carriage rules). This notice is consistent with the Secord...

  9. Hand Society and Matching Program Web Sites Provide Poor Access to Information Regarding Hand Surgery Fellowship.

    Science.gov (United States)

    Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T

    2016-08-01

    The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.

  10. Storage stability of bevacizumab in polycarbonate and polypropylene syringes

    Science.gov (United States)

    Khalili, H; Sharma, G; Froome, A; Khaw, P T; Brocchini, S

    2015-01-01

    Purpose To compare and examine the storage stability of compounded bevacizumab in polycarbonate (PC) and polypropylene (PP) syringes over a 6-month period. PC syringes have been used in a recent clinical study and bevacizumab stability has not been reported for this type of syringe. Methods Repackaged bevacizumab was obtained from Moorfields Pharmaceuticals in PC and PP syringes. Bevacizumab from the stored syringes was analysed at monthly time points for a 6-month period and compared with bevacizumab from a freshly opened vial at each time point. SDS-PAGE electrophoresis and size-exclusion chromatography (SEC) was used to observe aggregation and degradation. Dynamic light scattering (DLS) provided information about the hydrodynamic size and particle size distribution of bevacizumab in solution. VEGF binding and the active concentration of bevacizumab was determined by surface plasmon resonance (SPR) using Biacore. Results SDS-PAGE and SEC analysis did not show any changes in the presence of higher molecular weight species (HMWS) or degradation products in PC and PP syringes from T0 to T6 compared with bevacizumab sampled from a freshly opened vial. The hydrodynamic diameter of bevacizumab in the PC syringe after 6 months of storage was not significantly different to bevacizumab taken from a freshly opened vial. Using SPR, the VEGF binding activity of bevacizumab in the PC syringe was comparable to bevacizumab taken from a freshly opened vial. Conclusion No significant difference over a 6-month period was observed in the quality of bevacizumab repackaged into prefilled polycarbonate and polypropylene syringes when compared with bevacizumab that is supplied from the vial. PMID:25853399

  11. 78 FR 77074 - Accessibility of User Interfaces, and Video Programming Guides and Menus; Accessible Emergency...

    Science.gov (United States)

    2013-12-20

    ... navigation devices'' be made accessible upon request by blind or visually impaired individuals. Both of these..., Federal Communications Commission. People with Disabilities: Contact the FCC to request reasonable...., Room CY-B402, Washington, DC 20554. Alternative formats are available for people with disabilities...

  12. Accessibility benchmarks: interpretive programs and services in north central California

    Science.gov (United States)

    Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson

    1995-01-01

    The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...

  13. Mexico's "Telesecundaria" Program and Equitable Access to Resources

    Science.gov (United States)

    Craig, Dana; Etcheverry, Jose; Ferris, Stefan

    2016-01-01

    This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…

  14. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    Science.gov (United States)

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, pwellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. 47 CFR 76.1507 - Competitive access to satellite cable programming.

    Science.gov (United States)

    2010-10-01

    ... programming. 76.1507 Section 76.1507 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... access to satellite cable programming. (a) Any provision that applies to a cable operator under §§ 76... provides video programming on its open video system, except as limited by paragraph (a) (1)-(3) of this...

  16. Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting

    Directory of Open Access Journals (Sweden)

    Alexander RW

    2013-04-01

    Full Text Available Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG with use of disposable, microcannula systems. Design: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. Results: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. Conclusion: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are

  17. Access to special education for exceptional students in French immersion programs: An equity issue

    Directory of Open Access Journals (Sweden)

    Nancy Wise

    2011-06-01

    Full Text Available Abstract Exceptional pupils enrolled in Canadian French immersion programs rarely have access to the same range of special education programs and services that are available to students in the regular English program. More often than not, students with special needs are encouraged to transfer to English programs to access necessary support services. This counselling-out process perpetuates the elitist status commonly attributed to French immersion programs. From a critical pedagogy perspective, this inquiry examines the lack of incentive on the part of multiple French immersion stakeholders to accommodate students with special needs. It further attempts to unveil the myths created by these stakeholders to better understand this discriminatory educational practice. The impact of federal and provincial funding models on access to special education programs and services is discussed, and the application of funding allocations by English-language district school boards is explored. The inquiry concludes with recommendations to promote more inclusionary practices.

  18. Prefilled syringes for intravitreal injection reduce preparation time

    DEFF Research Database (Denmark)

    Subhi, Yousif; Kjer, Birgit; Munch, Inger Christine

    2016-01-01

    INTRODUCTION: The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal...... injection treatment using either prefilled syringes or vials in routine clinical practice. METHODS: We video-recorded preparations of intravitreal injections (n = 172) for each preparation type (ranibizumab prefilled syringe (n = 56), ranibizumab vial (n = 56) and aflibercept vial (n = 60)) in a multi......-centre time and motion study. The preparation times for each step were extracted from videos and the three preparation types were compared. RESULTS: Prefilled syringes eliminated several steps in the preparation process. Total preparation time was 40.3-45.1 sec. using vials, and the use of prefilled syringes...

  19. Hypertensive Crisis During Norepinephrine Syringe Exchange: A Case Report.

    Science.gov (United States)

    Snijder, Roland A; Knape, Johannes T A; Egberts, Toine C G; Timmerman, Annemoon M D E

    2017-04-01

    A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0.8 mL, +2700%) if no clamp was used. Clamping and awareness are advised.

  20. Feasibility of Using Fluorescence Spectrophotometry to Develop a Sensitive Dye Immersion Method for Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Lu, Xujin; Lloyd, David K; Klohr, Steven E

    2016-01-01

    has recently gained industry attention due to increased regulatory agency scrutiny regarding the analytical rigor of container closure integrity testing methods and expectations to use container closure integrity testing in lieu of sterility tests in stability programs. Methylene blue dye is often used for dye ingress testing of container closure integrity, but we found it unsuitable for reliable detection of small breaches in prefilled syringes of drug product. This work describes the suitability and advantages of using a fluorescent dye and spectroscopic detection for a robust, sensitive, and quality control-friendly container closure integrity testing method for prefilled syringes. © PDA, Inc. 2016.

  1. Program partitioning for NUMA multiprocessor computer systems. [Nonuniform memory access

    Energy Technology Data Exchange (ETDEWEB)

    Wolski, R.M.; Feo, J.T. (Lawrence Livermore National Lab., CA (United States))

    1993-11-01

    Program partitioning and scheduling are essential steps in programming non-shared-memory computer systems. Partitioning is the separation of program operations into sequential tasks, and scheduling is the assignment of tasks to processors. To be effective, automatic methods require an accurate representation of the model of computation and the target architecture. Current partitioning methods assume today's most prevalent models -- macro dataflow and a homogeneous/two-level multicomputer system. Based on communication channels, neither model represents well the emerging class of NUMA multiprocessor computer systems consisting of hierarchical read/write memories. Consequently, the partitions generated by extant methods do not execute well on these systems. In this paper, the authors extend the conventional graph representation of the macro-dataflow model to enable mapping heuristics to consider the complex communication options supported by NUMA architectures. They describe two such heuristics. Simulated execution times of program graphs show that the model and heuristics generate higher quality program mappings than current methods for NUMA architectures.

  2. 75 FR 19464 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Science.gov (United States)

    2010-04-14

    ... for Unauthorized Access to Customer Information and Customer Notice AGENCY: Office of Thrift...: Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and Customer Notice... physical safeguards to: (1) Ensure the security and confidentiality of customer records and information; (2...

  3. 34 CFR 395.12 - Access to program and financial information.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... information. Each blind vendor under this part shall be provided access to all financial data of the State... annual financial reports, provided that such disclosure does not violate applicable Federal or State laws...

  4. 76 FR 41323 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2011-07-13

    ... defined in 49 CFR 37.3 as a bus characterized by an elevated passenger deck located over a baggage... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... availability of funds in Fiscal Year (FY) 2011 for the Over-the-Road Bus (OTRB) Accessibility Program...

  5. Association of mandated language access programming and quality of care provided by mental health agencies.

    Science.gov (United States)

    McClellan, Sean R; Snowden, Lonnie

    2015-01-01

    This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

  6. Auricular Clyster, Otenchytes, and Pyoulcos: Precursors of the Ear Syringe.

    Science.gov (United States)

    Rousseau, Nathalie; Mudry, Albert

    2018-04-01

    In Western medicine, the long history of the ear syringe dates back at least to the end of the 1st millennium BCE; but the corresponding Ancient Greek word surinx designates another tool. Other Greek and Latin words and phrases, in particular auricular clyster, otenchytes, and pyoulcos, were known as names of the ear syringe until modern times. The aim of this article is to study the Greek and Latin words and phrases referred to as names of the ear syringe up until modern times before syringe became the standard word. Historical and philological review of ancient Greek and Latin medical literature dealing with the subject. Careful reading of ancient medical texts mentioning these tools shows a variety of shapes and uses: beside the piston-driven syringe, the system of a bladder attached to a catheter remained in use throughout Antiquity; the otenchytes, being a piston-driven syringe, obviously was not used to squirt the liquid when the remedy put inside was warmed by a flame; the piston-driven pyoulcos is most likely of greater size, and never linked with ear care in Antiquity. Latin auricular clyster and Greek otenchytes and pyoulcos, in the few ancient texts in which they occur, designate tools of a large variety of shapes and uses, significantly different from Heron's description of piston-driven pyoulcos.

  7. 12 CFR 410.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ....150 Section 410.150 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED... extent compelled by the Architectural Barriers Act of 1968, as amended (42 U.S.C. 4151 through 4157), and...

  8. Access, Equity, and Opportunity. Women in Machining: A Model Program.

    Science.gov (United States)

    Warner, Heather

    The Women in Machining (WIM) program is a Machine Action Project (MAP) initiative that was developed in response to a local skilled metalworking labor shortage, despite a virtual absence of women and people of color from area shops. The project identified post-war stereotypes and other barriers that must be addressed if women are to have an equal…

  9. Expanding Access and Opportunity: The Washington State Achievers Program

    Science.gov (United States)

    Ramsey, Jennifer; Gorgol, Laura

    2010-01-01

    In 2001, the Bill & Melinda Gates Foundation launched a 10-year, multi-million dollar initiative, the Washington State Achievers Program (WSA), to increase opportunities for low-income students to attend postsecondary institutions in Washington State. The Bill & Melinda Gates Foundation granted funds to the College Success Foundation…

  10. 12 CFR 410.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-01-01

    ... prohibited. 410.149 Section 410.149 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED... unusable by handicapped persons, be denied the benefits of, be excluded from participation in, or otherwise...

  11. Syringe Administration of Epinephrine by Emergency Medical Technicians for Anaphylaxis.

    Science.gov (United States)

    Latimer, Andrew J; Husain, Sofia; Nolan, Jonathan; Doreswamy, Vinod; Rea, Thomas D; Sayre, Michael R; Eisenberg, Mickey S

    2018-01-15

    In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction. Treatment was guided by an EMT protocol that required a trigger and symptoms. We sought to determine if the "Check and Inject" program was safely implemented by EMTs treating presumed prehospital anaphylaxis or serious allergic reaction. We conducted a prospective investigation of all cases treated as part of the "Check and Inject" program from July 2014 through December 2016 in suburban King County, Washington, and January 2016 through December 2016 within the city of Seattle. All cases were prospectively collected using a custom quality improvement data form completed by the first responding EMTs. Two physicians completed a structured review of each EMS medical record to determine if the EMTs followed the Check and Inject protocol and determine if epinephrine was clinically-indicated based on physician review. Of the 411 cases eligible for analysis, EMTs followed the protocol appropriately in 367 (89.3%) cases. In the remaining 44 (10.7%) cases, the EMS incident report form failed to document either a clear inciting allergic trigger or an appropriate symptom from the protocol list. Physician review determined that epinephrine was clinically indicated in 36 of the 44 cases. Among the remaining 8 cases (1.9%) that did not meet protocol criteria and were not clinically-indicated based on physician review, none had a documented adverse reaction to the epinephrine. We observed that EMTs successfully implemented the manual "Check and Inject" program for severe

  12. Accessibility

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2017-01-01

    This contribution is timely as it addresses accessibility in regards system hardware and software aligned with introduction of the Twenty-First Century Communications and Video Accessibility Act (CVAA) and adjoined game industry waiver that comes into force January 2017. This is an act created...... by the USA Federal Communications Commission (FCC) to increase the access of persons with disabilities to modern communications, and for other purposes. The act impacts advanced communications services and products including text messaging; e-mail; instant messaging; video communications; browsers; game...... platforms; and games software. However, the CVAA has no legal status in the EU. This text succinctly introduces and questions implications, impact, and wider adoption. By presenting the full CVAA and game industry waiver the text targets to motivate discussions and further publications on the subject...

  13. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    Science.gov (United States)

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.

  14. Moving from College Aspiration to Attainment: Learning from One College Access Program

    Science.gov (United States)

    Dyce, Cherrel Miller; Albold, Cheryll; Long, Deborah

    2013-01-01

    Using data from a survey of 75 parents and high school students who were eligible for a college access program, this article examines parents' and students' college aspirations and their confidence in fulfilling that goal. The authors argue that pre-college preparation programs can benefit from the non-economic forms of capital that these families…

  15. Dual Language Immersion Program Equity and Access: Is There Equity for All Students?

    Science.gov (United States)

    Fernandez, Patricia Espinoza

    2016-01-01

    This is a mixed methods study of K-12 school administrators with dual language immersion school leadership expertise. The paramount research focus was to identify equity and access issues in dual language immersion programs serving grades K-12, as identified by school administrators who have led such programs. A total pool of 498 were invited to…

  16. Federal funding for syringe exchange in the US: Explaining a long-term policy failure.

    Science.gov (United States)

    Showalter, David

    2018-03-08

    The United States prohibited federal funding for syringe exchange programs for people who inject drugs nearly continuously from 1988 to 2015, despite growing scientific evidence, diminishing AIDS-related controversy, and tens of thousands of deaths from injection-related AIDS. This study investigates the political and institutional bases of this long-term failure to support lifesaving public policy. This study draws on national, regional, and local media coverage, archival sources, and semi-structured, in-depth interviews with 6 long-time syringe exchange researchers and activists from California. I use case-oriented process tracing methods to explain the persistence and reform of the federal funding ban. Though previous studies focus on the symbolic clash between conservative morality and empirical science, I find that changing demographic and regional inequalities in the effects of the AIDS epidemic and dynamics produced by the federal structure of US government were more important factors in the creation and persistence of the funding ban. The persistence and eventual repeal of the ban on federal funding for syringe exchange was a product of the changing demographic, geographic, and political effects of the AIDS epidemic within the federal structure of US government, rather than a consequence of intractable morality politics. These contextual dynamics continue to shape AIDS and public health policy at all levels of government. Copyright © 2018. Published by Elsevier B.V.

  17. Associative programming language and virtual associative access manager

    Science.gov (United States)

    Price, C.

    1978-01-01

    APL provides convenient associative data manipulation functions in a high level language. Six statements were added to PL/1 via a preprocessor: CREATE, INSERT, FIND, FOR EACH, REMOVE, and DELETE. They allow complete control of all data base operations. During execution, data base management programs perform the functions required to support the APL language. VAAM is the data base management system designed to support the APL language. APL/VAAM is used by CADANCE, an interactive graphic computer system. VAAM is designed to support heavily referenced files. Virtual memory files, which utilize the paging mechanism of the operating system, are used. VAAM supports a full network data structure. The two basic blocks in a VAAM file are entities and sets. Entities are the basic information element and correspond to PL/1 based structures defined by the user. Sets contain the relationship information and are implemented as arrays.

  18. Social-structural contexts of needle and syringe sharing behaviours of HIV-positive injecting drug users in Manipur, India: a mixed methods investigation

    Directory of Open Access Journals (Sweden)

    Shunmugam Murali

    2011-05-01

    Full Text Available Abstract Background Few investigations have assessed risk behaviours and social-structural contexts of risk among injecting drug users (IDUs in Northeast India, where injecting drug use is the major route of HIV transmission. Investigations of risk environments are needed to inform development of effective risk reduction interventions. Methods This mixed methods study of HIV-positive IDUs in Manipur included a structured survey (n = 75, two focus groups (n = 17, seven in-depth interviews, and two key informant interviews. Results One-third of survey participants reported having shared a needle/syringe in the past 30 days; among these, all the men and about one-third of the women did so with persons of unknown HIV serostatus. A variety of social-structural contextual factors influenced individual risk behaviours: barriers to carrying sterile needles/syringes due to fear of harassment by police and "anti-drug" organizations; lack of sterile needles/syringes in drug dealers' locales; limited access to pharmacy-sold needles/syringes; inadequate coverage by needle and syringe programmes (NSPs; non-availability of sterile needles/syringes in prisons; and withdrawal symptoms superseding concern for health. Some HIV-positive IDUs who shared needles/syringes reported adopting risk reduction strategies: being the 'last receiver' of needles/syringes and not a 'giver;' sharing only with other IDUs they knew to be HIV-positive; and, when a 'giver,' asking other IDUs to wash used needles/syringes with bleach before using. Conclusions Effective HIV prevention and care programmes for IDUs in Northeast India may hinge on several enabling contexts: supportive government policy on harm reduction programmes, including in prisons; an end to harassment by the police, army, and anti-drug groups, with education of these entities regarding harm reduction, creation of partnerships with the public health sector, and accountability to government policies that protect IDUs

  19. Healthcare utilization of patients accessing an African national treatment program

    Directory of Open Access Journals (Sweden)

    Wood Robin

    2007-06-01

    Full Text Available Abstract Background The roll-out of antiretroviral therapy (ART in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. Methods This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count Results 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO, excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. Conclusion Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.

  20. [Safe injection rooms and police crackdowns in areas with heavy drug dealing. Evaluation by counting discarded syringes collected from the public space].

    Science.gov (United States)

    Vecino, Carmen; Villalbí, Joan R; Guitart, Anna; Espelt, Albert; Bartroli, Montserrat; Castellano, Yolanda; Brugal, M Teresa

    2013-01-01

    The evolution of drug injection in public places is analysed using as indicator the number of syringes collected from public spaces, evaluating as well the influence of public health harm reduction interventions and of police actions, with a before and after quasi experimental study. Monthly syringe counts on the semester before and after each intervention were compared both in the involved district and in the city as a whole, using the U and z tests with a 95% confidence level. The average number of collected syringes drops from 13.132 in 2004 to 3.190 in 2012. Comparing indicators before and after health and police interventions, the opening of a facility with a supervised drug consumption room in the inner city was associated with a huge reduction in the number of abandoned syringes in the city, while its number did not rise in the district where the facility was located. The subsequent opening of another drug consumption room did not have a significant impact in collected syringes in the area. Some police interventions in 2005-2006 and 2011 had a significant impact in the indicators of the involved districts, while others did not. Harm reduction programs might have a favourable impact on drug injection in public spaces and related syringe presence. Some police interventions appear to have an impact while others do not or just have a modest local and temporary effect.

  1. Improving access to exercise training programs for patients with serious mental illness.

    Science.gov (United States)

    Druss, Benjamin G

    2017-03-01

    In a recent issue of this journal, Pratt et al report on an important new position statement by the Society of Behavioral Medicine and the American College of Sports Medicine to improve access to exercise programming as a treatment for patients treated in community mental health settings. If implemented, these recommendations could greatly expand access to these services and improve outcomes for patients treated in community mental health settings.

  2. Successful systems integration strategies: the access program for persons who are homeless and mentally ill.

    Science.gov (United States)

    Cocozza, J J; Steadman, H J; Dennis, D L; Blasinsky, M; Randolph, F L; Johnsen, M; Goldman, H

    2000-07-01

    In 1993, the Access to Community Care and Effective Services and Supports (ACCESS) federal demonstration program was initiated. Using a quasi-experimental design, the 5-year demonstration program sought to assess the impact of integrated systems of care on outcomes for homeless persons with mental illness. The authors report on which integration strategies were chosen and how their implementation is quantified. Data collected primarily through annual site visits revealed that only two strategies were used by all nine systems. The systems integration strategies employed remained relatively stable over the 5 years. Successful implementation appears to be related to the strategies selected.

  3. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  4. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    Science.gov (United States)

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  5. 75 FR 36610 - Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions...

    Science.gov (United States)

    2010-06-28

    ... appropriate Utilization and Quality Control Quality Improvement Organization (QIO). (Additional information... and 485 [CMS-3228-P] RIN 0938-AQ06 Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation To Ensure Visitation Rights for All Patients AGENCY...

  6. 75 FR 70831 - Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions...

    Science.gov (United States)

    2010-11-19

    ... appropriate Utilization and Quality Control Quality Improvement Organization (QIO). (Additional information... and 485 [CMS-3228-F] RIN 0938-AQ06 Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation To Ensure Visitation Rights for All Patients AGENCY...

  7. Changes in sport and physical activity behavior after participation in easily accessible sporting programs.

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2014-01-01

    Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups

  8. 78 FR 77721 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

    Science.gov (United States)

    2013-12-24

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...

  9. 78 FR 2449 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

    Science.gov (United States)

    2013-01-11

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...

  10. 78 FR 33445 - Office of Small Credit Unions (OSCUI) Grant Program Access For Credit Unions

    Science.gov (United States)

    2013-06-04

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access For Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...

  11. 78 FR 31530 - Applications for New Awards; Child Care Access Means Parents in School Program

    Science.gov (United States)

    2013-05-24

    ... DEPARTMENT OF EDUCATION Applications for New Awards; Child Care Access Means Parents in School Program AGENCY: Office of Postsecondary Education, Department of Education. ACTION: Notice. Overview... created by concentrations of poverty or by geographic isolation. 5. Other relevant data (see section 419N...

  12. Smile Alabama! Initiative: Interim Results from a Program To Increase Children's Access to Dental Care.

    Science.gov (United States)

    Greene-McIntyre, Mary; Finch, Mary Hayes; Searcy, John

    2003-01-01

    An Alabama initiative aimed to improve access to oral health care for Medicaid-eligible children through four components: improved Medicaid claims processing, increased reimbursement for providers, outreach and educational activities to support providers, and parent and patient education about children's oral health. In the first 3 program years,…

  13. The syringe suction drain - A unique improvisation in rural plastic ...

    African Journals Online (AJOL)

    Background: Closed suction drains are often needed in surgical practice. However, they are luxury in rural plastic surgery practice. This study highlights how syringes have become a reliable substitute. Materials and methods: This is a prospective study of the surgical outcome of patient who had various plastic surgical ...

  14. Need for needle and syringe programmes in Africa | Derrick | African ...

    African Journals Online (AJOL)

    A narrative review was conducted, drawing on peer reviewed literature and relevant grey literature on injecting drug use in African countries and ethical dilemmas facing harm reduction especially the provision of sterile needles and syringes to injecting drug users. This review aimed at highlighting evidence and the ...

  15. Improving access to preventive dental services through a school-based dental sealant program.

    Science.gov (United States)

    Devlin, Dee; Henshaw, Michelle

    2011-01-01

    The lack of access to preventive dental services, such as dental sealants, can be a major barrier to optimal dental health. School-based dental sealant programs can serve as programs to improve access to preventive dental services. This school-based dental sealant program managed by a Boston dental school with collaborating partners in the metro west area of Massachusetts provides free dental sealants to second grade children. The number of second grade children having dental sealants was tracked for 6 school years and compared with the Healthy People 2010 objective of 50% of all children aged 8 years to have at least 1 dental sealant. From school years 2003 to 2004 through 2008 to 2009, 1,609 dental screenings were provided for second grade children. Of those, 1,189 received dental sealants. To determine whether or not the Healthy People 2010 objective was met, the number of children who received dental sealants from the school-based program was added to the number of children who already had their permanent first molars sealed by their own dentist at the time of the dental screening, plus children with sealants per parent report. In total, the aggregate second grade enrollment having sealants during the designated school years was 54%. The specific Healthy People 2010 objective was achieved over the designated time period. School-based dental sealant programs can help to decrease or eliminate barriers for access to preventive dental services by increasing the number of children who receive dental sealants.

  16. Accessing Secondary Markets as a Capital Source for Energy Efficiency Finance Programs: Program Design Considerations for Policymakers and Administrators

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-02-01

    Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.

  17. Policies and programs to facilitate access to targeted cancer therapies in Thailand.

    Directory of Open Access Journals (Sweden)

    Rosarin Sruamsiri

    Full Text Available Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time.We selected two medicines on the 2013 Thai national list of essential medicines (NLEM [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923 to 3683 (95% CI 2,748-4,618; for imatinib from 103 (95% CI 72-174 to 350 (95% CI 307-398; and for trastuzumab from 68 (95% CI 45-118 to 412 (95% CI 344-563.Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these

  18. Open-Access Physical Activity Programs for Older Adults: A Pragmatic and Systematic Review.

    Science.gov (United States)

    Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M

    2018-01-10

    Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Vocational outcomes among formerly homeless persons with severe mental illness in the access program.

    Science.gov (United States)

    Cook, J A; Pickett-Schenk, S A; Grey, D; Banghart, M; Rosenheck, R A; Randolph, F

    2001-08-01

    This study examined the vocational outcomes of 4,778 formerly homeless individuals with severe mental illness who were enrolled in the Access to Community Care and Effective Services and Support (ACCESS) program, a multisite demonstration project designed to provide services to this population. Participants were interviewed at the time of enrollment and again three months and 12 months later by trained researchers who were not part of the treatment team to determine their employment status. At 12 months, participants were also asked about the types of services they had received during the past 60 days. Multiple logistic regression analysis was used to predict employment at 12 months. ACCESS participants reported receiving relatively few job-related services. Nonetheless, modest but significant increases occurred between baseline and three months and between three months and 12 months in the total proportion of participants who were employed and who were employed full-time and in hourly earnings and estimated monthly earnings. The number of hours worked per week increased significantly between three months and 12 months. When the analysis controlled for site, study condition (whether the ACCESS site received or did not receive extra funds to improve service integration), minority status, addiction treatment, and mental health treatment, participants who were employed at 12 months were more likely to have received job training and job placement services. Programs that work with homeless mentally ill persons may better serve their clients by placing as great an emphasis on providing employment services as on providing housing and clinical treatment.

  20. Supporting the whole student: Inclusive program design for making undergraduate research experiences accessible

    Science.gov (United States)

    Haacker-Santos, R.; Allen, L.; Batchelor, R. L.

    2013-12-01

    As undergraduate research experiences have become an unofficial pre-requisite to enter graduate school programs in the sciences, we have to make sure that these experiences are inclusive and accessible to all students. Program managers who make a conscious effort to recruit students from traditionally under-represented groups, including veterans, non-traditional students or students with disabilities, are often unaware of the financial and program implications these students require, and discover that their current program design might inadvertently exclude or not fully support these students. The SOARS Program, an undergraduate-to-graduate bridge program in the atmospheric sciences, has supported this group of students for over 15 years. We have found that we needed to adjust some program elements and secure extra funding sources to holistically support our students in their research experience, however, the program and the students have reaped tremendous benefits. Involving non-traditional students or veterans in our program has raised the maturity level and problem solving skills of the group, and having students with disabilities participate has been a vehicle for broadening perspective and diverse knowledge into the field of study, e.g. researching weather and climate beyond what you can 'see'. This presentation will highlight some of the findings from the SOARS program experience, and will share practices for recruitment and holistic support to ensure student success. We will share resources and tips on inclusive program design, including working with students with family commitments or physical disabilities, and will report on the enormous program benefits and peer learning these students have brought to the student cohorts and research labs they are working in.

  1. The National Access to Antiretroviral Program for PHA (NAPHA) in Thailand.

    Science.gov (United States)

    Chasombat, Sanchai; Lertpiriyasuwat, Cheewanan; Thanprasertsuk, Sombat; Suebsaeng, Laksami; Lo, Ying Ru

    2006-07-01

    To describe the development, components, initial results and lessons learned from Thailand's National Access to Antiretroviral Program for People living with HIV/AIDS (NAPHA), a historical review was conducted and program monitoring was analyzed. The national antiretroviral therapy program at different levels of the public health system was implemented with all major program components; ARV protocol development, health care professional training, drug supply chain management, laboratory network formation, monitoring and evaluation, and multi-sector and PHA involvement since 2001, which was based on elements of research, pilot projects, training, national guideline development, experiences and policy making. A national monitoring system was developed to monitor the progress of the program. From February 2001 to December 2004, the monitoring reports received from implementing hospitals showed that 58,133 cases had received antiretroviral therapy (ART), and 85% (49,477) of them were continuing to take ARV drugs. In conclusion, the NAPHA was implemented nationwide with comprehensive systems. The reports indicate achievement of expansion of the ART program. Lessons learned from the program initiation and scaling up show local leadership, comprehensive training, adherence, and coordination are essential to program effectiveness and sustainability.

  2. A piezoelectric vibration-based syringe for reducing insertion force

    Science.gov (United States)

    Huang, Y. C.; Tsai, M. C.; Lin, C. H.

    2012-12-01

    Puncturing of the human skin with a needle is perhaps the most common invasive medical procedure. Clinical studies have revealed that tissue deformation and needle deflection are the primary problem for needle misplacement in percutaneous procedures. To avoid this, various techniques for reducing insertion forces during needle insertion have been considered. This paper presents a piezoelectric vibration-based syringe to reduce insertion force. AC power was applied to the piezoelectric elements to vibrate the needle with high frequency and thereby reduce the friction and cutting forces between the needle and tissue. Vibration mode shapes of the needle were observed by finite element analysis and verified by experimental results. Effects of reducing insertion force via the vibrating needle were also confirmed by inserting the needle into the porcine tissues. The proposed syringe, which minimizes the insertion force and overcomes limitations of needle materials, can be widely utilized in robot-assisted needle insertion systems.

  3. Stability of erythropoietin repackaging in polypropylene syringes for clinical use

    Directory of Open Access Journals (Sweden)

    Angela Marsili

    2017-02-01

    Full Text Available Introduction: Epoetin alfa (Eprex® is a subcutaneous, injectable formulation of short half-life recombinant human erythropoietin (rHuEPO. To current knowledge there are no published studies regarding the stability of rHuEPO once repackaging occurs (r-EPO for clinical trial purposes. Materials and methods: We assessed EPO concentration in Eprex® and r-EPO syringes at 0, 60, 90, and 120 days after repackaging in polypropylene syringes. R-EPO was administered to 56 patients taking part in a clinical trial in Friedreich Ataxia. Serum EPO levels were measured at baseline and 48 h after r-EPO administration. Results: No differences were found between r-EPO and Eprex® syringes, but both globally decreased in total EPO content during storage at 4 °C. Patients receiving r-EPO had similar levels in EPO content as expected from previous trials in Friedreich Ataxia and from pharmacokinetics studies in healthy volunteers. Discussion: We demonstrate that repackaging of EPO does not alter its concentration if compared to the original product (Eprex®. This is true both for repackaging procedures and for the stability in polypropylene tubes. The expiration date of r-EPO can be extended from 1 to 4 months after repackaging, in accordance with pharmacopeia rules.

  4. The influence of Community Access to Child Health (CATCH) program on community pediatrics.

    Science.gov (United States)

    Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David

    2014-01-01

    The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.

  5. TimeSet: A computer program that accesses five atomic time services on two continents

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

    TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.

  6. 3D Printing Prototypes for Healthcare Professionals: Creating a Reciprocating Syringe.

    Science.gov (United States)

    Rothenberg, Steven; Abdullah, Selwan; Hirsch, Jeffrey

    2017-10-01

    3D printing (additive manufacturing) has been around since 1984, but interest in the technology has increased exponentially as it has become both accessible and inexpensive. The applications of the technology in healthcare are still being explored; however, initial forays have been encouraging. It has the potential to revolutionize the process of prototyping for healthcare professionals by democratizing the process and enhancing collaboration, making it cheaper to do iterative prototyping with little or no engineering experience. This case report details the creation of a multi-lumen reciprocating syringe with 3D printing. The product has been created and tested using a variety of publicly available resources. It provides a detailed overview of the approach and the framework required to create such a medical device. However, the implications of this report are much larger than this one product, and the fundamental ideas discussed here could be used for creating customized solutions for many healthcare problems.

  7. Characterization of Protein Aggregating Tungstates: Electrospray Mass Spectrometry Analysis of Extracts from Prefilled Syringes and from Tungsten Pins Used in the Manufacture of Syringes.

    Science.gov (United States)

    Ronk, Michael; Lee, Hans; Fujimori, Kiyoshi; Yeh, Ping; Nashed-Samuel, Yasser

    2016-01-01

    Glass prefilled syringes are increasingly becoming a container of choice for storing and administering therapeutic protein products to patients. Tungsten leaching from a PFS is known to induce protein particle formation, and the source was traced to the tungsten pins used in the manufacturing process of the syringe barrels. Study of the tungstates present in extracts from both tungsten pins used in the syringe manufacturing process and from single syringes from various suppliers was undertaken. Electrospray mass spectrometry was chosen as a technique with the sensitivity to characterize tungstates at levels (∼1 ppm of elemental tungsten) observed in single syringes. Extraction solvents were chosen to simulate the range (pH 4.0-7.0) typically used for therapeutic protein formulation. A commercial product formulation buffer was also used as an extraction solution to characterize tungstate species used for tungsten spiking studies of protein. All pin and syringe extracts from various manufacturers were similar in regards to containing stable Na/K containing lacunary polytungstate ([W11O39](7-)) species, which were the main species present in syringe extracts and are different than the metatungstate ([W12O39](6-)) species identified in commercially available sodium polytungstate and as the main species in pin extracts. These stable Na/K containing polytungstates species present in pin and syringe extracts are likely formed during the glass manufacturing process at >400 °C and may have the capability to subsequently form larger polytungstate complexes. Glass prefilled syringes are a type of container used for storing and administering biotechnology medicines to patients. The manufacturing process for the syringes may lead to very low levels of the metal tungsten being present in the syringes, and thus in the medicine stored in the syringes. The presence of tungsten in certain biotechnology medicines has been shown to cause changes to the medicine. Understanding

  8. [Embolic complications by ink clots removed from syringes during cerebral angiography].

    Science.gov (United States)

    Kohyama, Shinya; Ishihara, Shoichiro; Yamane, Fumitaka; Ishihara, Hideaki; Kanazawa, Ryuzaburo; Suzuki, Masanori; Neki, Hiroaki; Ohkawara, Mai

    2009-01-01

    We noted, during cerebral angiography, that the contrast medium was contaminated with numerous small black ink clots from gradation marks on syringes. In this report, we show that ink can be removed from syringes in solid form, and that they may result in embolic complications during cerebral angiography. To demonstrate that the ink from gradation marks on syringes can come off in a solid form and attach itself to the gloves during cerebral angiography, syringes were gripped many times (just as in an angiographic procedure) after immersion in contrast medium or 0.9% saline for 10 minutes. To see if difference of contrast medium and syringes could affect the removing of ink, five types of nonangiographic syringes and one type of angiographic syringe were rubbed with gauze after certain time periods after immersing them in four kinds of contrast medium or 0.9% saline. Ink attached itself to the gloves in a solid form by repeated gripping due to adherence of contrast medium. Ink was removed from all nonangiographic syringes by rubbing after immersion in any type of contrast medium for two hours. Gradation marks on angiographic syringes were stable with all types of contrast medium. Thus, ink for gradation marks on nonangiographic syringes, which is easily removed in a solid form due to contrast medium, can be the source of embolic complication during cerebral angiography.

  9. Survival of Hepatitis C Virus in Syringes: Implication for Transmission among Injection Drug Users

    Science.gov (United States)

    Paintsil, Elijah; He, Huijie; Peters, Christopher; Lindenbach, Brett D.; Heimer, Robert

    2010-01-01

    Background We hypothesized that the high prevalence of HCV among injection drug users (IDUs) might be due to prolonged virus survival in contaminated syringes. Methods We developed a microculture assay to examine the viability of HCV. Syringes were loaded with blood spiked with HCV reporter virus (Jc1/GLuc2A) to simulate two scenarios of residual volumes; low (2 μl) void volume for 1-ml insulin syringes, and high (32 μl) void volume for 1-ml tuberculin syringes. Syringes were stored at 4°C, 22°C, and 37°C for up to 63 days before testing for HCV infectivity using luciferase activity. Results The virus decay rate was biphasic (t½ α = 0.4h and t½β = 28h). Insulin syringes failed to yield viable HCV beyond day one at all storage temperatures except for 4o in which 5% of syringes yielded viable virus on day 7. Tuberculin syringes yielded viable virus from 96%, 71%, and 52% of syringes following storage at 4o, 22° and 37o for 7 days, respectively, and yielded viable virus up to day 63. Conclusions The high prevalence of HCV among IDUs may be partly due to the resilience of the virus and the syringe type. Our findings may be used to guide prevention strategies. PMID:20726768

  10. Analysis of event logs from syringe pumps: a retrospective pilot study to assess possible effects of syringe pumps on safety in a university hospital critical care unit in Germany.

    Science.gov (United States)

    Kastrup, Marc; Balzer, Felix; Volk, Thomas; Spies, Claudia

    2012-07-01

    Medication errors occur in approximately one out of five doses in a typical hospital setting. Patients in the intensive care unit (ICU) are particularly susceptible to errors during the application of intravenous drugs as they receive numerous potent drugs applied by syringe pumps. The aim of this study was to analyse the effects on potential harmful medication errors and to address factors that have potential for improving medication safety after the introduction of a standardized drug library into syringe pumps with integrated decision support systems. A team of physicians and nurses developed a dataset that defined standardized drug concentrations, application rates and alert limits to prevent accidental overdosing of intravenous medications. This dataset was implemented in 100 syringe pumps with the ability to log programming errors, alerts, reprogramming events and overrides ('smart pumps'). In this retrospective pilot study, all pump-related transaction data were obtained from the pump logs, by downloading the data from the pumps, covering 20 months of use between 1 April 2008 and 30 November 2009. Patient data were gathered from the electronic patient charts. The study was performed in a cardiothoracic ICU of the Charité University Hospital, Berlin, Germany. A total of 7884 patient treatment days and 133,601 infusion starts were evaluated. The drug library with the features of the dose rate was used in 92.8% of the syringe pump starts, in 1.5% of the starts a manual dosing mode without the use of the drug library was used and in 5.7% of the starts the mode 'mL/h', without any calculation features, was used. The most frequently used drugs were vasoactive drugs, followed by sedation medication. The user was alerted for a potentially harmful overdosing in 717 cases and in 66 cases the pumps were reprogrammed after the alert. During the early morning hours a higher rate of alarms was generated by the pumps, compared with the rest of the day. Syringe pumps with

  11. The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

    Science.gov (United States)

    Treloar, Carla; McCredie, Luke; Lloyd, Andrew R

    2016-01-01

    A formal Needle and Syringe Program (NSP) is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and risk mitigation opportunities for inmates. The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons. A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison. The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

  12. Bilateral innervation of syringeal muscles by the hypoglossal nucleus in the jungle crow (Corvus macrorhynchos).

    Science.gov (United States)

    Tsukahara, Naoki; Kamata, Naoki; Nagasawa, Miyuki; Sugita, Shoei

    2009-08-01

    Bird vocalizations are produced by contractions of syringeal muscles, which are controlled by the hypoglossal nucleus. In oscines, syringeal muscles are controlled by the hypoglossal nucleus ipsilaterally, whereas syringeal innervation is bilateral in non-oscines. We have determined the course of hypoglossal nerves in the jungle crow Corvus macrorhynchos. Our results indicate a cross-over of the hypoglossal nerve from the left side to the right side on the trachea 7 mm rostral to the Musculus sternotrachealis. We also investigated the innervation of the syringeal muscles of jungle crows from the hypoglossal nucleus using the horseradish peroxidase (HRP) method. After HRP was injected into the syringeal muscles on each side, HRP-labeled cells were found bilaterally in the hypoglossal nerve. These results suggest that the syringeal muscles of jungle crows are innervated bilaterally from the hypoglossal nucleus, although these birds are categorized as oscines.

  13. Embedded nanomicro syringe on chip for molecular therapy

    Directory of Open Access Journals (Sweden)

    Jalil MA

    2011-11-01

    Full Text Available Muhammad Arif Jalil1, Nathaporn Suwanpayak2,3, Kathawut Kulsirirat3, Saisudawan Suttirak3, Jalil Ali4, Preecha P Yupapin31Ibnu Sina Institute of Fundamental Science Studies, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 2King Mongkut's Institute of Technology Ladkrabang, Chumphon Campus, Chumphon, Thailand; 3Nanoscale Science and Engineering Research Alliance, Advanced Research Center for Photonics, Faculty of Science, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand; 4Institute of Advanced Photonics Science, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, MalaysiaBackground: A novel nanomicro syringe system was proposed for drug storage and delivery using a PANDA ring resonator and atomic buffer. A PANDA ring is a modified optical add/drop filter, named after the well known Chinese bear. In principle, the molecule/drug is trapped by the force generated by different combinations of gradient fields and scattering photons within the PANDA ring. A nanomicro needle system can be formed by optical vortices in the liquid core waveguide which can be embedded on a chip, and can be used for long-term treatment. By using intense optical vortices, the required genes/molecules can be trapped and transported dynamically to the intended destinations via the nanomicro syringe, which is available for drug delivery to target tissues, in particular tumors. The advantage of the proposed system is that by confining the treatment area, the effect can be decreased. The use of different optical vortices for therapeutic efficiency is also discussed.Keywords: nanomicro syringe, nanomicro needle, molecular therapy, therapeutic efficiency, cancer

  14. User preference for a portable syringe pump for iloprost infusion.

    Science.gov (United States)

    Laria, Antonella; Lurati, Alfredo Maria; Re, Katia Angela; Marrazza, Maria Grazia; Mazzocchi, Daniela; Farina, Alberto; Scarpellini, Magda

    2015-01-01

    Administration of intravenous iloprost - a first-line European League Against Rheumatism (EULAR)-recommended choice for the treatment of scleroderma (SSc)-related digital vasculopathy - requires repeated treatment cycles of 6 hours per day in a hospital setting. During the infusion, patient mobility is considerably restricted due to the size and fixity of traditional syringe pumps. The aim of this study was to evaluate the satisfaction level of patients and nurses, after the introduction of a new portable syringe pump (Infonde(®), Italfarmaco S.p.A., Milan, Italy) at the Department of Rheumatology, Magenta Hospital, Milan, Italy. Thirty-four consecutive SSc patients receiving stable therapy with iloprost, previously administered with a fixed pump, were treated using the portable Infonde(®) pump. Patients (n=34) and nurses (n=4) were asked to answer a nine- and six-item questionnaire, respectively, to assess the satisfaction of the administration comparing the new device versus the previous one. The health care staff of the ward developed the questionnaire, and the response scores ranged from 0 (fixed device better) to 10 (portable device better); thus a score >5 indicates a preference for Infonde(®). Patients' answers indicated a preference towards the new portable syringe pump, versus the previous fixed pump. Questionnaires administered to patients generated a total of 306 responses, with over 95% of the responses in the range 8-10, of which 89% had a score equal to 10. The responses of nurses showed a score equal to 10 in 100% cases. No significant adverse events were recorded, indicating no change in the tolerability profile of the drug. Iloprost administration with Infonde(®) pump was preferred by both patients and health care professionals, and was well tolerated. The possibility to perform daily activities and the freedom of movement suggest a positive impact of Infonde(®) on the treatment, with a potential favorable effect on the quality of life of

  15. Electron beam irradiations of polypropylene syringe barrels and the resulting physical and chemical property changes

    Science.gov (United States)

    Abraham, Ann C.; Czayka, M. A.; Fisch, M. R.

    2010-01-01

    Mechanical, thermal, chemical decomposition and electron spin resonance (ESR) methods were used to study electron beam irradiated polypropylene syringe barrels that were irradiated to a total fractionated dose of 0, 20, 40, 60, and 80 kGy (in steps of 20 kGy). Dose mapping was conducted to determine dose to and through the syringe barrel. Analysis of these data indicated that degradation of the polypropylene syringes increased with an increase in electron beam irradiation.

  16. Medicines access programs to cancer medicines in Australia and New Zealand: An exploratory study.

    Science.gov (United States)

    Grover, Piyush; Babar, Zaheer-Ud-Din; Oehmen, Raoul; Vitry, Agnes

    2018-03-01

    Medicines Access Programs (MAP) offer access to publicly unfunded medicines at the discretion of pharmaceutical companies. Limited literature is available on their extent and scope in Australia and New Zealand. This study aims to identify MAPs for cancer medicines that were operational in 2014-15 in Australia and New Zealand and describe their characteristics. A preliminary list of MAPs was sent to hospital pharmacists in Australia and New Zealand to validate and collect further information. Pharmaceutical companies were contacted directly to provide information regarding MAPs offered. Key stakeholders were interviewed to identify issues with MAPs. Fifty-one MAPs were identified covering a range of indications. The majority of MAPs were provided free of charge to the patient for medicines that were registered or in the process of being registered but were not funded. Variability in the number of MAPs across institutions and characteristics was observed. Australia offered more MAPs than New Zealand. Only two of 17 pharmaceutical companies contacted agreed to provide information on their MAPs. Eight stakeholder interviews were conducted. This identified that while MAPs are widely operational there is lack of clinical monitoring, inequity to access, operational issues and lack of transparency. Our results suggest a need for a standardised and mandated policy to mitigate issues with MAPs. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. A Comparison of Protein Stability in Prefillable Syringes Made of Glass and Plastic.

    Science.gov (United States)

    Waxman, Lloyd; Vilivalam, Vinod D

    2017-01-01

    The development of protein therapeutics requires stabilization of these labile molecules during shipment and storage. Biologics, particularly monoclonal antibodies, are frequently packaged at high concentration in prefillable syringes traditionally made of glass. However, some biologics are unstable in glass due to sensitivity to silicone oil, tungsten, glue, or metal ions. Syringes made from the plastic cyclic olefin polymer, Daikyo Crystal Zenith® (CZ), with a Flurotec-laminated piston, have none of these issues. This study compared the stability of several proteins including biotherapeutics when stored up to 14 months at 5 °C and 25 °C in prefillable siliconized syringes made of glass or silicone oil-free CZ syringes, and when subjected to mild agitation by end-over-end rotation at room temperature. At each time point, proteins were analyzed by several techniques including turbidity, size exclusion high-performance liquid chromatography, reversed phase high-performance liquid chromatography, ion-exchange chromatography, electrophoresis, and light scattering to monitor changes in aggregation and degradation. The results show that proteins have comparable stability when stored in glass syringes or in syringes made of CZ sterilized by E-beam or autoclave. In addition, proteins stressed by agitation were generally more stable and aggregated less in syringes made of CZ than in ones made of glass. LAY ABSTRACT: Biotherapeutic protein drugs such as monoclonal antibodies are frequently packaged at high concentration in prefillable syringes, which allows the drug to be directly administered by the patient or caregiver. Protein drugs, or biologics, can be unstable, and may aggregate, particularly when shaken. These aggregates can be immunogenic, stimulating the body's immune system to produce antibodies that can reduce the drug's efficacy. Although prefillable syringes are traditionally made of glass, some biologics are unstable in glass syringes due to the presence of

  18. Remote Memory Access: A Case for Portable, Efficient and Library Independent Parallel Programming

    Directory of Open Access Journals (Sweden)

    Alexandros V. Gerbessiotis

    2004-01-01

    Full Text Available In this work we make a strong case for remote memory access (RMA as the effective way to program a parallel computer by proposing a framework that supports RMA in a library independent, simple and intuitive way. If one uses our approach the parallel code one writes will run transparently under MPI-2 enabled libraries but also bulk-synchronous parallel libraries. The advantage of using RMA is code simplicity, reduced programming complexity, and increased efficiency. We support the latter claims by implementing under this framework a collection of benchmark programs consisting of a communication and synchronization performance assessment program, a dense matrix multiplication algorithm, and two variants of a parallel radix-sort algorithm and examine their performance on a LINUX-based PC cluster under three different RMA enabled libraries: LAM MPI, BSPlib, and PUB. We conclude that implementations of such parallel algorithms using RMA communication primitives lead to code that is as efficient as the message-passing equivalent code and in the case of radix-sort substantially more efficient. In addition our work can be used as a comparative study of the relevant capabilities of the three libraries.

  19. One-year housing arrangements among homeless adults with serious mental illness in the ACCESS program.

    Science.gov (United States)

    Mares, Alvin S; Rosenheck, Robert A

    2004-05-01

    This study examined the various living arrangements among formerly homeless adults with mental illness 12 months after they entered case management. The study surveyed 5,325 clients who received intensive case management services in the Access to Community Care and Effective Services and Supports (ACCESS) program. Living arrangements 12 months after program entry were classified into six types on the basis of residential setting, the presence of others in the home, and stability (living in the same place for 60 days). Differences in perceived housing quality, unmet housing needs, and overall satisfaction were compared across living arrangements by using analysis of covariance. One year after entering case management, 37 percent of clients had been independently housed during the previous 60 days (29 percent lived alone in their own place and 8 percent lived with others in their own place), 52 percent had been dependently housed during the previous 60 days (11 percent lived in someone else's place, 10 percent lived in an institution, and 31 percent lived in multiple places), and 11 percent had literally been homeless during the previous 60 days. Clients with less severe mental health and addiction problems at baseline and those in communities that had higher social capital and more affordable housing were more likely to become independently housed, to show greater clinical improvement, and to have greater access to housing services. After the analysis adjusted for potentially confounding factors, independently housed clients were more satisfied with life overall. However, no significant association was found between specific living arrangements and either perceived housing quality or perceived unmet needs for housing. Living independently was positively associated with satisfaction of life overall, but it was not associated with the perception that the quality of housing was better or that there was less of a need for permanent housing.

  20. Yakima Tributary Access and Habitat Program, 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Myra, D.; Ready, C.

    2003-12-01

    The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects and be

  1. Impact of syringe size on the performance of infusion pumps at low flow rates.

    Science.gov (United States)

    Schmidt, Nadia; Saez, Claudia; Seri, Istvan; Maturana, Andrés

    2010-03-01

    To evaluate the impact of syringe size on start-up delay and the time to reach 50% and 90% of target flow rates, using two commercially available syringe infusion pumps at infusion rates of < or =1 mL/hr. Two syringes (Terumo) of different size (10-mL and 50-mL), using two syringe infusion pumps (Pump A, Terumo Terufusion Infusion Pump TE-331; and Pump B, Braun Perfusor Compact S) were studied. Effective fluid delivery was measured at 0.4 mL/hr, 0.8 mL/hr, and 1.0 mL/hr for the initial 60 mins, using the gravimetric method. Instant flow was calculated as volume difference for every 1-min interval per minute. Start-up delay was defined as time in minutes of 0 flow from the start of infusion. Syringe placement, bubble removal, infusion line priming, and positioning were standardized for all measurements, using new syringes and infusion lines. Each experiment was repeated six times. Statistical analysis was performed, using a nonparametric test (Mann-Whitney U test). None. None. None. Using the 50-mL syringe, the start-up delay was consistently higher and the time to reach 50% and 90% of target flow were significantly longer, independent of which syringe infusion pump was used. At every flow rate studied, the pumps did not reach the target flow rate before 60 mins with the 50-mL syringe. With the 10-mL syringe, target flow rate was achieved before 20 mins for both pumps. Our findings demonstrate a clinically relevant impact of syringe size on syringe infusion pump performance at low flow rates. The time to reach 50% and 90% of target flow are significantly longer, using the 50-mL syringe compared with the 10-mL syringe, and the time to reach 50% of target flow is independent of the longer start-up delay. Based on our findings, we speculate that smaller syringe sizes and higher infusion rates are preferable for continuous drug infusions, particularly when prompt establishment of the drug effect is critical.

  2. Impact of Drug Formulation Variables on Silicone Oil Structure and Functionality of Prefilled Syringe System.

    Science.gov (United States)

    Shi, Galen H; Gopalrathnam, Ganapathy; Shinkle, Sharon L; Dong, Xia; Hofer, Jeffrey D; Jensen, Eric C; Rajagopalan, Natarajan

    2018-01-01

    Use of prefilled syringes to self-administer biologics via subcutaneous administration provides convenience to patients. The barrel interior of prefilled syringes is typically coated with silicone oil for lubrication to aid plunger movement at the time of administration. This study intended to evaluate the impact of formulation variables on the silicone oil on the barrel interior surface. Characterization techniques including syringe glide force, break loose force, Schlieren imaging, contact angle, inductively coupled plasma spectrometry, and thin film interference reflectometry were used in assessing the interactions. Data indicated that formulation variables such as pH, buffer/tonicity agent type and concentration, and surfactant present in the formulation can effect silicone oil lubrication of prefilled syringes, leading to changes in functional properties of the syringe over time. Syringe samples containing acetate and histidine buffers showed an increase in glide force at accelerated storage temperature conditions, but the change was minimal at 5 °C. The samples with the highest glide force correlated with the presence of mannitol in combination with sodium acetate buffer. Sodium chloride had lesser impact on glide force than mannitol. Samples with higher glide force exhibited a substantial change in the silicone oil layer of the syringe, as observed with Schlieren imaging, as well as a significant reduction in surface hydrophobicity, as demonstrated through contact angle measurement. These data indicated that the structure of the siliconized surface can change over time in contact with different formulations. During formulation development of drug products in prefilled syringes, in addition to potential impact on molecule stability, the selection of formulation variables should also be guided by assessing the impact to syringe functionality with the glide force as one of the key parameters. LAY ABSTRACT: Self-administering drug products packaged in prefilled

  3. Learning to Thrive: Building Diverse Scientists' Access to Community and Resources through the BRAINS Program.

    Science.gov (United States)

    Margherio, Cara; Horner-Devine, M Claire; Mizumori, Sheri J Y; Yen, Joyce W

    2016-01-01

    Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants' career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. © 2016 C. Margherio et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  4. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    Science.gov (United States)

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  5. Service systems integration and outcomes for mentally ill homeless persons in the ACCESS program. Access to Community Care and Effective Services and Supports.

    Science.gov (United States)

    Rosenheck, Robert A; Lam, Julie; Morrissey, Joseph P; Calloway, Michael O; Stolar, Marilyn; Randolph, Frances

    2002-08-01

    The authors evaluated the second of the two core questions around which the ACCESS (Access to Community Care and Effective Services and Supports) evaluation was designed: Does better integration of service systems improve the treatment outcomes of homeless persons with severe mental illness? The ACCESS program provided technical support and about $250,000 a year for four years to nine sites to implement strategies to promote systems integration. These sites, along with nine comparison sites, also received funds to support outreach and assertive community treatment programs to assist 100 clients a year at each site. Outcome data were obtained at baseline and three and 12 months later from 7,055 clients across four annual cohorts at all sites. Clients at all sites demonstrated improvement in outcome measures. However, the clients at the experimental sites showed no greater improvement on measures of mental health or housing outcomes across the four cohorts than those at the comparison sites. More extensive implementation of systems integration strategies was unrelated to these outcomes. However, clients of sites that became more integrated, regardless of the degree of implementation or whether the sites were experimental sites or comparison sites, had progressively better housing outcomes. Interventions designed to increase the level of systems integration in the ACCESS demonstration did not result in better client outcomes.

  6. Is crime associated with over-the-counter pharmacy syringe sales? Findings from Los Angeles, California.

    Science.gov (United States)

    Stopka, Thomas J; Geraghty, Estella M; Azari, Rahman; Gold, Ellen B; DeRiemer, Kathryn

    2014-03-01

    More than 50,000 new HIV infections occur annually in the United States. Injection drug users represent twelve percent of incident HIV infections each year. Pharmacy sales of over-the-counter (OTC) syringes have helped prevent HIV transmission among injection drug users in many states throughout the United States. However, concerns exist among some law enforcement officials, policymakers, pharmacists, and community members about potential links between OTC syringe sales and crime. We used a geographic information system and novel spatial and longitudinal analyses to determine whether implementation of pharmacy-based OTC syringe sales were associated with reported crime between January 2006 and December 2008 in Los Angeles Police Department Reporting Districts. We assessed reported crime pre- and post-OTC syringe sales initiation as well as longitudinal associations between crime and OTC syringe-selling pharmacies. By December 2008, 9.3% (94/1010) of Los Angeles Police Department Reporting Districts had at least one OTC syringe-selling pharmacy. Overall reported crime counts and reported crime rates decreased between 2006 and 2008 in all 1010 Reporting Districts. Using generalized estimating equations and adjusting for potential confounders, reported crime rates were negatively associated with OTC syringe sales (adjusted rate ratio: 0.89; 95% confidence interval: 0.81, 0.99). Our findings demonstrate that OTC pharmacy syringe sales were not associated with increases in reported crime in local communities in Los Angeles during 2006-2008. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Inhibitory Activities of Alkyl Syringates and Related Compounds on Aflatoxin Production.

    Science.gov (United States)

    Furukawa, Tomohiro; Iimura, Kurin; Kimura, Taichi; Yamamoto, Toshiyoshi; Sakuda, Shohei

    2016-06-07

    Inhibitors of aflatoxin production of aflatoxigenic fungi are useful for preventing aflatoxin contamination in crops. As methyl syringate weakly inhibits aflatoxin production, aflatoxin production inhibitory activities of additional alkyl syringates with alkyl chains from ethyl to octyl were examined. Inhibitory activity toward aflatoxin production of Aspergillus flavus became stronger as the length of the alkyl chains on the esters became longer. Pentyl, hexyl, heptyl, and octyl syringates showed strong activity at 0.05 mM. Heptyl and octyl parabens, and octyl gallate also inhibited aflatoxin production as strongly as octyl syringate. Alkyl parabens and alkyl gallates inhibit the complex II activity of the mitochondrial respiration chain; thus, whether alkyl syringates inhibit complex II activity was examined. Inhibitory activities of alkyl syringates toward complex II also became stronger as the length of the alkyl chains increased. The complex II inhibitory activity of octyl syringate was comparable to that of octyl paraben and octyl gallate. These results suggest that alkyl syringates, alkyl parabens, and alkyl gallates, including commonly used food additives, are useful for aflatoxin control.

  8. Inhibitory Activities of Alkyl Syringates and Related Compounds on Aflatoxin Production

    Directory of Open Access Journals (Sweden)

    Tomohiro Furukawa

    2016-06-01

    Full Text Available Inhibitors of aflatoxin production of aflatoxigenic fungi are useful for preventing aflatoxin contamination in crops. As methyl syringate weakly inhibits aflatoxin production, aflatoxin production inhibitory activities of additional alkyl syringates with alkyl chains from ethyl to octyl were examined. Inhibitory activity toward aflatoxin production of Aspergillus flavus became stronger as the length of the alkyl chains on the esters became longer. Pentyl, hexyl, heptyl, and octyl syringates showed strong activity at 0.05 mM. Heptyl and octyl parabens, and octyl gallate also inhibited aflatoxin production as strongly as octyl syringate. Alkyl parabens and alkyl gallates inhibit the complex II activity of the mitochondrial respiration chain; thus, whether alkyl syringates inhibit complex II activity was examined. Inhibitory activities of alkyl syringates toward complex II also became stronger as the length of the alkyl chains increased. The complex II inhibitory activity of octyl syringate was comparable to that of octyl paraben and octyl gallate. These results suggest that alkyl syringates, alkyl parabens, and alkyl gallates, including commonly used food additives, are useful for aflatoxin control.

  9. Effects of syringe material and silicone oil lubrication on the stability of pharmaceutical proteins.

    Science.gov (United States)

    Krayukhina, Elena; Tsumoto, Kouhei; Uchiyama, Susumu; Fukui, Kiichi

    2015-02-01

    Currently, polymer-based prefillable syringes are being promoted to the pharmaceutical market because they provide an increased break resistance relative to traditionally used glass syringes. Despite this significant advantage, the possibility that barrel material can affect the oligomeric state of the protein drug exists. The present study was designed to compare the effect of different syringe materials and silicone oil lubrication on the protein aggregation. The stability of a recombinant fusion protein, abatacept (Orencia), and a fully human recombinant immunoglobulin G1, adalimumab (Humira), was assessed in silicone oil-free (SOF) and silicone oil-lubricated 1-mL glass syringes and polymer-based syringes in accelerated stress study. Samples were subjected to agitation stress, and soluble aggregate levels were evaluated by size-exclusion chromatography and verified with analytical ultracentrifugation. In accordance with current regulatory expectations, the amounts of subvisible particles resulting from agitation stress were estimated using resonant mass measurement and dynamic flow-imaging analyses. The amount of aggregated protein and particle counts were similar between unlubricated polymer-based and glass syringes. The most significant protein loss was observed for lubricated glass syringes. These results suggest that newly developed SOF polymer-based syringes are capable of providing biopharmaceuticals with enhanced physical stability upon shipping and handling. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

  10. The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

    Science.gov (United States)

    Holmes, George M; Pink, George H; Friedman, Sarah A

    2013-01-01

    To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

  11. User preference for a portable syringe pump for iloprost infusion

    Directory of Open Access Journals (Sweden)

    Laria A

    2015-05-01

    Full Text Available Antonella Laria,1 Alfredo Maria Lurati,1 Katia Angela Re,1 Maria Grazia Marrazza,1 Daniela Mazzocchi,1 Alberto Farina,2 Magda Scarpellini,1 1Department of Rheumatology, Fornaroli Hospital, Magenta, Milan, Italy; 2Medical Affairs Department, Italfarmaco S.p.A., Cinisello Balsamo, Milan, Italy Purpose: Administration of intravenous iloprost – a first-line European League Against Rheumatism (EULAR-recommended choice for the treatment of scleroderma (SSc-related digital vasculopathy – requires repeated treatment cycles of 6 hours per day in a hospital setting. During the infusion, patient mobility is considerably restricted due to the size and fixity of traditional syringe pumps. The aim of this study was to evaluate the satisfaction level of patients and nurses, after the introduction of a new portable syringe pump (Infonde®, Italfarmaco S.p.A., Milan, Italy at the Department of Rheumatology, Magenta Hospital, Milan, Italy. Patients and methods: Thirty-four consecutive SSc patients receiving stable therapy with iloprost, previously administered with a fixed pump, were treated using the portable Infonde® pump. Patients (n=34 and nurses (n=4 were asked to answer a nine- and six-item questionnaire, respectively, to assess the satisfaction of the administration comparing the new device versus the previous one. The health care staff of the ward developed the questionnaire, and the response scores ranged from 0 (fixed device better to 10 (portable device better; thus a score >5 indicates a preference for Infonde®. Results: Patients' answers indicated a preference towards the new portable syringe pump, versus the previous fixed pump. Questionnaires administered to patients generated a total of 306 responses, with over 95% of the responses in the range 8–10, of which 89% had a score equal to 10. The responses of nurses showed a score equal to 10 in 100% cases. No significant adverse events were recorded, indicating no change in the tolerability

  12. Expanding access to gerontological education via distance learning: the Management of Aging Services Masters Program at UMass Boston.

    Science.gov (United States)

    Nadash, Pamela; Miller, Edward Alan; Porell, Frank W; Birchander, Ellen; Glickman, Lillian; Burr, Jeffrey A

    2014-01-01

    This article describes the online Management of Aging Services Masters Program at the University of Massachusetts Boston and reports on a recent Program review. The Program has experienced rapid growth, evolving from seven matriculating students in 2003 to 108 in 2012. It has graduated 125 students and boasts a 78% completion rate. The authors describe the Program and report on faculty and student perceptions of performance. The Program demonstrates sound pedagogical practice for online education, incorporating techniques to foster community and encourage students and faculty interaction. Distance learning holds considerable promise for expanding access to gerontological education to reach future aging services professionals.

  13. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

  14. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  15. Leakage of Oxygen from Blood and Water Samples Stored in Plastic and Glass Syringes

    Science.gov (United States)

    Scott, Peter V.; Horton, J. N.; Mapleson, W. W.

    1971-01-01

    Theory and experiment showed that samples of blood and water stored in 2-ml and 5-ml syringes made of polypropylene, polystyrene, or S.A.N. co-polymer exchanged oxygen with their surroundings. In the first hour the exchange was due mainly to equilibration with the plastic of the syringe and only in small degree to permeation through the plastic. With high initial tension or with blood of low haemoglobin concentration the exchange can result in errors in Po2 of up to 6% in two minutes and 16% in 30 to 60 minutes. With all-glass syringes the exchange was much slower but, even so, after 24 hours was important in all but a few of 18 interchangeable glass syringes. Therefore unless analysis can be started immediately all-glass syringes are to be preferred, and for prolonged storage even these should be selected. PMID:5565518

  16. Syringe calibration factors and volume correction factors for the NPL secondary standard radionuclide calibrator

    CERN Document Server

    Tyler, D K

    2002-01-01

    The activity assay of a radiopharmaceutical administration to a patient is normally achieved via the use of a radionuclide calibrator. Because of the different geometries and elemental compositions between plastic syringes and glass vials, the calibration factors for syringes may well be significantly different from those for the glass containers. The magnitude of these differences depends on the energies of the emitted photons. For some radionuclides variations have been observed of 70 %, it is therefore important to recalibrate for syringes or use syringe calibration factors. Calibration factors and volume correction factors have been derived for the NPL secondary standard radionuclide calibrator, for a variety of commonly used syringes and needles, for the most commonly used medical radionuclide.

  17. Pre-filled syringes: a review of the history, manufacturing and challenges.

    Science.gov (United States)

    Sacha, Gregory; Rogers, J Aaron; Miller, Reagan L

    2015-01-01

    Pre-filled syringes are convenient devices for the delivery of parenteral medications. They are small which makes them easy to carry and are dependable for delivering a precise dose of medication. These and many other reasons are leading to their growth in the pharmaceutical market. There are a number of review articles that describe the advantages and disadvantages of pre-filled syringes. However, there are few journal articles that present information on their manufacturing and challenges. The intent of this review article is to provide information on the history of the pre-filled syringe, methods of their manufacture, methods of filling syringes as a drug product and to examine the types of syringes available. This type of knowledge can familiarize the formulation scientist with the choices available and their possible challenges.

  18. Specialty Care Access Network-Extension of Community Healthcare Outcomes Model Program for Liver Disease Improves Specialty Care Access.

    Science.gov (United States)

    Glass, Lisa M; Waljee, Akbar K; McCurdy, Heather; Su, Grace L; Sales, Anne

    2017-12-01

    To improve subspecialty access, VA Ann Arbor Healthcare System (VAAAHS) implemented the first Specialty Care Access Network (SCAN)-Extension of Community Healthcare Outcomes (ECHO) in chronic liver disease. SCAN-ECHO Liver links primary care providers (PCPs) to hepatologists via secure video-teleconferencing. We aim to describe characteristics of participants (PCPs) and patients (clinical question and diagnosis) in SCAN-ECHO Liver. This is a prospective study of the VAAAHS SCAN-ECHO Liver (June 10, 2011-March 31, 2015). This evaluation was carried out as a non-research activity under the guidance furnished by VHA Handbook 1058.05. It was approved through the Medicine Service at VAAAHS as noted in the attestation document which serves as documentation of approved non-research, quality improvement activities in VHA. In total, 106 PCPs from 23 sites participated. A total of 155 SCAN-ECHO sessions discussed 519 new and 49 return patients. 29.4% of Liver Clinic requests were completed in SCAN-ECHO Liver. SCAN-ECHO Liver consults were completed an average of 10 days sooner than in conventional clinic. Potential travel saving was 250 miles round-trip (median 255 (IQR 142-316) per patient. SCAN-ECHO Liver provided specialty care with increased efficiency and convenience for chronic liver disease patients. One of three of Liver Clinic consults was diverted to SCAN-ECHO Liver, reducing consult completion time by 20%.

  19. Pembrolizumab for advanced melanoma: experience from the Spanish Expanded Access Program.

    Science.gov (United States)

    González-Cao, M; Arance, A; Piulats, J M; Marquez-Rodas, I; Manzano, J L; Berrocal, A; Crespo, G; Rodriguez, D; Perez-Ruiz, E; Berciano, M; Soria, A; Castano, A G; Espinosa, E; Montagut, C; Alonso, L; Puertolas, T; Aguado, C; Royo, M A; Blanco, R; Rodríguez, J F; Muñoz, E; Mut, P; Barron, F; Martin-Algarra, S

    2017-06-01

    The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases.

  20. The Partnership Access Line: evaluating a child psychiatry consult program in Washington State.

    Science.gov (United States)

    Hilt, Robert J; Romaire, Melissa A; McDonell, Michael G; Sears, Jeanne M; Krupski, Antoinette; Thompson, Jeffery N; Myers, Jim; Trupin, Eric W

    2013-02-01

    To evaluate a telephone-based child mental health consult service for primary care providers (PCPs). Record review, provider surveys, and Medicaid database analysis. Washington State Partnership Access Line (PAL) program. A total of 2285 PAL consultations by 592 PCPs between April 1, 2008, and April 30, 2011. Primary care provider-initiated consultations with PAL service. The PAL call characteristics, PCP feedback surveys, and Medicaid claims between April 2007 and December 2009 for fee-for-service Medicaid children before and after a PAL call. Sixty-nine percent of calls were about children with serious emotional disturbances, and 66% of calls were about children taking psychiatric medications. Primary care providers nearly always received new psychosocial treatment advice (87% of calls) and were more likely to receive advice to start rather than stop a medication (46% vs 24% of calls). Primary care provider feedback surveys reported uniformly positive satisfaction with the program. Among Medicaid children, there was significant increases in attention-deficit/hyperactivity disorder and antidepressant medication use after the PAL call but no significant change in reimbursements for mental health medications (P < .05). Children with a history of foster care experienced a 132% increase in outpatient mental health visits after the PAL call (P < .05). Primary care providers used PAL for psychosocial and medication treatment assistance for particularly high-needs children and were satisfied with the service. Furthermore, PAL was associated with increased use of outpatient mental health care for some children.

  1. Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access.

    Science.gov (United States)

    Rutkow, Lainie; Turner, Lydia; Lucas, Eleanor; Hwang, Catherine; Alexander, G Caleb

    2015-03-01

    State prescription drug monitoring programs are common tools intended to reduce prescription drug abuse and diversion, or the nonmedical use of a prescribed drug. The success of these programs depends largely upon physicians' awareness and use of them. We conducted a nationally representative mail survey of 1,000 practicing primary care physicians in 2014 to characterize their attitudes toward and awareness and use of prescription drug monitoring programs. A total of 420 eligible physicians (adjusted response rate: 58 percent) returned completed surveys. Among all physicians surveyed, 72 percent were aware of their state's prescription drug monitoring program, and 53 percent reported using one of the programs. We identified several barriers that may prevent greater use of the programs, including the time-consuming nature of information retrieval and the lack of an intuitive format for data provided by the programs. These results suggest that the majority of US primary care physicians are aware of and use prescription drug monitoring programs at least on occasion, although many did not access these programs routinely. To increase the use of the programs in clinical practice, states should consider implementing legal mandates, investing in prescriber education and outreach, and taking measures to enhance ease of access to and use of the programs. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Evaluation of an Enhanced Role-Based Access Control model to manage information access in collaborative processes for a statewide clinical education program.

    Science.gov (United States)

    Le, Xuan Hung; Doll, Terry; Barbosu, Monica; Luque, Amneris; Wang, Dongwen

    2014-08-01

    Managing information access in collaborative processes is a critical requirement to team-based biomedical research, clinical education, and patient care. We have previously developed a computation model, Enhanced Role-Based Access Control (EnhancedRBAC), and applied it to coordinate information access in the combined context of team collaboration and workflow for the New York State HIV Clinical Education Initiative (CEI) program. We report in this paper an evaluation study to assess the effectiveness of the EnhancedRBAC model for information access management in collaborative processes when applied to CEI. We designed a cross-sectional study and performed two sets of measurement: (1) degree of agreement between EnhancedRBAC and a control system CEIAdmin based on 9152 study cases, and (2) effectiveness of EnhancedRBAC in terms of sensitivity, specificity, and accuracy based on a gold-standard with 512 sample cases developed by a human expert panel. We applied stratified random sampling, partial factorial design, and blocked randomization to ensure a representative case sample and a high-quality gold-standard. With the kappa statistics of four comparisons in the range of 0.80-0.89, EnhancedRBAC has demonstrated a high level of agreement with CEIAdmin. When evaluated against the gold-standard, EnhancedRBAC has achieved sensitivities in the range of 97-100%, specificities at the level of 100%, and accuracies in the range of 98-100%. The initial results have shown that the EnhancedRBAC model can be effectively used to manage information access in the combined context of team collaboration and workflow for coordination of clinical education programs. Future research is required to perform longitudinal evaluation studies and to assess the effectiveness of EnhancedRBAC in other applications. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

    Science.gov (United States)

    Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie; Smyth, Daniel

    2018-02-13

    The availability of curative hepatitis C therapies has created an opportunity to improve treatment delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a communitybased prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: (1) treatment effectiveness using intention-to-treat analysis; and (2) patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

  4. Modeling hospital infrastructure by optimizing quality, accessibility and efficiency via a mixed integer programming model.

    Science.gov (United States)

    Ikkersheim, David; Tanke, Marit; van Schooten, Gwendy; de Bresser, Niels; Fleuren, Hein

    2013-06-16

    The majority of curative health care is organized in hospitals. As in most other countries, the current 94 hospital locations in the Netherlands offer almost all treatments, ranging from rather basic to very complex care. Recent studies show that concentration of care can lead to substantial quality improvements for complex conditions and that dispersion of care for chronic conditions may increase quality of care. In previous studies on allocation of hospital infrastructure, the allocation is usually only based on accessibility and/or efficiency of hospital care. In this paper, we explore the possibilities to include a quality function in the objective function, to give global directions to how the 'optimal' hospital infrastructure would be in the Dutch context. To create optimal societal value we have used a mathematical mixed integer programming (MIP) model that balances quality, efficiency and accessibility of care for 30 ICD-9 diagnosis groups. Typical aspects that are taken into account are the volume-outcome relationship, the maximum accepted travel times for diagnosis groups that may need emergency treatment and the minimum use of facilities. The optimal number of hospital locations per diagnosis group varies from 12-14 locations for diagnosis groups which have a strong volume-outcome relationship, such as neoplasms, to 150 locations for chronic diagnosis groups such as diabetes and chronic obstructive pulmonary disease (COPD). In conclusion, our study shows a new approach for allocating hospital infrastructure over a country or certain region that includes quality of care in relation to volume per provider that can be used in various countries or regions. In addition, our model shows that within the Dutch context chronic care may be too concentrated and complex and/or acute care may be too dispersed. Our approach can relatively easily be adopted towards other countries or regions and is very suitable to perform a 'what-if' analysis.

  5. Accessibility in Teaching Assistant Training: A Critical Review of Programming from Ontario's Teaching and Learning Centres

    Science.gov (United States)

    Vander Kloet, Marie

    2015-01-01

    It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and…

  6. Collaboration and Perspectives on Identity Management and Access from two Geoscience Cyberinfrastructure Programs

    Science.gov (United States)

    Ramamurthy, M. K.

    2016-12-01

    Increasingly, the conduct of science requires close international collaborations to share data, information, knowledge, expertise, and other resources. This is particularly true in the geosciences where the highly connected nature of the Earth system and the need to understand global environmental processes have heightened the importance of scientific partnerships. As geoscience studies become a team effort involving networked scientists and data providers, it is crucial that there is open and reliable access to earth system data of all types, software, tools, models, and other assets. That environment demands close attention to security-related matters, including the creation of trustworthy cyberinfrastructure to facilitate the efficient use of available resources and support the conduct of science. Unidata and EarthCube, both of which are NSF-funded and community-driven programs, recognize the importance of collaborations and the value of networked communities. Unidata, a cornerstone cyberinfrastructure facility for the geosciences, includes users in nearly 180 countries. The EarthCube initiative is aimed at transforming the conduct of geosciences research by creating a well-connected and facile environment for sharing data and in an open, transparent, and inclusive manner and to accelerate our ability to understand and predict the Earth system. We will present the Unidata and EarthCube community perspectives on the approaches to balancing an environment that promotes open and collaborative eScience with the needs for security and communication, including what works, what is needed, the challenges, and opportunities to advance science.

  7. Mass surveillance, privacy, and freedom : A case for public access to information about mass government surveillance programs

    NARCIS (Netherlands)

    Newell, Bryce; Moore, Adam D.

    2015-01-01

    This chapter examines judicial decisions about the legality of mass surveillance in the United States and Europe (at the European Court of Human Rights), and explores how the existence of these programs threatens individual freedom. In doing so, the chapter presents a theory of information access

  8. Frequently Identified Gaps in Antimicrobial Stewardship Programs in Critical Access Hospitals

    Science.gov (United States)

    Chung, Philip; Nailon, Regina; Tyner, Kate; Beach, Sue; Bergman, Scott; Drake, Margaret; Fitzgerald, Teresa; Lyden, Elizabeth; Rupp, Mark E; Schwedhelm, Michelle; Tierney, Maureen; Schooneveld, Trevor Van; Ashraf, Muhammad Salman

    2017-01-01

    Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH. Methods NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February 2017. ASP activities related to the 7 CDC recommended core elements (CE) including leadership support (LS), accountability, drug expertise (DE), action, tracking, reporting, and education were assessed using a CDC Infection Control Assessment Tool for acute care hospitals. Descriptive analyses evaluated CAH characteristics and frequency of CE implementation. Fisher’s exact, Mann–Whitney, and Kruskal–Wallis tests were used for statistical analyses examining the association of various factors with level of ASP activities. Results The 36 surveyed CAH had a median of 20 (range 10–25) beds and employed a median of 0.4 (range 0.1–1.6) infection preventionist (IP) full-time equivalent (FTE)/25-bed. Frequency of CE implementation varied among CAH with action and LS as the most (69%) and least (28%) frequently implemented elements, respectively. Close to half (47%) of surveyed CAH had implemented ≥4 CE but only 14% of facilities had all 7 CE. Median bed size and IP FTE/25-bed were similar among CAH with 0–2, 3-5, or ≥6 CE in place. CAH with LS or accountability for ASP implemented higher median numbers of the remaining CE compared with CAH without LS or accountability (5 vs. 2, P < 0.01 and 4 vs. 2, P < 0.01, respectively). Facilities with The presence of LS, accountability and drug expertise

  9. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  10. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

    Science.gov (United States)

    Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted

  11. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  12. KEBERHASILAN PENETRASI BAHAN PIT & FISSURE SEALANT KE DALAM FISURA MENGGUNAKAN SYRINGE BLUE MICRO TIPS DAN SYRINGE WHITE MINI BRUSH TIPS (LAPORAN PENELITIAN

    Directory of Open Access Journals (Sweden)

    Avy Permata Sari

    2015-07-01

    Full Text Available The aim of this study was to know the success and differences of pit & fissure sealant materal penetration of composite resin type (UltraSeal XT Plus into fissure by using syringe blue micro tips and syringe white mini brush tips in fissure closure efforts for caries prevention of permanent teeth. The study was conducted to 30 maxillary first premolar, using syring blue micro tips, and 30 maxilary first premolar using syringw white mini brush tips. The samples, then, were made smears and observed by optic microscope with 300 times magnification. The result of this stuy showed that mean of pit & fissure sealant material penetration of composite resin type into fissure by using blue micro tips was (67.93 ± 13.09%. By using syringe white mini brush tips was (92.96 ± 6.18%. With t-test, it showed a significant difference (t = 9.84, p<0,01.

  13. Evaluation of syringe shield effectiveness in handling radiopharmaceuticals

    Directory of Open Access Journals (Sweden)

    Cho Yong-In

    2015-01-01

    Full Text Available The purpose of this study was to evaluate the effectiveness of the radiation shield of radionuclide syringes and the personal dose equivalent by performing a simulation of radionuclides used in nuclear medicine diagnosis. In order to evaluate the dose depending on the distance between the radiation source and the ICRU sphere against the thickness of the shielding device, the distance at which a nuclear medicine worker may inadvertently come into contact with radiation from the radiation source was set at 0 cm to 30 cm according to the thickness of the shield, thus fixing the ICRU sphere. For a dose evaluation, Hp(10, Hp(3, and Hp(0.07 measurable in specific depth of the ICRU were evaluated. It was found that a dose measured on skin surface of nuclear medicine workers was relatively higher, that the dose varied in relation to the thickness of the radiation shield, and that the shielding effect decreased for some radiation sources such as 67Ga and 111In. It proved necessary to increase thickness of shielding device to the radiation sources such as 67Ga and 111In. It is also considered that a study of proper shielding thickness will be needed in future.

  14. Study on the radiation effect of plastic syringe materials

    International Nuclear Information System (INIS)

    Byun, H.C.; Yun, B.M.; Kim, K.Y.; Kong, Y.K.; Park, H.Y.

    1983-01-01

    From the viewpoint of gammasterilization, the defects of domestic polypropylene as the syringe material are to get worse the mechanical properties and discoloration by irradiation. Therefore, the domestic polystyrene (GPPS 150) were inspected to use as substitute for the polypropylene. The gel point of the polystyrene was about 100Mrad and none momentous change of the mechanical properties were appeared until the dose reached to the point. Above the point, as the crosslinking reaction proceed both strength of tensile and impact were increased with discoloration. No significant problem was also found in the water extract test and chemical resistance test. In addition to the pure polystyrene, the copolymer of butadiene (HIPS 425) and the blend material of polypropylene were also inspected for the purpose and almost same results were obtained in the radiation irradiation. From the above result, it is considered that polystyrene and the copolymer and the blend mentioned above are available for the medical plastics which would be sterilized by gamma-radiation. (Author)

  15. Mechanized syringe homogenization of human and animal tissues.

    Science.gov (United States)

    Kurien, Biji T; Porter, Andrew C; Patel, Nisha C; Kurono, Sadamu; Matsumoto, Hiroyuki; Scofield, R Hal

    2004-06-01

    Tissue homogenization is a prerequisite to any fractionation schedule. A plethora of hands-on methods are available to homogenize tissues. Here we report a mechanized method for homogenizing animal and human tissues rapidly and easily. The Bio-Mixer 1200 (manufactured by Innovative Products, Inc., Oklahoma City, OK) utilizes the back-and-forth movement of two motor-driven disposable syringes, connected to each other through a three-way stopcock, to homogenize animal or human tissue. Using this method, we were able to homogenize human or mouse tissues (brain, liver, heart, and salivary glands) in 5 min. From sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis and a matrix-assisted laser desorption/ionization time-of-flight mass spectrometric enzyme assay for prolidase, we have found that the homogenates obtained were as good or even better than that obtained used a manual glass-on-Teflon (DuPont, Wilmington, DE) homogenization protocol (all-glass tube and Teflon pestle). Use of the Bio-Mixer 1200 to homogenize animal or human tissue precludes the need to stay in the cold room as is the case with the other hands-on homogenization methods available, in addition to freeing up time for other experiments.

  16. Increasing access to evidence-based smoking cessation treatment: effectiveness of a free nicotine patch program among Chinese immigrants.

    Science.gov (United States)

    Shelley, Donna; Nguyen, Nam; Peng, Cha-Hui; Chin, Margaret; Chang, Ming-der; Fahs, Marianne

    2010-04-01

    Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

  17. Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia

    Directory of Open Access Journals (Sweden)

    Emily Saurman

    2014-07-01

    Full Text Available The Mental Health Emergency Care-Rural Access Program (MHEC-RAP is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

  18. Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

    Science.gov (United States)

    Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

    2018-03-01

    Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (p<0.001), duration (p<0.001), and amplitude (p<0.001) compared with control data. This novel data collection and signal processing analysis showed a significant increase in frequency, duration, and magnitude of systolic blood pressure perturbations surrounding epinephrine syringe exchange events.

  19. Community decision-making about critical access hospitals: lessons learned from Montana's Medical Assistance Facility Program.

    Science.gov (United States)

    Shreffler, M J; Capalbo, S M; Flaherty, R J; Heggem, C

    1999-01-01

    Limited-service hospitals have been used as a means of maintaining health care services in rural communities with full-service hospitals at risk of closure. The Medical Assistance Facility (MAF) limited-service hospital model has been implemented in 12 communities in Montana and has been evaluated by the Health Care Financing Administration as a viable alternative to a full-service hospital in frontier communities. The 1997 federal Critical Access Hospital (CAH) legislation is the most recent nationwide alternative for maintaining health care in rural communities, and it incorporates many of the features of the MAF model. The purpose of this study was to examine rural community decision making regarding MAF conversion from the perspectives of key informants who were involved in the decision-making process. A descriptive multiple case study design was used. Data were obtained through interviews with community members during site visits. The research focused on identification of local issues that were influential in the decision to convert to or reopen as an MAF, features of the MAF model that made it a locally acceptable alternative, and elements that characterized the decision-making process. The issues found to be influential in the conversion decision and the features that made the MAF locally acceptable were those that made the provision of basic services more stable and sustainable. The study suggests that programs to maintain health care services in isolated communities should allow for and encourage an expanded role for nonphysician providers. The lessons learned from the communities included in this study are instructive to rural communities nationwide that are considering a CAH as well as to policy-makers, researchers, and regional and national health care decision makers.

  20. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    R. Respaud

    2014-01-01

    Full Text Available Background. Ectopic pregnancy (EP is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX. Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays.

  1. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Science.gov (United States)

    Respaud, R.; Gaudy, A. S.; Arlicot, C.; Tournamille, J. F.; Viaud-Massuard, M. C.; Elfakir, C.; Antier, D.

    2014-01-01

    Background. Ectopic pregnancy (EP) is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX). Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays. PMID:24900977

  2. Efficacy of Syringe Filtration for the Selective Isolation of Campylobacter from Chicken Carcass Rinse.

    Science.gov (United States)

    Chon, Jung-Whan; Kim, Hong-Seok; Kim, Dong-Hyeon; Kim, Young-Ji; Sung, Kidon; Kim, Hyunsook; Seo, Kun-Ho

    2017-06-01

    We investigated the efficacy of syringe filtration for selective isolation of Campylobacter from chicken carcass rinse by combining syringe filtration with the conventional culture method. Whole chicken carcass rinses were incubated in Bolton enrichment broth, set aside or subjected to syringe filtration, and streaked on Campy-Cefex agar with or without cefoperazone antibiotic supplement. Compared with the conventional method without filtration, 0.65-μm-pore-size syringe filtration resulted in a significantly higher number of Campylobacter-positive samples (23.8 to 37.5% versus 70.0 to 72.5%; P Campylobacter (93.8% versus 6.3 to 26.3%), and a lower growth index (1 = growth of a few colonies; 2 = growth of colonies on about half of the plate; and 3 = growth on most of the plate) for competing microbiota (2.9 to 3.0 versus 1.2 to 1.4). When syringe filtration was applied, agar plates containing the antibiotic had significantly less contamination (6.3% versus 26.3%; P Campylobacter isolation rate was similar (P > 0.05). Syringe filtration combined with conventional enrichment improved the rate and selectivity of Campylobacter isolation from chicken carcasses.

  3. 75 FR 6790 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Science.gov (United States)

    2010-02-10

    ... for Unauthorized Access to Customer Information and Customer Notice AGENCY: Office of Thrift... for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form...) Ensure the security and confidentiality of customer records and information; (2) protect against any...

  4. 77 FR 47440 - Office of the Assistant Secretary for Office of Disability Employment Program Accessible...

    Science.gov (United States)

    2012-08-08

    ...- assessment, policies and practices, infrastructure, and continuous improvement; (3) facilitate policy... employment and creating accessible human resource management systems (e.g., accessible online job application... through a competitive process for a 12-month period of performance, with the possibility of up to four (4...

  5. Integrating a Writing-Across-Curriculum Program into a Self-Access Learning Center

    Science.gov (United States)

    Hsu, Jeng-yih

    2007-01-01

    In recent years, several writing centers have been set up in colleges and universities of Taiwan. Almost at the same time, many self-access learning centers are being designed and built on campuses all over the island. Whether these two institutes function jointly or independently, dissatisfaction arises. In order to run the self-access learning…

  6. 77 FR 44515 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2012-07-30

    ... policies, restrictions, and/or requirements to be imposed on fly-in guests who taxi from the airport... a legal right of access from the property to the airport (e.g., by easement or contract) in.... Because the ability of some sponsors to control access has been compromised as a result of legal rights...

  7. Evaluation of an open-access CBT-based Internet program for social anxiety: Patterns of use, retention, and outcomes.

    Science.gov (United States)

    Dryman, M Taylor; McTeague, Lisa M; Olino, Thomas M; Heimberg, Richard G

    2017-10-01

    Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. [Manual intrauterine aspiration using a Karmann syringe. Multicenter study in Sonora and Sinaloa, Mexico].

    Science.gov (United States)

    Rocha Cortes, F; Chacon Iñiguez, J; Amaro Patron, R; Ramon Alvarez Morales, J; Vargas Zepeda, D

    1996-03-01

    These are the results of a prospective, multicentric study carried out in five institutional hospitals in Sonora and Sinaloa, using Karmann syringe and cannulae for manual intrauterine aspiration in cases of incomplete abortion, dead and retained ovum, hidatiform mola and endometrial biopsy. Management data in 1046 patients, are described; methodology is shown, and demonstrating that it converts uterine emptying is a simple, efficacious and economical procedure, with a very low risk and it allows these patients management in an ambulatory way. From these results, and as it is demonstrated in the study, institutions may increase their programable resources as to amount of disposable beds, for other type of patients, and the offering of attention by surgeon, anesthetist, nurse and medication, as their hospital stay is minimal, and in most of the cases active anesthetist participation is not required. In the same way, it permits the patient a better relationship with the personal of the institution, and so, a more human care and the possibility of reintegrating the patient to a familiar environment, rapidly, and in good psychical and physical conditions.

  9. Integrated employee assistance program/managed behavioral health care benefits: relationship with access and client characteristics.

    Science.gov (United States)

    Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G

    2009-11-01

    This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier.

  10. The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan.

    Science.gov (United States)

    Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim

    2017-01-01

    End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

  11. The effect of an educational program for vascular access care on nurses’ knowledge at dialysis centers in Khartoum State, Sudan

    Directory of Open Access Journals (Sweden)

    Kalthoum Ibrahim Yousif

    2017-01-01

    Full Text Available End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses’ knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group. Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82. Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses’ knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001. The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

  12. 34 CFR Appendix A to Subpart C of... - Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study A Appendix A to Subpart C of Part 692 Education Regulations of the Offices of...) State Grant Allotment Case Study ER29OC09.010 ER29OC09.011 ER29OC09.012 ER29OC09.013 ER29OC09.014...

  13. Technology access from the FS-X radar program. Lessons for technology transfer and US acquisition policy

    Science.gov (United States)

    Chang, Ike Y., Jr.

    The FS-X is a cooperative aircraft development program launched in 1989 between the United States and Japan. The FS-X program entitles the U.S. government and U.S. industry access to Japanese FS-X technology. This report explores the issue of U.S. access and possible licensed transfer of Japanese FS-X radar technology for use by the U.S. government and industry. The FS-X radar program is significant in that it may be the first program to develop an operational active phased array radar (APAR) for airborne fire control. APAR technology has the benefits of superior performance, rehability, and maintainability. Nevertheless, because of stringent U.S. program requirements and high production costs, APAR has not yet become an operational reality in the United States. The FS-X is, therefore, important in that it may signify growing strengths of Japan in a technical area historically dominated by U.S. firms.

  14. Safe and unsafe spaces: Non-fatal overdose, arrest, and receptive syringe sharing among people who inject drugs in public and semi-public spaces in Baltimore City.

    Science.gov (United States)

    Hunter, Kyle; Park, Ju Nyeong; Allen, Sean T; Chaulk, Patrick; Frost, Taeko; Weir, Brian W; Sherman, Susan G

    2018-04-13

    The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing. The sample of PWID (N = 283) was mostly 45 years and older (54%), male (69%), Black (55%), and heroin users (96%). Compared to PWID who primarily used private settings, the adjusted odds of recent overdose were greater among PWID who mostly used semi-public and public locations to inject drugs. We also found independent associations between arrest and semi-public spaces, and between receptive syringe sharing and public spaces (all p spaces where PWID can reduce their risk of overdose, likelihood of arrest and blood-borne diseases, and the dual potential of the environment in promoting health and risk. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Galveston Head Start Captive Reared Sea Turtle Program 1979 to 2016 (NCEI Accession 0157625)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This is a compilation of several data sets related to the Galveston Texas Seaturtle Headstart program. Most notable is the Kemp's ridley headstart program...

  16. National Program for Improving Access and Quality of Primary Care: Implications of its implementation in the Brazilian Northeast

    Directory of Open Access Journals (Sweden)

    Ianna Priscilla Dantas de Queiroz

    2017-06-01

    Full Text Available Introduction: The Ministry of Health has been very interested in initiative to maintain and / or improve the quality of population health, among which the National Program for Improving Access and Quality of Basic Care (PMAQ stands out. Objective: To analyze the changes in the area of work management of the basic care teams after the implementation of the Program of Improvement of Access and Quality of Primary Care (PMAQ from the perspective of professionals inserted in Primary Care. Method: This is a descriptive study with a qualitative approach, carried out in the city of Santa Cruz, in the county of the PMAQ implementation in the Trairi region, in the state of Rio Grande do Norte, from September to November 2016. Two techniques were used for data collection: the semi-structured interview with the secretary of health and coordinator of basic care of the county, and the technique of focus group with the graduated professionals who work in the Basic Units that joined the PMAQ. Results: From this analysis emerged 3 categories: Implementation of the National Program for Improving Access and Quality of Primary Care, PMAQ encouraging changes in the health work process, and Evaluation on the PMAQ. Conclusion: The main change made by the PMAQ in the work process of Primary Care professionals was their organization.   KEY WORDS: primary health Care; Unified Health System; human resources.

  17. Stability of cyclosporine solutions stored in polypropylene-polyolefin bags and polypropylene syringes.

    Science.gov (United States)

    Li, Mengqing; Forest, Jean-Marc; Coursol, Christian; Leclair, Grégoire

    2011-09-01

    The stability of cyclosporine diluted to 0.2 or 2.5 mg/mL with 0.9% sodium chloride injection or 5% dextrose injection and stored in polypropylene-polyolefin containers or polypropylene syringes was evaluated. Intravenous cyclosporine solutions (0.2 and 2.5 mg/mL) were aseptically prepared and transferred to 250-mL polypropylene-polyolefin bags or 60-mL polypropylene syringes. Chemical stability was measured using a stability-indicating high-performance liquid chromatography (HPLC) assay. Physical stability was assessed by visual inspection and a dynamic light scattering (DLS) method. After 14 days, HPLC assay showed that the samples of i.v. cyclosporine stored in polypropylene-polyolefin bags remained chemically stable (>98% of initial amount remaining); the physical stability of the samples was confirmed by DLS and visual inspection. The samples stored in polypropylene syringes were found to contain an impurity (attributed to leaching of a syringe component by the solution) that could be detected by HPLC after 1 day; on further investigation, no leaching was detected when the syringes were exposed to undiluted i.v. cyclosporine 50 mg/mL for 10 minutes. Samples of i.v. cyclosporine solutions of 0.2 and 2.5 mg/mL diluted in 0.9% sodium chloride injection or 5% dextrose injection and stored at 25 °C in polypropylene-polyolefin bags were physically and chemically stable for at least 14 days. When stored in polypropylene syringes, the samples were contaminated by an impurity within 1 day; however, the short-term (i.e., ≤10 minutes) use of the syringes for the preparation and transfer of i.v. cyclosporine solution is considered safe.

  18. Comparison of drug delivery with autoinjector versus manual prefilled syringe and between three different autoinjector devices administered in pig thigh

    Directory of Open Access Journals (Sweden)

    Hill RL

    2016-08-01

    Full Text Available Robert L Hill,1,* John G Wilmot,1,* Beth A Belluscio,1 Kevin Cleary,2 David Lindisch,3 Robin Tucker,4 Emmanuel Wilson,2 Rajesh B Shukla11Meridian Medical Technologies Inc., Columbia, MD, 2Children’s National Medical Center, 3Washington DC VA Medical Center, 4Georgetown University Medical Center, Washington, DC, USA *These authors have contributed equally to this work Abstract: Parenteral routes of drug administration are often selected to optimize actual dose of drug delivered, assure high bioavailability, bypass first-pass metabolism or harsh gastrointestinal environments, as well as maximize the speed of onset. Intramuscular (IM delivery can be preferred to intravenous delivery when initiating intravenous access is difficult or impossible. Drugs can be injected intramuscularly using a syringe or an automated delivery device (autoinjector. Investigation into the IM delivery dynamics of these methods may guide further improvements in the performance of injection technologies. Two porcine model studies were conducted to compare differences in dispersion of injectate volume for different methods of IM drug administration. The first study compared the differences in the degree of dispersion and uptake of injectate following the use of a manual syringe and an autoinjector. The second study compared the spatial spread of the injected formulation, or dispersion volume, and uptake of injectate following the use of five different autoinjectors (EpiPen® [0.3 mL], EpiPen® Jr [0.3 mL], Twinject® [0.15 mL, 0.3 mL], and Anapen® 300 [0.3 mL] with varying needle length, needle gauge, and force applied to the plunger. In the first study, the autoinjector provided higher peak volumes of injectate, indicating a greater degree of dispersion, compared with manual syringe delivery. In the second study, EpiPen autoinjectors resulted in larger dispersion volumes and higher initial dispersion ratios, which decreased rapidly over time, suggesting a greater

  19. Evaluation of Florida physicians' knowledge and attitudes toward accessing the state prescription drug monitoring program as a prescribing tool.

    Science.gov (United States)

    Gershman, Jennifer A; Gershman, Jason A; Fass, Andrea D; Popovici, Ioana

    2014-12-01

    The purpose of this study is to assess Florida physicians' attitudes and knowledge toward accessing the state's prescription drug monitoring program (PDMP). Five thousand medical doctors and osteopathic physicians licensed in Florida were randomly selected for a voluntary and anonymous 15-question self-administered survey approved by the Institutional Review Board. Surveys were distributed through U.S. postal service mail. Likert-scale questions were used to assess prior knowledge (1 = none to 5 = excellent) and attitudes toward accessing the PDMP (1 = strongly disagree to 5 = strongly agree). The study yielded a response rate of 7.8%, 71.5% of whom agreed or strongly agreed that the PDMP is a useful tool. Among participants that have access and answered the PDMP usefulness question, 94.8% agree or strongly agree that it is a useful tool. There were 63 out of 64 physicians (98.4%) who conducted 25 or more searches who agreed or strongly agreed that the PDMP is a useful tool for monitoring patients' controlled substance histories. There were 72.5% of participants with access that answered the "doctor shopping" question who agreed that "doctor shopping" will decrease. Among the 64 most frequent PDMP users, 69.4% agreed or strongly agreed that they have prescribed fewer controlled substances after accessing the PDMP. The study revealed that a majority of participants believe that the PDMP is a useful tool for monitoring patients' controlled substance histories. More continuing education programs should be provided to Florida physicians to enhance their knowledge regarding PDMPs. Wiley Periodicals, Inc.

  20. Achievements of the Australian Access to Allied Psychological Services (ATAPS) program: summarising (almost) a decade of key evaluation data.

    Science.gov (United States)

    Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Fletcher, Justine; Machlin, Anna; Ftanou, Maria; Blashki, Grant; Burgess, Philip; Pirkis, Jane

    2016-01-01

    Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional

  1. The TRPA1 agonist, methyl syringate suppresses food intake and gastric emptying.

    Directory of Open Access Journals (Sweden)

    Min Jung Kim

    Full Text Available Transient receptor potential channel ankryn 1 (TRPA1 expressed in the gastrointestinal tract is associated with gastric motility, gastric emptying, and food intake. In this study, we investigated the effects of methyl syringate, a specific and selective TRPA1 agonist, on food intake, gastric emptying, and gut hormone levels in imprinting control region (ICR mice. The administration of methyl syringate suppressed cumulative food intake and gastric emptying. In addition, treatment with ruthenium red (RR, a general cation channel blocker, and HC-030031, a selective TRPA1 antagonist, inhibited methyl syringate-induced reduction of food intake and delayed gastric emptying in ICR mice. Methyl syringate also increased plasma peptide YY (PYY levels, but not glucagon-like peptide-1 (GLP-1 levels. The elevation in PYY was blocked by treatment with RR and HC-030031. The present findings indicate that methyl syringate regulates food intake and gastric emptying through a TRPA1-mediated pathway and, by extension, can contribute to weight suppression.

  2. Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

    Science.gov (United States)

    Bai, Taoping; Jiang, Wentao; Fan, Yubo

    2017-11-14

    Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.

  3. 77 FR 25529 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2012-04-30

    ...-the-road bus'' is defined in 49 CFR 37.3 as a bus characterized by an elevated passenger deck located... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... Administration (FTA) announces the availability of funds in Fiscal Year (FY) 2012 for the Over-the-Road Bus...

  4. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2010-01-15

    ... elevated passenger deck located over a baggage compartment. Intercity, fixed-route over-the-road bus... transporting baggage carried by passengers; and makes meaningful connections with scheduled intercity bus... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility...

  5. 76 FR 65891 - Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of...

    Science.gov (United States)

    2011-10-24

    ... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... impediments may be unduly limiting access to care and/or delaying treatment for patients and causing undue... the State in which the hospital is located, a doctor of dental surgery or dental medicine. CMS...

  6. 78 FR 36478 - Accessibility of User Interfaces, and Video Programming Guides and Menus

    Science.gov (United States)

    2013-06-18

    ... accessible to people who are blind or visually impaired. We also propose new rules to require activation of... [of section 205(a)] with respect to navigation devices that it provides to a requesting blind or... the navigation device to the requesting blind or visually impaired individual ``shall provide any such...

  7. 77 FR 48199 - Privacy Act; System of Records: State-35, Information Access Programs Records

    Science.gov (United States)

    2012-08-13

    ... Programs and Services, A/GIS/IPS; Department of State, SA-2; 515 22nd Street NW.; Washington, DC 20522-8001. FOR FURTHER INFORMATION CONTACT: Director; Office of Information Programs and Services, A/GIS/IPS..., the exemptions applied pursuant to the Freedom of Information Act or Privacy Act. These records may...

  8. Expanding Access and Opportunity: The Impact of the Gates Millennium Scholars Program

    Science.gov (United States)

    Ramsey, Jennifer

    2010-01-01

    In 1999, the Bill & Melinda Gates Foundation began an innovative scholarship program that provides full financial support to low-income minority students across the United States. The Gates Millennium Scholars (GMS) program has already awarded more than 10,000 scholarships to exceptional students, with the ultimate goal of funding at least…

  9. Between Vulnerability and Risk: Promoting Access and Equity in a School-University Partnership Program

    Science.gov (United States)

    Bourke, Alan; Jayman, Alison Jenkins

    2011-01-01

    This article utilizes interview data to explore how notions of risk operate in a school-university partnership program. Our analysis traces the divergence between conceptualizations of "at-risk" in scholarship, its use in policy, and students' responses to this terminology. Although students targeted in such programs are often…

  10. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement

    Science.gov (United States)

    Mina, D. Santa; Sabiston, C.M.; Au, D.; Fong, A.J.; Capozzi, L.C.; Langelier, D.; Chasen, M.; Chiarotto, J.; Tomasone, J.R.; Jones, J.M.; Chang, E.; Culos-Reed, S.N.

    2018-01-01

    Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks (“pathways”) that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer. PMID:29719431

  11. Direct observation of syringeal muscle function in songbirds and a parrot

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Goller, Franz

    2002-01-01

    . Under the experimental conditions used in this study, full constriction of the syringeal lumen could not be achieved by stimulating adductor muscles. Full closure may require simultaneous activation of extrinsic syringeal muscles or the supine positioning of the bird may have exerted excessive tension....... In parrots (cockatiels, Nymphicus hollandicus), direct observations show that even during quiet respiration the lateral tympaniform membranes (LTMs) are partially adducted into the tracheal lumen to form a narrow slot. Contraction of the superficial intrinsic muscle, m. syringealis superficialis, adducts...... the LTMs further into the tracheal lumen but does not close the syringeal aperture fully. The intrinsic deep muscle, m. syringealis profundus, abducts the LTMs through cranio-laterad movement of a paired, protruding half-ring. The weakly developed extrinsic m. sternotrachealis seems to increase tension...

  12. Does a voucher program improve reproductive health service delivery and access in Kenya?

    Science.gov (United States)

    Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

    2015-05-23

    Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

  13. Evaluation and validation of a bee venom sting challenge performed by a micro-syringe.

    Science.gov (United States)

    Cortellini, Gabriele; Severino, Maurizio; Francescato, Elisabetta; Turillazzi, Stefano; Spadolini, Igino; Rogkakou, Anthi; Passalacqua, Giovanni

    2012-12-01

    The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. To assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. Patients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. Nineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. This preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program.

    Science.gov (United States)

    Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros

    2017-01-01

    While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.

  15. Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program

    Science.gov (United States)

    Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G. Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros

    2017-01-01

    While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud—Health Windows—(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S. PMID:28713806

  16. Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program

    Directory of Open Access Journals (Sweden)

    Maria Gudelia Rangel Gomez

    2017-06-01

    Full Text Available While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud—Health Windows—(VDS. The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.

  17. Long-term outcomes of a national expanded access program to antiretroviral therapy: the Chilean AIDS cohort.

    Science.gov (United States)

    Wolff, Marcelo J; Cortés, Claudia P; Shepherd, Bryan E; Beltrán, Carlos J

    2010-11-01

    To evaluate impact of the program after up to 6 years of follow-up in survival, virologic, and immunologic response. Prospective follow-up of patients initiating first highly active antiretroviral therapy from 2001 to 2007. Chile began in 2001 an expanded access program to antiretroviral therapy. The Chilean AIDS Cohort has enrolled >85% of patients from this program in the public health system. χ², Fisher tests, survival, univariate and multivariate analysis. Five thousand one hundred fifteen adults (16% women); median follow-up: 3.64 years (18,159 patient-years). At baseline: median age, 35.8 years; 45.6% had clinical AIDS; median CD4 cell count, 102 cells per cubic millimeter. Global mortality, 9.0%; loss to follow-up, 6.8%. Probability of survival at 1 and 5 years were 0.95 and 0.89, respectively. First regimen was maintained in 72% of those alive and in control at 1 year and 48% at end of study. Main reason for therapy change/discontinuation was drug toxicity (44.9%). At last visit, 74% of active patients had viral suppression, and median CD4 cell count had reached 301 cells per cubic millimeter. In this middle-income country, wide access highly active antiretroviral therapy has been successfully implemented and evaluated. Despite advanced disease at initiation, survival, clinical, virologic, and immunologic outcomes have been comparable with that of industrialized countries.

  18. SuperB R&D computing program: HTTP direct access to distributed resources

    Science.gov (United States)

    Fella, A.; Bianchi, F.; Ciaschini, V.; Corvo, M.; Delprete, D.; Diacono, D.; Di Simone, A.; Franchini, P.; Donvito, G.; Giacomini, F.; Gianoli, A.; Longo, S.; Luitz, S.; Luppi, E.; Manzali, M.; Pardi, S.; Perez, A.; Rama, M.; Russo, G.; Santeramo, B.; Stroili, R.; Tomassetti, L.

    2012-12-01

    The SuperB asymmetric energy e+e- collider and detector to be built at the newly founded Nicola Cabibbo Lab will provide a uniquely sensitive probe of New Physics in the flavor sector of the Standard Model. Studying minute effects in the heavy quark and heavy lepton sectors requires a data sample of 75 ab-1 and a luminosity target of 1036cm-2s-1. The increasing network performance also in the Wide Area Network environment and the capability to read data remotely with good efficiency are providing new possibilities and opening new scenarios in the data access field. Subjects like data access and data availability in a distributed environment are key points in the definition of the computing model for an HEP experiment like SuperB. R&D efforts in such a field have been brought on during the last year in order to release the Computing Technical Design Report within 2013. WAN direct access to data has been identified as one of the more interesting viable option; robust and reliable protocols as HTTP/WebDAV and xrootd are the subjects of a specific R&D line in a mid-term scenario. In this work we present the R&D results obtained in the study of new data access technologies for typical HEP use cases, focusing on specific protocols such as HTTP and WebDAV in Wide Area Network scenarios. Reports on efficiency, performance and reliability tests performed in a data analysis context have been described. Future R&D plan includes HTTP and xrootd protocols comparison tests, in terms of performance, efficiency, security and features available.

  19. EntrezAJAX: direct web browser access to the Entrez Programming Utilities.

    Science.gov (United States)

    Loman, Nicholas J; Pallen, Mark J

    2010-06-21

    Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX) to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

  20. NODC Standard Format NOS Coastal Wave Program (F182) Data (1979-1983) (NODC Accession 0014203)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data type was designed for analyzed wave data originating from the National Ocean Service (NOS) Coastal Wave Program. The data are organized into 3 record...

  1. Syringe-vacuum microfluidics: A portable technique to create monodisperse emulsions.

    Science.gov (United States)

    Abate, Adam R; Weitz, David A

    2011-03-16

    We present a simple method for creating monodisperse emulsions with microfluidic devices. Unlike conventional approaches that require bulky pumps, control computers, and expertise with device physics to operate devices, our method requires only the microfluidic device and a hand-operated syringe. The fluids needed for the emulsion are loaded into the device inlets, while the syringe is used to create a vacuum at the device outlet; this sucks the fluids through the channels, generating the drops. By controlling the hydrodynamic resistances of the channels using hydrodynamic resistors and valves, we are able to control the properties of the drops. This provides a simple and highly portable method for creating monodisperse emulsions.

  2. Performance of a device to minimise radiation dose to the hands during radioactive syringe calibration

    International Nuclear Information System (INIS)

    Lindner, Oliver; Burchert, Wolfgang; Busch, Frank

    2003-01-01

    The preparation of syringes for routine applications in nuclear medicine, and in particular the calibration procedure, is associated with high radiation exposure to the hands. To reduce this radiation burden, our group developed a modified calibration procedure based on a device that we refer to as the ActivoFix, which allows syringes to be drawn up inside the dose calibrator. This study investigated the performance of the new device as compared to the usual procedure of syringe calibration with regard to the absorbed radiation dose to the hands (fingertips and middle finger bases), the precision of the calibration procedure and the time required to calibrate syringes. Fourteen experienced nuclear medicine technologists drew up syringes from an initial eluate of 8.2 GBq using the conventional technique and the new calibration procedure. All technologists had to calibrate syringes with 50 MBq, 250 MBq and 650 MBq. This sequence was repeated four times using the conventional technique and then the new procedure. The equivalent dose to the hands was measured with thermoluminescent dosimeters. The exact amount of radioactivity in the syringe and the time needed for the calibration procedure were also recorded. The reduction in equivalent dose using the new device compared with the routine procedure ranged from 8.3- to 19.6-fold (mean 14.3-fold) for the fingers of the dominant hand and from 13.6- to 40.3-fold (mean 27-fold) for those of the non-dominant hand (total mean 21.3-fold). For small volumes, time could be saved with the ActivoFix, whereas for greater volumes time was lost. The device produced less variability in calibrating doses at 250 MBq and 650 MBq. Following the ALARA principle, the new device can be recommended for syringe calibration in nuclear medicine because the use of the ActivoFix-based procedure reduces finger dose by an average factor of 21, improves the precision of calibration and reduces the filling time for small volumes. (orig.)

  3. Access to primary care child weight management programs: Urban parent barriers and facilitators to participation.

    Science.gov (United States)

    Kulik, Noel L; Thomas, Erica M; Iovan, Samantha; McKeough, Margaret; Kendzierski, Stephanie; Leatherwood, Stacy

    2017-12-01

    The prevalence and comorbidities of childhood obesity among low-income urban children are a significant health issue in the United States. Programs designed to assist families are underutilized. The aim of this study is to describe barriers and facilitators relevant to intervention program participation from the perspective of parents who have children who are overweight or obese. Systematic thematic analysis of focus groups and semi-structured interviews with parents from multiple urban pediatrics and family medicine practices were used to gather data. A framework analysis approach was used and a codebook of themes was developed. Transcripts were coded independently by the research team and consensus among researchers was reached. Forty-eight parents participated in the study. Perceived barriers to participation included (1) varied referral process (lack of follow-up or varying referral experience), (2) costs (time and program fee), (3) logistics (location and program schedule), and (4) child motivation. Perceived facilitators to participation included (1) systematic referral process (in-office referral and timely follow-up), (2) program content and organization, and (3) no cost. Multiple barriers and facilitators affect weight management program participation among families, which should be specifically targeted in future obesity interventions in order to effectively reach urban, minority parents and children.

  4. Implementing needle and syringe programmes in Kenya: Changes ...

    African Journals Online (AJOL)

    HIV infection among people who inject drugs (PWID) in Kenya is at 18%, and has been attributed to risky injecting practices. The risk environment enabling these practices has not been explored. This paper reports findings from Access to Care, a qualitative study in Kenya. Using in-depth interviews with PWID, we explore ...

  5. Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

    Science.gov (United States)

    Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

    2013-11-01

    To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

  6. Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

    Science.gov (United States)

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan

    2013-02-01

    Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

  7. Impact of physical parameters on dosing errors due to a syringe exchange in multi-infusion therapy

    NARCIS (Netherlands)

    Snijder, Roland A.; Konings, Maurits K.; van den Hoogen, Agnes; Timmerman, Annemoon M.D.E.

    2017-01-01

    Introduction Infusion therapy is challenging and dosing errors may occur due to physical phenomena related to the infusion hardware, despite the use of accurate syringe pumps. These errors typically occur after interventions, such as the exchange of a syringe. We aimed to characterize and quantify

  8. Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

    Science.gov (United States)

    Scotten, E Shirin L; Absher, Ann C

    2006-01-01

    In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

  9. Access to Adequate Healthcare for Hmong Women: A Patient Navigation Program to Increase Pap Test Screening

    Directory of Open Access Journals (Sweden)

    Moon S. Chen, Jr

    2010-01-01

    Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.

  10. Handbook for Producing Educational and Public-Access Programs for Cable Television.

    Science.gov (United States)

    Bretz, Rudolph

    This handbook responds to local cable television broadcasters' need to generate more local programing in order to comply with federal statutes and to capitalize on growing interest in local interests. The text begins with a brief overview of the cable television industry, and there are chapters which cover the following topics: (1) goals of local…

  11. 76 FR 21741 - Twenty-First Century Communications and Video Programming Accessibility Act; Announcement of Town...

    Science.gov (United States)

    2011-04-18

    ....m. ADDRESSES: The Manchester Grand Hyatt Hotel, One Market Place, Room H- I, San Diego, CA 92101... provisions on advanced communications services, video description, the deaf-blind equipment distribution... gaps in video programming through the provision of video description on television and closed...

  12. 77 FR 29033 - Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of...

    Science.gov (United States)

    2012-05-16

    ... allowed hospitals to have an optional program for patient(s)/support person(s) on self- administration of... Regulatory Flexibility Act RPCH Rural Primary Care Hospital SBA Small Business Administration SBREFA Small... and the hospital's administration. At that time, we decided to leave decisions about liaison and...

  13. 12 CFR 410.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-01-01

    ... alterations. 410.151 Section 410.151 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED..., requirements, and standards of the Architectural Barriers Act (42 U.S.C. 4151 through 4157), as established in...

  14. Programmatic Knowledge Management: Technology, Literacy, and Access in 21st-Century Writing Programs

    Science.gov (United States)

    York, Eric James

    2015-01-01

    Growing out of research in Technical Communication, Composition Studies, and Writing Program Administration, the articles in this dissertation explicitly seek to address changes in the practices and products of writing and writing studies wrought by the so-called "digital revolution" in communication technology, which has been ongoing in…

  15. 78 FR 23893 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2013-04-23

    ... strategy and a program effectiveness time line against which results can be measured at specific intervals... allocation strategy to fund applicants who can demonstrate performance and address the objectives of the GPRA... share the cost of certain overseas marketing and promotion activities. MAP Participants may receive...

  16. 75 FR 26194 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2010-05-11

    ... considers whether the applicant provides a clear, long-term agricultural trade strategy and a program effectiveness time line against which results can be measured at specific intervals using quantifiable product... the greatest growth potential. These factors are part of the FAS resource allocation strategy to fund...

  17. 76 FR 21325 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2011-04-15

    ...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and... with eligible participants to share the cost of certain overseas marketing and promotion activities...

  18. 77 FR 24169 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2012-04-23

    ...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and... with eligible participants to share the cost of certain overseas marketing and promotion activities...

  19. 76 FR 60651 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2011-09-29

    ... programming vendor affiliated with the defendant MVPD,\\25\\ based on a combination of factors, such as genre... that the defendant MVPD carries an affiliated music channel targeted to younger viewers but has declined to carry an unaffiliated music channel targeted to older viewers with lower ratings and a higher...

  20. Farmers' Market Use Patterns Among Supplemental Nutrition Assistance Program Recipients With High Access to Farmers' Markets.

    Science.gov (United States)

    Freedman, Darcy A; Flocke, Susan; Shon, En-Jung; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Osborne, Amanda; Borawski, Elaine

    2017-05-01

    Evaluate farmers' market (FM) use patterns among Supplemental Nutrition Assistance Program (SNAP) recipients. Cross-sectional survey administered June to August, 2015. Cleveland and East Cleveland, OH. A total of 304 SNAP recipients with children. Participants lived within 1 mile of 1 of 17 FMs. Most were African American (82.6%) and female (88.1%), and had received SNAP for ≥5 years (65.8%). Patterns of FM shopping, awareness of FM near home and of healthy food incentive program, use of SNAP to buy fruits and vegetables and to buy other foods at FMs, receipt of healthy food incentive program. Two-stage cluster analysis to identify segments with similar FM use patterns. Bivariate statistics including chi-square and ANOVA to evaluate main outcomes, with significance at P ≤ .05. A total of 42% reported FM use in the past year. Current FM shoppers (n = 129) were segmented into 4 clusters: single market, public market, multiple market, and high frequency. Clusters differed significantly in awareness of FM near home and the incentive program, use of SNAP to buy fruit and vegetables at FMs, and receipt of incentive. Findings highlight distinct types of FM use and had implications for tailoring outreach to maximize first time and repeat use of FMs among SNAP recipients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Learning to Thrive: Building Diverse Scientists' Access to Community and Resources through the BRAINS Program

    Science.gov (United States)

    Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.

    2016-01-01

    BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD,…

  2. Ecological and environmental data as under-utilized national resources: results of the TIE/ACCESS program

    Energy Technology Data Exchange (ETDEWEB)

    Armentano, T.V.; Loucks, O.L.

    1979-06-01

    The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.

  3. Using the inflating syringe as a safety valve to limit laryngeal mask airway cuff pressure.

    Science.gov (United States)

    Rice, Mark J; Gravenstein, Nikolaus L; Brull, Sorin J; Morey, Timothy E; Gravenstein, Nikolaus

    2011-12-01

    Hyperinflation of the laryngeal mask airway (LMA) cuff is thought to be the etiology underlying many of the complications associated with the use of this device. Until now, there has not been a clinically acceptable method (besides direct measurement) to assure that the cuff pressure is maintained less than the recommended maximum value of 44 mm Hg (60 cm H(2)O). We inflated sizes #2 and #5 LMAs with air to 40, 60, or 120 mm Hg starting pressures, using 30- and 60-ml BD™ and B Braun™ syringes; we then allowed the syringe plungers to recoil to equilibrium before removing the syringe from the LMA inflation port. Residual LMA cuff pressures following complete passive recoil were measured and recorded. A number of combinations of syringes (30 and 60 ml) and starting pressures (40, 60, 120 mm Hg) resulted in safe residual (#2 and #5 LMA) cuff pressures of inflation pressures, these data demonstrate an efficient, practical and easy method to achieve an initial equilibrium recoil LMA cuff pressure that is less than, or very near to, the recommended upper safe limit of 44 mm Hg.

  4. Comparison between ultrasonic irrigation and syringe irrigation in clinical and laboratory studies.

    Science.gov (United States)

    Chen, Shulan; Liu, Jianxin; Dong, Gang; Peng, Bin; Yang, Pishan; Chen, Zhenggang; Yang, Fang; Guo, Dawei

    2016-01-01

    Ultrasonic irrigation and syringe irrigation were compared for their efficacy at cleaning root canal in vivo and in vitro. The in vivo study used 60 anterior teeth or premolars from 60 patients with periapical periodontitis who were randomly assigned to a syringe irrigation group (group S) or an ultrasonic irrigation group (group U). After instrumentation with a K-file using the step-back technique, the two groups received ultrasonic or syringe irrigation using 40 mL of 2.5% NaOCl respectively, followed by conventional lateral compaction. The in vitro study used 60 extracted single-canal premolars, which were also divided into U and S groups, and underwent the same irrigation and compaction. Forty of them were evaluated histologically by light microscopy, and the remaining 20 by scanning electron microscopy. No difference in main root canal filling was observed between the U and S groups. Notably, group U had a larger number of obturated lateral canals than group S. Moreover, a smaller amount of organic debris and more open dentinal tubules were observed in the root canal in group U than in group S. Our findings suggest that ultrasonic irrigation has a greater capacity to clean instrumented root canals than syringe irrigation. (J Oral Sci 58, 373-378, 2016).

  5. Comparison of Epidrum, Epi‑jet, and Loss of Resistance Syringe ...

    African Journals Online (AJOL)

    2017-09-14

    Exmoor Innovations Ltd), Epi-Jet, or. LOR syringe was attached to the hub ..... Thomas PS, Gerson JI, Strong G. Analysis of human epidural pressures. Reg Anesth 1992;17:212-5. 12. Deighan M, Briain DO, Shakeban H, O'Flaherty ...

  6. Acute and life-threatening remifentanil overdose resulting from the misuse of a syringe pump.

    NARCIS (Netherlands)

    Vanneste, B; Van de Velde, M; Struys, Michel; Rex, S

    2017-01-01

    In the perioperative setting, syringe pumps are frequently used. They guarantee constant plasma levels of hypnotics, opioids, cardiovascular medication, insulin or other drugs. We present a case in which an inadvertent rapid intravenous injection of 2 mg remifentanil occurred due to the misuse of a

  7. News from the Library: Facilitating access to a program for radiation shielding - the Library can help

    CERN Document Server

    CERN Library

    2013-01-01

    MicroShield® is a comprehensive photon/gamma ray shielding and dose assessment programme. It is widely used for designing shields, estimating source strength from radiation measurements, minimising exposure to people, and teaching shielding principles.   Integrated tools allow the graphing of results, material and source file creation, source inference with decay (dose-to-Bq calculations accounting for decay and daughter buildup), the projection of exposure rate versus time as a result of decay, access to material and nuclide data, and decay heat calculations. The latest version is able to export results using Microsoft Office (formatted and colour-coded for readability). Sixteen geometries accommodate offset dose points and as many as ten standard shields plus source self-shielding and cylinder cladding are available. The library data (radionuclides, attenuation, build-up and dose conversion) reflect standard data from ICRP 38 and 107* as well as ANSI/ANS standards and RSICC publicat...

  8. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People.

    Science.gov (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

    2017-03-24

    Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the

  9. Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.

    Science.gov (United States)

    Vachharajani, Tushar J; Moossavi, Shahriar; Salman, Loay; Wu, Steven; Dwyer, Amy C; Ross, Jamie; Dukkipati, Ramanath; Maya, Ivan D; Yevzlin, Alexander S; Agarwal, Anil; Abreo, Kenneth D; Work, Jack; Asif, Arif

    2011-01-01

    The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities. © 2011 Wiley Periodicals, Inc.

  10. Stability of ceftazidime (with arginine) stored in plastic syringes at three temperatures.

    Science.gov (United States)

    Nahata, M C; Morosco, R S; Fox, J L

    1992-12-01

    The stability of ceftazidime (with arginine) stored in plastic syringes at three temperatures was studied. Ceftazidime (with arginine) was reconstituted with sterile water for injection to a concentration of 100 mg/mL and transferred to plastic syringes. Syringes were stored at 22 degrees C for 24 hours; at 4 degrees C for 7 or 10 days, then at 22 degrees C for 24 hours; or at -20 degrees C for 91 days, then at 22 degrees C for 24 hours or at 4 degrees C for seven days followed by 22 degrees C for 24 hours. Ceftazidime concentration was measured at various times by using a stability-indicating high-performance liquid chromatographic method. At each sampling time, each syringe was visually inspected and the pH of each solution was measured. Mean ceftazidime concentration remained > 90% of initial concentration at all storage conditions. Although during storage the color of the solutions changed from light straw to dark yellow and the pH decreased, no precipitate was visually detected and no peaks for degradation products appeared on the chromatograms. Ceftazidime 100 mg/mL (with arginine) in sterile water for injection was stable when stored in plastic syringes for up to 24 hours at 22 degrees C, for 10 days at 4 degrees C followed by up to 24 hours at 22 degrees C, and for 91 days at -20 degrees C followed by up to 24 hours at 22 degrees C or by 7 days at 4 degrees C and up to 24 hours at 22 degrees C.

  11. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    Science.gov (United States)

    Goodman, Daisy

    2015-01-01

    Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

  12. Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals

    Directory of Open Access Journals (Sweden)

    Madeline Carpinelli Wallack

    2012-01-01

    Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

  13. The Student Spaceflight Experiments Program: Access to the ISS for K-14 Students

    Science.gov (United States)

    Livengood, T. A.; Goldstein, J. J.; Hamel, S.; Manber, J.; Hulslander, M.

    2013-12-01

    The Student Spaceflight Experiments Program (SSEP) has flown 53 experiments to space, on behalf of students from middle school through community college, on 4 missions: each of the last 2 Space Shuttle flights, the first SpaceX demonstration flight to the International Space Station (ISS), and on SpaceX-1 to ISS. Two more missions to ISS have payloads flying in Fall 2013. SSEP plans 2 missions to the ISS per year for the foreseeable future, and is expanding the program to include 4-year undergraduate college students and home-schooled students. SSEP experiments have explored biological, chemical, and physical phenomena within self-contained enclosures developed by NanoRacks, currently in the form of MixStix Fluid Mixing Enclosures. 21,600 students participated in the initial 6 missions of SSEP, directly experiencing the entire lifecycle of space science experimentation through community-wide participation in SSEP, taking research from a nascent idea through developing competitive research proposals, down-selecting to three proposals from each participating community and further selection of a single proposal for flight, actual space flight, sample recovery, analysis, and reporting. The National Air and Space Museum has hosted 3 National Conferences for SSEP student teams to report results in keeping with the model of professional research. Student teams have unflinchingly reported on success, failure, and groundbased efforts to develop proposals for future flight opportunities. Community participation extends outside the sciences and the immediate proposal efforts to include design competitions for mission patches, which also fly to space. Student experimenters have rallied around successful proposal teams to support a successful experiment on behalf of the entire community. SSEP is a project of the National Center for Earth and Space Science Education enabled through NanoRacks LLC, working in partnership with NASA under a Space Act Agreement as part of the

  14. A standard data access layer for fusion devices R and D programs

    International Nuclear Information System (INIS)

    Neto, A.; Fernandes, H.; Alves, D.; Valcarcel, D.F.; Carvalho, B.B.; Ferreira, J.; Vega, J.; Sanchez, E.; Pena, A.; Hron, M.; Varandas, C.A.F.

    2007-01-01

    Each EURATOM Association stores data using proprietary schemes, usually developed by the research unit or using third party software. The temporary exchange of researchers between laboratories is a common practice nowadays. When the researchers returns to the home laboratory, there is usually the need to follow the work. The amount of available data is becoming enormous and the main data index is changing from shot number to time and events, where the pulse number is just one among the most relevant events against data is catalogued. These difficulties can be overcome by using a common software layer between end-users and laboratories. The components needed to create this software abstraction layer, between users and laboratories data, have already been developed using a universal and well known remote procedure call standard (RPC) based on the eXtensible Markup Language (XML): XML-RPC. The library allows data retrieval using the same methods for all associations. Users are authenticated through the PAPI system ( (http://papi.rediris.es)), allowing each organization to use its own authentication schema. Presently there are libraries and server implementations in Java and C++. These libraries have been included and tested in some of the most common data analysis programs such as MatLab and IDL. The system is already being used in ISTTOK/PT and CASTOR/CZ

  15. Lunar and Planetary Science XXXV: Undergraduate Education and Research Programs, Facilities, and Information Access

    Science.gov (United States)

    2004-01-01

    The titles in this section include: 1) GRIDVIEW: Recent Improvements in Research and Education Software for Exploring Mars Topography; 2) Software and Hardware Upgrades for the University of North Dakota Asteroid and Comet Internet Telescope (ACIT); 3) Web-based Program for Calculating Effects of an Earth Impact; 4) On-Line Education, Web- and Virtual-Classes in an Urban University: A Preliminary Overview; 5) Modelling Planetary Material's Structures: From Quasicrystalline Microstructure to Crystallographic Materials by Use of Mathematica; 6) How We Used NASA Lunar Set in Planetary and Material Science Studies: Textural and Cooling Sequences in Sections of Lava Column from a Thin and a Thick Lava-Flow, from the Moon and Mars with Terrestrial Analogue and Chondrule Textural Comparisons; 7) Classroom Teaching of Space Technology and Simulations by the Husar Rover Model; 8) New Experiments (In Meteorology, Aerosols, Soil Moisture and Ice) on the New Hunveyor Educational Planetary Landers of Universities and Colleges in Hungary; 9) Teaching Planetary GIS by Constructing Its Model for the Test Terrain of the Hunveyor and Husar; 10) Undergraduate Students: An Untapped Resource for Planetary Researchers; 11) Analog Sites in Field Work of Petrology: Rock Assembly Delivered to a Plain by Floods on Earth and Mars; 12) RELAB (Reflectance Experiment Laboratory): A NASA Multiuser Spectroscopy Facility; 13) Full Text Searching and Customization in the NASA ADS Abstract Service.

  16. Remotely Accessible Instrumented Monitoring of Global Development Programs: Technology Development and Validation

    Directory of Open Access Journals (Sweden)

    Michael Fleming

    2013-08-01

    Full Text Available Many global development agencies self-report their project outcomes, often relying on subjective data that is collected sporadically and communicated months later. These reports often highlight successes and downplay challenges. Instrumented monitoring via distributed data collection platforms may provide crucial evidence to help inform the sector and public on the effectiveness of aid, and the on-going challenges. This paper presents the process of designing and validating an integrated sensor platform with cellular-to-internet reporting purposely targeted at global development programs. The integrated hardware platform has been applied to water, sanitation, energy and infrastructure interventions and validated through laboratory calibration and field observations. Presented here are two examples: a water pump and a household water filter, wherein field observations agreed with the data algorithm with a linear fit slope of between 0.91 and 1, and an r-squared of between 0.36 and 0.39, indicating a wide confidence interval but with low overall error (i.e., less than 0.5% in the case of structured field observations of water volume added to a household water filter and few false negatives or false positives.

  17. WOMEN'S ACCESSION TO THE PROGRAM FOR CANCER PREVENTION OF CERVICAL IN PRIMARY CARE, ANANINDEUA-PA

    Directory of Open Access Journals (Sweden)

    Fernanda Suelen Jacques Sousa de Assis

    2014-02-01

    Full Text Available Objective: To evaluate the adherence of women to take on the Prevention of Cervical Cancer (PCC, their difficulties and their knowledge. Methods: Cross-sectional study by interviewing women enrolled in a Family Health Strategy (FHS, Ananindeua-Pará. Results: Most women were between 20-39 years of age (72.6%, had low income and low education. Reported the exam annually (64.0% and every two years (17.0%, while 14.0% of them never realized. Of the participants who never performed the examination, the age group of 20-29 was the most prevalent (73.3% (p<0.05. It was found that the women had heard about the disease (97.1% and considered cancer as a wound that can lead to death (81.4%. There was a significant relationship between knowledge about cancer of the cervix (heard, concept, as it is known, timing, late detection, first sexual intercourse, condom use, contraceptive use and sexually transmitted disease with the examination (p<0.05. Shame was reported as greater difficulty (25.5%, followed by neglect (22.5% and lack of time (12.5%. Women who were examined rated as "Good" program PCC FHS. Conclusion: Women showed good adhesion to take PCC, said the main difficulty shame and demonstrated the concept on the subject.

  18. 50 nm AlxOy resistive random access memory array program bit error reduction and high temperature operation

    Science.gov (United States)

    Ning, Sheyang; Ogura Iwasaki, Tomoko; Takeuchi, Ken

    2014-01-01

    In order to decrease program bit error rate (BER) of array-level operation in AlxOy resistive random access memory (ReRAM), program BERs are compared by using 4 × 4 basic set and reset with verify methods on multiple 1024-bit-pages in 50 nm, mega-bit class ReRAM arrays. Further, by using an optimized reset method, 8.5% total BER reduction is obtained after 104 write cycles due to avoiding under-reset or weak reset and ameliorating over-reset caused wear-out. Then, under-set and over-set are analyzed by tuning the set word line voltage (VWL) of ±0.1 V. Moderate set current shows the best total BER. Finally, 2000 write cycles are applied at 125 and 25 °C, respectively. Reset BER increases 28.5% at 125 °C whereas set BER has little difference, by using the optimized reset method. By applying write cycles over a 25 to 125 to 25 °C temperature variation, immediate reset BER change can be found after the temperature transition.

  19. Costs of a Hospital-Based, Ready-To-Use Syringe Delivery Programme

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Vand, S; Lisby, M

    2017-01-01

    with a conventional delivery programme at day surgery and endoscopy departments at a large university hospital. Methods: The cost analysis used the hospital perspective and developed an “activity-based costing” model to assess the costs of medicine- handling activities. The model was calibrated with six-month data......Objective: The risk of errors in the medication administration process is high. Applications of pre lled syringes may improve patient safety but could be more costly. The objective of this study was to assess the additional costs of a ready-to-use syringe delivery programme in comparison...... cost is likely to provide improvements in the quality of the administrative process, patient safety and staff satisfaction....

  20. Direct observation of syringeal muscle function in songbirds and a parrot

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Goller, Franz

    2002-01-01

    . In parrots (cockatiels, Nymphicus hollandicus), direct observations show that even during quiet respiration the lateral tympaniform membranes (LTMs) are partially adducted into the tracheal lumen to form a narrow slot. Contraction of the superficial intrinsic muscle, m. syringealis superficialis, adducts......The role of syringeal muscles in controlling the aperture of the avian vocal organ, the syrinx, was evaluated directly for the first time by observing and filming through an endoscope while electrically stimulating different muscle groups of anaesthetised birds. In songbirds (brown thrashers......, Toxostoma rufum, and cardinals, Cardinalis cardinalis), direct observations of the biomechanical effects of contraction largely confirm the functions of the intrinsic syringeal muscles proposed from indirect studies. Contraction of the dorsal muscles, m. syringealis dorsalis (dS) and m. tracheobronchialis...

  1. Syringe-feeding as a novel delivery method for accurate individual dosing of probiotics in rats

    DEFF Research Database (Denmark)

    Tillmann, Sandra; Wegener, Gregers

    2017-01-01

    Probiotic administration to rodents is typically achieved using oral gavage or water bottles, but both approaches may compromise animal welfare, bacterial viability, dosing accuracy, or ease of administration. Oral gavage dosing may induce stress, especially when given daily over several weeks...... leftovers or clogging of the bottle further threaten the reliability of this method. To date, no method has been described that can provide non-stressful precise dosing of probiotics or prebiotics in individual rats. In accordance with the 3R principles (replace, reduce, refine), we propose syringe......-feeding as a refinement method for simple yet accurate administration of probiotics. Animals hereby voluntarily consume the solution directly from a syringe held into their home cage, thereby enabling controlled dosing of individual animals. This method requires a short training phase of approximately 3 days, but is very...

  2. Stability of busulfan solutions in polypropylene syringes and infusion bags as determined with an original assay.

    Science.gov (United States)

    Guichard, Nicolas; Bonnabry, Pascal; Rudaz, Serge; Fleury-Souverain, Sandrine

    2017-11-15

    The stability of busulfan solution in 0.9% sodium chloride and stored in polypropylene syringes or infusion bags was evaluated. Busulfan solutions (0.54 mg/mL) were prepared and transferred to 50-mL polypropylene syringes and 100- and 500-mL polypropylene infusion bags and stored at 2-8 and 23-27 °C. Chemical stability was measured using a stability-indicating, ultrahigh performance liquid chromatography coupled to mass spectrometry method. The stability of busulfan was assessed by measuring the percentage of the initial concentration remaining at the end of each time point of analysis. The initial busulfan concentration was defined as 100%. Stability was defined as retention of at least 90% of the initial busulfan concentration. A visual inspection of the samples for particulate matter, clarity, and color without instrumentation of magnification was conducted at each time point of analysis. The visual inspection demonstrated no influence of the storage container when busulfan infusions diluted in 0.9% sodium chloride injection were stored at 23-27 °C. No color change or precipitate was observed at this temperature; however, a rapid decrease of the busulfan content in all containers stored at room temperature was observed. Busulfan in syringes was chemically stable for 12 hours, while busulfan in infusion bags (100 and 500 mL) was stable only for 3 hours at 23-27 °C. Busulfan 0.54-mg/mL solution in 0.9% sodium chloride injection was physically and chemically stable for 30 hours when stored in 50-mL polypropylene syringes at 2-8 °C and protected from light. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. Iloprost infusion by a new device as a portable syringe pump: safety, tolerability and agreement

    Directory of Open Access Journals (Sweden)

    Paola Faggioli

    2012-12-01

    Full Text Available Background Iloprost, prostacyclin (PGI2 analogue, effective in treatment of peripheral arterial disease, secondary Raynaud's phenomenon (RP to connective tissue disease (CTD, vasculitis, pulmonary hypertension, is usually infused through peristaltic pump, or recently through a flow regulator.Materials and methods We tested a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Milano on 120 patients affected by RP to CTD and cryoglobulinaemia, in iloprost therapy with a flow regulator.Results Iloprost infused through portable syringe pump is better tolerated, better appreciated by the patients and nurses and no difference was observed on therapeutic effects, with a lower incidence of side effects statistically significant. Only 3 patients were unable to tolerate the device (2 for changes in pressure and 1 for fear and shifted to traditional method of iloprost infusion.Conclusions Iloprost infusion through the portable syringe Pompa Infonde® appears to be safe, better tolerated, more acceptable and equally effective compared to infusion through a flow regulator.

  4. Antimicrobial Effect of Ozone Made by KP Syringe of High-Frequency Ozone Generator.

    Science.gov (United States)

    Prebeg, Domagoj; Katunarić, Marina; Budimir, Ana; Pavelić, Božidar; Šegović, Sanja; Anić, Ivica

    2016-06-01

    The aim of this study was to evaluate in vitro the antibacterial effect of ozone on suspension of three different bacteria inoculated in prepared canals of extracted human teeth. Ozone was produced by special KP syringe of high frequency ozone generator Ozonytron (Biozonix, München, Germany) from aspirated atmospheric air by dielectric barrier discharge and applied through the tip of the syringe to the prepared root canal. The microorganisms used were Enterococcus faecalis , Staphylococcus aureus and Staphylococcus epidermidis . However, none of the methods was 100% effective against the three bacterial types in suspension. Application of ozone significantly decreased the absolute count of microorganisms (89.3%), as well as the count of each type of bacteria separately ( Staphylococcus aureus 94.0%; Staphylococcus epidermidis 88.6% and Enterococcus faecalis 79.7%). Ozone generated by KP syringe was statistically more effective compared to NaOCl as positive control, for Staphylococcus aureus and Staphylococcus epidermidis . The absolute count of Enterococcus faecalis was statistically decreased without a statistically significant difference between the tested group and positive control, respectively. Among the three types of bacteria in suspension, KP probe had the lowest antimicrobial effect against Enterococcus faecalis .

  5. The prescription of insulin pen devices versus syringes for older people with diabetes.

    Science.gov (United States)

    Shaghouli, Amna A; Shah, Baiju R

    2009-07-01

    Insulin pen devices are easier to use and lead to better treatment adherence than syringes. This study sought to determine factors associated with the decision to prescribe insulin pen devices rather than syringes for older patients initiating insulin therapy. A population-based study examined all Ontario, Canada residents > or = 66 years old who received a first prescription for insulin between 1998 and 2006 (n = 47,810). Associations between demographic/clinical factors and the use of pen devices for insulin delivery were determined. Seventy-two percent of patients began insulin therapy using pen devices for insulin delivery, increasing from 46% in 1998 to 86% in 2006. Insulin initiation by a specialist was positively associated with the use of pen devices (odds ratio [OR] 2.24, 95% confidence interval [CI] 2.08-2.40), whereas long-term care residence (OR 0.51, 95% CI 0.49-0.54) and initiation during hospitalization (OR 0.74, 95% CI 0.71-0.78) were negatively associated. Insulin pen devices were used by most patients starting insulin, but a substantial proportion of patients continued to be prescribed syringes for insulin delivery. The use of pen devices was positively associated with specialist care and negatively associated with insulin initiation during hospitalization. Increasing physicians' awareness of the benefits of pen devices to facilitate patient self-management could further increase their use and improve diabetes care.

  6. An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation.

    Directory of Open Access Journals (Sweden)

    Allison P Hawkes

    Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.

  7. Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions.

    Science.gov (United States)

    Wawginiak, Guilherme Henrique; Balsalobre, Leonardo; Kosugi, Eduardo Macoto; Mangussi-Gomes, João Paulo; Samaniego, Raul Ernesto; Stamm, Aldo Cassol

    Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. To investigate the efficacy of topical sinonasal therapy with syringe and the influence of the middle turbinate on this process METHODS: Intervention study in training models (S.I.M.O.N.T.). After standard dissection, three interventions were performed (Nasal Spray 4 puffs, 60-mL syringe and 240-mL Squeeze Bottle) with normal and Sutured Middle Turbinate. Images of each sinus were captured after the interventions, totalizing 144 images. The images were classified by 10 evaluators according to the amount of residual volume from zero to 3, with zero and 1 being considered poor penetration and 2 and 3, good penetration. The 1440 evaluations were used in this study. Considering all middle turbinate situations, the amount of good penetrations were 8.1% for Spray; 68.3% for Syringe, and 78.3% for Squeeze (pirrigation with a 60-mL syringe was more effective than that with nasal spray. The status of the middle turbinate proved to be fundamental and influenced topical therapy. Irrigation with syringe was as effective as the squeeze bottle when the middle turbinate was sutured to the nasal septum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  8. Development of a Mechatronic Syringe Pump to Control Fluid Flow in a Microfluidic Device Based on Polyimide Film

    Science.gov (United States)

    Sek Tee, Kian; Sharil Saripan, Muhammad; Yap, Hiung Yin; Fhong Soon, Chin

    2017-08-01

    With the advancement in microfluidic technology, fluid flow control for syringe pump is always essential. In this paper, a mechatronic syringe pump will be developed and customized to control the fluid flow in a poly-dimethylsiloxane (PDMS) microfluidic device based on a polyimide laminating film. The syringe pump is designed to drive fluid with flow rates of 100 and 1000 μl/min which intended to drive continuous fluid in a polyimide based microfluidic device. The electronic system consists of an Arduino microcontroller board and a uni-polar stepper motor. In the system, the uni-polar stepper motor was coupled to a linear slider attached to the plunger of a syringe pump. As the motor rotates, the plunger pumps the liquid out of the syringe. The accuracy of the fluid flow rate was determined by adjusting the number of micro-step/revolution to drive the stepper motor to infuse fluid into the microfluidic device. With the precise control of the electronic system, the syringe pump could accurately inject fluid volume at 100 and 1000 μl/min into a microfluidic device.

  9. Potential Air Contamination During CO2 Angiography Using a Hand-Held Syringe: Theoretical Considerations and Gas Chromatography

    International Nuclear Information System (INIS)

    Cho, David R.; Cho, Kyung J.; Hawkins, Irvin F.

    2006-01-01

    Purpose. To assess air contamination in the hand-held syringes currently used for CO 2 delivery and to determine whether there is an association between their position and the rate of air contamination. Methods. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO 2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. Results. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO 2 at 0.1599 cm 2 /sec (9.594 cm 2 /min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Conclusion. Air contamination occurs in hand-held syringes filled with CO 2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions

  10. Comparison of bulb syringe and pulsed lavage irrigation with use of a bioluminescent musculoskeletal wound model.

    Science.gov (United States)

    Svoboda, Steven J; Bice, Terry G; Gooden, Heather A; Brooks, Daniel E; Thomas, Darryl B; Wenke, Joseph C

    2006-10-01

    Despite the fact that wound irrigation is a common surgical procedure, there are many variables, including delivery device, irrigant type, and fluid volume, that have yet to be optimized. The purpose of this study was to compare, with use of transgenic bioluminescent bacteria and standard quantitative microbiological methods, the efficacy of pulsed lavage and bulb syringe irrigation in reducing wound bacterial counts. A caprine model of a complex, contaminated musculoskeletal wound was developed with use of a bioluminescent strain of Pseudomonas aeruginosa that can be quantified. Luminescent activity was recorded as relative luminescent units with use of a photon-counting camera six hours after the wound was created and inoculated. Twelve goats were randomly assigned to either the pulsed lavage group or the bulb syringe irrigation group. Each wound was irrigated with normal saline solution in 3-L increments for a total of 9 L and was imaged after each 3-L increment. In addition, quantitative culture samples were obtained from different tissues within the wound before and after irrigation. Pulsed lavage decreased the amount of relative luminescent units by 52%, 64%, and 70% at 3, 6, and 9 L, respectively. The bulb syringe irrigation reduced the amount of relative luminescent units by 33%, 44%, and 51% at these same time-points. Significant differences in luminescence were noted between the two groups after both 6 and 9 L of irrigation (p irrigation and after irrigation were r = 0.96 and 0.83, respectively. Pulsed lavage was more effective than bulb syringe irrigation in reducing bacterial luminescence after both 6 and 9 L of irrigation. Both device and volume effects can be demonstrated with use of this model. Bioluminescent bacteria provide a method to visualize bacterial distribution and to quantify the bacteria in a wound. Pulsed lavage is a more effective and efficient method of irrigation to remove bacteria in a complex musculoskeletal wound. In the model we

  11. The IRIS Education and Outreach Program: Providing access to data and equipment for educational and public use

    Science.gov (United States)

    Taber, J.; Toigo, M.; Bravo, T. K.; Hubenthal, M.; McQuillan, P. J.; Welti, R.

    2009-12-01

    The IRIS Education and Outreach Program has been an integral part of IRIS for the past 10 years and during that time has worked to advance awareness and understanding of seismology and earth science while inspiring careers in geophysics. The focus on seismology and the use of seismic data has allowed the IRIS E&O program to develop and disseminate a unique suite of products and services for a wide range of audiences. One result of that effort has been increased access to the IRIS Data Management System by non-specialist audiences and simplified use of location and waveform data. The Seismic Monitor was one of the first Web-based tools for observing near-real-time seismicity. It continues to be the most popular IRIS web page, and thus it presents aspects of seismology to a very wide audience. For individuals interested in more detailed ground motion information, waveforms can be easily viewed using the Rapid Earthquake Viewer, developed by the University of South Carolina in collaboration with IRIS E&O. The Seismographs in Schools program gives schools the opportunity to apply for a low-cost educational seismograph and to receive training for its use in the classroom. To provide better service to the community, a new Seismographs in Schools website was developed in the past year with enhanced functions to help teachers improve their teaching of seismology. The site encourages schools to make use of seismic data and communicate with other educational seismology users throughout the world. Users can view near-real-time displays of other participating schools, upload and download data, and use the “find a teacher” tool to contact nearby schools that also may be operating seismographs. In order to promote and maintain program participation and communication, the site features a discussion forum to encourage and support the growing global community of educational seismograph users. Any data that is submitted to the Seismographs in Schools Website is also accessible

  12. Long-term Survival with Ipilimumab: Experience from a National Expanded Access Program for Patients with Melanoma.

    Science.gov (United States)

    Krajsová, Ivana; Arenberger, Petr; Lakomý, Radek; Kubala, Eugen; Březinová, Ivana; Poprach, Alexandr; Šťastný, Marek; Mužík, Jan; Melichar, Bohuslav

    2015-11-01

    Evaluation of efficacy and safety of ipilimumab in patients with advanced, refractory melanoma enrolled into a national ipilimumab Expanded Access Program. Adult patients with advanced/metastatic refractory melanoma were eligible for study inclusion. Ipilimumab was administered up to a total of four doses. One hundred and ninety-six patients were analyzed. Full ipilimumab induction was administered to 66.8% of patients. Median overall survival (OS) in the entire cohort was 7.5 months. Median OS for patients after four doses of ipilimumab was significantly longer than for patients with fewer doses (12.3 months vs. 2.0 months respectively; p<0.001). Median OS for patients with objective tumor response was 42.3 months. Normal baseline serum lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels, and the number of affected organs correlated with improved OS. The number of affected organs and combination of baseline LDH and CRP levels could potentially serve as predictors for both treatment response and OS. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  13. 75 FR 4409 - Ryan White HIV/AIDS Program Part D-Coordinated HIV Services and Access to Research for Women...

    Science.gov (United States)

    2010-01-27

    ... HIV/AIDS Program Part D--Coordinated HIV Services and Access to Research for Women, Infants, Children... Orange County Health Department, Orlando, Florida, that will ensure continuity of Part D HIV/AIDS care and treatment services without disruption to HIV/ AIDS-infected women, infants and children in Orange...

  14. Effects of an emergency medical services-based resource access program on frequent users of health services.

    Science.gov (United States)

    Tadros, Anthony S; Castillo, Edward M; Chan, Theodore C; Jensen, Anne Marie; Patel, Ekta; Watts, Kerin; Dunford, James V

    2012-01-01

    A small group of adults disproportionately and ineffectively use acute services including emergency medical services (EMS) and emergency departments (EDs). The resulting episodic, uncoordinated care is of lower quality and higher cost and simultaneously consumes valuable public safety and acute care resources. To address this issue, we measured the impact of a pilot, EMS-based case management and referral intervention termed the San Diego Resource Access Program (RAP) to reduce EMS, ED, and inpatient (IP) visits. This was a historical cohort study of RAP records and billing data of EMS and one urban hospital for 51 individuals sequentially enrolled in the program. The study sample consisted of adults with ≥ 10 EMS transports within 12 months and others reported by prehospital personnel with significant recent increases in transports. Data were collected over a 31-month time period from December 2006 to June 2009. Data were collected for equal pre- and postenrollment time periods based on date of initial RAP contact, and comparisons were made using the Wilcoxon signed-rank test. Overall use for subjects is reported. The majority of subjects were male (64.7%), homeless (58.8%), and 40 to 59 years of age (72.5%). Between the pre and post periods, EMS encounters declined 37.6% from 736 to 459 (p = 0.001), resulting in a 32.1% decrease in EMS charges from $689,743 to $468,394 (p = 0.004). The EMS task time and mileage decreased by 39.8% and 47.5%, respectively, accounting for 262 (p = 0.008) hours and 1,940 (p = 0.006) miles. The number of ED encounters at the one participating hospital declined 28.1% from 199 to 143, which correlated with a 12.7% decrease in charges from $413,410 to $360,779. The number of IP admissions declined by 9.1% from 33 to 30, corresponding to a 5.9% decrease in IP charges from $687,306 to $646,881. Hospital length of stay declined 27.9%, from 122 to 88 days. Across all services, total charges declined by $314,406. This pilot study

  15. Farmácia Popular Program: changes in geographic accessibility of medicines during ten years of a medicine subsidy policy in Brazil.

    Science.gov (United States)

    Emmerick, Isabel Cristina Martins; do Nascimento, José Miguel; Pereira, Marco Aurélio; Luiza, Vera Lucia; Ross-Degnan, Dennis

    2015-01-01

    The Brazilian constitution guarantees the right to health, including access to medicines. In May 2004, Brazil's government announced the "Farmácia Popular" Program (FPP) as a new mechanism to improve the Brazilian population's access to medicines. Under FPP, a selected list of medicines is subsidized by the government and provided in public and private pharmacies. The aim of this study is to describe the historical stages of the FPP and to identify associated changes in the geographical accessibility of medicines through the FPP over time. It was performed documentary review and an ecological study assessing program coverage in terms of number of facilities and a FPP Pharmacy Facilities Density (PFD) index at national and regional levels from 2004 to 2013, using the FPP database. We used geographic information system mapping to depict a pharmaceutical facilities density (PFD) index at the municipality level on thematic maps. A growth of the PFD index coincident with the phases of the FPP was noticed. In the public sector, the program started in 2004; by 2006, there was a sharp increase in the numbers of participating pharmacies, stabilizing in 2009. In the private sector, the program started in 2006; by 2009 the PFD ratio had increased substantially and it continued to grow through 2011. There was an increase in FPP coverage in most regions between 2006, when the private pharmacy component started, and 2013, but participating pharmacies remain unequally distributed across geographical regions. Specifically, the wealthy areas in the South and Southeast have higher coverage, with lower coverage mostly in the North and Northeast, relatively poorer areas with greater need for access to medicines, health care, and other basic services such as potable water and sanitization. There has been a substantial increase in the number of pharmacies participating in the FPP over time. This has led to greater program coverage and has potentially improved access to FPP medicines in

  16. Socio-Economic Status Determines Risk of Receptive Syringe Sharing Behaviors among Iranian Drug Injectors; A National Study.

    Science.gov (United States)

    Assari, Shervin; Ahmadi, Khodabakhsh; Rezazade, Majid

    2014-01-01

    Although needle and syringe sharing is one of the main routs of transmission of HIV in several countries in the middle east, very little is known about how socio-economic status of injecting drug users (IDUs) is linked to the receptive syringe sharing behaviors in these countries. To study socio-economic correlates of receptive needle and syringe sharing among IDUs in Iran. The study used data from the Unhide Risk Study, a national survey of IDUs. This study sampled 636 IDUs (91% male) via snowball sampling from eight provinces in Iran in 2009. Socio-demographic and drug use characteristics were collected. We used a logistic regression to determine factors associated with receptive needle and syringe sharing during the past 6 months. From 636 IDUs enrolled in this study, 68% (n = 434) reported receptive needle and syringe sharing behaviors in the past 6 months. Odds of receptive needle and syringe sharing in the past 6 months was lower among IDUs who were male [odds ratios (OR) = 0.29, 95% confidence interval (CI) = 0.12-0.70], had higher education (OR = 0.74, 95% CI = 0.64-0.86) but higher among those who were unemployed (OR = 4.05, 95% CI = 1.50-10.94), and were single (OR = 1.47, 95% CI = 1.02-2.11). This study presented factors associated with risk of receptive needle and syringe sharing among Iranian IDUs. This information may be used for HIV prevention and harm reduction purposes. Socio-economic status of Iranian IDUs may be closely linked to high-risk injecting behaviors among them.

  17. Socio-economic status and receptive needle and syringe sharing behaviors among Iranian Drug Injectors; a national study

    Directory of Open Access Journals (Sweden)

    Shervin eAssari

    2015-03-01

    Full Text Available Background: Although needle and syringe sharing is one of the main routs of transmission of HIV in several countries in the middle east, very little is known about how socioeconomic status of injecting drug users (IDUs is linked to the receptive syringe sharing behaviors in these countries. Aim: To study socioeconomic correlates of receptive needle and syringe sharing among IDUs in Iran.Methods: The study used data from the Unhide Risk Study, a national survey of IDUs. This study sampled 636 IDUs (91% male via snowball sampling from eight provinces in Iran in 2009. Socio-demographic and drug use characteristics were collected. We used a logistic regression to determine factors associated with receptive needle and syringe sharing during the past six months.Results: From 636 IDUs enrolled in this study, 68% (n=434 reported receptive needle and syringe sharing behaviors in the past six months. Odds of receptive needle and syringe sharing in the past six months was lower among IDUs who were male (OR=0.29, 95% CI= 0.12 to 0.70, had higher education (OR=0.74, 95% CI=0.64 to 0.86 but higher among those who were unemployed (OR=4.05, 95% CI=1.50 to 10.94, and were single (OR=1.47, 95% CI=1.02 to 2.11.Conclusion: This study presented factors associated with risk of receptive needle and syringe sharing among Iranian IDUs. This information may be used for HIV prevention and harm reduction purposes. Socioeconomic status of Iranian IDUs may be closely linked to high risk injecting behaviors among them.

  18. Socio-Economic Status Determines Risk of Receptive Syringe Sharing Behaviors among Iranian Drug Injectors; A National Study

    Science.gov (United States)

    Assari, Shervin; Ahmadi, Khodabakhsh; Rezazade, Majid

    2015-01-01

    Background: Although needle and syringe sharing is one of the main routs of transmission of HIV in several countries in the middle east, very little is known about how socio-economic status of injecting drug users (IDUs) is linked to the receptive syringe sharing behaviors in these countries. Aim: To study socio-economic correlates of receptive needle and syringe sharing among IDUs in Iran. Methods: The study used data from the Unhide Risk Study, a national survey of IDUs. This study sampled 636 IDUs (91% male) via snowball sampling from eight provinces in Iran in 2009. Socio-demographic and drug use characteristics were collected. We used a logistic regression to determine factors associated with receptive needle and syringe sharing during the past 6 months. Results: From 636 IDUs enrolled in this study, 68% (n = 434) reported receptive needle and syringe sharing behaviors in the past 6 months. Odds of receptive needle and syringe sharing in the past 6 months was lower among IDUs who were male [odds ratios (OR) = 0.29, 95% confidence interval (CI) = 0.12–0.70], had higher education (OR = 0.74, 95% CI = 0.64–0.86) but higher among those who were unemployed (OR = 4.05, 95% CI = 1.50–10.94), and were single (OR = 1.47, 95% CI = 1.02–2.11). Conclusion: This study presented factors associated with risk of receptive needle and syringe sharing among Iranian IDUs. This information may be used for HIV prevention and harm reduction purposes. Socio-economic status of Iranian IDUs may be closely linked to high-risk injecting behaviors among them. PMID:25852577

  19. Efficacy of syringe-irrigation topical therapy and the influence of the middle turbinate in sinus penetration of solutions

    Directory of Open Access Journals (Sweden)

    Guilherme Henrique Wawginiak

    Full Text Available Abstract Introduction: Topical therapies are the best postoperative treatment option for chronic rhinosinusitis, especially those with high volume and pressure, such as the squeeze bottles. However, they are not an available option in Brazil, where irrigation syringes are used. Objective: To investigate the efficacy of topical sinonasal therapy with syringe and the influence of the middle turbinate on this process Methods: Intervention study in training models (S.I.M.O.N.T.. After standard dissection, three interventions were performed (Nasal Spray 4 puffs, 60-mL syringe and 240-mL Squeeze Bottle with normal and Sutured Middle Turbinate. Images of each sinus were captured after the interventions, totalizing 144 images. The images were classified by 10 evaluators according to the amount of residual volume from zero to 3, with zero and 1 being considered poor penetration and 2 and 3, good penetration. The 1440 evaluations were used in this study. Results: Considering all middle turbinate situations, the amount of good penetrations were 8.1% for Spray; 68.3% for Syringe, and 78.3% for Squeeze (p < 0.0001. Considering all types of interventions, the Normal Middle Turbinate group had 48.2% of good penetrations and the Sutured Middle Turbinate, 55% (p = 0.01. Considering only the Sutured Middle Turbinates, there was no difference between the interventions with Syringe and Squeeze (76.3% vs. 80.4%; p = 0.27. Conclusion: Topical therapy of irrigation with a 60-mL syringe was more effective than that with nasal spray. The status of the middle turbinate proved to be fundamental and influenced topical therapy. Irrigation with syringe was as effective as the squeeze bottle when the middle turbinate was sutured to the nasal septum.

  20. Multistate outbreak of Serratia marcescens bloodstream infections caused by contamination of prefilled heparin and isotonic sodium chloride solution syringes.

    Science.gov (United States)

    Blossom, David; Noble-Wang, Judith; Su, John; Pur, Stacy; Chemaly, Roy; Shams, Alicia; Jensen, Bette; Pascoe, Neil; Gullion, Jessica; Casey, Eric; Hayden, Mary; Arduino, Matthew; Budnitz, Daniel S; Raad, Isaam; Trenholme, Gordon; Srinivasan, Arjun

    2009-10-12

    To investigate clusters of Serratia marcescens (SM) bloodstream infections (BSIs) at health care facilities in several states and determine whether contaminated prefilled heparin and isotonic sodium chloride solution (hereinafter, saline) syringes from a single manufacturer (company X) were the likely cause, we performed an outbreak investigation of inpatient and outpatient health care facilities from October 2007 through February 2008. Active case finding for clusters of SM BSIs. Information on SM BSIs was obtained, and SM blood isolates were sent to the Centers for Disease Control and Prevention (CDC). Culture specimens were taken from various lots of prefilled heparin and saline syringes by health care facilities and the CDC to test for the presence of SM. The SM isolates from syringes and blood were compared by pulsed-field gel electrophoresis. A total of 162 SM BSIs in 9 states were reported among patients at facilities using prefilled heparin and/or saline syringes made by company X. Cultures of unopened prefilled heparin and saline syringes manufactured by company X grew SM. Of 83 SM blood isolates submitted to the CDC from 7 states, 70 (84%) were genetically related to the SM strain isolated from prefilled syringes. A US Food and Drug Administration inspection revealed that company X was not in compliance with quality system regulations. A multistate outbreak of SM BSIs was associated with intrinsic contamination of prefilled syringes. Our investigation highlights important issues in medication safety, including (1) the importance of pursuing possible product-associated outbreaks suggested by strong epidemiologic data even when initial cultures of the suspected product show no contamination and (2) the challenges of medical product recalls when production has been outsourced from one company to another.

  1. A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

    Science.gov (United States)

    Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

    2017-12-01

    Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

  2. Determination of bismuth and cadmium after solid-phase extraction with chromosorb-107 in a syringe

    Energy Technology Data Exchange (ETDEWEB)

    Tokman, Nilgun; Akman, Suleyman

    2004-08-09

    The determination of bismuth and cadmium by graphite furnace atomic absorption spectrometry (GFAAS) after solid-phase extraction (SPE) on Chromosorb-107 filled in a syringe was described. To retain the analytes, the sample solution treated with and without ammonium pyrolidine dithiocarbamate (APDC) was drawn into the syringe filled with Chromosorb-107 and discharged back manually. Bismuth and cadmium were quantitatively sorbed at pH {>=} 6 irrespective of whether the analyte was complexed with APDC prior to passing through the Chromosorb-107. Analyte elements sorbed on the resin were quantitatively eluted with 3.0 M of HNO{sub 3} again drawing and discharging the eluent into the syringe and ejected it back. Optimum flow rates of sample or eluent for sorption and elution processes were 20 ml min{sup -1} for drawing and 20 ml min{sup -1} for discharging in all cases. Bismuth and cadmium were analyzed by graphite furnace atomic absorption spectrometry. The elements could be concentrated by drawing and discharging several portions of sample successively but eluting only one time. The validity of the proposed method was checked with standard reference materials (NIST SRM 1515 Apple-Leaves, CWW-TM-E Waste Water and CRM-SW Sea Water). The analyte elements were quantitatively (>95%) recovered from different matrices irrespective of treated samples with APDC. Detection limits ({delta}) were 0.8 and 1.2 {mu}g l{sup -1} for Bi and Cd, respectively. The method can be characterized with fastness, simplicity, quantitative recovery and high reproducibility.

  3. [Preference for etanercept pen versus syringe in patients with chronic arthritis. Nurse education workshop].

    Science.gov (United States)

    Garcia-Diaz, Silvia; Girabent-Farrés, Montserrat; Roig-Vilaseca, Daniel; Reina, Delia; Cerdà, Dacia; González, Marina; Torrente-Segarra, Vicenç; Fíguls, Ramon; Corominas, Hèctor

    2013-01-01

    The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. Non-stick syringe needles: Beneficial effects of thin film metallic glass coating

    OpenAIRE

    Chu, Jinn P.; Yu, Chia-Chi; Tanatsugu, Yusuke; Yasuzawa, Mikito; Shen, Yu-Lin

    2016-01-01

    This paper reports on the use of Zr-based (Zr53Cu33Al9Ta5) thin film metallic glass (TFMG) for the coating of syringe needles and compares the results with those obtained using titanium nitride and pure titanium coatings. TFMG coatings were shown to reduce insertion forces by ?66% and retraction forces by ?72%, when tested using polyurethane rubber block. The benefits of TFMG-coated needles were also observed when tested using muscle tissue from pigs. In nano-scratch tests, the TFMG coatings ...

  5. Syringe confiscation as an HIV risk factor: the public health implications of arbitrary policing in Tijuana and Ciudad Juarez, Mexico.

    Science.gov (United States)

    Beletsky, Leo; Lozada, Remedios; Gaines, Tommi; Abramovitz, Daniela; Staines, Hugo; Vera, Alicia; Rangel, Gudelia; Arredondo, Jaime; Strathdee, Steffanie A

    2013-04-01

    Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over the counter without a prescription, but police practices are often at odds with the law. FSW-IDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48%. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR] = 2.54, 95% confidence interval [CI] = 1.11-5.80), reporting sexual abuse by police (aOR = 12.76, 95% CI = 6.58-24.72), engaging in groin injection (aOR = 1.84, 95% CI = 1.15-2.93), injecting in public (aOR = 1.64; 95% CI = 1.14-2.36), and obtaining syringes from pharmacies (aOR = 1.54; 95% CI = 1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR = 0.92, 95% CI = 0.87-0.98) as was frequent injection with clients within the last month (aOR = 0.64, 95% CI = 0.44-0.94). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

  6. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    Science.gov (United States)

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  7. Access 2010 Programmer's Reference

    CERN Document Server

    Hennig, Teresa; Griffith, Geoffrey L

    2010-01-01

    A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem

  8. Using a modified syringe technique to adjust the intracuff pressure of a laryngeal mask airway.

    Science.gov (United States)

    Hung, Kuo-Chuan; Chen, Wei-Hung; Shih, Yu-Hsuan; Yeh, Li-Ren

    2015-12-01

    Limiting the intracuff pressure of a laryngeal mask airway (LMA) to pressure of an LMA. In a preclinical study, commercially available 20-mL syringes were attached to the pilot balloon of LMAs with different preset intracuff pressures (40 cmH2O, 50 cmH2O, 60 cmH2O, 70 cmH2O, 80 cmH2O, 100 cmH2O, and 120 cmH2O). After attachment, the syringe plunger was allowed to passively rebound. If no rebound of the plunger was observed after attachment, 1 mL of air was withdrawn and the plunger was allowed to passively rebound again. This technique allowed the plunger to overcome static friction and avoid excessive deflation of the LMA cuffs. The intracuff pressure was measured using a manometer after the plunger ceased moving. In the preclinical study, the intracuff pressure was always less than or close to 60 cmH2O after adjustment using this modified syringe technique. After evaluating the performance and characteristics of the syringe in the preclinical study, we concluded that the modified syringe technique may be useful for adjusting LMA intracuff pressure effectively. Copyright © 2015. Published by Elsevier B.V.

  9. Long-term effectiveness of the ACCESS program in linking community mental health services to homeless persons with serious mental illness.

    Science.gov (United States)

    Rothbard, Aileen B; Min, So-Young; Kuno, Eri; Wong, Yin-Ling Irene

    2004-01-01

    This study examined the long-term effectiveness of the ACCESS (Access to Community Care and Effective Services and Supports) project on service utilization and continuity of care among homeless persons with serious mental illness. A 3-year longitudinal analysis, using Medicaid claims data, tracked behavioral health service utilization among 146 Medicaid-eligible participants in the Pennsylvania ACCESS program. Utilization patterns of inpatient, outpatient, and emergency department services for psychiatric and substance abuse treatment were examined during the year prior to, during, and one year after the implementation of the ACCESS project. Use of psychiatric ambulatory care significantly increased among intervention participants and remained greater following ACCESS intervention. Better continuity of care following hospitalization was achieved during and after the intervention. The number of days spent hospitalized significantly decreased during the intervention. These results suggest that the ACCESS intervention was effective in linking hard-to-reach homeless persons with serious mental illness to the community mental health service system, and that this effect was maintained after termination of the intervention.

  10. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

    Science.gov (United States)

    McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

    2012-06-01

    Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

  11. "Utstein style" spreadsheet and database programs based on Microsoft Excel and Microsoft Access software for CPR data management of in-hospital resuscitation.

    Science.gov (United States)

    Adams, Bruce D; Whitlock, Warren L

    2004-04-01

    In 1997, The American Heart Association in association with representatives of the International Committee on Resuscitation (ILCOR) published recommended guidelines for reviewing, reporting and conducting in-hospital cardiopulmonary resuscitation (CPR) outcomes using the "Utstein style". Using these guidelines, we developed two Microsoft Office based database management programs that may be useful to the resuscitation community. We developed a user-friendly spreadsheet based on MS Office Excel. The user enters patient variables such as name, age, and diagnosis. Then, event resuscitation variables such as time of collapse and CPR team arrival are entered from a "code flow sheet". Finally, outcome variables such as patient condition at different time points are recorded. The program then makes automatic calculations of average response times, survival rates and other important outcome measurements. Also using the Utstein style, we developed a database program based on MS Office Access. To promote free public access to these programs, we established at a website. These programs will help hospitals track, analyze, and present their CPR outcomes data. Clinical CPR researchers might also find the programs useful because they are easily modified and have statistical functions.

  12. Targeted release of transcription factors for cell reprogramming by a natural micro-syringe.

    Science.gov (United States)

    Berthoin, Lionel; Toussaint, Bertrand; Garban, Frédéric; Le Gouellec, Audrey; Caulier, Benjamin; Polack, Benoît; Laurin, David

    2016-11-20

    Ectopic expression of defined transcription factors (TFs) for cell fate handling has proven high potential interest in reprogramming differentiated cells, in particular for regenerative medicine, ontogenesis study and cell based modelling. Pluripotency or transdifferentiation induction as TF mediated differentiation is commonly produced by transfer of genetic information with safety concerns. The direct delivery of proteins could represent a safer alternative but still needs significant advances to be efficient. We have successfully developed the direct delivery of proteins by an attenuated bacterium with a type 3 secretion system that does not require challenging and laborious steps for production and purification of recombinant molecules. Here we show that this natural micro-syringe is able to inject TFs to primary human fibroblasts and cord blood CD34 + hematopoietic stem cells. The signal sequence for vectorization of the TF Oct4 has no effect on DNA binding to its nucleic target. As soon as one hour after injection, vectorized TFs are detectable in the nucleus. The injection process is not associated with toxicity and the bacteria can be completely removed from cell cultures. A three days targeted release of Oct4 or Sox2 embryonic TFs results in the induction of the core pluripotency genes expression in fibroblasts and CD34 + hematopoietic stem cells. This micro-syringe vectorization represents a new strategy for TF delivery and has potential applications for cell fate reprogramming. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. THE NURSE IN THE CONTEXT OF NATIONAL PROGRAM TO IMPROVE ACCESS AND QUALITY OF PRIMARY CARE (PMAQ: REPORT EXERIÊNCIA

    Directory of Open Access Journals (Sweden)

    Andreia Souza de Jesus

    2015-06-01

    Full Text Available This is an experience report of a nurse from the Family Health Strategy (FHS, which occurred between February and October 2012, in a city in the interior of Bahia. The aim was to reflect on the experience of nurses in their work process from the perspective of the National Programme for Improving Access and Quality of Primary Care (PMAQ. Phases of Accession, Development and external evaluation of the program were reported, getting compromised the account of other phases due to interruption of the process of nursing work in the team. The experience was significant, demonstrating that PMAQ is a new program, but with goals and targets already recommended above, but without the specific financial incentive. Other factors identified were workload of nurses in the face of new demands on health and the interference of precarious employment relations in the continuity of actions.

  14. A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity.

    Science.gov (United States)

    McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M

    2015-08-01

    The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

  15. Radiation dose to the operator during vertebroplasty: prospective comparison of the use of 1-cc syringes versus an injection device.

    Science.gov (United States)

    Kallmes, David F; O, Erwin; Roy, Soma Sinha; Piccolo, Richard G; Marx, William F; Lee, Jae K; Jensen, Mary E

    2003-01-01

    Percutaneous vertebroplasty procedures require relatively long durations of fluoroscopic guidance, which might lead to substantial radiation dose to operators. Specialized injection devices have been proposed to limit operator exposure. Our purpose was to compare the radiation dose to the operator's hands during vertebroplasty when using 1-cc syringes versus that when using an injection device. Radiation dosimeters were worn on the left wrist during 39 vertebroplasty injection procedures in 25 patients. Cases were alternated between the use of 1-cc syringes (19 procedures) and the use of an injection device (20 procedures). For each procedure, one dosimeter was worn throughout the procedure, both during needle placement and injection, and a second dosimeter was worn during the injection phase only. Mean doses for the whole case and mean doses for the injection procedure alone were compared between groups. Mean whole case dose was 128 +/- 161 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 98 +/- 90 mrem (range, 0-340 mrem) for the injection device group (P =.23). Mean dose during injection was 100 +/- 145 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 55 +/- 43 mrem (range, 0-130 mrem) for the injection device group (P =.09). Three of 19 1-cc syringe cases yielded zero dose, compared with four of 20 injection device cases. Duration of injection was markedly different between groups, with mean injection times of 4.2 and 7.5 min for 1-cc syringe and injection device cases, respectively (P device groups, respectively (P =.002). The use of an injection device significantly decreased the radiation dose to the operator's extremity per unit time of injection. However, total dose per injection was equivalent between groups because of significantly longer injection duration for the injection device cohort.

  16. 76 FR 5755 - Medicare and Medicaid Programs; Patient Notification of Right To Access State Survey Agencies and...

    Science.gov (United States)

    2011-02-02

    ... Organization (QIO) Program was established to improve the efficiency, effectiveness, economy and quality of... the Medicare program. Home health services are covered for the elderly and disabled under the Hospital...

  17. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    Science.gov (United States)

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  18. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž

    2015-12-01

    Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.

  19. Applying RE-AIM to evaluate two community-based programs designed to improve access to eye care for those at high-risk for glaucoma.

    Science.gov (United States)

    Sapru, Saloni; Berktold, Jennifer; Crews, John E; Katz, L Jay; Hark, Lisa; Girkin, Christopher A; Owsley, Cynthia; Francis, Brittney; Saaddine, Jinan B

    2017-12-01

    Glaucoma is a leading cause of vision loss and blindness in the U.S. Risk factors include African American race, older age, family history of glaucoma, and diabetes. This paper describes the evaluation of a mobile eye health and a telemedicine program designed to improve access to eye care among people at high-risk for glaucoma. The RE-AIM (reach, efficacy, adoption, implementation, and maintenance) evaluation framework was used to harmonize indicators. Both programs provided community-based eye health education and eye services related to glaucoma detection and care. Each program reported data on participants and community partners. An external evaluator conducted site visit interviews with program staff and community partners. Quantitative and qualitative data were integrated and analyzed using the RE-AIM dimensions. By targeting high-risk populations and providing comprehensive eye exams, both programs detected a large proportion of new glaucoma-related cases (17-19%) - a much larger proportion than that found in the general population (<2%). The educational intervention increased glaucoma knowledge; evidence that it led people to seek eye care was inconclusive. Evaluation findings from the mobile eye health program and the telemedicine program may provide useful information for wider implementation in public health clinics and in optometrist clinics located in retail outlets. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Impact of an easy-access telephonic interpreter program in the acute care setting: an evaluation of a quality improvement intervention.

    Science.gov (United States)

    Tuot, Delphine S; Lopez, Monica; Miller, Cecily; Karliner, Leah S

    2012-02-01

    Language barriers render interaction with the health care system difficult and lead to health disparities for patients with limited English proficiency (LEP). Despite a long-standing legal obligation for large health care organizations in the United States to try to provide free language access services for patients with LEP, professional interpretation is not always widely accessible, and even when it is, its use is often suboptimal. A dual-handset phone with 24-hour access to professional telephonic interpretation was placed at the bedside of all patients admitted to the general medicine floor of a tertiary care academic hospital. Nurses and physicians were surveyed before and after the easy-access interpretation program's implementation. Distribution of pre- and postimplementation surveys to 127 and 122 nurses, respectively, yielded a total of 163 completed surveys (overall participation rate, 65%). Distribution of surveys to 96 and 78 physicians, respectively, yielded 116 completed surveys (overall participation rate, 67%). After implementation, use of professional telephonic interpreters for communication with LEP patients increased fourfold, without a decrease in use of professional in-person interpreters. There were significant increases in professional interpreter use during brief communications with high error potential, including medication administration (odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.1-3.2) and pre-rounding (OR = 3.4, 95% CI 1.2-9.8). Increasing ease of access to dual-handset interpreter telephones promotes use of professional interpreters in the acute care setting. Future hospital policy should focus on further integrating language services into the hospital environment, accompanied by an educational program to assist in shifting professional norms toward use of professional interpreters.

  1. A rapid and economic in-house DNA purification method using glass syringe filters.

    Directory of Open Access Journals (Sweden)

    Yun-Cheol Kim

    Full Text Available BACKGROUND: Purity, yield, speed and cost are important considerations in plasmid purification, but it is difficult to achieve all of these at the same time. Currently, there are many protocols and kits for DNA purification, however none maximize all four considerations. METHODOLOGY/PRINCIPAL FINDINGS: We now describe a fast, efficient and economic in-house protocol for plasmid preparation using glass syringe filters. Plasmid yield and quality as determined by enzyme digestion and transfection efficiency were equivalent to the expensive commercial kits. Importantly, the time required for purification was much less than that required using a commercial kit. CONCLUSIONS/SIGNIFICANCE: This method provides DNA yield and quality similar to that obtained with commercial kits, but is more rapid and less costly.

  2. Non-stick syringe needles: Beneficial effects of thin film metallic glass coating.

    Science.gov (United States)

    Chu, Jinn P; Yu, Chia-Chi; Tanatsugu, Yusuke; Yasuzawa, Mikito; Shen, Yu-Lin

    2016-08-30

    This paper reports on the use of Zr-based (Zr53Cu33Al9Ta5) thin film metallic glass (TFMG) for the coating of syringe needles and compares the results with those obtained using titanium nitride and pure titanium coatings. TFMG coatings were shown to reduce insertion forces by ∼66% and retraction forces by ∼72%, when tested using polyurethane rubber block. The benefits of TFMG-coated needles were also observed when tested using muscle tissue from pigs. In nano-scratch tests, the TFMG coatings achieved a coefficient of friction (COF) of just ∼0.05, which is about one order of magnitude lower than those of other coatings. Finite-element modeling also indicates a significant reduction in injection and retraction forces. The COF can be attributed to the absence of grain boundaries in the TFMG coating as well as a smooth surface morphology and low surface free energy.

  3. Failure mode and effects analysis applied to the administration of liquid medication by oral syringes

    Directory of Open Access Journals (Sweden)

    Eva María Guerra-Alia

    2017-11-01

    Full Text Available To carry out a Failure Mode and Effects Analysis (FMEA to the use of oral syringes. Methods: A multidisciplinary team was assembled within the Safety Committee. The stages of oral administration process of liquid medication were analysed, identifying the most critical and establishing the potential modes of failure that can cause errors. The impact associated with each mode of failure was calculated using the Risk Priority Number (RPN. Preventive actions were proposed. Results: Five failure modes were identified, all classified as high risk (RPN> 100. Seven of the eight preventive actions were implemented. Conclusions: The FMEA methodology was a useful tool. It has allowed to know the risks, analyse the causes that cause them, their effects on patient safety and the measures to reduce them

  4. Ensuring injection safety during measles immunization campaigns: more than auto-disable syringes and safety boxes.

    Science.gov (United States)

    Hersh, Bradley S; Carr, Richard M; Fitzner, Julia; Goodman, Tracey S; Mayers, Gillian F; Everts, Hans; Laurent, Eric; Larsen, Gordon A; Bilous, Julian B

    2003-05-15

    Measles immunization campaigns are effective elements of a comprehensive strategy for preventing measles cases and deaths. However, if immunizations are not properly administered or if immunization waste products are not safely managed, there is the potential to transmit bloodborne pathogens (e.g., human immunodeficiency virus and hepatitis B and hepatitis C). A safe injection can be defined as one that results in no harm to the recipient, the vaccinator, and the surrounding community. Proper equipment, such as the exclusive use of auto-disable syringes and safety boxes, is necessary, but these alone are not sufficient to ensure injection safety in immunization campaigns. Equally important are careful planning and managerial activities that include policy and strategy development, financing, budgeting, logistics, training, supervision, and monitoring. The key elements that must be in place to ensure injection safety in measles immunization campaigns are outlined.

  5. Mechanical properties of composites as functions of the syringe storage temperature and energy dose

    Directory of Open Access Journals (Sweden)

    Fernanda Oliveira CHAVES

    2015-04-01

    Full Text Available Objective: To investigate the mechanical properties of different classifications of composites indicated for posterior application as functions of the storage condition and of the energy dose. Material and Methods: Specimens (8x2x2 mm were obtained according to the factors: I Composites (3M ESPE: Filtek P60, Filtek Z350XT, and Filtek Silorane; II Syringe storage conditions: room temperature, aged, oven, refrigerator, and freezer; and III Energy dose: 24 J/cm2 and 48 J/cm2. After photoactivation, the specimens were stored at 37ºC for 24 h. After storage, a three-point bending test was carried out in a universal testing machine at 0.5 mm/min. Flexural strength (S and flexural modulus (E were calculated. Data were analyzed by three-way ANOVA and Tukey's test (α=0.05. Results: Different storage conditions significantly affected the silorane composite for S; conversely, no effects were noted in terms of E. The accelerated aging protocol significantly increased the S of Filtek P60 and Filtek Silorane, whereas storage in the oven significantly decreased the S for all of the composites tested. Filtek P60 was the only composite not affected by the lower storage temperatures tested for S, whereas for the silorane this parameter was impacted at the same conditions. The factor "dose" was not statistically significant. Conclusions: The syringe storage at different temperature conditions proved to influence mostly the flexural strength, a clinically important characteristic considering the posterior indication of the materials tested. The silorane composite should not be stored at lower temperatures.

  6. Syringe-Injectable Electronics with a Plug-and-Play Input/Output Interface.

    Science.gov (United States)

    Schuhmann, Thomas G; Yao, Jun; Hong, Guosong; Fu, Tian-Ming; Lieber, Charles M

    2017-09-13

    Syringe-injectable mesh electronics represent a new paradigm for brain science and neural prosthetics by virtue of the stable seamless integration of the electronics with neural tissues, a consequence of the macroporous mesh electronics structure with all size features similar to or less than individual neurons and tissue-like flexibility. These same properties, however, make input/output (I/O) connection to measurement electronics challenging, and work to-date has required methods that could be difficult to implement by the life sciences community. Here we present a new syringe-injectable mesh electronics design with plug-and-play I/O interfacing that is rapid, scalable, and user-friendly to nonexperts. The basic design tapers the ultraflexible mesh electronics to a narrow stem that routes all of the device/electrode interconnects to I/O pads that are inserted into a standard zero insertion force (ZIF) connector. Studies show that the entire plug-and-play mesh electronics can be delivered through capillary needles with precise targeting using microliter-scale injection volumes similar to the standard mesh electronics design. Electrical characterization of mesh electronics containing platinum (Pt) electrodes and silicon (Si) nanowire field-effect transistors (NW-FETs) demonstrates the ability to interface arbitrary devices with a contact resistance of only 3 Ω. Finally, in vivo injection into mice required only minutes for I/O connection and yielded expected local field potential (LFP) recordings from a compact head-stage compatible with chronic studies. Our results substantially lower barriers for use by new investigators and open the door for increasingly sophisticated and multifunctional mesh electronics designs for both basic and translational studies.

  7. A syringe-like love dart injects male accessory gland products in a tropical hermaphrodite.

    Directory of Open Access Journals (Sweden)

    Joris M Koene

    Full Text Available Sexual conflict shapes the evolution of many behaviours and processes involved in reproduction. Nearly all evidence supporting this comes from species where the sexes are separated. However, a substantial proportion of animals and most plants are hermaphroditic, and theoretical work predicts that sexual conflict plays an important role even when the sexes are joined within one individual. This seems to have resulted in bizarre mating systems, sophisticated sperm packaging and complex reproductive morphologies. By far the best-known example of such a strategy in hermaphrodites is the shooting of so-called love-darts in land snails. All known love darts carry a gland product on their outside and enter this into the partner's hemolymph by stabbing. Here, we show that species of the snail genus Everettia possess a syringe-like dart that serves as a real injection needle. Their dart is round in cross-section, contains numerous channels, and has perforations along its side. Histology and electron microscopy show that these holes connect to the channels inside the dart and run all the way up to the elaborate mucus glands that are attached to the dart sac. This is the first report on a love dart that is used as a syringe to directly inject the gland product into the partner's hemolymph. Although the exact use and function of this dart remains to be demonstrated, this clearly adds to the complexity of the evolution of reproductive strategies in hermaphrodites in general. Moreover, the perforations on the outside of the love dart resemble features of other injection devices, thus uncovering common design and repeated evolution of such features in animals.

  8. A syringe-like love dart injects male accessory gland products in a tropical hermaphrodite.

    Science.gov (United States)

    Koene, Joris M; Liew, Thor-Seng; Montagne-Wajer, Kora; Schilthuizen, Menno

    2013-01-01

    Sexual conflict shapes the evolution of many behaviours and processes involved in reproduction. Nearly all evidence supporting this comes from species where the sexes are separated. However, a substantial proportion of animals and most plants are hermaphroditic, and theoretical work predicts that sexual conflict plays an important role even when the sexes are joined within one individual. This seems to have resulted in bizarre mating systems, sophisticated sperm packaging and complex reproductive morphologies. By far the best-known example of such a strategy in hermaphrodites is the shooting of so-called love-darts in land snails. All known love darts carry a gland product on their outside and enter this into the partner's hemolymph by stabbing. Here, we show that species of the snail genus Everettia possess a syringe-like dart that serves as a real injection needle. Their dart is round in cross-section, contains numerous channels, and has perforations along its side. Histology and electron microscopy show that these holes connect to the channels inside the dart and run all the way up to the elaborate mucus glands that are attached to the dart sac. This is the first report on a love dart that is used as a syringe to directly inject the gland product into the partner's hemolymph. Although the exact use and function of this dart remains to be demonstrated, this clearly adds to the complexity of the evolution of reproductive strategies in hermaphrodites in general. Moreover, the perforations on the outside of the love dart resemble features of other injection devices, thus uncovering common design and repeated evolution of such features in animals.

  9. Development of a Communication Training Program to Improve Access to Legal Services for People with Complex Communication Needs

    Science.gov (United States)

    Togher, Leanne; Balandin, Susan; Young, Katherine; Given, Fiona; Canty, Michael

    2006-01-01

    People with communication disabilities experience problems in accessing the justice system. In this article we describe the development of a multimedia package designed to train legal personnel to identify and reduce communication barriers to their services. The training package is being developed collaboratively by a diverse team that included…

  10. 12 CFR Appendix B to Part 748 - Guidance on Response Programs for Unauthorized Access to Member Information and Member Notice

    Science.gov (United States)

    2010-01-01

    ... guidance on preventing, detecting, and responding to intrusions into financial institution computer systems... member information that would allow someone to log onto or access the member's account, such as user name... nationwide credit reporting agency and have information relating to fraudulent transactions deleted; d. An...

  11. Romania's accession process into the European Union: discourses at policy-, program-, and project-levels in the justice sector

    NARCIS (Netherlands)

    D. Rem (Dana); D.R. Gasper (Des)

    2008-01-01

    textabstractSpecial arrangements were made by the European Union for decision-making on the possible accession of Romania and Bulgaria. A regime of extra procedures was added to the arrangements used for the Eastern European countries which joined the Union in 2004. This paper examines how the

  12. Three-dimensional Quantitative Porosity Characterization of Syringe- versus Hand-mixed Set Epoxy Resin Root Canal Sealer.

    Science.gov (United States)

    De-Deus, Gustavo; Scelza, Miriam Z; Neelakantan, Prasanna; Sharma, Subash; Neves, Aline de Almeida; Silva, Emmanuel João Nogueira Leal

    2015-01-01

    The aim of the present study was to compare the porosity characteristics of AH Plus Jet(tm) syringe-mix and the conventional hand-mixed AH Plus root canal sealers by three-dimensional quantitative high-resolution micro-computed tomography (micro-CT). Seven test specimens were prepared from each tested sealer by a single operator following the manufacturer's instructions and poured into pre-lubricated plastic split-ring moulds. Set sealer test specimens were scanned using a micro-CT device and the shadow images were reconstructed into cross-sectional slices. The evaluated parameters were (i) total pore count, (ii) total pore volume and mean pore volume, (iii) total porosity (% of pore volume in relation to total sealer volume) and (iv) mean pore distance to the sealer lateral external surface. In both groups, most pores were localized within the external sealer perimeter (0.05 mm from the external surface). Hand-mixed AH Plus specimens showed statistically significant higher mean total pore count, total pore volume and total porosity (p=0.001) than the syringe-mixed specimens. However, mean pore sizes in AH Plus syringe-mixed specimens were significantly higher (p=0.046) than the AH Plus hand-mixed counterparts. Hand-mixed AH Plus was associated with higher total mean pore count, volume and total porosity compared to syringe mixed AH Plus.

  13. A computer-controlled syringe driver for use during anaesthesia. A modification of the Graseby MS16A.

    Science.gov (United States)

    Cohen, A T

    1986-06-01

    The requirements of a drug infusion device for use in theatre are discussed. A modification of the Graseby MS16A syringe pump and an interface circuit permitting its remote control by microcomputer are described. The pump is controlled via a standard computer interface (RS232) which makes it a unique and powerful research tool. Aspects of safety are considered.

  14. Evaluating the Influence of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Allocation Package on Healthy Food Availability, Accessibility, and Affordability in Texas.

    Science.gov (United States)

    Lu, Wenhua; McKyer, E Lisako J; Dowdy, Diane; Evans, Alexandra; Ory, Marcia; Hoelscher, Deanna M; Wang, Suojin; Miao, Jingang

    2016-02-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was implemented to improve the health of pregnant women and children of low socioeconomic status. In 2009, the program was revised to provide a wider variety of healthy food choices (eg, fresh fruits, vegetables, and whole-grain items). The purpose of this study was to evaluate (1) the impact of the revised WIC Nutrition Program's food allocation package on the availability, accessibility, and affordability of healthy foods in WIC-authorized grocery stores in Texas; and (2) how the impact of the policy change differed by store types and between rural and urban regions. WIC-approved stores (n=105) across Texas were assessed using a validated instrument (88 items). Pre- (June-September 2009) and post-new WIC package implementation (June-September 2012) audits were conducted. Paired-sample t tests were conducted to compare the differences between pre- and post-implementation audits on shelf width and number of varieties (ie, availability), visibility (ie, accessibility), and inflation-adjusted price (ie, affordability). Across the 105 stores, post-implementation audits showed increased availability in terms of shelf space for most key healthy food options, including fruit (PFood visibility increased for fresh juices (Pfoods such as fruits (Pbread (Pbread (Pfood availability and visibility were observed in stores of different types and in different locations, although smaller or fewer effects were noted in small stores and stores in rural regions. Implementation of the revised WIC food package has generally improved availability and accessibility, but not affordability, of healthy foods in WIC-authorized stores in Texas. Future studies are needed to explore the impact of the revised program on healthy food option purchases and consumption patterns among Texas WIC participants. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  15. Structural factors for public dental health services in Regional Health Care Network 13: an analysis of the Brazilian National Program for Improving Access and Quality of Primary Care

    Directory of Open Access Journals (Sweden)

    Lucila Brandão HIROOKA

    2018-02-01

    Full Text Available Abstract Introduction The Brazilian National Program for Improving Access and Quality of Primary Care aims to induce the institution of processes that expand the capacity of federal, state and municipal administrations and Primary Care teams to offer services that ensure greater access and quality. Objective To identify the characteristics of infrastructure for the dental health care of the health units from the Regional Health Care Network 13, from the perspective of a health evaluation. Material and method This is a descriptive and cross-sectional study in which is used the Module V database of the External Evaluation instrument of 156 health units of this region that participated of the 2nd cycle of the referred program, which discuss the modality of the health teams, structure and environment of the dental office, the hours of operation, equipment, instruments and dental supplies. Result In general, the oral health units of this study have dental offices with good structural conditions and sufficient equipment and supplies to carry out clinical activities, except those for dental prostheses, possibly due to the permanence of this service in secondary care. However, they point out that advances in access and coverage by oral health services are still necessary. Conclusion Although the theme includes other studies and reflections, the present work may contribute to discussions about the present condition, and it is recommended the active participation of all the actors involved in the care, in the search for the qualification of oral health services in this region.

  16. Improved access and cycle time with an "in-house" patient-centered teleglaucoma program versus traditional in-person assessment.

    Science.gov (United States)

    Arora, Sourabh; Rudnisky, Chris J; Damji, Karim F

    2014-05-01

    To compare access time and cycle time between an "in-house" teleglaucoma program and in-person glaucoma consultation. This was a prospective comparative study of 71 patients seen through the teleglaucoma program (eligible patients were glaucoma suspects or early-stage open-angle glaucoma) and 63 patients seen via a traditional in-person exam with a physician present. Access time was calculated as the time from the patient being referred to the date of a booked visit for either a teleglaucoma or in-person exam. Cycle time was defined as the time from registration until departure during the visit to the hospital; it was calculated for the subset of patients from each study group who completed activity logs on the day of their visit. The mean access time was significantly shorter for patients seen through teleglaucoma compared with in-person exam: 45±22 days (range, 13-121 days) (n=68) versus 88±47 days (range, 27-214 days) (n=63), respectively (pglaucoma suspects and patients with early-stage glaucoma compared with in-person assessment.

  17. Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo.

    Science.gov (United States)

    Ho, Lara S; Wheeler, Erin

    2018-03-21

    Unmet need for family planning in the conflict-affected area of eastern Democratic Republic of the Congo (DRC) has been reported to be as high as 38%, and women in such conflict settings are often the most at risk for maternal mortality. The International Rescue Committee implements the Family Planning and Post-Abortion Care in Emergencies program in 3 provinces of eastern DRC to provide women and couples access to family planning, including long-acting reversible contraceptives (LARCs). This article presents routine program data from June 2011 through December 2013 from 2 health zones as well as results from a qualitative assessment of family planning clients and of male and female non-users, conducted in 2013. It then describes how these findings were used to make program adjustments to improve access to family planning services and client informed choice and assesses the effects of the program design changes on family planning uptake and method mix using routine program data from January 2014 through December 2016. Between 2011 and 2013, 8,985 clients adopted family planning, with an average 14 clients adopting a method per facility, per month. The method mix remained stable during this period, with implants dominating at 48%. Barriers to uptake identified from the qualitative research were both supply- and demand-related, including misconceptions about certain modern contraceptive methods on the part of providers, users, and other community members. The program implemented several program changes based on the assessment findings, including clinical coaching and supportive supervision to improve provider skills and attitudes, introduction of immediate postpartum insertion of the intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS), and behavior change communication campaigns to raise awareness about family planning. After these program changes, the mean number of clients adopting modern family planning per facility, per month

  18. Contact with hospital syringes containing body fluids: implications for medical waste management regulation Jeringas en contacto con sangre y fluidos corporales utilizadas en el hospital: implicaciones para el manejo de desechos hospitalarios

    OpenAIRE

    Patricia Volkow; Bénédicte Jacquemin; Diana Vilar-Compte; José Ramón Castillo

    2003-01-01

    OBJECTIVE: To determine amount of syringes used in the hospital and extent of contact with blood and body fluids of these syringes. MATERIAL AND METHODS: Syringe use was surveyed at a tertiary care center for one week; syringes were classified into the following four categories according to use: a) contained blood; b) contained other body fluids (urine, gastric secretion, cerebrospinal fluid, wound drainage); c) used exclusively for drug dilution and application in plastic intravenous (IV) tu...

  19. Sediment toxicity data from the NOAA National Status and Trends Program, March 1991 to July 1996 (NODC Accession 9800146)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — As part of its bioeffects assessment program. NOAA has begun a series of surveys of the toxicity and other biological effects of toxicants in selected bays and...

  20. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) from 07 June 1999 to 16 September 1999 (NODC Accession 0000513)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of Coral Reef Assessment and Monitoring Program (CRAMP) surveys taken in 1999 and include quantitative estimates of substrate type, rugosity,...

  1. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

  2. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare?

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

    Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  3. AN AUDIT OF WHETHER PRESCRIBED DOSES ARE MEASURABLE ON THE GRADUATIONS OF ONE ORAL SYRINGE.

    Science.gov (United States)

    Balsara, Jigna; Fletcher, Penny

    2016-09-01

    In paediatrics drugs are prescribed as mg/kg doses to facilitate accurate dosing. Anecdotally, some drugs are prescribed in such a way that the volume to be given is difficult to measure which may lead to inaccuracies and potential for error. Locally, errors have been reported where there has been a misunderstanding of the required dose, especially when decimal points are involved. This audit aimed to evaluate doses prescribed for in-patient children and evaluate whether they can be measured using the printed markings of one oral syringe. Data were collected for paediatric in-patients between 16th February and 27th March 2015 from paper drug charts and an electronic prescribing system depending which was in use in each area. Specific data on patient age, weight and prescribed dose were collected. Volumes were then calculated using the enteral products kept in the Trust formulary, including unlicensed specials. The prescribed volumes were reviewed against the Medicina Home® enteral syringes to see if they were measurable on the printed graduations of one oral syringe (in line with local dispensing standards). If they could not be measured, the percentage dose rounding required was calculated to see if doses could be rounded. A judgement was then made as to whether this was within an acceptable safe dose limit. Data for 560 individual medication orders for oral medicine were collected, 257 from electronic prescribing and 303 from paper charts. Of these 457 were liquid doses, 103 were from products only available as tablets or capsules. Of the 257 electronically prescribed doses, 61 (24%) were not measurable. Of the 303 paper chart doses, 57 (19%) were not measurable.Of the 457 liquid doses 77 only needed up to 4% dose adjustment to become measurable. A further 10 doses required up to 9% dose adjustment.Drugs that were frequently prescribed as non-measurable doses were: diazepam, alimemazine, chloral hydrate, azithromycin, metronidazole, paracetamol & ibuprofen

  4. Community Adaptation of Youth Accessing Residential Programs or a Home-Based Alternative: School Attendance and Academic Functioning

    Science.gov (United States)

    Frensch, Karen; Cameron, Gary; Preyde, Michele

    2009-01-01

    Caregivers of 210 youth receiving residential treatment (RT) or intensive family services (IFS) in Ontario were interviewed about the long term community adaptation of youth after leaving these programs. School attendance and academic functioning data at admission, discharge, and 12-18 months post-discharge were analyzed to explore predictors of…

  5. The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

    Science.gov (United States)

    Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

    2012-09-01

    Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

  6. The Relationship Between Exclusions from Gambling Arcades and Accessibility: Evidence from a Newly Introduced Exclusion Program in Hesse, Germany.

    Science.gov (United States)

    Strohäker, Tanja; Becker, Tilman

    2018-02-28

    An exclusion system for gambling arcades has been introduced recently in the state of Hesse. The aim of this paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. Next to socio-demographic factors, we control for three different accessibility variables in two models: the number of electronic gambling machines (EGMs) in model I, and the number of locations and density of gambling machines at a location in model II. We disentangle the association between EGMs and exclusions of model I into a location and a clustering effect. Considering the socio-demographic variables, the explanatory power of our cross-sectional models is rather low. Only the age group of the 30-39 years old and those who are not in a partnership (in model I) yield significant results. As self-exclusion systems reduce availability for the group of vulnerable players, this analysis provides evidence for the assumption that the two groups-pathological gamblers and vulnerable players-seem to have little overlap concerning sociodemographic characteristics. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The results of model II show that the location effect is more pronounced then the clustering effect of EGMs, i.e. the effect of an additional single-licensed arcade on the number of exclusions is stronger than the increase in the number of license at one location.

  7. Access to highly active antiretroviral therapy for injection drug users: adherence, resistance, and death

    Directory of Open Access Journals (Sweden)

    David Vlahov

    Full Text Available Injection drug users (IDUs continue to comprise a major risk group for HIV infection throughout the world and represent the focal population for HIV epidemics in Asia and Eastern Europe/Russia. HIV prevention programs have ranged from HIV testing and counseling, education, behavioral and network interventions, drug abuse treatment, bleach disinfection of needles, needle exchange and expanded syringe access, as well as reducing transition to injection and primary substance abuse prevention. With the advent of highly active antiretroviral therapy (HAART in 1996, dramatic clinical improvements have been seen. In addition, the treatment's impact on reducing HIV viral load (and therefore transmission by all routes provides a stronger rationale for an expansion of the focus on prevention to emphasize early identification and treatment of HIV infected individuals. However, treatment of IDUs has many challenges including adherence, resistance and relapse to high risk behaviors, all of which impact issues of access and ultimately effectiveness of potent antiretroviral treatment. A major current challenge in addressing the HIV epidemic revolves around an appropriate approach to HIV treatment for IDUs.

  8. Access to highly active antiretroviral therapy for injection drug users: adherence, resistance, and death

    Directory of Open Access Journals (Sweden)

    Vlahov David

    2006-01-01

    Full Text Available Injection drug users (IDUs continue to comprise a major risk group for HIV infection throughout the world and represent the focal population for HIV epidemics in Asia and Eastern Europe/Russia. HIV prevention programs have ranged from HIV testing and counseling, education, behavioral and network interventions, drug abuse treatment, bleach disinfection of needles, needle exchange and expanded syringe access, as well as reducing transition to injection and primary substance abuse prevention. With the advent of highly active antiretroviral therapy (HAART in 1996, dramatic clinical improvements have been seen. In addition, the treatment's impact on reducing HIV viral load (and therefore transmission by all routes provides a stronger rationale for an expansion of the focus on prevention to emphasize early identification and treatment of HIV infected individuals. However, treatment of IDUs has many challenges including adherence, resistance and relapse to high risk behaviors, all of which impact issues of access and ultimately effectiveness of potent antiretroviral treatment. A major current challenge in addressing the HIV epidemic revolves around an appropriate approach to HIV treatment for IDUs.

  9. A novel tantalum-based sol-gel packed microextraction syringe for highly specific enrichment of phosphopeptides in MALDI-MS applications.

    Science.gov (United States)

    Çelikbıçak, Ömür; Atakay, Mehmet; Güler, Ülkü; Salih, Bekir

    2013-08-07

    A new tantalum-based sol-gel material was synthesized using a unique sol-gel synthesis pathway by PEG incorporation into the sol-gel structure without performing a calcination step. This improved its chemical and physical properties for the high capacity and selective enrichment of phosphopeptides from protein digests in complex biological media. The specificity of the tantalum-based sol-gel material for phosphopeptides was evaluated and compared with tantalum(V) oxide (Ta2O5) in different phosphopeptide enrichment applications. The tantalum-based sol-gel and tantalum(V) oxide were characterized in detail using FT-IR spectroscopy, X-ray diffraction (XRD) and scanning electron microscopy (SEM), and also using a surface area and pore size analyzer. In the characterization studies, the surface morphology, pore volume, crystallinity of the materials and PEG incorporation into the sol-gel structure to produce a more hydrophilic material were successfully demonstrated. The X-ray diffractograms of the two different materials were compared and it was noted that the broad signals of the tantalum-based sol-gel clearly represented the amorphous structure of the sol-gel material, which was more likely to create enough surface area and to provide more accessible tantalum atoms for phosphopeptides to be easily adsorbed when compared with the neat and more crystalline structure of Ta2O5. Therefore, the phosphopeptide enrichment performance of the tantalum-based sol-gels was found to be remarkably higher than the more crystalline Ta2O5 in our studies. Phosphopeptides at femtomole levels could be selectively enriched using the tantalum-based sol-gel and detected with a higher signal-to-noise ratio by matrix-assisted laser desorption/ionization-mass spectrometer (MALDI-MS). Moreover, phosphopeptides in a tryptic digest of non-fat bovine milk as a complex real-world biological sample were retained with higher yield using a tantalum-based sol-gel. Additionally, the sol-gel material

  10. Strategies of Building a Stronger Sense of Community for Sustainable Neighborhoods: Comparing Neighborhood Accessibility with Community Empowerment Programs

    Directory of Open Access Journals (Sweden)

    Te-I Albert Tsai

    2014-05-01

    Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.

  11. An Open-Source Sandbox for Increasing the Accessibility of Functional Programming to the Bioinformatics and Scientific Communities.

    Science.gov (United States)

    Fenwick, Matthew; Sesanker, Colbert; Schiller, Martin R; Ellis, Heidi Jc; Hinman, M Lee; Vyas, Jay; Gryk, Michael R

    2012-01-01

    Scientists are continually faced with the need to express complex mathematical notions in code. The renaissance of functional languages such as LISP and Haskell is often credited to their ability to implement complex data operations and mathematical constructs in an expressive and natural idiom. The slow adoption of functional computing in the scientific community does not, however, reflect the congeniality of these fields. Unfortunately, the learning curve for adoption of functional programming techniques is steeper than that for more traditional languages in the scientific community, such as Python and Java, and this is partially due to the relative sparseness of available learning resources. To fill this gap, we demonstrate and provide applied, scientifically substantial examples of functional programming, We present a multi-language source-code repository for software integration and algorithm development, which generally focuses on the fields of machine learning, data processing, bioinformatics. We encourage scientists who are interested in learning the basics of functional programming to adopt, reuse, and learn from these examples. The source code is available at: https://github.com/CONNJUR/CONNJUR-Sandbox (see also http://www.connjur.org).

  12. A two-stage procedure for determining unsaturated hydraulic characteristics using a syringe pump and outflow observations

    DEFF Research Database (Denmark)

    Wildenschild, Dorthe; Jensen, Karsten Høgh; Hollenbeck, Karl-Josef

    1997-01-01

    A fast two-stage methodology for determining unsaturated flow characteristics is presented. The procedure builds on direct measurement of the retention characteristic using a syringe pump technique, combined with inverse estimation of the hydraulic conductivity characteristic based on one......-step outflow experiments. The direct measurements are obtained with a commercial syringe pump, which continuously withdraws fluid from a soil sample at a very low and accurate how rate, thus providing the water content in the soil sample. The retention curve is then established by simultaneously monitoring......-step outflow data and the independently measured retention data are included in the objective function of a traditional least-squares minimization routine, providing unique estimates of the unsaturated hydraulic characteristics by means of numerical inversion of Richards equation. As opposed to what is often...

  13. Technical communication: design and in vitro testing of a pressure-sensing syringe for endotracheal tube cuffs.

    Science.gov (United States)

    Slocum, Alexander H; Slocum, Alexander H; Spiegel, Joan E

    2012-05-01

    Endotracheal intubation is a frequently performed procedure in the prehospital setting, intensive care unit, and for patients undergoing surgery. The endotracheal tube cuff must be inflated to a pressure that prevents air leaks without compromising tracheal mucosal blood flow. For simultaneous endotracheal tube cuff inflation and measurement, we designed and tested a novel pressure-sensing syringe in vitro. The prototype was developed using a standard 10-mL polycarbonate syringe body that houses a plunger and a silicone rubber bellows, the pressure-sensing element. Bellow feasibility was determined and modeled using finite element analysis. Repeatability testing at each pressure measurement for each bellows (pressure versus deflection) was within an average standard deviation of 0.3 cm to 1.61 cm (1%-5% error). Using an aneroid manometer for comparison, there was excellent linear correlation with a Spearman rank of 0.99 (P < 0.001), up to 30 cm H(2)O.

  14. Prospective clinical evaluation of a new manometer syringe that distinguishes pressures below 30 and above 50 mmHg.

    Science.gov (United States)

    Schummer, Wolfram; Schummer, Claudia

    2008-09-01

    To evaluate a new disposable syringe (Certofix PresSure Check [B Braun Melsungen AG, Melsungen, Germany]) that serves as a manometer. Prospective study. University hospital's cardiac surgery suite. 21 consecutive patients with continuous invasive monitoring of central venous and arterial pressures during cardiothoracic surgery. The Certofix PresSure Check syringe was connected to the side port of the central venous and arterial catheters. Central venous pressures were correctly indicated as below 30 mmHg and arterial pressures as above 50 mmHg in all 21 patients. Certofix PresSure Check provides a unique way of testing whether a catheter is placed in a low or high pressure system. It can be used for identifying inadvertent arterial punctures.

  15. A novel and innovative technique of using a disposable syringe and mesh for harvesting fat for structural fat grafting

    Directory of Open Access Journals (Sweden)

    B C Ashok

    2015-01-01

    Full Text Available Background: Successful restoration of structure and function using autologous free fat grafts has remained elusive. Review of literature shows that various harvesting and preparation techniques have been suggested. The goal of these techniques is to obtain greater adipocyte cell survival and consequently more reliable clinical results. Materials and Methods: In our technique, a piece of mesh is kept at one end of the lipoaspiration syringe, which is then connected to the Suction pump. As one syringe fills, it is replaced by another one until the required amount of fat is obtained. Results: By using a polypropylene mesh in our technique, we can separate the transfusate from the harvested fat graft during harvesting itself. The fat graft thus obtained is dense and concentrated, with fewer impurities. Conclusion: Hence, we recommend our technique as a reliable method for extracting sterile emulsified fat in an economical way.

  16. A portable multi-syringe flow system for spectrofluorimetric determination of iodide in seawater.

    Science.gov (United States)

    Frizzarin, Rejane M; Aguado, Enrique; Portugal, Lindomar A; Moreno, Daniel; Estela, José M; Rocha, Fábio R P; Cerdà, Victor

    2015-11-01

    A miniaturized analyzer encompassing a poly(methyl methacrylate) chip with integrated spectrofluorimetric detection and solutions propelling by a multi-syringe module is proposed. Iodide was determined through its catalytic effect on the reaction between Ce(IV) and As(III). Matrix isopotential synchronous fluorescence was explored to set the excitation and emission wavelengths. A two-level full factorial design allowed to evaluate the significance of variables (Ce(IV), As(III) and H2SO4 concentrations) and their interaction effects in the experimental domain. A Doehlert Matrix was applied to identify the critical values. The optimized procedure showed a linear response from 1 to 100 μg L(-1) (S=53.7+2.61C, in which S is the net fluorescence and C is iodide concentration in μg L(-1)). Detection limit, coefficient of variation (n=6) and sampling rate were estimated at 0.3 μg L(-1), 0.8% and 20 h(-1), respectively. Recoveries within 90-117% were estimated for iodide spiked to seawater samples. The proposed procedure stands out because of the portability, robustness, and simplicity for in-field analysis of iodide in seawater. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: Qualitative study.

    Science.gov (United States)

    Sarang, Anya; Rhodes, Tim; Platt, Lucy; Kirzhanova, Valentina; Shelkovnikova, Olga; Volnov, Venyamin; Blagovo, Dmitri; Rylkov, Andrei

    2006-12-01

    Evidence highlights the prison as a high risk environment in relation to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission associated with injecting drug use. We undertook qualitative studies among 209 injecting drug users (IDUs) in three Russian cities: Moscow (n = 56), Volgograd (n = 83) and Barnaul in western Siberia (n = 70). Over three-quarters (77%) reported experience of police arrest related to their drug use, and 35% (55% of men) a history of imprisonment or detention. Findings emphasize the critical role that penitentiary institutions may play as a structural factor in the diffusion of HIV associated with drug injection in the Russian Federation. While drugs were perceived to be generally available in penitentiary institutions, sterile injection equipment was scarce and as a consequence routinely shared, including within large groups. Attempts to clean borrowed needles or syringes were inadequate, and risk reduction was severely constrained by a combination of lack of injecting equipment availability and punishment for its possession. Perceptions of relative safety were also found to be associated with assumptions of HIV negativity, resulting from a perception that all prisoners are HIV tested upon entry with those found HIV positive segregated. This study shows an urgent need for HIV prevention interventions in the Russian penitentiary system.

  18. Functional Evaluation and Characterization of a Newly Developed Silicone Oil-Free Prefillable Syringe System

    Science.gov (United States)

    Yoshino, Keisuke; Nakamura, Koji; Yamashita, Arisa; Abe, Yoshihiko; Iwasaki, Kazuhiro; Kanazawa, Yukie; Funatsu, Kaori; Yoshimoto, Tsuyoshi; Suzuki, Shigeru

    2014-01-01

    The functionality of a newly developed silicone oil-free (SOF) syringe system, of which the plunger stopper is coated by a novel coating technology (i-coating™), was assessed. By scanning electron microscopy observations and other analysis, it was confirmed that the plunger stopper surface was uniformly covered with the designed chemical composition. A microflow imaging analysis showed that the SOF system drastically reduced both silicone oil (SO) doplets and oil-induced aggregations in a model protein formulation, whereas a large number of subvisible particles and protein aggregations were formed when a SO system was used. Satisfactory container closure integrity (CCI) was confirmed by means of dye and microorganism penetration studies. Furthermore, no significant difference between the break loose and gliding forces was observed in the former, and stability studies revealed that the SOF system could perfectly show the aging independence in break loose force observed in the SO system. The results suggest that the introduced novel SOF system has a great potential and represents an alternative that can achieve very low subvisible particles, secure CCI, and the absence of a break loose force. In particular, no risk of SO-induced aggregation can bring additional value in the highly sensitive biotech drug market. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:1520–1528, 2014 PMID:24643749

  19. Syringic Acid Extracted from Herba dendrobii Prevents Diabetic Cataract Pathogenesis by Inhibiting Aldose Reductase Activity

    Directory of Open Access Journals (Sweden)

    Xiaoyong Wei

    2012-01-01

    Full Text Available Objective. Effects of Syringic acid (SA extracted from dendrobii on diabetic cataract (DC pathogenesis were explored. Methods. Both in vitro and in vivo DC lens models were established using D-gal, and proliferation of HLEC exposed to SA was determined by MMT assay. After 60-day treatment with SA, rat lens transparency was observed by anatomical microscopy using a slit lamp. SA protein targets were extracted and isolated using 2-DE and MALDI TOF/TOF. AR gene expression was investigated using qRT-PCR. Interaction sites and binding characteristics were determined by molecule-docking techniques and dynamic models. Results. Targeting AR, SA provided protection from D-gal-induced damage by consistently maintaining lens transparency and delaying lens turbidity development. Inhibition of AR gene expression by SA was confirmed by qRT-PCR. IC50 of SA for inhibition of AR activity was 213.17 μg/mL. AR-SA binding sites were Trp111, His110, Tyr48, Trp20, Trp79, Leu300, and Phe122. The main binding modes involved hydrophobic interactions and hydrogen bonding. The stoichiometric ratio of non-covalent bonding between SA and AR was 1.0 to 13.3. Conclusion. SA acts to prevent DC in rat lenses by inhibiting AR activity and gene expression, which has potential to be developed into a novel drug for therapeutic management of DC.

  20. Direct Evidence of Egestion and Salivation of Xylella fastidiosa Suggests Sharpshooters Can Be "Flying Syringes".

    Science.gov (United States)

    Backus, Elaine A; Shugart, Holly J; Rogers, Elizabeth E; Morgan, J Kent; Shatters, Robert

    2015-05-01

    Xylella fastidiosa is unique among insect-transmitted plant pathogens because it is propagative but noncirculative, adhering to and multiplying on the cuticular lining of the anterior foregut. Any inoculation mechanism for X. fastidiosa must explain how bacterial cells exit the vector's stylets via the food canal and directly enter the plant. A combined egestion-salivation mechanism has been proposed to explain these unique features. Egestion is the putative outward flow of fluid from the foregut via hypothesized bidirectional pumping of the cibarium. The present study traced green fluorescent protein-expressing X. fastidiosa or fluorescent nanoparticles acquired from artificial diets by glassy-winged sharpshooters, Homalodisca vitripennis, as they were egested into simultaneously secreted saliva. X. fastidiosa or nanoparticles were shown to mix with gelling saliva to form fluorescent deposits and salivary sheaths on artificial diets, providing the first direct, conclusive evidence of egestion by any hemipteran insect. Therefore, the present results strongly support an egestion-salivation mechanism of X. fastidiosa inoculation. Results also support that a column of fluid is transiently held in the foregut without being swallowed. Evidence also supports (but does not definitively prove) that bacteria were suspended in the column of fluid during the vector's transit from diet to diet, and were egested with the held fluid. Thus, we hypothesize that sharpshooters could be true "flying syringes," especially when inoculation occurs very soon after uptake of bacteria, suggesting the new paradigm of a nonpersistent X. fastidiosa transmission mechanism.

  1. Broadband Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Broadband Access. Worldwide market for broadband access $30 Billion! Over 200 million broadband subscribers worldwide! Various Competing Broadband access. Digital Subscriber line; Wireless; Optical Fiber.

  2. The impact of realized access to care on health-related quality of life: a two-year prospective cohort study of children in the California State Children's Health Insurance Program.

    Science.gov (United States)

    Seid, Michael; Varni, James W; Cummings, Lesley; Schonlau, Matthias

    2006-09-01

    To examine the effect of realized access to care (problems getting care, access to needed care) on health-related quality of life (HRQOL) in the California State Children's Health Insurance Program. This was a prospective cohort study (n = 4,925; 70.5% [3438] had complete data). Surveys were taken at enrollment and after 1 and 2 years in the program. Parents and children reported HRQOL (PedsQL 4.0 Generic Core Scales). Repeated-measures analysis accounted for within-person correlation and adjusted for baseline PedsQL, baseline realized access, race/ethnicity, language, chronic health condition, and having a regular physician. Realized access to care during the prior year was related to HRQOL for each subsequent year. Foregone care and problems getting care were associated with decrements of 3.5 (P Insurance Program.

  3. Syringing method as an alternative to Śṛṇga therapy in Vātakaṇṭaka.

    Science.gov (United States)

    Joshi, Suma; Toshikhane, Sangeeta Hemant; Toshikhane, Hemant D

    2014-01-01

    Calcaneus forms the bone of the foot. Due to abnormal pressures, foot muscles and ligaments are stretched beyond their normal limits that lead to chronic plantar heel pain, among which calcaneal spur tops the list. In Ayurveda, it can be correlated to "Vātakaṇṭaka" (pricking sensation in the foot)-a painful condition of heel caused by its improper placement on the ground. To assess the effect of syringing method (modified Śṛṅga) in the treatment of Vātakaṇṭaka. A 10 ml syringe was for ease, hygiene, and to enable the case to be managed in the outpatient department. A diagnosed case of calcaneal spurs with pain, tenderness, and swelling visited KLE University's Shri BMK Ayurveda Hospital and Research Centre, Belgaum, Karnataka, India. After Snigdha Patrapoṭṭali sveda (a form of sudation therapy), bloodletting was performed by syringing method. In total procedure was performed for 4 times on the patient. Marked subjective relief was observed. Pain from 8 visual analog scale (VAS) came to 2 visual analog scale (VAS) and tenderness and swelling relived completely.

  4. Syringing method as an alternative to Śṛṇga therapy in Vātakaṇṭaka

    Directory of Open Access Journals (Sweden)

    Suma Joshi

    2014-01-01

    Full Text Available Calcaneus forms the bone of the foot. Due to abnormal pressures, foot muscles and ligaments are stretched beyond their normal limits that lead to chronic plantar heel pain, among which calcaneal spur tops the list. In Ayurveda, it can be correlated to "Vātakaṇṭaka" (pricking sensation in the foot-a painful condition of heel caused by its improper placement on the ground. To assess the effect of syringing method (modified Śṛṅga in the treatment of Vātakaṇṭaka. A 10 ml syringe was for ease, hygiene, and to enable the case to be managed in the outpatient department. A diagnosed case of calcaneal spurs with pain, tenderness, and swelling visited KLE University′s Shri BMK Ayurveda Hospital and Research Centre, Belgaum, Karnataka, India. After Snigdha Patrapoṭṭali sveda (a form of sudation therapy, bloodletting was performed by syringing method. In total procedure was performed for 4 times on the patient. Marked subjective relief was observed. Pain from 8 visual analog scale (VAS came to 2 visual analog scale (VAS and tenderness and swelling relived completely.

  5. Organic Extractives from Mentha spp. Honey and the Bee-Stomach: Methyl Syringate, Vomifoliol, Terpenediol I, Hotrienol and Other Compounds

    Directory of Open Access Journals (Sweden)

    Igor Jerković

    2010-04-01

    Full Text Available The GC and GC/MS analyses of the solvent organic extractive from the stomach of the bees, having collected Mentha spp. nectar, revealed the presence of methyl syringate (6.6%, terpendiol I (5.0% and vomifoliol (3.0% that can be attributed to the plant origin. Other major compounds from the bee-stomach were related to the composition of cuticular waxes and less to pheromones. Organic extractivesfrom Mentha spp. honey were obtained by solvent-free headspace solid-phase microextraction (HS-SPME and ultrasonic solvent extraction (USE and analyzed by GC and GC/MS. The major honey headspace compounds were hotrienol (31.1%–38.5%, 2-methoxy-4-methylphenol (0.5–6.0%, cis- and trans-linalool oxides (0.9–2.8%, linalool (1.0–3.1% and neroloxide (0.9–1.9%. Methyl syringate was the most abundant compound (38.3-56.2% in the honey solvent extractives followed by vomifoliol (7.0–26.6%. Comparison of the honey organic extractives with the corresponding bee-stomach extractive indicated that methyl syringate and vomofoliol were transferred to the honey while terpendiol I was partially transformed to hotrienol in ripened honey.

  6. Analysis of Hypodermic Needles and Syringes for the Presence of Blood and Polydimethylsiloxane (Silicone) Utilizing Microchemical Tests and Infrared Spectroscopy.

    Science.gov (United States)

    Crowe, John B; Lanzarotta, Adam; Witkowski, Mark R; Andria, Sara E

    2015-07-01

    Suspect hypodermic needles and syringes were seized from an unlicensed individual who was allegedly injecting patients with silicone (polydimethylsiloxane [PDMS]) for cosmetic enhancement. Since control syringe barrels and needles often contain an interfering PDMS lubricant, a risk for false positives of foreign PDMS exists. The focus of this report was to minimize this risk and determine a quick and reliable test for the presence of blood in PDMS matrices. Using ATR-FT-IR spectroscopy, the risk for false-positive identification of foreign PDMS was reduced by (i) overfilling the sampling aperture to prevent spectral distortions and (ii) sampling a region of the suspect syringe/needle assembly where manufacturer-applied PDMS is not typically located. Analysis for blood indicated that the Teichman microchemical test was effective for detecting blood in the presence of PDMS. Overall, detecting PDMS established intent and detecting blood established that the needle containing the PDMS had been used for injection. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  7. Achieving the Recommended Endotracheal Tube Cuff Pressure: A Randomized Control Study Comparing Loss of Resistance Syringe to Pilot Balloon Palpation

    Directory of Open Access Journals (Sweden)

    Fred Bulamba

    2017-01-01

    Full Text Available Background. Both under- and overinflation of endotracheal tube cuffs can result in significant harm to the patient. The optimal technique for establishing and maintaining safe cuff pressures (20–30 cmH2O is the cuff pressure manometer, but this is not widely available, especially in resource-limited settings where its use is limited by cost of acquisition and maintenance. Therefore, anesthesia providers commonly rely on subjective methods to estimate safe endotracheal cuff pressure. This study set out to determine the efficacy of the loss of resistance syringe method at estimating endotracheal cuff pressures. Methods. This was a randomized clinical trial. We enrolled adult patients scheduled to undergo general anesthesia for elective surgery at Mulago Hospital, Uganda. Study participants were randomized to have their endotracheal cuff pressures estimated by either loss of resistance syringe or pilot balloon palpation. The pressures measured were recorded. Results. One hundred seventy-eight patients were analyzed. 66.3% (59/89 of patients in the loss of resistance group had cuff pressures in the recommended range compared with 22.5% (20/89 from the pilot balloon palpation method. This was statistically significant. Conclusion. The loss of resistance syringe method was superior to pilot balloon palpation at administering pressures in the recommended range. This method provides a viable option to cuff inflation.

  8. Organic extractives from Mentha spp. honey and the bee-stomach: methyl syringate, vomifoliol, terpenediol I, hotrienol and other compounds.

    Science.gov (United States)

    Jerković, Igor; Hegić, Gordana; Marijanović, Zvonimir; Bubalo, Dragan

    2010-04-22

    The GC and GC/MS analyses of the solvent organic extractive from the stomach of the bees, having collected Mentha spp. nectar, revealed the presence of methyl syringate (6.6%), terpendiol I (5.0%) and vomifoliol (3.0%) that can be attributed to the plant origin. Other major compounds from the bee-stomach were related to the composition of cuticular waxes and less to pheromones. Organic extractives from Mentha spp. honey were obtained by solvent-free headspace solid-phase microextraction (HS-SPME) and ultrasonic solvent extraction (USE) and analyzed by GC and GC/MS. The major honey headspace compounds were hotrienol (31.1%-38.5%), 2-methoxy-4-methylphenol (0.5-6.0%), cis- and trans-linalool oxides (0.9-2.8%), linalool (1.0-3.1%) and neroloxide (0.9-1.9%). Methyl syringate was the most abundant compound (38.3-56.2%) in the honey solvent extractives followed by vomifoliol (7.0-26.6%). Comparison of the honey organic extractives with the corresponding bee-stomach extractive indicated that methyl syringate and vomofoliol were transferred to the honey while terpendiol I was partially transformed to hotrienol in ripened honey.

  9. Phase I - Smart Grid Data Access Pilot Program: Utilizing STEM Education as a Catalyst for Residential Consumer Decision Making and Change

    Energy Technology Data Exchange (ETDEWEB)

    Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)

    2014-11-19

    Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.

  10. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: Anin vitrostudy.

    Science.gov (United States)

    Shetty, Vidhi Prabhakar; Naik, Balaram Damodar; Pachlag, Amit Kashinath; Yeli, Mahantesh Mrityunjay

    2017-01-01

    The aim of this study is to compare the effects of conventional syringe, passive ultrasonic irrigation (PUI), and EndoIrrigator Plus on the amount of apically extruded debris. Thirty extracted human mandibular premolars were selected and randomly assigned to three groups ( n = 10). The root canals were irrigated with conventional syringe, PUI, and EndoIrrigator Plus. Sodium hypochlorite was used as an irrigant, and debris was collected in a previously described experimental model (Myers and Montgomery 1991). It was then stored in an incubator at 37°C for 10 days to evaporate the irrigant before weighing the dry debris. The mean weight of debris was assessed, one-way analysis of variance was used for comparison of values, and post hoc Tukey's test was used between groups ( P = 0.05). The EndoIrrigator Plus group extruded significantly less debris than PUI and conventional syringe groups ( P extruded significantly less debris than conventional syringe irrigation group ( P extruded significantly less debris than the PUI system and the conventional syringe irrigation system, 3. PUI system extruded significantly less debris than the conventional syringe irrigation system.

  11. Data Portal for the Library of Integrated Network-based Cellular Signatures (LINCS) program: integrated access to diverse large-scale cellular perturbation response data

    Science.gov (United States)

    Koleti, Amar; Terryn, Raymond; Stathias, Vasileios; Chung, Caty; Cooper, Daniel J; Turner, John P; Vidović, Dušica; Forlin, Michele; Kelley, Tanya T; D’Urso, Alessandro; Allen, Bryce K; Torre, Denis; Jagodnik, Kathleen M; Wang, Lily; Jenkins, Sherry L; Mader, Christopher; Niu, Wen; Fazel, Mehdi; Mahi, Naim; Pilarczyk, Marcin; Clark, Nicholas; Shamsaei, Behrouz; Meller, Jarek; Vasiliauskas, Juozas; Reichard, John; Medvedovic, Mario; Ma’ayan, Avi; Pillai, Ajay

    2018-01-01

    Abstract The Library of Integrated Network-based Cellular Signatures (LINCS) program is a national consortium funded by the NIH to generate a diverse and extensive reference library of cell-based perturbation-response signatures, along with novel data analytics tools to improve our understanding of human diseases at the systems level. In contrast to other large-scale data generation efforts, LINCS Data and Signature Generation Centers (DSGCs) employ a wide range of assay technologies cataloging diverse cellular responses. Integration of, and unified access to LINCS data has therefore been particularly challenging. The Big Data to Knowledge (BD2K) LINCS Data Coordination and Integration Center (DCIC) has developed data standards specifications, data processing pipelines, and a suite of end-user software tools to integrate and annotate LINCS-generated data, to make LINCS signatures searchable and usable for different types of users. Here, we describe the LINCS Data Portal (LDP) (http://lincsportal.ccs.miami.edu/), a unified web interface to access datasets generated by the LINCS DSGCs, and its underlying database, LINCS Data Registry (LDR). LINCS data served on the LDP contains extensive metadata and curated annotations. We highlight the features of the LDP user interface that is designed to enable search, browsing, exploration, download and analysis of LINCS data and related curated content. PMID:29140462

  12. Outcomes from a university-based low-cost in vitro fertilization program providing access to care for a low-resource socioculturally diverse urban community.

    Science.gov (United States)

    Herndon, Christopher N; Anaya, Yanett; Noel, Martha; Cakmak, Hakan; Cedars, Marcelle I

    2017-10-01

    To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. Retrospective cohort study. Academic infertility center. Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population. Patients were nonrandomly allocated to one of four mild stimulation protocols: clomiphene/letrozole alone, two clomiphene/letrozole-based protocols involving sequential or flare addition of low-dose gonadotropins, and low-dose gonadotropins alone. Clinical fellows managed all aspects of cycle preparation, monitoring, oocyte retrieval, and embryo transfer under an attending preceptor. Retrieval was undertaken without administration of deep anesthesia, and laboratory interventions were minimized. All embryo transfers were performed at the cleavage stage. Sociomedical demographics, treatment response, and pregnancy outcomes were recorded. From August 2010 to June 2016, 65 patients initiated 161 stimulation IVF cycles, which resulted in 107 retrievals, 91 fresh embryo transfers, and 40 frozen embryo transfer cycles. The mean age of patients was 33.3 years, and mean reported duration of infertility was 5.3 years; 33.5% (54/161) of cycles were cancelled before oocyte retrieval, with 13% due to premature ovulation. Overall, cumulative live birth rates per retrieval including subsequent use of frozen embryos was 29.0%; 44.6% (29/65) of patients enrolled in the program achieved pregnancy. Use of mild stimulation protocols, simplified monitoring, and minimized laboratory handling procedures enabled access to care in a low-resource socioculturally diverse infertile population. Copyright © 2017. Published by Elsevier Inc.

  13. On-line lab-in-syringe cloud point extraction for the spectrophotometric determination of antimony.

    Science.gov (United States)

    Frizzarin, Rejane M; Portugal, Lindomar A; Estela, José M; Rocha, Fábio R P; Cerdà, Victor

    2016-02-01

    Most of the procedures for antimony determination require time-consuming sample preparation (e.g. liquid-liquid extraction with organic solvents), which are harmful to the environment. Because of the high antimony toxicity, a rapid, sensitive and greener procedure for its determination becomes necessary. The goal of this work was to develop an analytical procedure exploiting for the first time the cloud point extraction on a lab-in-syringe flow system aiming at the spectrophotometric determination of antimony. The procedure was based on formation of an ion-pair between the antimony-iodide complex and H(+) followed by extraction with Triton X-114. The factorial design showed that the concentrations of ascorbic acid, H2SO4 and Triton X-114, as well as second and third order interactions were significant at the 95% confidence level. A Box-Behnken design was applied to obtain the response surfaces and to identify the critical values. System is robust at the 95% confidence level. A linear response was observed from 5 to 50 µg L(-1), described by the equation A=0.137+0.050C(Sb) (r=0.998). The detection limit (99.7% confidence level), the coefficient of variation (n=5; 15 µg L(-1)) and the sampling rate was estimated at 1.8 µg L(-1), 1.6% and 16 h(-1), respectively. The procedure allows quantification of antimony in the concentrations established by environmental legislation (6 µg L(-1)) and it was successfully applied to the determination of antimony in freshwater samples and antileishmanial drugs, yielding results in agreement with those obtained by HGFAAS at the 95% confidence level. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Resistance force for intraocular lens insertion through lens cartridges and syringe-type injectors.

    Science.gov (United States)

    Usui, Masahiko; Tanaka, Takao

    2015-08-01

    To measure and compare the resistance force for intraocular lens (IOL) insertion using 5 syringe-type injector systems. Tokyo Medical University and laboratory in Kowa Co., Tokyo, Japan. Experimental study. Intraocular lenses were inserted into the lens capsular bag of porcine eyes after phacoemulsification using 5 implantation systems (Groups A, B, C, D, and E). For each system, the resistance force for IOL insertion to the lens capsular bag of porcine eyes was measured using an automated force gauge system. For control, the resistance force for IOL delivery into a plastic dish was measured. Changes in the resistance force and its curve and maximum value were evaluated. The mean total area under the curve (AUC) was compared. Data were statistically analyzed. For all groups, the mean resistance forces were 17.2, 6.3, 4.2, 20.7, and 2.3 newtons (N), respectively, in porcine eyes, and 14.4, 5.8, 4.5, 12.6, and 2.2 N in controls. The mean sizes of the total AUC were 43 371, 8465, 6771, 30 306, and 2334 pixels in porcine eyes and 40 940, 7080, 6876, 20 710, and 2215 pixels in controls; the correlation coefficients between the resistance forces and the sizes of the total area were 0.576, 0.113, 0.346, 0.726, and 0.933 in porcine eyes and 0.707, 0.557, 0.914, 0.951, and 0.893 in controls. Resistance force and its curve were clarified in 5 IOL implantation systems. Appropriate IOL and injector selection may be achieved after clarifying resistance force and its waveform during IOL insertion. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015. Published by Elsevier Inc.

  15. Spectrophotometric determination of irrigant extrusion using passive ultrasonic irrigation, EndoActivator, or syringe irrigation.

    Science.gov (United States)

    Rodríguez-Figueroa, Carolina; McClanahan, Scott B; Bowles, Walter R

    2014-10-01

    Sodium hypochlorite (NaOCl) irrigation is critical to endodontic success, and several new methods have been developed to improve irrigation efficacy (eg, passive ultrasonic irrigation [PUI] and EndoActivator [EA]). Using a novel spectrophotometric method, this study evaluated NaOCl irrigant extrusion during canal irrigation. One hundred fourteen single-rooted extracted teeth were decoronated to leave 15 mm of the root length for each tooth. Cleaning and shaping of the teeth were completed using standardized hand and rotary instrumentation to an apical file size #40/0.04 taper. Roots were sealed (not apex), and 54 straight roots (n = 18/group) and 60 curved roots (>20° curvature, n = 20/group) were included. Teeth were irrigated with 5.25% NaOCl by 1 of 3 methods: passive irrigation with needle, PUI, or EA irrigation. Extrusion of NaOCl was evaluated using a pH indicator and a spectrophotometer. Standard curves were prepared with known amounts of irrigant to quantify amounts in unknown samples. Irrigant extrusion was minimal with all methods, with most teeth showing no NaOCl extrusion in straight or curved roots. Minor NaOCl extrusion (1-3 μL) in straight roots or curved roots occurred in 10%-11% of teeth in all 3 irrigant methods. Two teeth in both the syringe irrigation and the EA group extruded 3-10 μL of NaOCl. The spectrophotometric method used in this study proved to be very sensitive while providing quantification of the irrigant levels extruded. Using the PUI or EA tip to within 1 mm of the working length appears to be fairly safe, but apical anatomy can vary in teeth to allow extrusion of irrigant. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. Clinical trial on the effects of a free-access acidified milk replacer feeding program on the health and growth of dairy replacement heifers and veal calves.

    Science.gov (United States)

    Todd, C G; Leslie, K E; Millman, S T; Bielmann, V; Anderson, N G; Sargeant, J M; DeVries, T J

    2017-01-01

    The objectives of this study were to evaluate the effects of free-access acidified milk replacer feeding on the pre- and postweaning health of dairy and veal calves. Individually housed calves were systematically assigned at birth to 1 of 2 feeding programs: free-access feeding (ad libitum) of acidified milk replacer (ACD, n=249) or traditional restricted feeding (3L fed twice daily) of milk replacer (RES, n=249). Calves were fed milk replacer containing 24% crude protein and 18% fat. Acidified milk replacer was prepared to a target pH between 4.0 and 4.5 using formic acid. Calves were weaned off milk replacer at approximately 6wk of age. Weaning occurred over 5d, and during this weaning period, ACD calves had access to milk replacer for 12h/d and RES calves were offered only one feeding of milk replacer (3 L) daily. Calves were monitored daily for signs of disease. Fecal consistency scores were assigned each week from birth until weaning. A subset of calves was systematically selected for fecal sampling at 3 time points between 7 and 27d of age. Fecal samples were analyzed for enterotoxigenic Escherichia coli F5, Cryptosporidium parvum, rotavirus, and coronavirus. Hip width, hip height, body length, heart girth, and body weight were measured at birth and weaning. Postweaning body weight measurements were collected from the heifers at approximately 8mo of age. Postweaning body weight and carcass grading information was collected from the veal calves at slaughter once a live weight between 300 and 350kg had been achieved. The odds of ACD calves being treated for a preweaning disease event tended to be lower than that of the RES calves (1.2 vs. 5.2%, respectively). Preweaning mortality, postweaning disease treatment, and postweaning mortality did not differ between feeding treatments. The ACD feeding treatment supported greater preweaning average daily gain (0.59 vs. 0.43kg/d) and structural growth than RES feeding. Postweaning average daily gain and carcass

  17. [Users' perception of a harm reduction program in an outpatient drug dependency treatment center].

    Science.gov (United States)

    Daigre, Constanza; Comín, Marina; Rodríguez-Cintas, Laia; Voltes, Nuria; Alvarez, Alba; Roncero, Carlos; Gonzalvo, Begoña; Casas, Miguel

    2010-01-01

    We analyzed the perspective of users enrolled in a harm reduction program that provides syringe exchange, an educational room for «warmth and coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital. We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results. Five dimensions were identified in the users' discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants' experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding. The users' overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Single patient doses of {sup 99m}Tc-HDP: Assessment of radiochemical purity, sterility and extractables from a polypropylene syringe over six hours

    Energy Technology Data Exchange (ETDEWEB)

    Parkes, S.L.; Varelis, P. [St George Hospital, Kogarah, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: The purpose of this investigation was to determine the radiochemical purity (RCP), sterility and extractables for {sup 99m}Tc oxidronate ({sup 99m}Tc-HDP) stored in polypropylene syringes over < six-hour period. The radiochemical purity was determined using a two-strip ITLC procedure, performed at time 0, 1, 2, 4, 6 hours. The sterility and endotoxin levels were tested by a NATA accredited laboratory, after allowing the radiopharmaceutical to stand at room temperature for six hours in the syringes. Plasticisers and other likely compounds that could be extracted from the syringes into the aqueous solution were determined by high pressure liquid chromatography (HPLC) diode array detection. This analysis involved shaking normal saline in a syringe over night and then injecting an aliquot of this solution onto a C18 analytical column and monitoring the effluent at 200 and 253 nm. The radiochemical purity of {sup 99m}Tc-HDP did not significantly change over the course of the study and remained above the recommended RCP for this radiopharmaceutical. Furthermore, at six hours the RCP of {sup 99m}Tc-HDP stored in both the manufacturer`s vial and a syringe were identical. Sterility testing of {sup 99m}Tc-HDP stored in syringes showed no microbial growth and less than 10 endotoxin units/mL (pass). The HPLC analysis did not show the presence of any extraneous compounds in the aqueous solution. Single patient doses of {sup 99m}Tc-HDP stored in polypropylene syringes over a six-hour period fulfill all the quality control requirements for administration to humans.

  19. Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

    Science.gov (United States)

    Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

    2017-04-21

    Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

  20. Wireless Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.

  1. Formation and removal of apical vapor lock during syringe irrigation: a combined experimental and Computational Fluid Dynamics approach.

    Science.gov (United States)

    Boutsioukis, C; Kastrinakis, E; Lambrianidis, T; Verhaagen, B; Versluis, M; van der Sluis, L W M

    2014-02-01

    (i) To evaluate the effect of needle type and insertion depth, root canal size and irrigant flow rate on the entrapment of air bubbles in the apical part of a root canal (apical vapor lock) during syringe irrigation using experiments and a Computational Fluid Dynamics (CFD) model, (ii) to investigate whether the irrigant contact angle affects bubble entrapment, (iii) to examine if an established vapor lock can be removed by syringe irrigation. Bubble entrapment during irrigation of straight artificial root canals of size 35 or 50 was evaluated by real-time visualizations. The irrigant was delivered by a closed-ended or an open-ended needle positioned at 1 or 3 mm short of working length (WL) and at a flow rate of 0.033-0.260 mL s(-1) . Results were analysed by nonparametric tests at 0.05 significance. Selected cases were also simulated by a two-phase CFD model. A vapor lock was observed in 48% of the cases investigated experimentally. Increasing the apical size, using an open-ended needle, positioning the needle closer to WL and delivering the irrigant at higher flow rate resulted in significantly smaller vapor lock. An increased contact angle resulted in the entrapment of a larger bubble when a low flow rate was used. Both brief insertion of the needle to WL whilst irrigating at a flow rate of 0.083 mL s(-1) and delivering the irrigant at 0.260 mL s(-1) without changing the needle position were capable of removing an established vapor lock. Apical vapor lock may occur under certain conditions, but appears to be easily prevented or removed by syringe irrigation. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  2. Regional Outcome Evaluation Program (P.Re.Val.E.): Reduction of inequality in access to effective health care in the Lazio region of Italy (2012-2015).

    Science.gov (United States)

    Ventura, Martina; Fusco, Danilo; Bontempi, Katia; Colais, Paola; Davoli, Marina

    2018-01-01

    Inequalities in health among groups of various socio-economic status (as measured by education, occupation, and income) constitute one of the main challenges for public health. Since 2006, the Lazio Regional Outcome Evaluation Program (P.Re.Val.E.), presents a set of indicators of hospital performance based on quality standards driven by strong clinical recommendations, and measures the variation in the access to effective health care for different population groups and providers in the Lazio Region. One of the aims of the program was to compare population subgroups in order to promote equity in service provision. Since June 2013, a new management strategy has been put in place that assigned specific goals based on performance assessment to the chief executive officers of the hospitals. To evaluate whether, in recent years, there has been a reduction in the differential access to effective health care, among individuals with different educational levels. We enrolled all patients discharged from both public and private hospitals of the Lazio region between 2012 and 2015, living in Lazio region. We analysed the proportion of patients with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention within 90 minutes (primary PCI), the proportion of patients with hip fracture (HF) who underwent surgery within 2 days, and the proportion of women with primary C-section. We applied multivariate logistic regression models to assess the effect of educational level on health outcomes, adjusting for demographic characteristics and comorbidities that could affect the outcomes. For each year of the study period, we compared adjusted proportions of outcomes for the highest and the lowest level of education by using percentage differences. In the Lazio region, 44.6% of STEMI patients (N = 3,299) were treated with primary PCI, 54.4% of patients with hip fractures (N = 6,602) underwent surgery within 2 days, and 27.7% of women without a previous C

  3. Intrathecal catheter-syringe adaptor for short-term intrathecal analgesia with an externalized pump: a case report.

    Science.gov (United States)

    Wilkes, Denise; Cook, Michael; Solanki, Daneshvari

    2010-01-01

    In most patients, cancer pain is effectively treated with conservative medical management consisting of oral and/or transdermal analgesics. Cancer patients tend to fail conservative medical management near the end of their life expectancy, thus requiring alternative routes of analgesia such as intravenous, epidural, or intrathecal. The intrathecal route provides the most effective analgesia due to the close proximity of the opioid receptors in the spinal cord. Though there are many techniques that exist for intrathecal drug delivery, complications can limit effectiveness such as infection, bleeding, cerebrospinal fluid (CSF) leaks, post-dural puncture headaches (PDPH), pump and/or catheter malfunctions, or limitations of technical expertise. Therefore, an important goal in palliative cancer pain therapy is to use equipment that is going to have the fewest number of complications and will be the most familiar to the health care providers. We describe the combination of the Medtronic Indura 1P catheter, which has the least catheter-related complications and can be used with any external drug infusion pump. These are regular infusion pumps that the health care workers are familiar with so they can provide excellent and efficient service to the patient. In an operating room, the intrathecal catheter was placed using sterile technique under fluoroscopic guidance. The epidural space was identified with loss of resistance technique. Then the introducer needle (supplied in the Indura 1P catheter kit) was advanced until free-flowing CSF was obtained. The spinal catheter was advanced into the intrathecal space through the introducer needle to lumbar 2-3 level. The catheter was tunneled subcutaneously 10 cm lateral to the catheter exit site. A syringe filling device was inserted into the catheter opening and was secured with silk suture. A luer lock syringe was attached to the syringe filling device and CSF was aspirated. The syringe filling device was capped and later

  4. The American Geological Institute Minority Participation Program (MPP): Thirty Years of Improving Access to Opportunities in the Geosciences Through Undergraduate and Graduate Scholarships for Underrepresented Minorities

    Science.gov (United States)

    Callahan, C. N.; Byerly, G. R.; Smith, M. J.

    2001-05-01

    are used to gauge the needs of the scholar, and to access the success of the overall program. The MPP Advisory Committee aims to match the profession of the mentor with the scholar's academic interest. Throughout the year, mentors and scholars communicate about possible opportunities in the geosciences such as internships, participation in symposia, professional society meetings, and job openings. Mentors have also been active in helping younger students cope with the major changes involved in relocating to a new region of the country or a new college culture. We believe that AGI is well positioned to advance diversity in the geosciences through its unique standing as the major professional organization in the geosciences. AGI maintains strong links to its professional Member Societies, state and federal agencies and funding programs, many with distinctive programs in the geoscience education. AGI Corporate Associates have consistently pledged to support diversity issues in geoscience education. Current plans include seeking funding for 48 undergraduate awards at \\2500 each and \\24,000 to support undergraduate travel to professional meetings. We also expect to increase the size of our graduate scholarship program to 30 students and raise an additional \\$30,000 to support graduate travel to professional meetings.

  5. Topical ocular 0.1% cyclosporine A cationic emulsion in dry eye disease patients with severe keratitis: experience through the French early-access program

    Science.gov (United States)

    Labetoulle, Marc; Doan, Serge; Cochener-Lamard, Beatrice; Amrane, Mourad; Ismail, Dahlia; Creuzot-Garcher, Catherine; Baudouin, Christophe

    2018-01-01

    Purpose The objective of this study was to report the evaluation of efficacy and safety of cyclosporine A cationic emulsion (CsA CE) 0.1% for the treatment of severe keratitis in adults with dry eye disease (DED) in a French early-access program. Methods Patients with DED and severe keratitis (corneal fluorescein staining [CFS] score of 3–5 on the Oxford scale and/or the presence of corneal lesions [filaments or ulcers]) were enrolled in a compassionate use program (Authorization for Temporary Use [ATU]) for once-daily CsA CE, which was approved by French health authorities prior to its registration. Efficacy and safety at 1, 3, 6, and 12-month follow-up visits were evaluated. Results The ATU cohort (n=1,212; mean age =60.5 years; 79.5% female; 98.1% with severe keratitis; 74.5% with corneal lesions) consisted of 601 CsA-naïve patients and 611 patients treated previously with other CsA formulations. The primary DED etiology was Sjögren’s syndrome (48.7%). Clinical benefit could be discerned among 548 evaluable patients from months 1 to 12: keratitis improvement, 44.8% at month 1 and 42.1% at month 12; keratitis stabilization, 47.2% and 45.7%, respectively; symptom improvement, 47.2% and 48.6%; and symptom stabilization, 44.8% and 45.0%. Corneal clearing (CFS score =0) increased from 4.8% (month 1) to 11.4% (month 12). No unexpected safety concerns were identified; instillation site pain (10.2%) and eye irritation (7.8%) were the most common adverse events. Conclusion The French ATU cohort provides supportive data on the clinical benefit of CsA CE in improving/stabilizing symptoms and corneal damage in DED patients with severe keratitis in real-world clinical practice. PMID:29440872

  6. Limited english proficiency accessibility program : demonstration program.

    Science.gov (United States)

    2013-03-01

    In 2006, the Tri-County Metropolitan Transportation District of Oregon (TriMet) secured grant funding from the Federal Transit Administration : (FTA) that enabled the agency to launch a creative and ambitious Limited English Proficiency (LEP) demonst...

  7. Extraction of mandibular premolars and molars: comparison between local infiltration via pressure syringe and inferior alveolar nerve block anesthesia.

    Science.gov (United States)

    Thiem, Daniel G E; Schnaith, Florian; Van Aken, Caroline M E; Köntges, Anne; Kumar, Vinay V; Al-Nawas, Bilal; Kämmerer, Peer W

    2018-04-01

    The purpose of this study was to evaluate the anesthetic efficiency of local infiltration anesthesia administered with a pressure syringe (P-INF) via a special technique versus direct block anesthesia of the inferior alveolar nerve (IANB) for tooth extraction in the posterior mandible. In a prospective randomized study, 101 teeth in 101 patients were extracted in the posterior mandible under local anesthesia whereby two different administration techniques were used (P-INF n = 48; IANB n = 53). Primary objectives were comparisons of anesthetic success rate (yes/no) and efficacy (full/sufficient vs. insufficient). Secondary objectives were patients' pain perception during treatment, pain of injection (numerical rating scale), need for second injections (always IANB), time until onset of anesthetic action (min), and duration of local numbness (min). IANB was successful in all cases, whereas initial P-INF achieved 35% of success only. Furthermore, IANB reached significant higher values of anesthetic efficacy compared to P-INF (P local numbness were found to be equal. For anesthetic efficacy as well as anesthetic success, block anesthesia of the inferior alveolar nerve (IANB) turned out to be more proficient to local infiltration via special delivering system with a special technique. Infiltration, even when performed with 4% articaine and a pressure syringe system, is not a suitable method of anesthesia in the posterior mandible.

  8. Local reaction secondary to insulin injection. A potential role for latex antigens in insulin vials and syringes.

    Science.gov (United States)

    Towse, A; O'Brien, M; Twarog, F J; Braimon, J; Moses, A C

    1995-08-01

    To evaluate the possibility that latex antigens (natural rubber) can contribute to or cause local sensitivity at insulin injection sites. A subject with documented local cutaneous allergic reactions at the site of insulin injections and with systemic latex allergy manifested as anaphylaxis was tested with intradermal injections of insulin diluent from two manufacturers and with two brands of insulin syringes. The subject had high titer anti-latex Ige and elevated total levels of IgE in serum. Anti-insulin IgG and IgE antibodies were absent. Erythema and wheals occurred at the sites of intradermal injection of insulin therapy components (insulin diluent and syringes) that contain natural latex rubber but not at the site of injection of insulin therapy components that do not contain natural latex rubber. Small quantities of natural latex rubber antigens in insulin injection materials can be sufficient to produce local cutaneous reactions at the site of insulin injection in individuals highly allergic to natural latex rubber.

  9. Effect of liposomes on rheological and syringeability properties of hyaluronic acid hydrogels intended for local injection of drugs.

    Science.gov (United States)

    El Kechai, Naila; Bochot, Amélie; Huang, Nicolas; Nguyen, Yann; Ferrary, Evelyne; Agnely, Florence

    2015-06-20

    The aim of this work was to thoroughly study the effect of liposomes on the rheological and the syringeability properties of hyaluronic acid (HA) hydrogels intended for the local administration of drugs by injection. Whatever the characteristics of the liposomes added (neutral, positively or negatively charged, with a corona of polyethylene glycol chains, size), the viscosity and the elasticity of HA gels increased in a lipid concentration-dependent manner. Indeed, liposomes strengthened the network formed by HA chains due to their interactions with this polymer. The nature and the resulting effects of these interactions depended on liposome composition and concentration. The highest viscosity and elasticity were observed with liposomes covered by polyethylene glycol chains while neutral liposomes displayed the lowest effect. Despite their high viscosity at rest, all the formulations remained easily injectable through needles commonly used for local injections thanks to the shear-thinning behavior of HA gels. The present study demonstrates that rheological and syringeability tests are both necessary to elucidate the behavior of such systems during and post injection. In conclusion, HA liposomal gels appear to be a promising and versatile formulation platform for a wide range of applications in local drug delivery when an injection is required. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes.

    Science.gov (United States)

    Anderson, Collin; MacKay, Mark

    2015-12-16

    Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Four 5 mL samples of each drug and concentration were prepared in 10 mL polypropylene syringes. The samples were stored at ambient room temperature in a locked cabinet. Triplicate determinations of drug concentration for each sample were performed initially, on day 50 or 51, and on day 100 using high-performance liquid chromatography with diode-array detection. With the exception of the hydromorphone 100 mcg/mL dilution, all compounds were found to contain greater than 95% of their initial concentration remaining at 100 days. Each sample remained clear and colorless when visually inspected.

  11. Parabens determination in cosmetic and personal care products exploiting a multi-syringe chromatographic (MSC) system and chemiluminescent detection.

    Science.gov (United States)

    Rodas, Melisa; Portugal, Lindomar A; Avivar, Jessica; Estela, José Manuel; Cerdà, Víctor

    2015-10-01

    Parabens are widely used in dairy products, such as in cosmetics and personal care products. Thus, in this work a multi-syringe chromatographic (MSC) system is proposed for the first time for the determination of four parabens: methylparaben (MP), ethylparaben (EP), propylparaben (PP) and butylparaben (BP) in cosmetics and personal care products, as a simpler, practical, and low cost alternative to HPLC methods. Separation was achieved using a 5mm-long precolumn of reversed phase C18 and multi-isocratic separation, i.e. using two consecutive mobile phases, 12:88 acetonitrile:water and 28:72 acetonitrile:water. The use of a multi-syringe buret allowed the easy implementation of chemiluminescent (CL) detection after separation. The chemiluminescent detection is based on the reduction of Ce(IV) by p-hydroxybenzoic acid, product of the acid hydrolysis of parabens, to excite rhodamine 6G (Rho 6G) and measure the resulting light emission. Multivariate designs combined with the concepts of multiple response treatments and desirability functions have been employed to simultaneously optimize and evaluate the responses. The optimized method has proved to be sensitive and precise, obtaining limits of detection between 20 and 40 µg L(-1) and RSD <4.9% in all cases. The method was satisfactorily applied to cosmetics and personal care products, obtaining no significant differences at a confidence level of 95% comparing with the HPLC reference method. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder.

    Science.gov (United States)

    Oswald, Tasha M; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie

    2017-12-12

    The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning, including social and adaptive skills, self-determination skills, and coping self-efficacy. Forty-four adults with ASD (ages 18-38; 13 females) and their caregivers were randomly assigned to treatment or waitlist control. Compared to controls, adults in treatment significantly improved in adaptive and self-determination skills, per caregiver report, and self-reported greater belief in their ability to access social support to cope with stressors. Results provide evidence for the acceptability and efficacy of the ACCESS Program.

  13. Eye Care Quality and Accessibility Improvement in the Community (EQUALITY): impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care.

    Science.gov (United States)

    Rhodes, Lindsay A; Huisingh, Carrie E; McGwin, Gerald; Mennemeyer, Stephen T; Bregantini, Mary; Patel, Nita; Saaddine, Jinan; Crews, John E; Girkin, Christopher A; Owsley, Cynthia

    2016-01-01

    To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) telemedicine program on at-risk patients' knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY. New or existing patients presenting for a comprehensive eye exam (CEE) at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients' CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2-4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar's test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized. At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions). Those who were unemployed (odds ratio =0.63, 95% confidence interval =0.42-0.95, P=0.026) or had lower education (odds ratio =0.55, 95% confidence interval =0.29-1.02, P=0.058) were less likely to improve their knowledge after adjusting for age, sex, race, and prior glaucoma diagnosis. This association was attenuated after further adjustment for other patient-level characteristics. Ninety-eight percent (n=501) of patients reported being likely to have a CEE within the next 2 years, whereas 63% (n=326) had a CEE in the previous 2 years. Patient satisfaction with EQUALITY was high (99%). Improved knowledge about glaucoma and a high intent to

  14. Access to enterntainment and information programming for the crew as part of the communication system of future Mars mission or Lunar Base

    Science.gov (United States)

    Hargitai, H.

    In recent years the improtance of the psychologic conditions of the cure of a long- term Mars expedition (or a Lunar Base) is becoming a crucial factor concerning the success of such mission. The 500-day stay on Mars will be the longest planetary surface exploration opportunity ever experienced. [1] Manned planetary missions so far had no such long term isolation from the our cultural environment (or "bubble"), and cosmo - and astronauts consumed mostly recorded materials for enterntainment which will not be sufficent for such mission. The closest analogy for such a long-term isolation of a relatively small group of people is the situation at military bases or the American (or other) pioneer settlers. Both American and British Army uses an extensive enternatinment and information media network - both radio and TV - which provides programs for their personell in places which are out of the reach of their home media services but usually inside an other cultural environment. For a mission with a long duration (months or years), where the crew is absolutely cut off from Earth media and news (incl. politics, culture, music etc), especially for the flight time, it is important to create a special "buquet" of programs that keeps the crew inside the Earth cultural environment. In this paper I will discuss the technical requirements for the uplink to a Martian mission on the way to and from and on the surface of Mars, and the questions of optimal programming to such a mission, using the experiences from military media. The psychological problems encountered in space has been analyzed in great detail. [2] Kass and Kass list 28 such problems. Access to Earth mass media or quasi-live enterntainment and informational channel can help in solving the followings [from 3]: setting in of boredom and demoralisation; missing your own language - not fully fluent in the common language; lack of information sharing; confinement and isolation. A general homesickness would probably be an

  15. Chemical stability of morphine and methadone, and of methadone in combination with acepromazine, medetomidine or xylazine, during prolonged storage in syringes.

    Science.gov (United States)

    Lee, D Y; Watson, N; Whittem, T

    2017-08-01

    To assess the chemical and physical stability of morphine and methadone stored in syringes for 12 months and of methadone when mixed with acepromazine, medetomidine or xylazine. A high-performance liquid chromatography (HPLC) technique was developed and validated for the analysis of morphine and methadone. Morphine and methadone were dispensed into syringes and stored at 25°C/60% relative humidity (RH) and 40°C/75% RH. Solutions containing mixtures of methadone combined with acepromazine, medetomidine or xylazine were stored in syringes at 25°C/60%RH. At initiation, after 1 week and then 1, 3, 6, 9 and 12 months, samples were analysed by HPLC for the quantification of the morphine or methadone. Measured concentrations were assessed as a function of storage time and temperature using linear regression statistics to calculate stability. When stored at 40°C/75%RH as pre-dispensed syringes, severe physical and chemical changes were observed after the third month for both morphine and methadone. In contrast, at 25°C/60%RH both drugs remained chemically stable for 12 months, with concentration variations not exceeding a 5% change from initiation as stipulated in VICH stability guidelines. When in combination with acepromazine or xylazine, methadone also remained chemically stable, but the combination with medetomidine failed stability criteria prior to 6 months. Precipitation compromised the physical stability of methadone in all unsealed syringes prior to 9 months' storage. Pre-dispensing morphine or methadone into unsealed syringes compromises the drugs' physical stability. Mixing of methadone with other drugs can degrade its chemical stability. © 2017 Australian Veterinary Association.

  16. Open Access

    Science.gov (United States)

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  17. Printing and Curing of Conductive Ink Track on Fabric using Syringe Deposition System with DLP Projector and Hot Plate

    Directory of Open Access Journals (Sweden)

    Khirotdin Rd. Khairilhijra

    2017-01-01

    Full Text Available Printing is a technique to transfer ink onto substrates to create pattern and syringe deposition system has shown some great potential in printing due to its ability to produce filamentary bead tracks which is important concerning conductivity and easily adopted on conformal surfaces which could not be realized by conventional technique. Fabrics with integrated electrical features able to create intelligent articles and may potentially open up new perspective areas of application in textile printing. However, the applicability of this technique on fabrics remains unknown which the ink used has to meet certain requirements including high electrical conductivity, resistance to oxidation, dry out without clogging, good adhesion with suitable viscosity and surface tension. Thus, there is a need to do this study which is to determine the feasibility of syringe deposition system to print a conductive ink tracks using silver epoxy-based conductive ink on fabric substrate via lycra material. This study is also aim to investigate the feasibility of using DLP projector with hot plate as another source of heat to be used in curing the ink tracks on fabric. The effect of printing and curing parameters to the characteristics and conductivity of the ink track is investigated. Several mechanical and electrical tests were also administered to determine the cure, hardness, adhesion and resistance level of the ink tracks. The results obtained were as expected which higher printing speed and lower deposition height used, a narrower and thinner ink tracks were produced. Sample with 4 mm/s of printing speed and deposition height of 1 mm resulted in dimension closer to the targeted dimension. The longer curing time and higher temperature used, a lower resistance is produced. The lowest resistance achieved is 0.9 Ω cured at 150°C for 60 minutes. The conductivity of the ink track was affected by curing process and cross-sectional area of the ink track. It is proven

  18. Comparison of two negative pressure systems and syringe irrigation for root canal irrigation: an ex vivo study.

    Science.gov (United States)

    Adorno, C G; Fretes, V R; Ortiz, C P; Mereles, R; Sosa, V; Yubero, M F; Escobar, P M; Heilborn, C

    2016-02-01

    To compare in a laboratory study two negative pressure systems and syringe irrigation, regarding the delivery of a contrast solution (CS) to working length (WL) and into simulated lateral canals and the effective volume of irrigant aspirated during negative pressure irrigation. Twenty single-canaled incisor training models were constructed with six simulated lateral canals each (2, 4 and 6 mm to WL) and a size 40, 0.04 taper apical size canal. Each model underwent all irrigation procedures (EndoVac at WL (EndoVac-0) and WL-2 mm (EndoVac-2), iNP needle with negative pressure (iNPn) and syringe irrigation with the iNP needle (iNPs) and a 30-G side-slot needle placed at WL (SI0) and WL-2 (SI2) mm in a crossover design. CS was delivered at 4 mL min(-1) for 60 s with a peristaltic pump and a recovery device collected the volume (in mL) of irrigant suctioned by the negative pressure groups. The irrigation procedures were digitally recorded, and a still image of the 60-s time-point of irrigation was evaluated for CS distance to WL (in millimetres) after irrigation and penetration into lateral canals (3-point scale). Statistical tests used were Kruskal-Wallis and Dunn's test. EndoVac-0, iNPn and iNPs had median distances of CS to WL of 0 mm, followed by SI0 (0.2 mm), SI2 (0.7 mm) and EndoVac-2 (1.7 mm). There were no significant differences between EndoVac-0, iNPn, iNPs and SI0, but these were significantly different to SI2 and EndoVac-2 (P irrigation and that collected by iNPn (4 mL), but these were significantly greater than EndoVac-0 (2.8 mL, P irrigation procedures were ineffective at penetration into lateral canals. iNPn, EndoVac-0, iNPs and SI0 achieved greater irrigant penetration to WL. iNPn was able to collect a median volume of CS (4 mL) similar to that delivered by syringe irrigation (iNPp, SI0 and SI2). An adequate irrigant penetration into lateral canals could not be achieved by any of the systems. © 2015 International Endodontic Journal. Published by John

  19. Final Results of the Telaprevir Access Program: FibroScan Values Predict Safety and Efficacy in Hepatitis C Patients with Advanced Fibrosis or Cirrhosis.

    Directory of Open Access Journals (Sweden)

    Antonia Lepida

    Full Text Available Liver stiffness determined by transient elastography is correlated with hepatic fibrosis stage and has high accuracy for detecting severe fibrosis and cirrhosis in chronic hepatitis C patients. We evaluated the clinical value of baseline FibroScan values for the prediction of safety and efficacy of telaprevir-based therapy in patients with advanced fibrosis and cirrhosis in the telaprevir Early Access Program HEP3002.1,772 patients with HCV-1 and bridging fibrosis or cirrhosis were treated with telaprevir plus pegylated interferon-α and ribavirin (PR for 12 weeks followed by PR alone, the total treatment duration depending on virological response and previous response type. Liver fibrosis stage was determined either by liver biopsy or by non-invasive markers. 1,282 patients (72% had disease stage assessed by FibroScan; among those 46% were classified as Metavir F3 at baseline and 54% as F4.Overall, 1,139 patients (64% achieved a sustained virological response (SVR by intention-to-treat analysis. Baseline FibroScan values were tested for association with SVR and the occurrence of adverse events. By univariate analysis, higher baseline FibroScan values were predictive of lower sustained virological response rates and treatment-related anemia. By multivariate analysis, FibroScan was no longer statistically significant as an independent predictor, but higher FibroScan values were correlated with the occurrence of infections and serious adverse events.FibroScan has a limited utility as a predictor of safety and efficacy in patients treated with telaprevir-based triple therapy. Nevertheless it can be used in association with other clinical and biological parameters to help determine patients who will benefit from the triple regiments.ClinicalTrials.gov NCT01508286.

  20. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming.

    Science.gov (United States)

    Fawzi, Mary C Smith; Betancourt, Theresa S; Marcelin, Lilly; Klopner, Michelle; Munir, Kerim; Muriel, Anna C; Oswald, Catherine; Mukherjee, Joia S

    2009-12-22

    Previous studies of Haitian immigrant and refugee youth have emphasized "externalizing" behaviors, such as substance use, high risk sexual behavior, and delinquency, with very little information available on "internalizing" symptoms, such as depression and anxiety. Analyzing stressors and "internalizing" symptoms offers a more balanced picture of the type of social and mental health services that may be needed for this population. The present study aims to: 1) estimate the prevalence of depression and post-traumatic stress disorder (PTSD) among Haitian immigrant students; and 2) examine factors associated with depression and PTSD to identify potential areas of intervention that may enhance psychosocial health outcomes among immigrant youth from Haiti in the U.S. A stratified random sample of Haitian immigrant students enrolled in Boston public high schools was selected for participation; 84% agreed to be interviewed with a standardized questionnaire. Diagnosis of depression and PTSD was ascertained using the best estimate diagnosis method. The prevalence estimates of depression and PTSD were 14.0% and 11.6%; 7.9% suffered from comorbid PTSD and depression. Multivariate logistic regression demonstrated factors most strongly associated with depression (history of father's death, self-report of schoolwork not going well, not spending time with friends) and PTSD (concern for physical safety, having many arguments with parents, history of physical abuse, and lack of safety of neighborhood). A significant level of depression and PTSD was observed. Stressors subsequent to immigration, such as living in an unsafe neighborhood and concern for physical safety, were associated with an increased risk of PTSD and should be considered when developing programs to assist this population. Reducing exposure to these stressors and enhancing access to social support and appropriate school-based and mental health services may improve educational attainment and psychosocial health

  1. Comparison of adherence to chlamydia screening guidelines among Title X providers and non-Title X providers in the California Family Planning, Access, Care, and Treatment Program.

    Science.gov (United States)

    Chow, Joan M; de Bocanegra, Heike Thiel; Hulett, Denis; Park, Hye-Youn; Darney, Philip

    2012-08-01

    Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group-Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low

  2. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming

    Directory of Open Access Journals (Sweden)

    Muriel Anna C

    2009-12-01

    Full Text Available Abstract Background Previous studies of Haitian immigrant and refugee youth have emphasized "externalizing" behaviors, such as substance use, high risk sexual behavior, and delinquency, with very little information available on "internalizing" symptoms, such as depression and anxiety. Analyzing stressors and "internalizing" symptoms offers a more balanced picture of the type of social and mental health services that may be needed for this population. The present study aims to: 1 estimate the prevalence of depression and post-traumatic stress disorder (PTSD among Haitian immigrant students; and 2 examine factors associated with depression and PTSD to identify potential areas of intervention that may enhance psychosocial health outcomes among immigrant youth from Haiti in the U.S. Methods A stratified random sample of Haitian immigrant students enrolled in Boston public high schools was selected for participation; 84% agreed to be interviewed with a standardized questionnaire. Diagnosis of depression and PTSD was ascertained using the best estimate diagnosis method. Results The prevalence estimates of depression and PTSD were 14.0% and 11.6%; 7.9% suffered from comorbid PTSD and depression. Multivariate logistic regression demonstrated factors most strongly associated with depression (history of father's death, self-report of schoolwork not going well, not spending time with friends and PTSD (concern for physical safety, having many arguments with parents, history of physical abuse, and lack of safety of neighborhood. Conclusions A significant level of depression and PTSD was observed. Stressors subsequent to immigration, such as living in an unsafe neighborhood and concern for physical safety, were associated with an increased risk of PTSD and should be considered when developing programs to assist this population. Reducing exposure to these stressors and enhancing access to social support and appropriate school-based and mental health services

  3. Vascular Access in Children

    International Nuclear Information System (INIS)

    Krishnamurthy, Ganesh; Keller, Marc S.

    2011-01-01

    Establishment of stable vascular access is one of the essential and most challenging procedures in a pediatric hospital. Many clinical specialties provide vascular service in a pediatric hospital. At the top of the “expert procedural pyramid” is the pediatric interventional radiologist, who is best suited and trained to deliver this service. Growing awareness regarding the safety and high success rate of vascular access using image guidance has led to increased demand from clinicians to provide around-the-clock vascular access service by pediatric interventional radiologists. Hence, the success of a vascular access program, with the pediatric interventional radiologist as the key provider, is challenging, and a coordinated multidisciplinary team effort is essential for success. However, there are few dedicated pediatric interventional radiologists across the globe, and also only a couple of training programs exist for pediatric interventions. This article gives an overview of the technical aspects of pediatric vascular access and provides useful tips for obtaining vascular access in children safely and successfully using image guidance.

  4. Identification of Catechin, Syringic Acid, and Procyanidin B2 in Wine as Stimulants of Gastric Acid Secretion.

    Science.gov (United States)

    Liszt, Kathrin Ingrid; Eder, Reinhard; Wendelin, Sylvia; Somoza, Veronika

    2015-09-09

    Organic acids of wine, in addition to ethanol, have been identified as stimulants of gastric acid secretion. This study characterized the influence of other wine compounds, particularly phenolic compounds, on proton secretion. Forty wine parameters were determined in four red wines and six white wines, including the contents of organic acids and phenolic compounds. The secretory activity of the wines was determined in a gastric cell culture model (HGT-1 cells) by means of a pH-sensitive fluorescent dye. Red wines stimulated proton secretion more than white wines. Lactic acid and the phenolic compounds syringic acid, catechin, and procyanidin B2 stimulated proton secretion and correlated with the pro-secretory effect of the wines. Addition of the phenolic compounds to the least active white wine sample enhanced its proton secretory effect by 65 ± 21% (p wine contribute to its stimulatory effect on gastric acid secretion.

  5. Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes

    OpenAIRE

    Anderson, Collin; MacKay, Mark

    2015-01-01

    Purpose: Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Methods: Four 5 mL samples of each drug and concentra...

  6. Suction device for epidermal grafting in vitiligo: employing a syringe and a manometer to provide an adequate negative pressure.

    Science.gov (United States)

    Kim, H U; Yun, S K

    2000-07-01

    Suction devices for epidermal grafting need a suction pump to provide a negative pressure. The authors have developed a suction device in which a syringe and a manometer are employed to provide a negative pressure. The purpose of this study was to evaluate the efficacy of our suction device in vitiligo patients. The suction device was used to obtain epidermal blisters from the donor site. A CO2 laser was employed to remove the depigmented epidermis. The blister roofs of the donor site were harvested and were placed onto the recipient area. Ten patients with stable vitiligo were treated by epidermal grafting. Epidermal blisters were produced by suction in all patients. Also, all 10 patients regained repigmentation. Our suction blister device is simple and inexpensive to make, and it may become an alternative to the other suction devices.

  7. Expanding health access in the more vulnerable region in the state of São Paulo, Brazil: is this a reflection of the Mais Médicos (More Doctors) Program?

    Science.gov (United States)

    Silva, Bruna Pontes da; Stockmann, Denise; Lúcio, Donavan de Souza; Henna, Elaine; Rocha, Maria Carolina Pereira da; Junqueira, Fábio Miranda

    2016-09-01

    The Mais Médicos (More Doctors) Program seeks to broaden access to health by providing medical professionals, investments in health units and multi-professional integration geared to the Family Health Strategy. Vale do Ribeira includes 25 cities and is among the most vulnerable regions in São Paulo. It has been allocated 41 physicians from the Program. This study is to evaluate access to health, comparing health indicators before and after the Program. We collected data from DATASUS, SIAB, and the Ministry of Health. There was a marked increase in the number of appointments for infants under one year of age, adults, the elderly, STD/HIV patients and group patient care. There was a decrease in appointments outside the catchment area, as well as hospital admissions for other causes, mothers exclusively breastfeeding their infants up to four months. We concluded that after deployment of the Program, there was an increase in health access and health promotion focused on an area that presents an enormous challenge for Primary Health Care (PHC). It would seem that, since this is a high vulnerability area with a large area for care, hospital admissions for PHC care-sensitive conditions, as well as referrals for secondary services, did not decrease.

  8. In-syringe extraction using dissolvable layered double hydroxide-polymer sponges templated from hierarchically porous coordination polymers.

    Science.gov (United States)

    Ghani, Milad; Frizzarin, Rejane M; Maya, Fernando; Cerdà, Víctor

    2016-07-01

    Herein we report the use of cobalt porous coordination polymers (PCP) as intermediates to prepare advanced extraction media based on layered double hydroxides (LDH) supported on melamine polymer foam. The obtained dissolvable Ni-Co LDH composite sponges can be molded and used as sorbent for the in-syringe solid-phase extraction (SPE) of phenolic acids from fruit juices. The proposed sorbent is obtained due to the surfactant-assisted self-assembly of Co(II)/imidazolate PCPs on commercially available melamine foam, followed by the in situ conversion of the PCP into the final dissolvable LDH coating. Advantageous features for SPE are obtained by using PCPs with hierarchical porosity (HPCPs). The LDH-sponge prepared using intermediate HPCPs (HLDH-sponge) is placed in the headspace of a glass syringe, enabling flow-through extraction followed by analyte elution by the dissolution of the LDH coating in acidic conditions. Three phenolic acids (gallic acid, p-hydroxybenzoic acid and caffeic acid) were extracted and quantified using high performance liquid chromatography. Using a 5mL sample volume, the obtained detection limits were 0.15-0.35μgL(-1). The proposed method for the preparation of HLDH-sponges showed a good reproducibility as observed from the intra- and inter-day RSD's, which were <10% for all analytes. The batch-to-batch reproducibility for three different batches of HLDH-sponges was 10.6-11.2%. Enrichment factors of 15-21 were obtained. The HLDH-sponges were applied satisfactorily to the determination of phenolic acids in natural and commercial fruit juices, obtaining relative recoveries among 89.7-95.3%. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Assessment of an in vitro whole cigarette smoke exposure system: The Borgwaldt RM20S 8-syringe smoking machine

    Directory of Open Access Journals (Sweden)

    McAughey John

    2011-08-01

    Full Text Available Abstract Background There have been many recent developments of in vitro cigarette smoke systems closely replicating in vivo exposures. The Borgwaldt RM20S smoking machine (RM20S enables the serial dilution and delivery of cigarette smoke to exposure chambers for in vitro analyses. In this study we have demonstrated reliability and robustness testing of the RM20S in delivering smoke to in vitro cultures using an in-house designed whole smoke exposure chamber. Results The syringe precision and accuracy of smoke dose generated by the RM20S was assessed using a methane gas standard and resulted in a repeatability error of ≤9%. Differential electrical mobility particle spectrometry (DMS measured smoke particles generated from reference 3R4F cigarettes at points along the RM20S. 53% ± 5.9% of particles by mass reached the chamber, the remainder deposited in the syringe or connecting tubing and ~16% deposited in the chamber. Spectrofluorometric quantification of particle deposition within chambers indicated a positive correlation between smoke concentration and particle deposition. In vitro air-liquid interface (ALI cultures (H292 lung epithelial cells, exposed to whole smoke (1:60 dilution (smoke:air, equivalent to ~5 μg/cm2 demonstrated uniform smoke delivery within the chamber. Conclusions These results suggest this smoke exposure system is a reliable and repeatable method of generating and exposing ALI in vitro cultures to cigarette smoke. This system will enable the evaluation of future tobacco products and individual components of cigarette smoke and may be used as an alternative in vitro tool for evaluating other aerosols and gaseous mixtures such as air pollutants, inhaled pharmaceuticals and cosmetics.

  10. Programming

    International Nuclear Information System (INIS)

    Jackson, M.A.

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies. (orig.)

  11. Programming

    CERN Document Server

    Jackson, M A

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies.

  12. Eye Care Quality and Accessibility Improvement in the Community (EQUALITY: impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care

    Directory of Open Access Journals (Sweden)

    Rhodes LA

    2016-05-01

    Full Text Available Lindsay A Rhodes,1 Carrie E Huisingh,1 Gerald McGwin Jr,1,2 Stephen T Mennemeyer,3 Mary Bregantini,4 Nita Patel,4 Jinan Saaddine,5 John E Crews,5 Christopher A Girkin,1 Cynthia Owsley11Department of Ophthalmology, School of Medicine, 2Department of Epidemiology, 3Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 4Prevent Blindness, Chicago, IL, USA; 5Vision Health Initiative, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USAPurpose: To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY telemedicine program on at-risk patients’ knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY.Patients and methods: New or existing patients presenting for a comprehensive eye exam (CEE at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients’ CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2–4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar’s test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized.Results: At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions. Those who were unemployed (odds

  13. Preconcentration and separation of copper(II), cadmium(II) and chromium(III) in a syringe filled with 3-aminopropyltriethoxysilane supported on silica gel

    Energy Technology Data Exchange (ETDEWEB)

    Tokman, N.; Akman, S.; Ozcan, M.; Koklu, U. [Dept. of Chemistry, Istanbul Technical Univ., Maslak, Istanbul (Turkey)

    2002-11-01

    In this study, a syringe was filled with silica gel loaded with 3-aminopropyltriethoxysilane, for the separation and preconcentration of copper, cadmium and chromium prior to their determination by graphite furnace atomic absorption spectrometry (GFAAS) in seawater. For this purpose, a syringe was filled with 0.5 g of modified silica gel and the sample solution was drawn into the syringe and ejected back again. The analyte elements were quantitatively retained at pH 5. Then, the elements sorbed by the silica gel were eluted with 2.0 M of HCl and determined by GFAAS. At optimum conditions, the recovery of Cu, Cd and Cr were 96-98%. Detection limits (3{delta}) were 6.6, 7.5 and 6.0 {mu}g L{sup -1} for Cu, Cd and Cr, respectively. The elements could be concentrated by drawing and discharging several portions of sample successively but eluting only once. Cu, Cd and Cr added to a seawater sample were quantitatively recovered (>95%) in the range of the 95% confidence level. The method proposed in this paper was compared with a column technique. Optimum experimental conditions, reproducibility, precision and recoveries of both techniques are the same, but the syringe technique is much faster, easier and more practical than the column technique. It is a portable system and allows one to make the sorption process in the source of sample. In addition, the risk of contamination is less than in the column technique. (orig.)

  14. Cultivation and Differentiation of Encapsulated hMSC-TERT in a Disposable Small-Scale Syringe-Like Fixed Bed Reactor

    DEFF Research Database (Denmark)

    Weber, Christian; Pohl, Sebastian; Pörtner, Ralf

    2007-01-01

    The use of commercially available plastic syringes is introduced as disposable small-scale fixed bed bioreactors for the cultivation of implantable therapeutic cell systems on the basis of an alginate-encapsulated human mesenchymal stem cell line. The system introduced is fitted with a noninvasiv...

  15. Accessing memory

    Science.gov (United States)

    Yoon, Doe Hyun; Muralimanohar, Naveen; Chang, Jichuan; Ranganthan, Parthasarathy

    2017-09-26

    A disclosed example method involves performing simultaneous data accesses on at least first and second independently selectable logical sub-ranks to access first data via a wide internal data bus in a memory device. The memory device includes a translation buffer chip, memory chips in independently selectable logical sub-ranks, a narrow external data bus to connect the translation buffer chip to a memory controller, and the wide internal data bus between the translation buffer chip and the memory chips. A data access is performed on only the first independently selectable logical sub-rank to access second data via the wide internal data bus. The example method also involves locating a first portion of the first data, a second portion of the first data, and the second data on the narrow external data bus during separate data transfers.

  16. Rapid discrimination and determination of antibiotics drugs in plastic syringes using near infrared spectroscopy with chemometric analysis: Application to amoxicillin and penicillin.

    Science.gov (United States)

    Lê, Laetitia Minh Mai; Eveleigh, Luc; Hasnaoui, Ikram; Prognon, Patrice; Baillet-Guffroy, Arlette; Caudron, Eric

    2017-05-10

    The aim of this study was to investigate near infrared spectroscopy (NIRS) combined to chemometric analysis to discriminate and quantify three antibiotics by direct measurement in plastic syringes.Solutions of benzylpenicillin (PENI), amoxicillin (AMOX) and amoxicillin/clavulanic acid (AMOX/CLAV) were analyzed at therapeutic concentrations in glass vials and plastic syringes with NIR spectrometer by direct measurement. Chemometric analysis using partial least squares regression and discriminative analysis was conducted to develop qualitative and quantitative calibration models. Discrimination of the three antibiotics was optimal for concentrated solutions with 100% of accuracy. For quantitative analysis, the three antibiotics furnished a linear response (R²>0.9994) for concentrations ranging from 0.05 to 0.2 g/mL for AMOX, 0.1 to 1.0 MUI/mL for PENI and 0.005 to 0.05 g/mL for AMOX/CLAV with excellent repeatability (maximum 1.3%) and intermediate precision (maximum of 3.2%). Based on proposed models, 94.4% of analyzed AMOX syringes, 80.0% of AMOX/CLAV syringes and 85.7% of PENI syringes were compliant with a relative error including the limit of ± 15%.NIRS as rapid, non-invasive and non-destructive analytical method represents a potentially powerful tool to further develop for securing the drug administration circuit of healthcare institutions to ensure that patients receive the correct product at the right dose. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  18. Topical ocular 0.1% cyclosporine A cationic emulsion in dry eye disease patients with severe keratitis: experience through the French early-access program

    Directory of Open Access Journals (Sweden)

    Pisella P

    2018-02-01

    Full Text Available Pierre-Jean Pisella,1 Marc Labetoulle,2 Serge Doan,3 Beatrice Cochener-Lamard,4 Mourad Amrane,5 Dahlia Ismail,5 Catherine Creuzot-Garcher,6,7 Christophe Baudouin8–10 1Department of Ophthalmology, Tours University Hospital, University François Rabelais, Bretonneau Hospital, Tours, 2Department of Ophthalmology, Bicêtre Hospital, APHP, Paris-Sud University, Le Kremlin-Bicêtre, 3Department of Ophthalmology, Bichat Hospital and Fondation A de Rothschild, Paris, 4Brest University Medical School, Morvan Hospital, Brest, 5Santen SAS, Evry, 6Department of Ophthalmology, University Hospital, 7Department of Ophthalmology III, Eye and Nutrition Research Group, Burgundy, Dijon, 8Research Team S12, Quinze-Vingts National Ophthalmology Hospital, 9Department of Ophthalmology, Ambroise-Paré Hospital, APHP, UPMC University, Paris 6, Vision Institute, INSERM UMRS968, CNRS UMR7210, Paris, 10University of Versailles Saint-Quentin en Yvelines, Versailles, France Purpose: The objective of this study was to report the evaluation of efficacy and safety of cyclosporine A cationic emulsion (CsA CE 0.1% for the treatment of severe keratitis in adults with dry eye disease (DED in a French early-access program. Methods: Patients with DED and severe keratitis (corneal fluorescein staining [CFS] score of 3–5 on the Oxford scale and/or the presence of corneal lesions [filaments or ulcers] were enrolled in a compassionate use program (Authorization for Temporary Use [ATU] for once-daily CsA CE, which was approved by French health authorities prior to its registration. Efficacy and safety at 1, 3, 6, and 12-month follow-up visits were evaluated. Results: The ATU cohort (n=1,212; mean age =60.5 years; 79.5% female; 98.1% with severe keratitis; 74.5% with corneal lesions consisted of 601 CsA-naïve patients and 611 patients treated previously with other CsA formulations. The primary DED etiology was Sjögren’s syndrome (48.7%. Clinical benefit could be discerned among

  19. Open access

    CERN Document Server

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder consent, and many authors, musicians, filmmakers, and other creators who depend on royalties are understandably unwilling to give their consent. But for 350 years, scholars have written peer-reviewed journal articles for impact, not for money, and are free to consent to open access without losing revenue. In this concise introduction, Peter Suber tells us what open access is and isn't, how it benefits authors and readers of research, how we pay for it, how it avoids copyright problems, how it has moved from the periphery to the mainstream, and what its future may hold. Distilling a decade of Suber's influential writing and thinking about open access, this is the indispe...

  20. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Access French

    CERN Document Server

    Grosz, Bernard

    2014-01-01

    Access is the major new language series designed with the needs of today's generation of students firmly in mind. Whether learning for leisure or business purposes or working towards a curriculum qualification, Access French is specially designed for adults of all ages and gives students a thorough grounding in all the skills required to understand, speak, read and write contemporary French from scratch. The coursebook consists of 10 units covering different topic areas, each of which includes Language Focus panels explaining the structures covered and a comprehensive glossary. Learning tips

  2. Taking a Bite out of Malaria: Controlled Human Malaria Infection by Needle and Syringe

    Science.gov (United States)

    2013-01-01

    Potentiation of the curative action of primaquine in vivax malaria by quinine and chloro- quine. J Lab Clin Med 46: 301–306. 9. Shapiro TA, Ranasinha CD...2013 2. REPORT TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Taking a Bite out of Malaria : Controlled Human Malaria ...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Medical Research Center,U.S. Military Malaria Vaccine Program,503 Robert

  3. Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries

    Directory of Open Access Journals (Sweden)

    Littrell Megan

    2011-10-01

    Full Text Available Abstract Background Access to artemisinin-based combination therapy (ACT remains limited in high malaria-burden countries, and there are concerns that the poorest people are particularly disadvantaged. This paper presents new evidence on household treatment-seeking behaviour in six African countries. These data provide a baseline for monitoring interventions to increase ACT coverage, such as the Affordable Medicines Facility for malaria (AMFm. Methods Nationally representative household surveys were conducted in Benin, the Democratic Republic of Congo (DRC, Madagascar, Nigeria, Uganda and Zambia between 2008 and 2010. Caregivers responded to questions about management of recent fevers in children under five. Treatment indicators were tabulated across countries, and differences in case management provided by the public versus private sector were examined using chi-square tests. Logistic regression was used to test for association between socioeconomic status and 1 malaria blood testing, and 2 ACT treatment. Results Fever treatment with an ACT is low in Benin (10%, the DRC (5%, Madagascar (3% and Nigeria (5%, but higher in Uganda (21% and Zambia (21%. The wealthiest children are significantly more likely to receive ACT compared to the poorest children in Benin (OR = 2.68, 95% CI = 1.12-6.42; the DRC (OR = 2.18, 95% CI = 1.12-4.24; Madagascar (OR = 5.37, 95% CI = 1.58-18.24; and Nigeria (OR = 6.59, 95% CI = 2.73-15.89. Most caregivers seek treatment outside of the home, and private sector outlets are commonly the sole external source of treatment (except in Zambia. However, children treated in the public sector are significantly more likely to receive ACT treatment than those treated in the private sector (except in Madagascar. Nonetheless, levels of testing and ACT treatment in the public sector are low. Few caregivers name the national first-line drug as most effective for treating malaria in Madagascar (2%, the DRC (2%, Nigeria (4% and Benin (10

  4. Multiresidue determination of pesticides from aquatic media using polyaniline nanowires network as highly efficient sorbent for microextraction in packed syringe

    Energy Technology Data Exchange (ETDEWEB)

    Bagheri, Habib, E-mail: bagheri@sharif.edu [Environmental and Bio-Analytical Laboratories, Department of Chemistry, Sharif University of Technology, P.O. Box 11365-9516, Tehran (Iran, Islamic Republic of); Alipour, Noshin; Ayazi, Zahra [Environmental and Bio-Analytical Laboratories, Department of Chemistry, Sharif University of Technology, P.O. Box 11365-9516, Tehran (Iran, Islamic Republic of)

    2012-08-31

    Graphical abstract: Polyaniline nanowires network was prepared using soft template technique and used as sorbent of microextraction in packed syringe for the multiresidue determination of selected analytes from triazine, organochlrorine and organophosphorous pesticides in aqueous samples. Highlights: Black-Right-Pointing-Pointer Polyaniline nanowires network was synthesized using soft template method. Black-Right-Pointing-Pointer The presence of micelles was an important parameter in shaping the growing polymer. Black-Right-Pointing-Pointer The synthesized nanowires showed higher extraction capability in comparison with the bulk polymer. - Abstract: A simple, rapid and sensitive method based on microextraction in packed syringe (MEPS), in combination with gas chromatography-mass spectrometry (GC-MS) was developed. Polyaniline (PANI) nanowires network was synthesized and used as sorbent of MEPS for the multiresidue determination of selected analytes from triazine, organochlrorine and organophosphorous pesticides in aqueous samples. The PANI nanowires network was prepared using soft template technique and its characterization was studied by scanning electron microscopy (SEM). The presence of micelles in this methodology showed to be an important parameter in shaping the growing polymer. Hexadecyltrimethylammonium bromide (HTAB) was used as structure directing agent in PANI preparation procedure and this was led to the formation of nanowires with diameters ranging from 35 nm to 45 nm. The synthesized PANI nanowires network showed higher extraction capability in comparison with the bulk PANI. Important parameters influencing the extraction and desorption processes including desorption solvent, elution volume, draw-eject cycles of sample, draw-eject mode, pH effect and amount of sorbent were optimized. Limits of detection were in the range of 0.07-0.3 ng mL{sup -1} using time scheduled selected ion monitoring (SIM) mode. The linearity of method was in the range from 0

  5. Multiresidue determination of pesticides from aquatic media using polyaniline nanowires network as highly efficient sorbent for microextraction in packed syringe

    International Nuclear Information System (INIS)

    Bagheri, Habib; Alipour, Noshin; Ayazi, Zahra

    2012-01-01

    Graphical abstract: Polyaniline nanowires network was prepared using soft template technique and used as sorbent of microextraction in packed syringe for the multiresidue determination of selected analytes from triazine, organochlrorine and organophosphorous pesticides in aqueous samples. Highlights: ► Polyaniline nanowires network was synthesized using soft template method. ► The presence of micelles was an important parameter in shaping the growing polymer. ► The synthesized nanowires showed higher extraction capability in comparison with the bulk polymer. - Abstract: A simple, rapid and sensitive method based on microextraction in packed syringe (MEPS), in combination with gas chromatography–mass spectrometry (GC–MS) was developed. Polyaniline (PANI) nanowires network was synthesized and used as sorbent of MEPS for the multiresidue determination of selected analytes from triazine, organochlrorine and organophosphorous pesticides in aqueous samples. The PANI nanowires network was prepared using soft template technique and its characterization was studied by scanning electron microscopy (SEM). The presence of micelles in this methodology showed to be an important parameter in shaping the growing polymer. Hexadecyltrimethylammonium bromide (HTAB) was used as structure directing agent in PANI preparation procedure and this was led to the formation of nanowires with diameters ranging from 35 nm to 45 nm. The synthesized PANI nanowires network showed higher extraction capability in comparison with the bulk PANI. Important parameters influencing the extraction and desorption processes including desorption solvent, elution volume, draw–eject cycles of sample, draw–eject mode, pH effect and amount of sorbent were optimized. Limits of detection were in the range of 0.07–0.3 ng mL −1 using time scheduled selected ion monitoring (SIM) mode. The linearity of method was in the range from 0.5–200 ng mL −1 to 0.2–1000 ng mL −1 . The method precision

  6. Nuclear information access system

    International Nuclear Information System (INIS)

    Ham, C. H.; Yang, M. H.; Yoon, S. W.

    1998-01-01

    The energy supply in the countries, which have abundant energy resources, may not be affected by accepting the assertion of anti-nuclear and environment groups. Anti-nuclear movements in the countries which have little energy resources may cause serious problem in securing energy supply. Especially, it is distinct in Korea because she heavily depends on nuclear energy in electricity supply(nuclear share in total electricity supply is about 40%).The cause of social trouble surrounding nuclear energy is being involved with various circumstances. However, it is very important that we are not aware of the importance of information access and prepared for such a situation from the early stage of nuclear energy's development. In those matter, this paper analyzes the contents of nuclear information access system in France and Japan which have dynamic nuclear development program and presents the direction of the nuclear access regime through comparing Korean status and referring to progresses of the regime

  7. Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities: A Parent's Guide = Programas para Infantes y Ninos Pre-escolares con Discapacidades: Guia para Padres de Familia. Update.

    Science.gov (United States)

    Kupper, Lisa, Ed.

    This parent's guide (presented in both English and Spanish) is intended to help families access services for young children with special needs. It is presented in the form of questions and answers arranged in three parts. Part I presents 12 questions and answers about early intervention services for infants and toddlers (ages birth through 2…

  8. The Development of Learners' Support Mechanisms in a Self-Access Center and Their Implementation in a Credit-Based Self-Directed Learning Program

    Science.gov (United States)

    Victori, Mia

    2007-01-01

    This paper reports on the development of a self-access center (SAC) within a university context, and focuses on the kind of support mechanisms provided to learners to enhance their self-directed learning (SDL) skills. After providing background information on the center and its counseling service, the paper shows how changes in the university…

  9. Fully-automated in-syringe dispersive liquid-liquid microextraction for the determination of caffeine in coffee beverages.

    Science.gov (United States)

    Frizzarin, Rejane M; Maya, Fernando; Estela, José M; Cerdà, Víctor

    2016-12-01

    A novel fully-automated magnetic stirring-assisted lab-in-syringe analytical procedure has been developed for the fast and efficient dispersive liquid-liquid microextraction (DLLME) of caffeine in coffee beverages. The procedure is based on the microextraction of caffeine with a minute amount of dichloromethane, isolating caffeine from the sample matrix with no further sample pretreatment. Selection of the relevant extraction parameters such as the dispersive solvent, proportion of aqueous/organic phase, pH and flow rates have been carefully evaluated. Caffeine quantification was linear from 2 to 75mgL(-1), with detection and quantification limits of 0.46mgL(-1) and 1.54mgL(-1), respectively. A coefficient of variation (n=8; 5mgL(-1)) of a 2.1% and a sampling rate of 16h(-1), were obtained. The procedure was satisfactorily applied to the determination of caffeine in brewed, instant and decaf coffee samples, being the results for the sample analysis validated using high-performance liquid chromatography. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Stability of Diphenhydramine Hydrochloride, Lorazepam, and Dexamethasone Sodium Phosphate in 0.9% Sodium Chloride Stored in Polypropylene Syringes.

    Science.gov (United States)

    Anderson, Collin R; Halford, Zachery; MacKay, Mark

    2015-01-01

    Chemotherapy induced nausea and vomiting is problematic for many patients undergoing chemotherapy. Multiple-drug treatments have been developed to mitigate chemotherapy induced nausea and vomiting. A patient-controlled infusion of diphenhydramine hydrochloride, lorazepam, and dexamethasone sodium phosphate has been studied in patients who are refractory to first-line therapy. Unfortunately, the physical and chemical compatibility of this three-drug combination is not available in the published literature. Chemical compatibility was evaluated using high-performance liquid chromatography with ultraviolet detection. Visual observation was employed to detect change in color, clarity, or gas evolution. Turbidity and pH measurements were performed in conjunction with visual observation at hours 0, 24, and 48. Results showed that diphenhydramine hydrochloride 4 mg/mL, lorazepam 0.16 mg/mL, and dexamethasone sodium phosphate 0.27 mg/mL in 0.9% sodium chloride stored in polypropylene syringes were compatible, and components retained greater than 95% of their original concentration over 48 hours when stored at room temperature.

  11. Determination of clenbuterol from pork samples using surface molecularly imprinted polymers as the selective sorbents for microextraction in packed syringe.

    Science.gov (United States)

    Du, Wei; Lei, Chunmei; Zhang, Siruo; Bai, Gang; Zhou, Huiyan; Sun, Min; Fu, Qiang; Chang, Chun

    2014-03-01

    In this study, a selective sample pretreatment procedure combing surface molecularly imprinted polymers and microextraction in packed syringe (SMIPs-MEPS) was developed for the analysis of clenbuterol (CLB) from pork samples. SMIPs for CLB were synthesized on silica gel particles through a sol-gel process. A series of characterization and adsorption experiments revealed that the SMIPs exhibited porous structures, good thermal stability, high adsorption capacity and a fast mass transfer rate. The obtained SMIPs were employed as selective sorbents of SMIPs-MEPS for extraction of CLB from pork samples. Several parameters affecting the extraction efficiency were investigated, including the pH of sample solution, number of draw-eject cycles, volume of sample, type and volume of washing solution, and the type and volume of elution solution. Under the optimized conditions, a simple and rapid method for the determination of CLB from pork samples was established by coupling with high performance liquid chromatography (HPLC). The whole pretreatment process was rapid and it can be accomplished with 2min. The limit of quantitation and the limit of detection for CLB were 0.02 and 0.009μgkg(-1), respectively. The average recoveries of CLB at three spiked levels ranged from 86.5% to 91.2% with the relative standard deviations (RSD) ≤6.3%. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Vanillic and syringic acids from biomass burning: Behaviour during Fenton-like oxidation in atmospheric aqueous phase and in the absence of light

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Gabriela T.A.D.; Santos, Patrícia S.M., E-mail: patricia.santos@ua.pt; Duarte, Armando C.

    2016-08-05

    Highlights: • The rate of oxidation of small aromatic acids increase with the pH decrease. • With the oxidation of aromatic acids are formed new small aromatic compounds. • The initial and formed compounds are not totally degraded during the night period. • The substituents and their positions in ring affect the oxidation of aromatic acids. • The OH radical attack to vanillic and syringic acids is different in atmospheric waters. - Abstract: Biomass combustion is a threat to the environment since it emits to the atmosphere organic compounds, which may react and originate others more aggressive. This work studied the behaviours of vanillic and syringic acids, small aromatic tracers of biomass burning, during Fenton-like oxidation in aqueous phase and absence of light. For both compounds, the extent of oxidation increased with pH decrease from neutral to acid in atmospheric waters, but for vanillic acid the neutral pH was not able of promoting the oxidation. With the oxidation of both acids were formed chromophoric compounds, and the formation rate increased with the degree of electron-donator substituents in benzene ring. The initial and produced compounds were not totally degraded up to 24 h of reaction at pH 4.5, suggesting that the night period may be not sufficient for their full degradation in atmospheric waters. The major compounds formed were the 3,4-dihydroxybenzoic acid for vanillic acid, and the 1,4-dihydroxy-2,6-dimethoxybenzene for syringic acid. These findings suggest the occurrence of an ipso attack by the hydroxyl radical preferential to the methoxy and carboxyl groups of vanillic and syringic acids, respectively. It is important to highlight that for both aromatic acids the main compounds produced are also small aromatic compounds.

  13. Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: A randomized crossover trial.

    Science.gov (United States)

    Stevens, Allen D; Hernandez, Caleb; Jones, Seth; Moreira, Maria E; Blumen, Jason R; Hopkins, Emily; Sande, Margaret; Bakes, Katherine; Haukoos, Jason S

    2015-11-01

    Medication dosing errors remain commonplace and may result in potentially life-threatening outcomes, particularly for pediatric patients where dosing often requires weight-based calculations. Novel medication delivery systems that may reduce dosing errors resonate with national healthcare priorities. Our goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. We performed a prospective, block-randomized, cross-over study, where 10 full-time paramedics each managed two simulated pediatric arrests in situ using either prefilled, color-coded syringes (intervention) or their own medication kits stocked with conventional ampoules (control). Each paramedic was paired with two emergency medical technicians to provide ventilations and compressions as directed. The ambulance patient compartment and the intravenous medication port were video recorded. Data were extracted from video review by blinded, independent reviewers. Median time to delivery of all doses for the intervention and control groups was 34 (95% CI: 28-39) seconds and 42 (95% CI: 36-51) seconds, respectively (difference=9 [95% CI: 4-14] seconds). Using the conventional method, 62 doses were administered with 24 (39%) critical dosing errors; using the prefilled, color-coded syringe method, 59 doses were administered with 0 (0%) critical dosing errors (difference=39%, 95% CI: 13-61%). A novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Access to Experimental Cancer Drugs

    Science.gov (United States)

    An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

  15. Particle Characterization for a Protein Drug Product Stored in Pre-Filled Syringes Using Micro-Flow Imaging, Archimedes, and Quartz Crystal Microbalance with Dissipation.

    Science.gov (United States)

    Zheng, Songyan; Puri, Aastha; Li, Jinjiang; Jaiswal, Archana; Adams, Monica

    2017-01-01

    Micro-flow imaging (MFI) has been used for formulation development for analyzing sub-visible particles. Archimedes, a novel technique for analyzing sub-micron particles, has been considered as an orthogonal method to currently existing techniques. This study utilized these two techniques to investigate the effectiveness of polysorbate (PS-80) in mitigating the particle formation of a therapeutic protein formulation stored in silicone oil-coated pre-filled syringes. The results indicated that PS-80 prevented the formation of both protein and silicone oil particles. In the case of protein particles, PS-80 might involve in the interactions with the hydrophobic patches of protein, air bubbles, and the stressed surfaces of silicone oil-coated pre-filled syringes. Such interactions played a role in mitigating the formation of protein particles. Subsequently, quartz crystal microbalance with dissipation (QCM-D) was utilized to characterize the interactions associated with silicone oil, protein, and PS-80 in the solutions. Based on QCM-D results, we proposed that PS-80 likely formed a layer on the interior surfaces of syringes. As a result, the adsorbed PS-80 might block the leakage of silicone oil from the surfaces to solution so that the silicone oil particles were mitigated at the presence of PS-80. Overall, this study demonstrated the necessary of utilizing these three techniques cooperatively in order to better understand the interfacial role of PS-80 in mitigating the formation of protein and silicone oil particles.

  16. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP): digital still images from transects on Kauai, Oahu, Molokai, Maui, and Hawaii 2011-2012 (NCEI Accession 0119360)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of digital still images from the Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) taken 2011-2012 from 29 sites within 5 main...

  17. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP): digital still images from transects on Kauai, Oahu, Molokai, Maui, and Hawaii 2011-2012 (NODC Accession 0119360)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of digital still images from the Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) taken 2011-2012 from 29 sites within 5 main...

  18. National Coral Reef Monitoring Program: Assessment of coral reef benthic communities in Puerto Rico from 2014-05-19 to 2014-12-03 (NCEI Accession 0151729)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Benthic data collection for the National Coral Reef Ecosystem Monitoring Program (NCRMP) consists of two survey types: the Line Point-Intercept (LPI) method and the...

  19. National Coral Reef Monitoring Program: Stratified Random Surveys (StRS) of Reef Fish, including Benthic Estimate Data of the Mariana Archipelago in 2014 (NCEI Accession 0157596)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data provided in this data set were collected as part of the NOAA Pacific Islands Fisheries Science Center (PIFSC), Coral Reef Ecosystem Program (CREP) led NCRMP...

  20. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP): digital still images from transects on Kauai, Oahu, Molokai, Maui, and Hawaii 2008-2010 (NCEI Accession 0104357)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of digital still images from the Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) taken 2008-2010 from 24 sites within 5 main...

  1. Zooplankton biomass data collected from net tows from the Eltanin in the Antarctic in support of the US Antarctic Research Program (USARP) from 1963 - 1967 (NODC Accession 0068171)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Zooplankton biomass data (displacement volume, settled volume) sampled aboard the R/V ELTANIN during the U.S. Antarctic Research Program (USARP) from Apr 5 1963 to...

  2. Water quality data collected by the the National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP), 1996 - 1998 (NODC Accession 0000789)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP) collected water quality data in 22 reserves in the United States and...

  3. NOAA's Coastal Change Analysis Program (C-CAP) 1985 to 2010 Regional Land Cover Change Data - Coastal United States (NODC Accession 0121254)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Coastal Change Analysis Program (C-CAP) produces national standardized land cover and change products for the coastal regions of the U.S. C-CAP products...

  4. Groundtruthing Notes and Miscellaneous Biological Datasets from Coral Ecosystems Surveys from the Northwestern Hawaiian Islands Rapid Reef Assessment and Monitoring Program of 2000-2002 (NODC Accession 0001448)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Northwestern Hawaiian Islands Coral Reef Assessment and Monitoring Program (NOWRAMP) began in 2000 with the mission to rapidly evaluate and map the shallow water...

  5. Water quality, meteorological, and nutrient data collected by the the National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP), 1994 - 2005 (NODC Accession 0019215)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP) collected water quality, meteorological, and nutrient data in 25...

  6. Disparities in access to healthcare: the case of a drug and alcohol abuse detoxification treatment program among minority groups in a Texas hospital.

    Science.gov (United States)

    Coustasse, Alberto; Singh, Karan P; Trevino, Fernando M

    2007-01-01

    The authors analyzed ethnic/racial disparities in healthcare access and length of stay from a defined population of individuals seeking medical detoxification services at a hospital in Texas. Results indicated Blacks were more likely to be insured compared with Whites, mostly by public insurance, but this did not hold for Hispanics, who were about three times more likely to be uninsured compared with Blacks. In addition, the authors observed lower median of length of stay in the Medicaid category among Hispanics. These results can be explained by aggressive case management, sociocultural barriers, or discriminatory practices, both intentional and unintentional.

  7. Non-destructive vacuum decay method for pre-filled syringe closure integrity testing compared with dye ingress testing and high-voltage leak detection.

    Science.gov (United States)

    Simonetti, Andrea; Amari, Filippo

    2015-01-01

    In reaction to the limitations of the traditional sterility test methods, in 2008, the U.S. Food and Drug Administration issued the guidance "Container and Closure System Integrity Testing in Lieu of Sterility Testing as a Component of the Stability Protocol for Sterile Products" encouraging sterile drug manufacturers to use properly validated physical methods, apart from conventional microbial challenge testing, to confirm container closure integrity as part of the stability protocol. The case study presented in this article investigated the capability of four container closure integrity testing methods to detect simulated defects of different sizes and types on glass syringes, prefilled both with drug product intended for parenteral administration and sterile water. The drug product was a flu vaccine (Agrippal, Novartis Vaccines, Siena, Italy). Vacuum decay, pharmacopoeial dye ingress test, Novartis specific dye ingress test, and high-voltage leak detection were, in succession, the methods involved in the comparative studies. The case study execution was preceded by the preparation of two independent sets of reference prefilled syringes, classified, respectively, as examples of conforming to closure integrity requirements (negative controls) and as defective (positive controls). Positive controls were, in turn, split in six groups, three of with holes laser-drilled through the prefilled syringe glass barrel, while the other three with capillary tubes embedded in the prefilled syringe plunger. These reference populations were then investigated by means of validated equipment used for container closure integrity testing of prefilled syringe commercial production; data were collected and analyzed to determine the detection rate and the percentage of false results. Results showed that the vacuum decay method had the highest performance in terms of detection sensitivity and also ensured the best reliability and repeatability of measurements. An innovative technical

  8. Syringic acid from Tamarix aucheriana possesses antimitogenic and chemo-sensitizing activities in human colorectal cancer cells.

    Science.gov (United States)

    Abaza, Mohamed-Salah; Al-Attiyah, Raja'a; Bhardwaj, Radhika; Abbadi, Ghaneim; Koyippally, Mathew; Afzal, Mohammad

    2013-09-01

    For its variety of biological activities, Tamarix aucheriana (Decne.) Baum. (Tamaricaceae) has an extensive history as a traditional Arab medicine. Antimitogenic and chemo-sensitizing activities of syringic acid (SA) were studied against human colorectal cancer. Chromatographic and spectral data were used for the isolation and identification of SA. MTT, flow cytometry, in vitro invasion and angiogenesis assays, fluoremetry, ELISA and Real Time qPCR were used to test antimitogenic and chemo-sensitizing activities of SA, cell cycle, apoptosis, proteasome and NFκB-DNA-binding activities, cancer cell invasion and angiogenesis, and expression of cell cycle/apoptosis-related genes. SA showed a time- and dose-dependent (IC₅₀ = 0.95-1.2 mg mL⁻¹) antimitogenic effect against cancer cells with little cytotoxicity on normal fibroblasts (≤20%). SA-altered cell cycle (S/G2-M or G1/G2-M phases) in a time-dependent manner, induced apoptosis, inhibited DNA-binding activity of NFκB (p ≤ 0.0001), chymotrypsin-like/PGPH (peptidyl-glutamyl peptide-hydrolyzing) (p ≤ 0.0001) and the trypsin-like (p ≤ 0.002) activities of 26S proteasome and angiogenesis. SA also differentially sensitized cancer cells to standard chemotherapies with a marked increase in their sensitivity to camptothecin (500-fold), 5FU (20,000-fold), doxorubicin (210-fold), taxol (3134-fold), vinblastine (1000-fold), vincristine (130-fold) and amsacrine (107-fold) compared to standard drugs alone. SA exerted its chemotherapeutic and chemo-sensitizing effects through an array of mechanisms including cell-cycle arrest, apoptosis induction, inhibition of cell proliferation, cell migration, angiogenesis, NFκB DNA-binding and proteasome activities. These results demonstrate the potential of SA as an antimitogenic and chemo-sensitizing agent for human colorectal cancer.

  9. Distributing foil from needle and syringe programmes (NSPs) to promote transitions from heroin injecting to chasing: an evaluation.

    Science.gov (United States)

    Pizzey, Rachael; Hunt, Neil

    2008-07-21

    The report presents evaluation results from an intervention using specially produced foil packs to promote a transition from heroin injecting to inhalation (chasing) with injecting drug users (IDUs) attending four needle and syringe programmes (NSPs) in south west England. Service activity/uptake measures, brief structured interviews. Out of 320 attenders, 54% took the foil packs when they became available. Over the period of the evaluation, NSP transactions increased by 32.5% from 1,672 to 2,216. Additionally, 32 new clients (non-injecting heroin users) started attending the service to obtain the foil packs. This group would not otherwise have been in contact with the treatment service. More detailed data from one site are reported for 48 recent injectors who took foil within the NSP where the piloting first commenced. Prior to the introduction of the foil packs, 46% of this sub-group reported chasing heroin in the previous four weeks. At follow up, 85% reported using the foil to chase heroin on occasions when they would otherwise have injected. Among the people who took it, client satisfaction with the quality and size of the foil packs was good and respondents viewed its availability as a valuable extension to the NSP's services. These findings suggest that distributing foil packs can be a useful means of engaging NSP attenders in discussions about ways of reducing injecting risks and can reduce injecting in settings where there is a pre-existing culture of heroin chasing. Further research should see whether these findings can be reproduced in other cultural contexts and evaluate whether the observed behavioural changes are sustained and lead to reductions in harm including blood-borne infections and overdose.

  10. Multiresidue determination of pesticides from aquatic media using polyaniline nanowires network as highly efficient sorbent for microextraction in packed syringe.

    Science.gov (United States)

    Bagheri, Habib; Alipour, Noshin; Ayazi, Zahra

    2012-08-31

    A simple, rapid and sensitive method based on microextraction in packed syringe (MEPS), in combination with gas chromatography-mass spectrometry (GC-MS) was developed. Polyaniline (PANI) nanowires network was synthesized and used as sorbent of MEPS for the multiresidue determination of selected analytes from triazine, organochlrorine and organophosphorous pesticides in aqueous samples. The PANI nanowires network was prepared using soft template technique and its characterization was studied by scanning electron microscopy (SEM). The presence of micelles in this methodology showed to be an important parameter in shaping the growing polymer. Hexadecyltrimethylammonium bromide (HTAB) was used as structure directing agent in PANI preparation procedure and this was led to the formation of nanowires with diameters ranging from 35 nm to 45 nm. The synthesized PANI nanowires network showed higher extraction capability in comparison with the bulk PANI. Important parameters influencing the extraction and desorption processes including desorption solvent, elution volume, draw-eject cycles of sample, draw-eject mode, pH effect and amount of sorbent were optimized. Limits of detection were in the range of 0.07-0.3 ng mL(-1) using time scheduled selected ion monitoring (SIM) mode. The linearity of method was in the range from 0.5-200 ng mL(-1) to 0.2-1000 ng mL(-1). The method precision (RSD %) with three replicates were in the range of 5.3-18.4% at the concentration level of 5 ng mL(-1). The developed method was successfully applied to the Zayandeh-rood river water samples and the matrix factor obtained for the spiked real water samples were in the range of 0.79-0.94. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care: A Program Evaluation

    Science.gov (United States)

    Carpino, Rachel; Walker, Mary P.; Liu, Ying; Simmer-Beck, Melanie

    2017-01-01

    This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants (N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter…

  12. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. An in vitro and in vivo validation of a novel color-coded syringe device for measuring the intracuff pressure in cuffed endotracheal tubes.

    Science.gov (United States)

    Kamata, Mineto; Kako, Hiromi; Ramesh, Archana S; Krishna, Senthil G; Tobias, Joseph D

    2015-01-01

    The clinical practice of pediatric anesthesiology has changed with a transition to the use of cuffed endotracheal tubes (ETTs) in infants and children. The monitoring of intracuff pressure has been suggested as one means to limit the potential for damage to the tracheal mucosa. The current study evaluates the accuracy of a novel, color-coded syringe device which provides three zones (green, clear, and red) to estimate the intracuff pressure. The study was conducted in two phases. Phase 1 was an in vitro study where cuffed ETTs of sizes 4.0 mm, 5.0 mm and 6.0 mm ID were placed into polyvinylchloride tubing of appropriate sizes. A manometer and the syringe device were simultaneously attached to measure the intracuff pressure at the middle of the 3 different zones on the device (red, clear, and green). Phase 2 was an in vivo study where the syringe device and the manometer were simultaneously attached to the pilot balloon to measure the intracuff pressure and the corresponding zone on the color-coded syringe following endotracheal intubation. Statistical analysis included a descriptive reporting of the mean ± SD, median, range, and 95% confidence intervals (CI) of the actual intracuff pressure readings at the three zones of the syringe device during both its in vitro and in vivo use. For phase 1 of the study, the 95% CI for the green, clear, and red zones were 21.5-21.8, 29.2-29.5, and 46.5-47.4 cmH2O respectively. This correlated well with the manufacturer reported values of 20-30, 30-40, and 40-60 cmH2O for the 3 zones (green, clear, and red respectively). Phase 2 of the study included 200 patients ranging in age from 0.1 to 21.8 years (6.7 ± 5.1 years) and in weight from 4.0 to 129.1 kilograms (29.4 ± 23.3 kgs). The size of the ETTs ranged from 3.0 to 7.0 mm ID. The intracuff pressure measured by the manometer ranged from 4 to 65 cmH2O (27.6 ± 9.7 cmH2O). The 95% CI for the green, clear, and red zones were 20.5-21.7, 27.7-29.1, and 41.2-46.5 cmH2O respectively

  14. Cardiac EASE (Ensuring Access and Speedy Evaluation) – the impact of a single-point-of-entry multidisciplinary outpatient cardiology consultation program on wait times in Canada

    Science.gov (United States)

    Bungard, Tammy J; Smigorowsky, Marcie J; Lalonde, Lucille D; Hogan, Terry; Doliszny, Katharine M; Gebreyesus, Ghirmay; Garg, Sipi; Archer, Stephen L

    2009-01-01

    BACKGROUND: Universal access to health care is valued in Canada but increasing wait times for services (eg, cardiology consultation) raise safety questions. Observations suggest that deficiencies in the process of care contribute to wait times. Consequently, an outpatient clinic was designed for Ensuring Access and Speedy Evaluation (Cardiac EASE) in a university group practice, providing cardiac consultative services for northern Alberta. Cardiac EASE has two components: a single-point-of-entry intake service (prospective testing using physician-approved algorithms and previsit triage) and a multidisciplinary clinic (staffed by cardiologists, nurse practitioners and doctoral-trained pharmacists). OBJECTIVES: It was hypothesized that Cardiac EASE would reduce the time to initial consultation and a definitive diagnosis, and also increase the referral capacity. METHODS: The primary and secondary outcomes were time from referral to initial consultation, and time to achieve a definitive diagnosis and management plan, respectively. A conventionally managed historical control group (three-month pre-EASE period in 2003) was compared with the EASE group (2004 to 2006). The conventional referral mechanism continued concurrently with EASE. RESULTS: A comparison between pre-EASE (n=311) and EASE (n=3096) revealed no difference in the mean (± SD) age (60±16 years), sex (55% and 52% men, respectively) or reason for referral, including chest pain (31% and 40%, respectively) and arrhythmia (27% and 29%, respectively). Cardiac EASE reduced the time to initial cardiac consultation (from 71±45 days to 33±19 days) and time to a definitive diagnosis (from 120±86 days to 51±58 days) (P<0.0001). The annual number of new referrals increased from 1512 in 2002 to 2574 in 2006 due to growth in the Cardiac EASE clinic. The number of patients seen through the conventional referral mechanism and their wait times remained constant during the study period. CONCLUSIONS: Cardiac EASE reduced

  15. Hemodialysis access -- self care

    Science.gov (United States)

    ... hemodialysis. Taking good care of your access helps make it last longer. Prevent Infection in Your Access Keep your access clean. Wash the access with soap and water every day to decrease your risk ...

  16. Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development.

    Science.gov (United States)

    Adhikari, Bishwa B; Goodson, James L; Chu, Susan Y; Rota, Paul A; Meltzer, Martin I

    2016-12-01

    Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the cost-effectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs. We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates. The cost of microneedle vaccination was estimated at US$0.95 (range US$0.71-US$1.18) for the first dose, compared with US$1.65 (range US$1.24-US$2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$1.66 per measles case averted (range US$1.24-US$2.07) compared with an estimated cost of US$2.64 per case averted (range US$1.98-US$3.30) using subcutaneous vaccination. Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.

  17. Determination of pyrethroid metabolites in human urine using liquid phase microextraction coupled in-syringe derivatization followed by gas chromatography/electron capture detection.

    Science.gov (United States)

    Lin, Chiu-Hwa; Yan, Cheing-Tong; Kumar, Ponnusamy Vinoth; Li, Hong-Ping; Jen, Jen-Fon

    2011-08-01

    Metabolites of synthetic pyrethroids such as cis-3-(2,2-dibromovinyl)-2,2-di-methylcyclo-propane-1-carboxylic acid, cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid), 3-phenoxybenzoic acid (3-PBA), and 4-fluoro-3-PBA are biomarkers for exposure to phenothrin, tetramethrin, cyfluthrin, cypermethrin, deltamethrin, and permethrin. In this study, the pyrethroid metabolites in workers' urine samples were monitored for the first time with a novel sample pretreatment process combining hollow fiber liquid phase microextraction (HF-LPME) and in-syringe derivatization (ISD) followed by gas chromatography-electron capture detector (GC-ECD) analysis. A micro-syringe pre-filled with derivatizing agents and syringe needle connected to an extracting solvent impregnated hollow fiber segment was used as the LPME probe. Pyrethroid metabolites were extracted and enriched simultaneously from urine samples by HF-LPME sampling and acid hydrolysis at 70 °C for 10 min. After sampling, the ISD was performed by mixing the extracting solution and derivatizing agents through plunger movements, followed by GC-ECD analysis. Parameters influencing the HF-LPME efficiency and ISD were investigated and optimized. Under optimum conditions, the method provided enrichment factors of 69.8-154.6, repeatability from 5.0 to 12% (n = 5), and good linearity (R(2) = 0.9980-0.9998) for interested analytes spiked in urine samples. The method detection limits ranged from 1.6 to 17 ng/mL. A comparison was performed between the proposed method and conventional methods. The proposed method was applied to analyze pyrethroid metabolites in the urine samples collected from workers of pesticide formulation plants. The results suggested that the proposed HF-LPME coupled ISD method was a rapid, simple, efficient, and eco-friendly technique in the biomonitoring of metabolites of pyrethroids in workers' urine.

  18. Error free physically unclonable function with programmed resistive random access memory using reliable resistance states by specific identification-generation method

    Science.gov (United States)

    Tseng, Po-Hao; Hsu, Kai-Chieh; Lin, Yu-Yu; Lee, Feng-Min; Lee, Ming-Hsiu; Lung, Hsiang-Lan; Hsieh, Kuang-Yeu; Chung Wang, Keh; Lu, Chih-Yuan

    2018-04-01

    A high performance physically unclonable function (PUF) implemented with WO3 resistive random access memory (ReRAM) is presented in this paper. This robust ReRAM-PUF can eliminated bit flipping problem at very high temperature (up to 250 °C) due to plentiful read margin by using initial resistance state and set resistance state. It is also promised 10 years retention at the temperature range of 210 °C. These two stable resistance states enable stable operation at automotive environments from -40 to 125 °C without need of temperature compensation circuit. The high uniqueness of PUF can be achieved by implementing a proposed identification (ID)-generation method. Optimized forming condition can move 50% of the cells to low resistance state and the remaining 50% remain at initial high resistance state. The inter- and intra-PUF evaluations with unlimited separation of hamming distance (HD) are successfully demonstrated even under the corner condition. The number of reproduction was measured to exceed 107 times with 0% bit error rate (BER) at read voltage from 0.4 to 0.7 V.

  19. [Comparison of transverse short-axis classic and oblique long-axis "Syringe-Free" approaches for internal jugular venous catheterization under ultrasound guidance].

    Science.gov (United States)

    Ince, Ilker; Arı, Muhammet Ali; Sulak, Muhammet Mustafa; Aksoy, Mehmet

    2018-02-22

    There are different ultrasound probe positions used for internal jugular venous catheter placement. Also, in-plane or out of plane needle approach may be used for catheterization. Transverse short-axis classic approach is the most popular performed approach in literature. "Syringe-Free" is a new described technique that is performed with oblique long-axis approach. We aimed to compare performance of these two approaches. This study was conducted as a prospective and randomized study. 80 patients were included the study and divided into two groups that were named Group C (transverse short-axis classic approach) and Group SF (oblique long-axis syringe-free approach) by a computer-generated randomization. The primary outcome was mean time that guidewire is seen in the internal jugular vein (performing time). The secondary outcomes were to compare number of needle pass, number of skin puncture and complications between two groups. Demographic and hemodynamic data were not significantly different. The mean performing time was 54.9±19.1s in Group C and 43.9±15.8s in Group SF. Significant differences were found between the groups (p=0.006). Mean number of needle pass was 3.2(±2.1) in Group C and 2.1(±1.6) in Group SF. There were statistically significant differences between two groups (p=0.002). The number of skin puncture was 1.6(±0.8) and 1.2(±0.5) in Group C and SF, respectively (p=0.027). "Syringe-Free" technique has lower performing time, number of needle pass and skin puncture. Also, it allows to follow progress of guide-wire under continuous ultrasound visualization and the procedure does not need assistance during catheter insertion. Namely, "Syringe-Free" is effective, safe and fast technique that may be used to place internal jugular venous catheter. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Needle and syringe programmes and opioid substitution therapy for preventing HCV transmission among people who inject drugs: findings from a Cochrane Review and meta-analysis.

    Science.gov (United States)

    Platt, Lucy; Minozzi, Silvia; Reed, Jennifer; Vickerman, Peter; Hagan, Holly; French, Clare; Jordan, Ashly; Degenhardt, Louisa; Hope, Vivian; Hutchinson, Sharon; Maher, Lisa; Palmateer, Norah; Taylor, Avril; Bruneau, Julie; Hickman, Matthew

    2018-03-01

    To estimate the effects of needle and syringe programmes (NSP) and opioid substitution therapy (OST), alone or in combination, for preventing acquisition of hepatitis C virus (HCV) in people who inject drugs (PWID). Systematic review and meta-analysis. Bibliographic databases were searched for studies measuring concurrent exposure to current OST (within the last 6 months) and/or NSP and HCV incidence among PWID. High NSP coverage was defined as regular NSP attendance or ≥ 100% coverage (receiving sufficient or greater number of needles and syringes per reported injecting frequency). Studies were assessed using the Cochrane risk of bias in non-randomized studies tool. Random-effects models were used in meta-analysis. We identified 28 studies (n = 6279) in North America (13), United Kingdom (five), Europe (four), Australia (five) and China (one). Studies were at moderate (two), serious (17) critical (seven) and non-assessable risk of bias (two). Current OST is associated with 50% [risk ratio (RR) =0.50, 95% confidence interval (CI) = 0.40-0.63] reduction in HCV acquisition risk, consistent across region and with low heterogeneity (I 2  = 0, P = 0.889). Weaker evidence was found for high NSP coverage (RR = 0.79, 95% CI = 0.39-1.61) with high heterogeneity (I 2  = 77%, P = 0.002). After stratifying by region, high NSP coverage in Europe was associated with a 56% reduction in HCV acquisition risk (RR = 0.44, 95% CI = 0.24-0.80) with low heterogeneity (I 2  = 12.3%, P = 0.337), but not in North America (RR = 1.58, I 2  = 89.5%, P = Grades of Recommendation Assessment, Development and Evaluation (GRADE) criteria, the evidence on OST and combined OST/NSP is low quality, while NSP is very low. Opioid substitution therapy reduces risk of hepatitis C acquisition and is strengthened in combination with needle and syringe programmes (NSP). There is weaker evidence for the impact of needle syringe programmes alone, although stronger evidence

  1. Access and Ensuring Accessibility in the Regional Museum of Natural History (RMNH), Bhopal, India.

    Science.gov (United States)

    Venugopal, B.

    1999-01-01

    Identifies five types of museum accessibility: (1) physical; (2) socio-cultural; (3) economic; (4) sensory; and (5) intelligence/learning accessibility. Considers ways to coordinate museum services to ensure accessibility for potential museum patrons who are disabled. Describes various programs launched by the National Museum of Natural History in…

  2. CONTAMINATION OF ANTI-VEGF DRUGS FOR INTRAVITREAL INJECTION: How Do Repackaging and Newly Developed Syringes Affect the Amount of Silicone Oil Droplets and Protein Aggregates?

    Science.gov (United States)

    Schargus, Marc; Werner, Benjamin P; Geerling, Gerd; Winter, Gerhard

    2017-08-21

    The particle counts and the nature of particles of three different antivascular endothelial growth factor agents (VEGF) in different containers in a laboratory setting were compared. Original prefilled ranibizumab glass syringes, original vials with aflibercept, and repacked ready-to-use plastic syringes with bevacizumab from a compounding pharmacy and a compounding company (CC) were analyzed. Particle counts and size distributions were quantified by different particle characterization methods (nephelometry, light obscuration, Micro-Flow Imaging, nanotracking analysis, resonant mass measurement). Using high-performance size-exclusion chromatography (HP-SEC), levels of protein drug monomer and soluble aggregates were determined. Nearly all samples showed similar product quality. Light obscuration and Micro-Flow Imaging showed a 4-fold to 9-fold higher total particle count in compounding company bevacizumab (other samples up to 42,000 particles/mL). Nanotracking analysis revealed highest values for compounding company bevacizumab (6,375 million particles/mL). All containers showed similar amounts of silicone oil microdroplets. Ranibizumab showed lowest particle count of all tested agents with only one monomer peak in HP-SEC. Repackaged bevacizumab from different suppliers showed varying product quality. All three tested agents are available in similar quality regarding particulate purity and silicone oil microdroplet count. Repackaging can have a major impact on the quality.

  3. Fully automated dynamic in-syringe liquid-phase microextraction and on-column derivatization of carbamate pesticides with gas chromatography/mass spectrometric analysis.

    Science.gov (United States)

    Lee, Jingyi; Lee, Hian Kee

    2011-09-01

    A new fully automated dynamic in-syringe liquid-phase microextraction (LPME) and on-column derivatization approach, with gas chromatography/mass spectrometric (GC/MS) analysis, was developed to determine carbamate pesticides from water samples. With the use of a CTC CombiPal autosampler and its associated Cycle Composer software, a sample preparation-GC/MS method was enabled that allowed sample extraction, extract injection, and analyte derivatization to be carried out completely automatically. Optimization of extraction parameters was carried out by orthogonal array design which required a minimum of 16 experiments; the entire set of experiments was performed completely automatically and consecutively without any human intervention. Low limits of detection ranging from 0.05 to 0.1 μg/L were achieved for the carbamates. Effective enrichment of the analytes at a low concentration of 0.01 mg/L was also achieved (enrichment factors of between 57 and 138). The precision of the optimized method was satisfactory, with relative standard deviations of <6.0% (n = 6). High relative recoveries of between 81 and 125% were obtained when the method was applied to the analysis of real water samples, indicating that the sample matrix had little effect on the developed method. This automated dynamic in-syringe LPME approach demonstrated the feasibility of a complete analytical system comprising sample preparation and GC/MS that might be operated onsite, fully automatically without human intervention.

  4. A Practical Application of Solid-phase Extraction Using a Syringe Filled with Sorbent for the Determination of Lead and Cadmium in Water.

    Science.gov (United States)

    Ozbek, Nil; Turan, Gulcin Torunoglu; Senkal, Bahire Filiz; Akman, Suleyman

    2017-01-01

    In this study, at first the synthesis of 3-chloro-2-hydroxypropyl methacrylate-ethylene glycole dimethacrylate co-polymer beads and its modification with tris(2-aminoethyl) amine is described. Characterization of the polymer was done by FTIR and SEM. The functional co-polymer was filled in a disposable pipet tip and tightly connected to a 50-mL syringe for the separation and the enrichment of lead and cadmium prior to their determination by flame atomic absorption spectrometry. The sample and then the eluate were subsequently drawn and discharged to retain and desorb lead and cadmium by means of the syringe, respectively. Both analytes were quantitatively retained at pH 4 and eluted using 3.0 mol L -1 of HNO 3 at flow rates of approximately 10 mL min -1 . Under the optimum conditions, the enrichment factors of up to 50-fold both elements could be obtained by drawing and discharging 250 mL (5 × 50 mL) of the sample, and then 5 mL of the eluent. The recoveries were >90%. The limits of detection (3σ; N = 10 of blank) for Pb and Cd were 0.0034 and 0.0016 mg L -1 for a 50-fold enrichment, respectively. The analyte concentrations in a certified waste water reference agreed within the certified values in the 95% confidence range.

  5. Syringe needle-based sampling coupled with liquid-phase extraction for determination of the three-dimensional distribution of l-ascorbic acid in apples.

    Science.gov (United States)

    Tang, Sheng; Lee, Hian Kee

    2016-05-15

    A novel syringe needle-based sampling approach coupled with liquid-phase extraction (NBS-LPE) was developed and applied to the extraction of l-ascorbic acid (AsA) in apple. In NBS-LPE, only a small amount of apple flesh (ca. 10mg) was sampled directly using a syringe needle and placed in a glass insert for liquid extraction of AsA by 80 μL oxalic acid-acetic acid. The extract was then directly analyzed by liquid chromatography. This new procedure is simple, convenient, almost organic solvent free, and causes far less damage to the fruit. To demonstrate the applicability of NBS-LPE, AsA levels at different sampling points in a single apple were determined to reveal the spatial distribution of the analyte in a three-dimensional model. The results also showed that this method had good sensitivity (limit of detection of 0.0097 mg/100g; limit of quantification of 0.0323 mg/100g), acceptable reproducibility (relative standard deviation of 5.01% (n=6)), a wide linear range of between 0.05 and 50mg/100g, and good linearity (r(2)=0.9921). This interesting extraction technique and modeling approach can be used to measure and monitor a wide range of compounds in various parts of different soft-matrix fruits and vegetables, including single specimens. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Success factors for open access.

    Science.gov (United States)

    Till, James E

    2003-01-01

    Open access to the peer-reviewed primary research literature would greatly facilitate knowledge transfer between the creators and the users of the results of research and scholarship. Criteria are needed to assess the impact of recent initiatives, such as the Budapest Open Access Initiative. For example, how many open-access research journals exist within a given field, and what is the reputation of each one? And, how many openly-accessible institutional e-print archives have been created and how many are actually are being used by researchers and scholars? A simple approach to an assessment of the open-access portion of the medical literature is described, and some preliminary results are summarized. These preliminary results point to the need for incentives to foster the implementation of initiatives such as the Budapest Open Access Initiative. An example of an incentive model is proposed, where an agency or foundation that provides peer-reviewed grants-in-aid to researchers establishes an e-print archive. Only current grantees of the agency would be eligible to post reports about the results of research projects or programs that have been supported by the agency. Some advantages and implications of this particular model are outlined. It is suggested that incentive models of this kind are needed to increase the likelihood that open access to the primary medical research literature will soon reach a "tipping point" and move quickly toward wide acceptance.

  7. Inventário de ciclo de vida da manufatura de seringas odontológicas Life cycle inventory of dental syringes

    Directory of Open Access Journals (Sweden)

    Biagio F. Giannetti

    2008-01-01

    Full Text Available Uma das formas mais integradas, completas e eficazes para a gestão ambiental de atividades produtivas é baseada no ciclo de vida do produto, sendo a Avaliação do Ciclo de Vida sua principal ferramenta. O produto avaliado é a seringa odontológica tipo Carpule. O objetivo é a realização do Inventário de Ciclo de Vida (ICV simplificado da fabricação de seringas odontológicas tipo Carpule, visando quantificar o uso de energia elétrica e a emissão de resíduos sólidos desde a mineração até o descarte do produto. A estrutura metodológica está baseada nas normas da série NBR ISO 14.040 e ISO 14.040. As fronteiras do estudo incluem as etapas de mineração, beneficiamento e manufatura; a produção do polietileno que compõe o tubete e a embalagem da agulha; a produção do aço, utilizado na fabricação da agulha, e o uso do conjunto pelos dentistas. A unidade funcional utilizada é 10(6 (um milhão de anestesias aplicadas. Na avaliação de melhorias, as soluções propostas permitem reduzir o consumo de energia elétrica em aproximadamente 20% na etapa de manufatura. A quantidade de resíduos sólidos pode ser reduzida de 40% na etapa de manufatura, o que corresponde a aproximadamente 6,50% do total de resíduos sólidos no ciclo de vida da seringa odontológica.Among the methods proposed to environmental management of productive activities, Life Cycle Assessment is one of the most integrated, complete and efficacious. The product assessed is the dental carpule syringe. The aim of this work is to to perform a Streamlined Life Cycle Inventory (LCI to quantify the electric energy consumption and the solid waste release from dental carpule syringes manufacture. The methodological structure is based on NBR ISO 14.040 and ISO 14.040 series. The LCI covers the syringe life cycle from mining to disposal. The limits of the system include the stages of copper and zinc mining and ore beneficiation; the production of polyethylene used for

  8. Impact of flushing with aseptic non-touch technique using pre-filled flush or manually prepared syringes on central venous catheter occlusion and bloodstream infections in pediatric hemato-oncology patients: A randomized controlled study.

    Science.gov (United States)

    Gerçeker, Gülçin Özalp; Sevgili, Seda Ardahan; Yardımcı, Figen

    2018-04-01

    To compare standardized flushing methods with aseptic non-touch technique; (1) Manually prepared syringes (2) Single-use prefilled flush syringes. Forty-eight PHO patients with Hickman or Port catheters were recruited to participate in a prospective, randomized study. Standardized flushing methods with aseptic non-touch technique (ANTT) using single-use pre-filled flush syringes (intervention group) or manually prepared syringes (control group) also included the pulsatile technique, use of 10-mL syringe size with 0.9% NaCl for flushing, flushing once a day, flushing training of the nurses. The effects of standardized flushing methods on occlusion and CLABSI evaluated. Of the patients in the intervention group, 8.7% (n: 2) had catheter occlusion, while this rate was 20.0% (n: 5) in the control group. Of the patients in the intervention group, 8.7% (n: 2) had CLABSI, while this rate was 36.0% (n: 9) in the control group. While there was no difference in occlusion, there was a difference between the groups in terms of CLABSI development. In the intervention group, CLABSI rate was 1.9/1000 per catheter-days, in the control group CLABSI rate was 10.1/1000 per catheter-days. In the intervention group, occlusion rate was 1.9/1000 per catheter-days, in the control group, occlusion rate was 5.6/1000 per catheter-days. Standardized flushing and single-use prefilled flush syringes are effective in reducing CLABSI rates in PHO patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. VT Limited Access Highways

    Data.gov (United States)

    Vermont Center for Geographic Information — A limited-access road, known by various terms worldwide, including limited-access highway, dual carriageway, expressway, and partial controlled access highway, is a...

  10. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    and accessibility. Sensory accessibility accommodates aspects of a sensory disability and describes architectural design requirements needed to ensure access to architectural experiences. In the context of architecture accessibility has become a design concept of its own. It is generally described as ensuring...... physical access to the built environment by accommodating physical disabilities. While the existing concept of accessibility ensures the physical access of everyone to a given space, sensory accessibility ensures the choice of everyone to stay and be able to participate and experience....

  11. Fishing Access Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — The Vermont Fish & Wildlife Department maintains developed fishing access areas. These sites provide public access to waters in Vermont for shore fishing...

  12. Teaching Accessibility Standards to Generation Y Students

    Science.gov (United States)

    Klitzing, Sandra

    2011-01-01

    The Americans with Disabilities Act (ADA) of 1990 mandated that facilities and programs are accessible, so people with disabilities can be included in all aspects of community life including recreation (Dattilo, 2002). Understanding accessibility standards is not an easy task. Educators are faced with the challenge of teaching technical content,…

  13. Access to major overseas research facilities

    International Nuclear Information System (INIS)

    Bolderman, J. W.

    1997-01-01

    This paper will describe four schemes which have been established to permit Australian researchers access to some of the most advanced overseas research facilities. These include, access to Major Research Facilities Program, the Australian National Beamline Facility at the Photon Factory, the Australian Synchrotron Research Program and the ISIS Agreement. The details of each of these programs is discussed and the statistics on the scientific output provided. All programs are managed on behalf of the Department of Industry, Science and Tourism by the Australian Nuclear Science and Technology Organisation. One hundred and thirteen senior scientists plus forty, one postgraduate, students were supported through these schemes during the 1996-1997 financial year

  14. Open versus Controlled-Access Data | Office of Cancer Genomics

    Science.gov (United States)

    OCG employs stringent human subjects’ protection and data access policies to protect the privacy and confidentiality of the research participants. Depending on the risk of patient identification, OCG programs data are available to the scientific community in two tiers: open or controlled access. Both types of data can be accessed through its corresponding OCG program-specific data matrix or portal. Open-access Data

  15. The state-led large scale public private partnership 'Chiranjeevi Program' to increase access to institutional delivery among poor women in Gujarat, India: How has it done? What can we learn?

    Science.gov (United States)

    De Costa, Ayesha; Vora, Kranti S; Ryan, Kayleigh; Sankara Raman, Parvathy; Santacatterina, Michele; Mavalankar, Dileep

    2014-01-01

    Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. District level institutional delivery data (public, private, CY), national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000-2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. Institutional delivery rose from 40.7% (2001) to 89.3% (2010), driven by sharp increases in private sector deliveries. Public sector and CY contributed 25-29% and 13-16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women's access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require sections receive these. Other issues to explore include

  16. JISC Open Access Briefing Paper

    OpenAIRE

    Swan, Alma

    2005-01-01

    What Open Access is. What Open Access is not. How is Open Access provided? Open Access archives or repositories. Open Access journals. Why should authors provide Open Access to their work? Further information and resources

  17. Effervescence-assisted β-cyclodextrin/attapulgite composite for the in-syringe dispersive solid-phase extraction of pyrethroids in environmental water samples.

    Science.gov (United States)

    Yang, Xiaoling; Zhang, Panjie; Li, Xiaobing; Hu, Lu; Gao, Haixiang; Zhang, Sanbing; Zhou, Wenfeng; Lu, Runhua

    2016-06-01

    In this research, an effervescence-assisted β-cyclodextrin/attapulgite composite (β-CD/ATP) for the in-syringe dispersive solid-phase extraction (EAIS-DSPE) of pyrethroids in environmental samples was developed for the first time. A syringe was used to conduct the extraction procedure and a small amount of β-CD/ATP was dispersed into the solution with the release of carbon dioxide when the effervescent tablet components dissolved in water. Then, the sorbent was recovered using a filter membrane, and the analytes were directly eluted using acetonitrile. In the process, the β-CD/ATP sorbent resulted in an excellent extraction efficiency compared to commercially available sorbents such as C18 and HLB. Moreover, in the extraction procedure, both the β-cyclodextrin inclusion interactions (especially the hydrophobic effects) and the special structure of the ATP contributed to the efficient enrichment of pyrethroids in aqueous media. The amount of β-CD/ATP sorbent, the volume of desorption, the ratio of NaH2PO4/Na2CO3, the volume of the sample, and the pH were screened using a Plackett-Burman design. All factors affecting the procedure were optimized by applying a central composite design. Under the optimized conditions, a good repeatability (RSDs) ranging from 1.7 to 2.3, linearity (2.5-500μgL(-1)), limits of detection (LODs) (0.15-1.03μgL(-1)), and an acceptable recoveries (76.8-86.5%) were achieved. Finally, the proposed method was successfully applied for the determination of pyrethroids in environmental samples including river water, reservoir water and lake water. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Development of new portable miniaturize solid phase microextraction of silver-APDC complex using micropipette tip in-syringe system couple with electrothermal atomic absorption spectrometry.

    Science.gov (United States)

    Naeemullah; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shah, Faheem; Arain, Sadaf Sadia; Arain, Salma Aslam; Panhwar, Abdul Haleem; Arain, Mariam Shahzadi; Samoon, Muhammad Kashif

    2016-02-05

    An innovative and simple miniaturized solid phase microextraction (M-SPME) method, was developed for preconcentration and determination of silver(I) in the fresh and waste water samples. For M-SPME, a micropipette tip packed with activated carbon cloth (ACC) as sorbent, in a syringe system. The size, morphology and elemental composition of ACC before and after adsorption of analyte have been characterized by scanning electron microscopy and energy dispersive spectroscopy. The sample solution treated with a complexing reagent, ammonium pyrrolidine dithiocarbamate (APDC), was drawn into the syringe filled with ACC and dispensed manually for 2 to 10 aspirating/dispensing cycle. Then the Ag- complex sorbed on the ACC in micropipette was quantitatively eluted by drawing and dispensing of different concentrations of acids for 2 to 5 aspirating/dispensing cycles. The extracted Ag ions with modifier were injected directly into the electrothermal atomic absorption spectrometry for analysis. The influence of different variables on the extraction efficiency, including the concentration of ligand, pH, sample volume, eluent type, concentration and volume was investigated. Validity and accuracy of the developed method was checked by the standard addition method. Reliability of the proposed methodology was checked by the relative standard deviation (%RSD), which was found to be <5%. Under the optimized experimental variables, the limits of detection (LOD) and enhancement factors (EF), were obtained to be 0.86 ng L(-1) and 120, respectively. The proposed method was successfully applied for the determination of trace levels of silver ions in fresh and waste water samples. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Programming F#

    CERN Document Server

    Smith, Chris

    2009-01-01

    Why learn F#? This multi-paradigm language not only offers you an enormous productivity boost through functional programming, it also lets you develop applications using your existing object-oriented and imperative programming skills. With Programming F#, you'll quickly discover the many advantages of Microsoft's new language, which includes access to all the great tools and libraries of the .NET platform. Learn how to reap the benefits of functional programming for your next project -- whether it's quantitative computing, large-scale data exploration, or even a pursuit of your own. With th

  20. Accessing Substance Abuse Prevention Programs for Schools

    Science.gov (United States)

    Schroeder, Jennifer L.; Johnson, Gail E.

    2009-01-01

    Current estimates indicate that over 6 million children live with at least one parent who is a substance abuser or is substance dependent. Children who are exposed to drug and alcohol abuse are at a greater risk of experiencing academic and behavior difficulties. Additionally, several studies have shown that students with emotional and behavioral…