[Current treatment concepts for olecranon and prepatellar bursitis in Austria].

Science.gov (United States)

Baumbach, S F; Michel, M; Wyen, H; Buschmann, C T; Kdolsky, R; Kanz, K-G

2013-04-01

The limited evidence available on the diagnosis and treatment of olecranon and prepatellar bursitis indicates nationally varying treatment approaches. Therefore the aim of this study was to survey the current treatment concepts of olecranon and prepatellar bursitis in Austria. An online questionnaire comprising of demographic data, questions regarding diagnostics and differentiation between septic bursitis (SB) and non-septic bursitis (NSB) as well as two case reports for therapy appraisal were sent to members of the Austrian Society of Orthopaedics and Orthopaedic Surgery (ÖGO) and the Austrian Society of Traumatology (ÖGU). The overall response rates were 46 % (ÖGU)/12 % (ÖGO). Differentiation between SB and NSB was predominantly based on medical history/clinical presentation (ÖGU: 100 %/ÖGO: 84 %) and blood sampling (ÖGU: 82 %/ÖGO: 77 %). 64/36 % of surveyed members of ÖGO/OGU performed a bursal aspiration. 95/55 % of Austrian ÖGU opinion leaders favoured a surgical treatment approach in cases of SB/NSB. Conversely, ÖGO members rather favoured a conservative treatment approach (28/27 %). Significant differences were found between ÖGO and ÖGU, with the latter favouring a surgical treatment approach in cases of SB and NSB. However, the international literature argues for a conservative treatment approach. Further high quality research is needed to establish an evidence-based treatment approach. Georg Thieme Verlag KG Stuttgart · New York.

Plain film emergency radiology of child abuse: a strategy; Die akute Roentgendiagnostik der Kindesmisshandlung: Eine Strategie

Energy Technology Data Exchange (ETDEWEB)

Oestreich, A.E. [Children`s Hospital Medical Center, Cincinnati OH (United States). Dept. of Radiology

1998-04-01

A strategy is proposed for the dedicated interpretation of possible radiographic plain film signs that are suspicious for indicating child abuse. For each sign, the features `PRO` raise the question of abuse, while radiographic or clinical findings `CON` suggest an alternate explanation. Birth trauma, oesteogenesis imperfecta, rescue trauma, and metastatic neuroblastoma are among the many entities cited. A triad of situations may lead a radiologist to look systematically for changes from abuse; a triad of resolutions may result from the search. Periosteal reaction is the major factor in dating of fractures; physiologic periosteal reaction of infancy and periosteal reaction from previous fracture must be considered when so dating fractures. (orig.) [Deutsch] Es wird eine Strategie fuer die genaue Interpretation roentgenologischer Befunde, die auf eine Kindesmisshandlung hindeuten koennen, vorgeschlagen. Fuer jeden Befund werfen die unter `PRO` aufgefuehrten Merkmale die Frage nach einer Kindesmisshandlung auf, waehrend radiologische und klinische Befunde unter `CON` andere Erklaerungen nahelegen. Geburtstrauma, Osteogenesis imperfecta, Rettungstrauma und metastasierendes Neuroblastom sind unter den vielen zitierten Differentialdiagnosen. Drei moegliche Situationen koennen den Radiologen dazu veranlassen, systematisch nach Zeichen einer Kindesmisshandlung zu suchen, 3 moegliche Loesungen koennen aus dieser Suche hervorgehen. Eine Periostreaktion ist ein Kardinalbefund zur Datierung von Frakturen. Physiologische Periostreaktionen im fruehen Kindesalter und Periostreaktionen durch fruehere Frakturen muessen bei einer solchen Datierung von Frakturen mitbedacht werden. (orig.)

[Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy].

Science.gov (United States)

Taubner, Svenja; Volkert, Jana; Gablonski, Thorsten-Christian; Rossouw, Trudie

2017-07-01

Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.

Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment.

Science.gov (United States)

Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa; Vogel, Jörg; Madsen, Henrik Tækker; Hélix-Nielsen, Claus; Jansen, Jes la Cour; Jönsson, Karin

2018-02-01

Municipal wastewater treatment commonly involves mechanical, biological and chemical treatment steps to protect humans and the environment from adverse effects. Membrane technology has gained increasing attention as an alternative to conventional wastewater treatment due to increased urbanization. Among the available membrane technologies, microfiltration (MF) and forward osmosis (FO) have been selected for this study due to their specific characteristics, such as compactness and efficient removal of particles. In this study, two treatment concepts were evaluated with regard to their specific electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from bench- and pilot-scale experiments applying direct MF and FO, respectively. Additionally, available complementary data from a Swedish full-scale wastewater treatment plant and the literature were used to evaluate the concepts in depth. The results of this study indicate that both concepts are net positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area-efficient manner with techniques that are already commercially available and with future membrane technology.

An innovative treatment concept for future drinking water production : Fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

NARCIS (Netherlands)

Li, S.; Heijman, S.G.J.; Verberk, J.Q.J.C.; Van Dijk, J.C.

2009-01-01

A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX), ultrafiltration (UF), nanofiltration (NF), and granular activated carbon filtration (GAC). The FIEX process removed

Whole Brain Irradiation With Hippocampal Sparing and Dose Escalation on Multiple Brain Metastases: A Planning Study on Treatment Concepts

International Nuclear Information System (INIS)

Prokic, Vesna; Wiedenmann, Nicole; Fels, Franziska; Schmucker, Marianne; Nieder, Carsten; Grosu, Anca-Ligia

2013-01-01

Purpose: To develop a new treatment planning strategy in patients with multiple brain metastases. The goal was to perform whole brain irradiation (WBI) with hippocampal sparing and dose escalation on multiple brain metastases. Two treatment concepts were investigated: simultaneously integrated boost (SIB) and WBI followed by stereotactic fractionated radiation therapy sequential concept (SC). Methods and Materials: Treatment plans for both concepts were calculated for 10 patients with 2-8 brain metastases using volumetric modulated arc therapy. In the SIB concept, the prescribed dose was 30 Gy in 12 fractions to the whole brain and 51 Gy in 12 fractions to individual brain metastases. In the SC concept, the prescription was 30 Gy in 12 fractions to the whole brain followed by 18 Gy in 2 fractions to brain metastases. All plans were optimized for dose coverage of whole brain and lesions, simultaneously minimizing dose to the hippocampus. The treatment plans were evaluated on target coverage, homogeneity, and minimal dose to the hippocampus and organs at risk. Results: The SIB concept enabled more successful sparing of the hippocampus; the mean dose to the hippocampus was 7.55 ± 0.62 Gy and 6.29 ± 0.62 Gy, respectively, when 5-mm and 10-mm avoidance regions around the hippocampus were used, normalized to 2-Gy fractions. In the SC concept, the mean dose to hippocampus was 9.8 ± 1.75 Gy. The mean dose to the whole brain (excluding metastases) was 33.2 ± 0.7 Gy and 32.7 ± 0.96 Gy, respectively, in the SIB concept, for 5-mm and 10-mm hippocampus avoidance regions, and 37.23 ± 1.42 Gy in SC. Conclusions: Both concepts, SIB and SC, were able to achieve adequate whole brain coverage and radiosurgery-equivalent dose distributions to individual brain metastases. The SIB technique achieved better sparing of the hippocampus, especially when a10-mm hippocampal avoidance region was used.

The Male Aesthetic Patient: Facial Anatomy, Concepts of Attractiveness, and Treatment Patterns.

Science.gov (United States)

Keaney, Terrence C; Anolik, Robert; Braz, André; Eidelman, Michael; Eviatar, Joseph A; Green, Jeremy B; Jones, Derek H; Narurkar, Vic A; Rossi, Anthony M; Gallagher, Conor J

2018-01-01

BACKGROUND: The number of nonsurgical aesthetic procedures performed in men is growing rapidly. However, there are limited data on treatment principles and goals for the male aesthetic patient. OBJECTIVE: To review the objective data available on male aging and aesthetics and to synthesize with expert opinion on treatment considerations specific to male patients. METHODS: Expert advisors met to discuss anatomical differences in male versus female facial anatomy related to aging, facial treatment preferences in aesthetically oriented men, and current dosing data for facial injectable treatments in male versus female patients. RESULTS: Symmetry, averageness, sexual dimorphism, and youthfulness are generally accepted as factors that contribute to the perception of attractiveness. There are differences between men and women in facial anatomy, concepts of attractiveness in the context of masculinity and femininity, and treatment objectives. A communication gap exists for men, as evidenced by the lack of information available online or by word of mouth about injectable treatments. CONCLUSIONS: Approaches to aesthetic consultation and treatment should differ between men and women based on the fundamental dissimilarities between the sexes. Educating men about available aesthetic treatments and about the safety and side effects associated with each treatment, as well as addressing concerns about their treatment results looking natural, are key considerations. J Drugs Dermatol. 2018;17(1):19-28..

Malaria in rural Burkina Faso: local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour

Directory of Open Access Journals (Sweden)

Kouyaté Bocar

2007-08-01

Full Text Available Abstract Background The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. Methods In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Results Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. Conclusion The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes.

Performance of UASB septic tank for treatment of concentrated black water within DESAR concept

NARCIS (Netherlands)

Kujawa-Roeleveld, K.; Fernandes, T.; Wiryawan, Y.; Tafwik, A.; Visser, de M.; Zeeman, G.

2005-01-01

Separation of wastewater streams produced in households according to their origin, degree of pollution and affinity to a specific treatment constitutes a starting point in the DESAR concept (decentralised sanitation and reuse). Concentrated black water and kitchen waste carry the highest load of

SLUDGE TREATMENT PROJECT COST COMPARISON BETWEEN HYDRAULIC LOADING AND SMALL CANISTER LOADING CONCEPTS

Energy Technology Data Exchange (ETDEWEB)

GEUTHER J; CONRAD EA; RHOADARMER D

2009-08-24

The Sludge Treatment Project (STP) is considering two different concepts for the retrieval, loading, transport and interim storage of the K Basin sludge. The two design concepts under consideration are: (1) Hydraulic Loading Concept - In the hydraulic loading concept, the sludge is retrieved from the Engineered Containers directly into the Sludge Transport and Storage Container (STSC) while located in the STS cask in the modified KW Basin Annex. The sludge is loaded via a series of transfer, settle, decant, and filtration return steps until the STSC sludge transportation limits are met. The STSC is then transported to T Plant and placed in storage arrays in the T Plant canyon cells for interim storage. (2) Small Canister Concept - In the small canister concept, the sludge is transferred from the Engineered Containers (ECs) into a settling vessel. After settling and decanting, the sludge is loaded underwater into small canisters. The small canisters are then transferred to the existing Fuel Transport System (FTS) where they are loaded underwater into the FTS Shielded Transfer Cask (STC). The STC is raised from the basin and placed into the Cask Transfer Overpack (CTO), loaded onto the trailer in the KW Basin Annex for transport to T Plant. At T Plant, the CTO is removed from the transport trailer and placed on the canyon deck. The CTO and STC are opened and the small canisters are removed using the canyon crane and placed into an STSC. The STSC is closed, and placed in storage arrays in the T Plant canyon cells for interim storage. The purpose of the cost estimate is to provide a comparison of the two concepts described.

SLUDGE TREATMENT PROJECT COST COMPARISON BETWEEN HYDRAULIC LOADING AND SMALL CANISTER LOADING CONCEPTS

International Nuclear Information System (INIS)

Geuther, J.; Conrad, E.A.; Rhoadarmer, D.

2009-01-01

The Sludge Treatment Project (STP) is considering two different concepts for the retrieval, loading, transport and interim storage of the K Basin sludge. The two design concepts under consideration are: (1) Hydraulic Loading Concept - In the hydraulic loading concept, the sludge is retrieved from the Engineered Containers directly into the Sludge Transport and Storage Container (STSC) while located in the STS cask in the modified KW Basin Annex. The sludge is loaded via a series of transfer, settle, decant, and filtration return steps until the STSC sludge transportation limits are met. The STSC is then transported to T Plant and placed in storage arrays in the T Plant canyon cells for interim storage. (2) Small Canister Concept - In the small canister concept, the sludge is transferred from the Engineered Containers (ECs) into a settling vessel. After settling and decanting, the sludge is loaded underwater into small canisters. The small canisters are then transferred to the existing Fuel Transport System (FTS) where they are loaded underwater into the FTS Shielded Transfer Cask (STC). The STC is raised from the basin and placed into the Cask Transfer Overpack (CTO), loaded onto the trailer in the KW Basin Annex for transport to T Plant. At T Plant, the CTO is removed from the transport trailer and placed on the canyon deck. The CTO and STC are opened and the small canisters are removed using the canyon crane and placed into an STSC. The STSC is closed, and placed in storage arrays in the T Plant canyon cells for interim storage. The purpose of the cost estimate is to provide a comparison of the two concepts described

ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

Energy Technology Data Exchange (ETDEWEB)

Rubin, Philip; Constine, Louis S. [Univ. Rochester Medical Center, NY (United States). Dept. of Radiation Oncology; Marks, Lawrence B. (ed.) [Univ. North Carolina and Lineberger, Comprehensive Cancer Center, Chapel Hill, NC (United States). Dept. of Radiation Oncology

2014-09-01

Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

International Nuclear Information System (INIS)

Rubin, Philip; Constine, Louis S.; Marks, Lawrence B.

2014-01-01

Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

[Alcoholism: definition, diagnosis, illness concept, follow-up, results and costs of treatment].

Science.gov (United States)

Feuerlein, W

1991-02-01

The article starts with a review on the definition of alcoholism stressing the useful differentiation between alcohol abuse and alcohol dependence. On the basis of this definition the principles of the diagnosis of alcoholism are demonstrated. The disease concept of alcoholism is discussed in detail. Then the aims, the structure and the results of the therapy for alcoholics are briefly described. The article concludes with a short cost-benefit analysis of the alcoholism treatment.

Concepts and treatment for diabetes among traditional and faith healers in the northern province, South Africa.

Science.gov (United States)

Peltzer, K; Khoza, L B; Lekhuleni, M E; Madu, S N; Cherian, V I; Cherian, L

2001-05-01

The purpose of the study was to assess the concepts and treatment modalities for diabetes among traditional and faith healers in the Northern Province in South Africa. The sample consisted of 50 traditional healers (13 females and 37 males) and 50 faith healers (12 females and 38 males). They were interviewed on local terminology, clinical manifestations, causes, curability, and treatment for diabetes, help-seeking behaviour of diabetes patients, and the healers' sources of information about diabetes. Results indicate that all healers were familiar with "diabetes", however, not all of them had seen patients suffering from diabetes. The perceived causes of diabetes by both traditional and faith healers could be divided into (1) diet (especially too much of sugar), (2) heredity, (3) supernatural, and (4) psychological causes. Most traditional healers (92%) and faith healers (90%) indicated that diabetes is curable. Treatments used by the healers in this study included the use of prayer, diet, and herbs. The authors conclude that the concepts and treatment modalities for diabetes among traditional and faith healers should be taken note of by health workers while developing health education programmes in the Province.

Integrated Evaluation Concept to Assess the Efficacy of Advanced Wastewater Treatment Processes for the Elimination of Micropollutants and Pathogens.

Science.gov (United States)

Ternes, Thomas A; Prasse, Carsten; Eversloh, Christian Lütke; Knopp, Gregor; Cornel, Peter; Schulte-Oehlmann, Ulrike; Schwartz, Thomas; Alexander, Johannes; Seitz, Wolfram; Coors, Anja; Oehlmann, Jörg

2017-01-03

A multidisciplinary concept has been developed to compare advanced wastewater treatment processes for their efficacy of eliminating micropollutants and pathogens. The concept is based on (i) the removal/formation of selected indicator substances and their transformation products (TPs), (ii) the assessment of ecotoxicity via in vitro tests, and (iii) the removal of pathogens and antibiotic resistant bacteria. It includes substances passing biological wastewater treatment plants regulated or proposed to be regulated in the European Water Framework Directive, TPs formed in biological processes or during ozonation, agonistic/antagonistic endocrine activities, mutagenic/genotoxic activities, cytotoxic activities, further activities like neurotoxicity as well as antibiotics resistance genes, and taxonomic gene markers for pathogens. At a pilot plant, ozonation of conventionally treated wastewater resulted in the removal of micropollutants and pathogens and the reduction of estrogenic effects, whereas the in vitro mutagenicity increased. Subsequent post-treatment of the ozonated water by granular activated carbon (GAC) significantly reduced the mutagenic effects as well as the concentrations of remaining micropollutants, whereas this was not the case for biofiltration. The results demonstrate the suitability of the evaluation concept to assess processes of advanced wastewater treatment including ozonation and GAC by considering chemical, ecotoxicological, and microbiological parameters.

Self-concept and the perception of facial appearance in children and adolescents seeking orthodontic treatment.

Science.gov (United States)

Phillips, Ceib; Beal, Kimberly N Edwards

2009-01-01

To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need-Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients' diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Self-perception of the dentofacial region was the only statistically significant predictor (P self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. The self-perceived level of the attractiveness or "positive" feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion.

Essential role of radiation therapy for the treatment of pancreatic cancer. Novel study concepts and established treatment recommendations

International Nuclear Information System (INIS)

Dobiasch, Sophie; Goerig, Nicole L.; Fietkau, Rainer; Combs, Stephanie E.

2018-01-01

Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. (orig.) [de

Performance of UASB septic tank for treatment of concentrated black water within DESAR concept.

Science.gov (United States)

Kujawa-Roeleveld, K; Fernandes, T; Wiryawan, Y; Tawfik, A; Visser, M; Zeeman, G

2005-01-01

Separation of wastewater streams produced in households according to their origin, degree of pollution and affinity to a specific treatment constitutes a starting point in the DESAR concept (decentralised sanitation and reuse). Concentrated black water and kitchen waste carry the highest load of organic matter and nutrients from all waste(water)streams generated from different human activities. Anaerobic digestion of concentrated black water is a core technology in the DESAR concept. The applicability of the UASB septic tank for treatment of concentrated black water was investigated under two different temperatures, 15 and 25 degrees C. The removal of total COD was dependent on the operational temperature and attained 61 and 74% respectively. A high removal of the suspended COD of 88 and 94% respectively was measured. Effluent nutrients were mainly in the soluble form. Precipitation of phosphate was observed. Effective sludge/water separation, long HRT and higher operational temperature contributed to a reduction of E. coli. Based on standards there is little risk of contamination with heavy metals when treated effluent is to be applied in agriculture as fertiliser.

[ERRORS IN DIAGNOSIS AND TREATMENT OF IMMUNODEPENDENT PATHOLOGY (ORIGINAL CONCEPT)].

Science.gov (United States)

Kazmirchuk, V E; Tsaryk, V V; Maltsev, D V; Dyseeva, V V; Voytyuk, T V; Sidorenko, E I; Solon'ko, I I; Pyankova, A V

2015-01-01

Based on many years of experience in 2009, we developed the original concept of a mixed approach to the treatment of infectious diseases in patients. During 2.5 years(from 2013 to June 2015) to have applied for consultative-diagnostic help of 3965 patients who had not verified the primary diagnosis. The basic principle of verification of the pathology of the removal of various causes immunosuppression. Based on our extensive, research and observation was often found in patients ascaridosis (55%) and giardiasis (65%), as a possible cause of immunosuppression. In 13% of patients was found the mucosal candidiasis. Among frequently and chronically ill persons we identified the active forms of Epstein-Barr virus (quantitative polymerase chain reaction in saliva) in 40%. The criterion for assessing performance immunogram was a decrease of two sigmal deviation from the lower age limit. In the study of neutrophil myeloperoxidase content observed decline (Immunological study of patients should be redynamics after eliminating the causes immunosuppression and sanitation foci of infection. Only multi-level examination of the patient will determine the final diagnosis and adequate treatment.

Reciprocal effects of exercise and nutrition treatment-induced weight loss with improved body image and physical self-concept.

Science.gov (United States)

Annesi, James J; Porter, Kandice J

2015-01-01

Improvements in self-image and mood are often reported as outcomes of obesity interventions. However, they may also concurrently influence weight loss, suggesting a reciprocal effect. Although previously reported for overweight women, such relationships were untested in morbidly obese women whose psychosocial responses to treatment may be different, and health-risks greater. Women (N = 161, Meanage = 42 years) with morbid obesity (MeanBMI = 45.1 kg/m(2)) participated in a 6-month, behaviorally based physical activity and nutrition treatment. Significant within-group improvements in weight-loss behaviors (physical activity and eating), weight, body satisfaction, physical self-concept, and depression were found. After controlling for age, mediation analyses indicated that, as a result of the treatment, weight loss was both an outcome and mediator of improvements in body-areas satisfaction and physical self-concept (reciprocal effects), but not depression. Results replicated findings from women with lower degrees of overweight, and suggested that weight-loss treatments emphasize changes in self-perception.

Self-Concept and the Perception of Facial Appearance in Children and Adolescents Seeking Orthodontic Treatment

Science.gov (United States)

Phillips, Ceib; Beal, Kimberly N. Edwards

2009-01-01

Objective To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Methods and Materials Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need–Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients’ diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Results Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. Conclusion The self-perceived level of the attractiveness or “positive” feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion. PMID:19123700

Concept, design and equipment of a center for the treatment of radiation accidents at the Staedtisches Krankenhaus Muenchen-Schwabing

International Nuclear Information System (INIS)

Bogner, L.; Muehle, P.; Czempiel, H.; Henftling, H.G.

1987-01-01

The concept of the treatment center for radiation accidents at the Staedtisches Krankenhaus Muenchen-Schwabing is presented by means of a flow scheme for the treatment of different possible accidents. The resulting design and equipment are discussed in detail. (orig.) [de

Current concepts in the classification, diagnosis and treatment of vascular anomalies

International Nuclear Information System (INIS)

Ernemann, Ulrike; Kramer, Ulrich; Miller, Stephan; Bisdas, Sotirios; Rebmann, Hans; Breuninger, Helmut; Zwick, Christine; Hoffmann, Juergen

2010-01-01

Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise β-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions.

Current concepts in the classification, diagnosis and treatment of vascular anomalies

Energy Technology Data Exchange (ETDEWEB)

Ernemann, Ulrike, E-mail: ulrike.ernemann@med.uni-tuebingen.d [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Kramer, Ulrich; Miller, Stephan [Department of Diagnostic and Interventional Radiology, Radiological Clinic, University Hospital Tuebingen (Germany); Bisdas, Sotirios [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Rebmann, Hans [Department of Paediatrics, Children' s Hospital, University Hospital Tuebingen (Germany); Breuninger, Helmut [Department of Dermatology, University Hospital Tuebingen (Germany); Zwick, Christine [Department of Hand, Plastic, Reconstructive and Burns Surgery, BG Trauma Clinic Tuebingen, University Hospital Tuebingen (Germany); Hoffmann, Juergen [Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen (Germany)

2010-07-15

Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise {beta}-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions.

The Nepalese traditional concepts of illness and treatment

Directory of Open Access Journals (Sweden)

Prem K. Khatry

2011-12-01

Full Text Available The relation between magic, religion and therapy in Nepal is analyzed here in the context of the widest process of medicalization which takes place at global level. The Nepalese indigenous system of diagnosis, treatment and healing has evolved evolved in a process of trial-and-error, empirical observation and experimental procedure. The article suggests that it is an on-going process not dissimilar to modern medicine. The concept of disease does not include the germ theory but rather the theory that the essence of the body has been captured by some external power. Task of the healer is to try to release the soul or balance the system establishing “normal” functions. The article provides the description of multiple roles related to the diagnostic process and gives ethnographic case-studies of the relation between traditional and modern medicine. Government and private agencies are described as working in the rural areas with the healers in order to use their clout to take the modern health-package to the most remote communities and to reduce the mortality rate.

Treatment of waste incinerator air-pollution-control residues with FeSO4: Concept and product characterization

DEFF Research Database (Denmark)

Lundtorp, Kasper; Jensen, Dorthe Lærke; Sørensen, Mette Abildgaard

2002-01-01

This paper describes a new concept for treatment of air- pollution-control (APC) residues from waste incineration and characterises the wastewater and stabilised residues generated by the process. The process involves mixing of APC-residues with a ferrous sulphate solution and subsequent oxidation...

Recovery concept in a Norwegian setting to be examined by the assertive community treatment model and mixed methods.

Science.gov (United States)

Lofthus, Ann-Mari; Westerlund, Heidi; Bjørgen, Dagfinn; Lindstrøm, Jonas Christoffer; Lauveng, Arnhild; Rose, Diana; Ruud, Torleif; Heiervang, Kristin

2018-02-01

Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open-ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the "Users interview users" method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society. © 2016 Australian College of Mental Health Nurses Inc.

[Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

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Huan, J N

2017-04-20

Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

Application of super-omni wedge concept to conformal radiotherapy treatment planning

International Nuclear Information System (INIS)

Dai Jianrong; Fu Weihua; Hu Yimin

2004-01-01

Objective: To describe a method which can optimize beam weight, wedge angle, and wedge orientation simultaneously by combining the super-omni wedge (SOW) concept with the function of beam weight optimization provided by a commercial treatment planning system. Methods: A five-step procedure including: Step 1. To set up four 60 degree nominal wedged beams for each beam direction with the wedge orientations of 'LEFT', 'IN', 'RIGHT', 'OUT', respectively; Step 2. To define an optimization request, including an optimization goal and constraints. Authors use CMS Focus treatment planning system which allows us to choose 'maximize target dose' or 'minimize critical structure dose' as the optimization goal, and to set minimum target dose, maximum target dose, and maximum average dose of critical structures as constraints. Then the optimization process was launched as step 3; Step 4. To evaluate the plan using isodose distributions and dose-volume histograms. If acceptable, go to Step 5. Otherwise, go back to Step 2 to modify optimization constraints; and Step 5. Transform the SOW beams into the beams of omni wedge so as to reduce the number of to-be-delivered beams. Results: This procedure was found being able to demonstrate successfully in two clinical cases: an esophageal carcinoma and a brain tumor. Compared with manually designed plan, the optimized plan showed better dose homogeneity in the targets and better sparing of the critical structures. Conclusions: This method described is able to optimize beam weights while working with a treatment planning system. Not only does it improve treatment plans' quality, but also shorten the treatment planning process

The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment

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Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

2017-01-01

Background The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). Methods The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. Findings The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Conclusion Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them. PMID:29299211

The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment.

Science.gov (United States)

Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

2017-04-01

The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them.

Photodynamic therapy in neurosurgery: a proof of concept of treatment planning system

Science.gov (United States)

Dupont, C.; Reyns, N.; Mordon, S.; Vermandel, M.

2017-02-01

Glioblastoma (GBM) is the most common primary brain tumor. PhotoDynamic Therapy (PDT) appears as an interesting research field to improve GBM treatment. Nevertheless, PDT cannot fit into the current therapeutic modalities according to several reasons: the lack of reliable and reproducible therapy schemes (devices, light delivery system), the lack of consensus on a photosensitizer and the absence of randomized and controlled multicenter clinical trial. The main objective of this study is to bring a common support for PDT planning. Here, we describe a proof of concept of Treatment Planning System (TPS) dedicated to interstitial PDT for GBM treatment. The TPS was developed with the integrated development environment C++ Builder XE8 and the environment ArtiMED, developed in our laboratory. This software enables stereotactic registration of DICOM images, light sources insertion and an accelerated CUDA GPU dosimetry modeling. Although, Monte-Carlo is more robust to describe light diffusion in biological tissue, analytical model accelerated by GPU remains relevant for dose preview or fast reverse planning processes. Finally, this preliminary work proposes a new tool to plan interstitial or intraoperative PDT treatment and might be included in the design of future clinical trials in order to deliver PDT straightforwardly and homogenously in investigator centers.

An innovative concept for handling and operation of the wastewater treatment plant of Cottbus

International Nuclear Information System (INIS)

Spiller, K.; Schmitt, J.

1994-01-01

A new concept for handling and operating the wastewater treatment plant of Cottbus, with computerized modelling and an expert system as integral parts of process analysis and decision-making, is developed. Optimized plant operation and process stability is to be achieved by conrolling process-dependent dosage of wastewater coming from sludge treatment and from faecal wastewater. With the treatment plant still being built, a thorough analysis of the influent and the resulting process conditions is done, using the computerized model. Results and consequences for process optimization are presented in this article. Special attention has to be given to load smoothing and optimization of denitrification, influencing process stability and quality. Thereby not only the legal requirements can be fulfilled but improvement of effluent quality also could be achieved, reducing total nitrogen in the effluent by as much as 50%, lowering wastewater treatment costs by allowing lower control levels and fees to be payed. (orig.) [de

Surgical treatment of severe osteoporosis including new concept of advanced severe osteoporosis

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Jin Hwan Kim

2017-12-01

Full Text Available Severe osteoporosis is classified as those with a bone mineral density (BMD T-score of −2.5 or lower, and demonstrate one or more of osteoporotic, low-trauma, fragility fractures. According to the general principle of surgical approach, patients with severe osteoporosis require not only more thorough pre- and postoperative treatment plans, but improvements in surgical fixtures and techniques such as the concept of a locking plate to prevent bone deformity and maximizing the blood flow to the fracture site by using a minimally invasive plate osteosynthesis. Arthroplasty is often performed in cases of displaced femoral neck fracture. Otherwise internal fixation for the goal of bone union is the generally accepted option for intertrochanteric, subtrochanteric, and femoral shaft fractures. Most of osteoporotic spine fracture is stable compression fracture, but vertebroplasty or kyphoplasty may be performed some selective patients. If neurological paralysis, severe spinal instability, or kyphotic deformity occurs, open decompression or fusion surgery may be considered. In order to overcome shortcomings of the World Health Organization definition of osteoporosis, we proposed a concept of ‘advanced severe osteoporosis,’ which is defined by the presence of proximal femur fragility fracture or two or more fragility fractures in addition to BMD T-score of −2.5 or less. In conclusion, we need more meticulous approach for surgical treatment of severe osteoporosis who had fragility fracture. In cases of advanced severe osteoporosis, we recommend more aggressive managements using parathyroid hormone and receptor activator of nuclear factor kappa-B ligand monoclonal antibody.

The Genealogy of Epistemic Virtue Concepts | Thomas ...

African Journals Online (AJOL)

This paper examines the treatment of thick ethical concepts in Williams's work in order to evaluate the consistency of his treatment of ethical and epistemic concepts and to assess whether the idea of a thick concept can be extended from ethics to epistemology. A virtue epistemology is described modeled on a cognitivist ...

Promoting a Positive Middle School Transition: A Randomized-Controlled Treatment Study Examining Self-Concept and Self-Esteem.

Science.gov (United States)

Coelho, Vitor Alexandre; Marchante, Marta; Jimerson, Shane R

2017-03-01

The middle school transition is a salient developmental experience impacting adolescents around the world. This study employed a randomized-controlled treatment design, with randomization at the school level, to investigate the impact of a school adjustment program for middle school transition and potential gender differences. Participants included 1147 students (M age  = 9.62; SD = 0.30, 45.7 % girls), who were assessed at four time points during the transition, regarding five dimensions of self-concept (academic, social, emotional, physical and family) and self-esteem. Parallel growth curves were employed to analyze the evolution of self-concept. Following the transition to middle school, students reported lower levels of self-concept (academic, emotional and physical) and self-esteem, while participation in the intervention led to increases in self-esteem and gains in social self-concept. No gender differences were found. These results provide preliminary evidence supporting such interventions in early middle school transitions.

Hydrothermal Treatment (HTT) of Microalgae: Evaluation of the Process As Conversion Method in an Algae Biorefinery Concept

NARCIS (Netherlands)

Garcia Alba, Laura; Torri, C.; Samori, C.; van der Spek, J.J.; Fabbri, D.; Kersten, Sascha R.A.; Brilman, Derk Willem Frederik

2012-01-01

The hydrothermal treatment (HTT) technology is evaluated for its potential as a process to convert algae and algal debris into a liquid fuel, within a sustainable algae biorefinery concept in which, next to fuels (gaseous and liquid), high value products are coproduced, nutrients and water are

Designing a concept for an IT-infrastructure for an integrated research and treatment center.

Science.gov (United States)

Stäubert, Sebastian; Winter, Alfred; Speer, Ronald; Löffler, Markus

2010-01-01

Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform.

Nitrous Oxide for Treatment-Resistant Major Depression: A Proof-of-Concept Trial.

Science.gov (United States)

Nagele, Peter; Duma, Andreas; Kopec, Michael; Gebara, Marie Anne; Parsoei, Alireza; Walker, Marie; Janski, Alvin; Panagopoulos, Vassilis N; Cristancho, Pilar; Miller, J Philip; Zorumski, Charles F; Conway, Charles R

2015-07-01

N-methyl-D-aspartate receptor antagonists, such as ketamine, have rapid antidepressant effects in patients with treatment-resistant depression (TRD). We hypothesized that nitrous oxide, an inhalational general anesthetic and N-methyl-D-aspartate receptor antagonist, may also be a rapidly acting treatment for TRD. In this blinded, placebo-controlled crossover trial, 20 patients with TRD were randomly assigned to 1-hour inhalation of 50% nitrous oxide/50% oxygen or 50% nitrogen/50% oxygen (placebo control). The primary endpoint was the change on the 21-item Hamilton Depression Rating Scale (HDRS-21) 24 hours after treatment. Mean duration of nitrous oxide treatment was 55.6 ± 2.5 (SD) min at a median inspiratory concentration of 44% (interquartile range, 37%-45%). In two patients, nitrous oxide treatment was briefly interrupted, and the treatment was discontinued in three patients. Depressive symptoms improved significantly at 2 hours and 24 hours after receiving nitrous oxide compared with placebo (mean HDRS-21 difference at 2 hours, -4.8 points, 95% confidence interval [CI], -1.8 to -7.8 points, p = .002; at 24 hours, -5.5 points, 95% CI, -2.5 to -8.5 points, p nitrous oxide and placebo, p nitrous oxide compared with one patient (5%) and none after placebo (odds ratio for response, 4.0, 95% CI, .45-35.79; OR for remission, 3.0, 95% CI, .31-28.8). No serious adverse events occurred; all adverse events were brief and of mild to moderate severity. This proof-of-concept trial demonstrated that nitrous oxide has rapid and marked antidepressant effects in patients with TRD. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Evaluation of injuries of the upper cervical spine in a postmortem study with digital radiography, CT and MRI; Evaluation experimentell erzeugter Verletzungen der oberen Halswirbelsaeule mit digitaler Roentgentechnik, Computertomographie und Magnetresonanztomographie

Energy Technology Data Exchange (ETDEWEB)

Obenauer, S.; Herold, T.; Fischer, U.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik; Fadjasch, G.; Saternus, K.S. [Goettingen Univ. (Germany). Abt. fuer Rechtsmedizin; Koebke, J. [Koeln Univ. (Germany). Anatomisches Inst.

1999-12-01

obere Halswirbelsaeulen-Praeparate wurden nach definiertem Rotationstrauma sowie nach Praeparation mittels digitaler Roentgentechnik (DIMA Soft P41, Fa. Feinfokus), mittels CT (CTi, High Speed, GE) in konventioneller und in Spiraltechnik (Kollimation 1 mm, Pitch 1.0) sowie mit Hilfe der MRT (Magnetom Vision Siemens) in 2D- und 3D-Technik untersucht. Ergebnisse: Die Praeparation zeigte 6 Wirbelkoerperfrakturen, 5 Densfrakturen, 1 Fraktur des vorderen Atlasbogens, 4 knoecherne Ausrisse an den okzipitalen Kondylen und 6 Laesionen der Ligg. alaria. Die digitale Praeparateradiographie dokumentierte alle Frakturen und die 4 knoechernen Ausrissfrakturen am Condylus occipitalis. In der CT konnten alle Frakturen und ligamentaeren Verletzungen erkannt werden. Die 2D MRT wies 9 Frakturen sicher und 3 fraglich nach; die 3D MRT zeigte 7 Frakturen sicher und 5 fraglich. Von den 4 Ausrissfrakturen konnten 2 mit der 2D MRT und 1 mit der 3D MRT nachgewiesen werden. Ligamentaere Verletzungen waren sicher in der 2D MRT in 2/6 Faellen und in der 3D MRT in 1 Fall zu erkennen. Diskussion: In postmortalen Studien zeigt die CT gegenueber der digitalen Radiographie und der MRT in der Detektion von Frakturen und ligamentaeren Verletzungen der oberen Halswirbelsaeule eine Ueberlegenheit, wobei diese Ergebnisse nur bedingt auf Patienten nach Hochgeschwindigkeitstrauma uebertragbar sind. (orig.)

Development of a Web-based concept for patients with ulcerative colitis and 5-aminosalicylic acid treatment

DEFF Research Database (Denmark)

Elkjaer, Margarita; Burisch, Johan; Avnstrøm, Søren

2009-01-01

of life (QoL). Lack of easy access to inflammatory bowel disease clinics and patient education, their understanding of the importance of early treatment at relapse, poor compliance and self-adherence can be partly solved by a newly developed Web-based concept. AIMS: To describe the development......-treatment after the educational training (ET). A significant increase in knowledge from 36 to 69% (group A) and 28 to 75% (group B) was obtained. A majority of the patients were satisfied with the ET. Patients' QoL, anxiety, depression and general well-being showed no difference after the ET. CONCLUSION: Patient...

Isoeffect lines using TDF and CRE concepts

International Nuclear Information System (INIS)

Supe, S.J.; Sasane, J.B.; Gupta, M.K.; Supe, D.S.

1979-01-01

In most of the radiotherapy centres the treatment planning is based on isodose lines. Isoeffect lines are also being drawn based on the concepts of TDFs and CREs. A study has been made of whether the isoeffect lines based on the concepts of TDFs, CRes and the physical isodose lines are identical in all the treatment situations. Isoeffects lines for a few treatment schedules involving treatment of carcinoma of the bladder, treatment of cancer of the uterine cervix by combined intracavitary and external beam therapies and intracavitary therapy alone have been obtained and compared. The effect of treatment mode on the isoeffect lines has also been studied. It was found that the isodose curves and the isoeffect lines using the TDF and CRE concepts were not identical in all situations. Therefore, the ultimate treatment plans based on these isoeffect lines will not be exactly the same. The dependence of the isoeffect lines with the variation of the exponents of time and number of fractions used in the empirical relationship for NSD have also been investigated. Clinical trials have been initiated in the case of cancer of the bladder and cervix uterus based on the isodose curves and isoeffect lines using CRE and TDF concepts. (author)

The conception of municipal sewage treatment systems from an economical point of view

International Nuclear Information System (INIS)

Posch, A.

1999-09-01

The objective of this work is to show the fundamental decisions that are necessary for planning municipal sewage treatment systems in rural areas and to assess the consequences of the possible alternatives. The analysis shows that the specific costs depend strongly on the chosen technology, the structure of the system and the type of organization. For instance constructed wetlands used on small scales are much more favorable than complex technical sewage plants. Whether a central or decentral structured sewage treatment system is preferable depends on the local topographic conditions. The fact that private and cooperative organizations mostly cause lower costs per capita as public organizations can be explained with the principal-agent-theory of the New Institutional Economics. Further economical and important ecological criteria are discussed in the analysis, too. The conclusions drawn from analysis aim especially to improve the process of planing sewage treatment systems. Especially recommended are the implementation of a professional project management, a complete survey of the given local conditions, the use of modern planning methods, an early participation of the population, the particularly consideration of innovative technologies as well as the development of integrated concepts of water management. (author)

The evolution of the female sexual response concept: Treatment implications

Directory of Open Access Journals (Sweden)

Damjanović Aleksandar

2013-01-01

Full Text Available Sexual dysfunctions have been the most prevalent group of sexual disorders and include a large number of populations of both sexes. The research of sexual behavior and treatment of women with sexual distress arises many questions related to differences in sexual response of men and women. The conceptualization of this response in modern sexology has changed over time. The objective of our paper was to present the changes and evolution of the female’s sexual response concept in a summarized and integrated way, to analyze the expanded and revised definitions of the female sexual response as well as implications and recommendations of new approaches to diagnostics and treatment according to the established changes. The lack of adequate empirical basis of the female sexual response model is a critical question in the literature dealing with this issue. Some articles report that linear models demonstrate more correctly and precisely the sexual response of women with normal sexual functions in relation to women with sexual dysfunction. Modification of this model later resulted in a circular model which more adequately presented the sexual response of women with sexual function disorder than of women with normal sexual function. The nonlinear model of female sexual response constructed by Basson incorporates the value of emotional intimacy, sexual stimulus and satisfaction with the relationship. Female functioning is significantly affected by multiple psychosocial factors such as satisfaction with the relationship, self-image, earlier negative sexual experience, etc. Newly revised, expanded definitions of female sexual dysfunction try to contribute to new knowledge about a highly contextual nature of woman’s sexuality so as to enhance clinical treatment of dysfunctions. The definitions emphasize the evaluation of the context of women’s problematic sexual experiences.

Surgery and Multimodal treatments in pancreatic cancer. A review on the basis of future multimodal treatment concepts

International Nuclear Information System (INIS)

Link, K.H.; Leder, G; Formentini, A.; Fortnagel, G.; Kornmann, M.; Schatz, M.; Beger, H.G.

1999-01-01

The literature on the indications and results of adjuvant/neoadjuvant therapies in pancreatic cancer was reviewed to provide a solid base for current recommendations and future developments. A special view was concentrated on the biology of the disease in the spontaneous course, after surgery and during/after various palliative and adjuvant/neoadjuvant treatment modalities, to characterize the disease for an optimally targeted treatment in conjunction with surgical removal of the tumor. The results of systemic and regional chemotherapy and radiotherapy either alone or in combination, before, during, and after surgery, were critically analyzed with respect to the oncological possibilities and pitfalls of each treatment method. In two randomized trials, one testing postoperative radio chemotherapy (GITSG), and one postoperative chemotherapy (Bakkevold), the adjuvant treatment, achieved a significant prolongation of the median survival time. The 5- and 10-year survival rates were improved in the GITSG study. The EORTC-GITCCG trial could not confirm the benefit of adjuvant radiochemotherapy. This study had a different design than the GITSG trial. Several historical control studies supported the beneficial effect of postoperative radio chemotherapy. In three historical control trials using regional chemotherapy, one with intraoperative radiotherapy, the survival times were improved vs. surgery alone. Intraoperative or postoperative radiotherapy as single modalities might reduce local relapses, but a survival advantage is still debated. Preoperative neoadjuvant radio chemotherapy has several advantages, and does not seem to increase the postoperative morbidity. Several trials have confirmed the feasibility of this concept, but no survival advantage has yet been proven. Systemic and regional chemotherapy is able to down stage primarily nonresectable pancreatic cancers. (K.H.). 111 refs

Intended process water management concept for the mechanical biological treatment of municipal solid waste

Institute of Scientific and Technical Information of China (English)

D. Weichgrebe; S. Maerker; T. Boning; H. Stegemann

2008-01-01

Accumulating operational experience in both aerobic and anaerobic mechanical biological waste treatment (MBT) makes it increasingly obvious that controlled water management would substantially reduce the cost of MBT and also enhance resource recovery of the organic and inorganic fraction. The MBT plant at Gescher, Germany, is used as an example in order to determine the quantity and composition of process water and leachates from intensive and subsequent rotting, pressing water from anaerobic digestion and scrubber water from acid exhaust air treatment, and hence prepare an MBT water balance. The potential of, requirements for and limits to internal process water reuse as well as the possibilities of resource recovery from scrubber water are also examined. Finally, an assimilated process water management concept with the purpose of an extensive reduction of wastewater quantity and freshwater demand is presented.

An innovative treatment concept for future drinking water production: fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

Directory of Open Access Journals (Sweden)

J. C. van Dijk

2009-08-01

Full Text Available A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX, ultrafiltration (UF, nanofiltration (NF, and granular activated carbon filtration (GAC. The FIEX process removed calcium and other divalent cations; the UF membrane removed particles and micro-organisms; and the NF membrane and GAC removed natural organic matter (NOM and micro-pollutants. This study focused on the prevention of fouling of the UF and scaling of the NF and investigated the overall removal of micro-pollutants by the treatment concept. The results of the experiments showed that in 14 days of continuous operation at a flux of 65 l/h m2 the UF performance was stable with the FIEX pre-treated feed water without the aid of a coagulant. The scaling of the NF was also not observed even at 97% recovery. Different micro-pollutants were spiked in the NF feed water and their concentrations in the effluent of NF and GAC were measured. The combination of NF and GAC removed most of the micro-pollutants successfully, except for the very polar substances with a molecular weight lower than 100 Daltons.

Legal frameworks and key concepts regulating diversion and treatment of mentally disordered offenders in European Union member states.

Science.gov (United States)

Dressing, Harald; Salize, Hans Joachim; Gordon, Harvey

2007-10-01

There is only limited research on the various legal regulations governing assessment, placement and treatment of mentally ill offenders in European Union member states (EU-member states). To provide a structured description and cross-boundary comparison of legal frameworks regulating diversion and treatment of mentally disordered offenders in EU-member states before the extension in May 2004. A special focus is on the concept of criminal responsibility. Information on legislation and practice concerning the assessment, placement and treatment of mentally ill offenders was gathered by means of a detailed, structured questionnaire which was filled in by national experts. The legal regulations relevant for forensic psychiatry in EU-member states are outlined. Definitions of mental disorders given within these acts are introduced and compared with ICD-10 diagnoses. Finally the application of the concept of criminal responsibility by the law and in routine practice is presented. Legal frameworks for the processing and placement of mentally disordered offenders varied markedly across EU-member states. Since May 2004 the European Union has expanded to 25 member states and in January 2007 it will reach 27. With increasing mobility across Europe, the need for increasing trans-national co-operation is becoming apparent in which great variation in legal tradition pertains.

Impact of Self-concept on Preschoolers’ Dental Anxiety and Behavior

Science.gov (United States)

Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad

2015-01-01

Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P self-concept and child’s behavior scores (r = 0.491, P self-concept had lower anxiety level and better behavioral feedback during dental treatment. PMID:26697152

Impact of Self-concept on Preschoolers' Dental Anxiety and Behavior.

Science.gov (United States)

Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad

2015-01-01

Background and aims . Different factors affect children's behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child's anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child's anxiety and child's behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman's correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P self-concept and child's behavior scores (r = 0.491, P self-concept had lower anxiety level and better behavioral feedback during dental treatment.

Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study.

Science.gov (United States)

Bogenschutz, Michael P; Forcehimes, Alyssa A; Pommy, Jessica A; Wilcox, Claire E; Barbosa, P C R; Strassman, Rick J

2015-03-01

Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants' responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p psilocybin session (at week 4) strongly predicted change in drinking during weeks 5-8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. NCT02061293. © The Author(s) 2015.

Isoeffect lines using TDF and CRE concepts

International Nuclear Information System (INIS)

Supe, S.J.; Sasane, J.B.; Supe, D.S.

1980-01-01

Isoeffect lines based on Ellis' Nominal Standard Dose concept, Orton's Time Dose and Fractionation Factor (TDF) concept, and Kirk et al's Cumulative Radiation Effect (CRE) concept give differing results of treatment planning. Experience with isoeffect lines based on the above concepts in planning in case of radiotherapy for carcinoma of bladder and carcinoma of uterine cervix is narrated. (M.G.B.)

Deep remission: a new concept?

Science.gov (United States)

Colombel, Jean-Frédéric; Louis, Edouard; Peyrin-Biroulet, Laurent; Sandborn, William J; Panaccione, Remo

2012-01-01

Crohn's disease (CD) is a chronic inflammatory disorder characterized by periods of clinical remission alternating with periods of relapse defined by recurrent clinical symptoms. Persistent inflammation is believed to lead to progressive bowel damage over time, which manifests with the development of strictures, fistulae and abscesses. These disease complications frequently lead to a need for surgical resection, which in turn leads to disability. So CD can be characterized as a chronic, progressive, destructive and disabling disease. In rheumatoid arthritis, treatment paradigms have evolved beyond partial symptom control alone toward the induction and maintenance of sustained biological remission, also known as a 'treat to target' strategy, with the goal of improving long-term disease outcomes. In CD, there is currently no accepted, well-defined, comprehensive treatment goal that entails the treatment of both clinical symptoms and biologic inflammation. It is important that such a treatment concept begins to evolve for CD. A treatment strategy that delays or halts the progression of CD to increasing damage and disability is a priority. As a starting point, a working definition of sustained deep remission (that includes long-term biological remission and symptom control) with defined patient outcomes (including no disease progression) has been proposed. The concept of sustained deep remission represents a goal for CD management that may still evolve. It is not clear if the concept also applies to ulcerative colitis. Clinical trials are needed to evaluate whether treatment algorithms that tailor therapy to achieve deep remission in patients with CD can prevent disease progression and disability. Copyright © 2012 S. Karger AG, Basel.

A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes.

Science.gov (United States)

Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

2013-12-09

Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized controlled trial (RCT) has examined if treating periodontal disease before pregnancy reduces adverse birth outcomes. This study aims to examine if the pre-conception treatment of periodontal disease will lead to improved periodontal status during late pregnancy and subsequent birth outcomes. A sample of 470 (235 in each arm of the study) pre-conception women who plan to conceive within one year and with periodontal disease will be recruited for the study. All participants will be randomly allocated to the intervention or control group. The intervention group will receive free therapy including dental scaling and root planning (the standard therapy), supragingival prophylaxis, and oral hygiene education. The control group will only receive supragingival prophylaxis and oral hygiene education. Women will be followed throughout their pregnancy and then to childbirth. The main outcomes include periodontal disease status in late pregnancy and birth outcomes measured such as mean birth weight (grams), and mean gestational age (weeks). Periodontal disease will be diagnosed through a dental examination by measuring probing depth, clinical attachment loss and percentage of bleeding on probing (BOP) between gestational age of 32 and 36 weeks. Local and systemic inflammatory mediators are also included as main outcomes. This will be the first RCT to test whether treating periodontal disease among pre-conception women reduces periodontal disease during pregnancy and prevents adverse birth outcomes. If

Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment

DEFF Research Database (Denmark)

Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa

2018-01-01

electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from...... positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area...

Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review.

Science.gov (United States)

Akioyamen, Leo E; Minhas, Hersimren; Holloway, Alison C; Taylor, Valerie H; Akioyamen, Noel O; Sherifali, Diana

2016-05-01

While antidepressant medications are currently used during conception, gestation and post-partum, considerable uncertainty exists regarding the benefits and harms conferred to mothers and their offspring. A significant body of evidence has focused on antidepressant use during pregnancy and post-partum. However, it is difficult to know if this translates to specific populations. Women receiving treatment for infertility are especially vulnerable to symptoms of depression and adverse perinatal outcomes. This systematic review aimed to determine the effects of antidepressants taken during the perinatal period by women receiving fertility treatment on conception, birth, and long-term maternal and child health outcomes. We searched MEDLINE, EMBASE, CINAHL, the Cochrane Library, PsycINFO, ProQuest Dissertation & Theses, and Pubmed databases from January 1950 to November 2015. Articles were screened for inclusion independently by two reviewers. Studies were included if they enrolled women of reproductive age exposed to pharmacotherapy for depression and infertility at any point during the perinatal period. A total of 8587 unique citations, and 83 full-text articles were reviewed. Of these, two randomized controlled trials and two retrospective chart reviews were included in the narrative synthesis. While most studies reported on assisted reproduction processes and birth outcomes, none examined long-term impacts on maternal-child health. The few included studies did not find that antidepressant use by women receiving fertility therapy impacted gamete quality or pregnancy success. Currently, no studies address whether pharmacotherapy for the treatment of depression in women undergoing assisted reproduction affects their health or that of their offspring long-term. It appears that much like antidepressant use in fertile women, there are risks associated with both antidepressant use and untreated depression. Decisions regarding the treatment of depression should be made

Self-Concept Change in Behavior Modification

Science.gov (United States)

Ryan, Victor L.; And Others

1976-01-01

Changes in self-concept as a function of behavioral treatment for test anxiety are investigated. Test-anxious subjects (N=72) were randomly assigned to systematic desensitization, relaxation-training only, or no-treatment control conditions. Results indicate that the desensitization and relaxation treatments were both effective in reducing test…

Role of radiotherapy in the treatment of multiple myeloma; Wertigkeit der Radiotherapie in der Behandlung des multiplen Myeloms

Energy Technology Data Exchange (ETDEWEB)

Mose, S.; Pfitzner, D.; Rahn, A.; Nierhoff, C.; Schiemann, M.; Boettcher, H.D. [Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

2000-11-01

suppose that in multiple myeloma the local response to radiation is supported by a favorable performance status and simultaneous chemotherapy. Irradiation treatment does not change prognosis regarding overall survival. (orig.) [German] Die Radiotherapie nimmt im Rahmen der Schmerztherapie, die Behandlung von (drohenden) Frakturen und von Myelonkompressionen eine wichtige Rolle im palliativen Konzept ein. Ziel der vorliegenden retrospektiven Arbeit ist es, anhand dieser Indikationen den Effekt der Strahlentherapie auf Analgesie, Rekalzifizierung und neurologische Symptomatik am eigenen Patientenkollektiv aufzuzeigen und moegliche Einflussfaktoren auf den Therapieeffekt zu evaluieren. Patienten und Methoden: Vom 1.1.1988 bis 31.12.1998 wurden 42 Patienten (19 Frauen, 23 Maenner) im Alter von 46 bis 85 Jahren (Median: 64,9 Jahre) in 71 Zielvolumina aufgrund einer bestehenden Symptomatik (67/71: Ossaere Schmerzen, 45/71: Fraktur/-gefahr, 13/71: Rueckenmarkkompression) radiotherapiert (Median 36 Gy, 2 bis 3 Gy 2-mal/Woche). Die Zeit zwischen Diagnose und erster Bestrahlung betrug im Median 11,9 Monate (0,3 bis 90 Monate). Zum Zeitpunkt der ersten Radiotherapie befanden sich fuenf Patienten im Stadium II, 37 im Stadium III nach Salmon/Durie; der Karnofsky-Index lag im Median bei 70% (40 bis 90%). Ergebnisse: Im Verlauf der mindestens sechsmonatigen Nachbeobachtungszeit zeigte sich bei 85% der Zielvolumina eine komplette bzw. partielle Analgesie; es wurden 8,8% Schmerzrezidive gesehen. Eine roentgenologisch verifizierte Rekalzifizierung wurde in 26/56 (46,4%) auswertbaren Laesionen beobachtet; 17,9% waren progredient. In 22,3% der initial frakturgefaehrdeten Laesionen (4/18) kam es posttherapeutsich zu Frakturen. Eine simultane Chemotherapie sowie ein Karnofsky-Index{>=}70 wirkten sich signifikant positiv auf das Therapieansprechen aus. Eine Symptomreduktion nach Rueckenmarkkompression (nach Findley 1987) wurde bei 7/13 (53,8%) der Patienten erreicht. Das mediane Ueberleben

Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment.

Science.gov (United States)

Huhtaniemi, Ilpo

2014-01-01

Although suppressed serum testosterone (T) is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual (e.g., erectile dysfunction), physical (e.g. loss of vigor and frailty) and psychological (e.g., depression) symptoms. This syndrome carries many names, including male menopause or climacterium, andropause and partial androgen deficiency of the ageing male (PADAM). Late-onset hypogonadism (LOH) describes it best and is therefore generally preferred. The decrease of T in LOH is often marginal, and hypogonadism can be either due to primary testicular failure (low T, high luteinizing hormone (LH)) or secondary to a hypothalamic-pituitary failure (low T, low or inappropriately normal LH). The latter form is more common and it is usually associated with overweight/obesity or chronic diseases (e.g., type 2 diabetes mellitus, the metabolic syndrome, cardiovascular and chronic obstructive pulmonary disease, and frailty). A problem with the diagnosis of LOH is that often the symptoms (in 20%-40% of unselected men) and low circulating T (in 20% of men >70 years of age) do not coincide in the same individual. The European Male Ageing Study (EMAS) has recently defined the strict diagnostic criteria for LOH to include the simultaneous presence of reproducibly low serum T (total T treatment of comorbid diseases. T replacement is widely used for the treatment, but evidence-based information about its real benefi ts and short- and long-term risks, is not yet available. In this review, we will summarize the current concepts and controversies in the pathogenesis, diagnosis and treatment of LOH.

Impact of Self-concept on Preschoolers’ Dental Anxiety and Behavior

Directory of Open Access Journals (Sweden)

Leila Erfanparast

2015-09-01

Full Text Available Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and be-havior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxi-ety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation be-tween the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = −0.545, P < 0.001, and a moderate correlation between the self-concept and child’s behavior scores (r = 0.491, P < 0.001. A strong inverse relation was also found between the anxiety and behavior scores (r = −0.91, P < 0.001. Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treat-ment.

Essential role of radiation therapy for the treatment of pancreatic cancer. Novel study concepts and established treatment recommendations

Energy Technology Data Exchange (ETDEWEB)

Dobiasch, Sophie [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Goerig, Nicole L.; Fietkau, Rainer [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Universitaetsklinikum Erlangen, Erlangen (Germany); Combs, Stephanie E. [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Neuherberg (Germany)

2018-03-15

Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. (orig.) [German] Das Pankreaskarzinom gehoert zu den aggressivsten menschlichen Tumoren und verzeichnete in den letzten 6 Jahren eine steigende Inzidenz. Die Diagnose wird meist erst im fortgeschrittenen Stadium gestellt; dies schliesst haeufig eine primaer kurative Intervention mithilfe der chirurgischen Resektion aus und bedingt die hohe Mortalitaet. Obwohl die Strahlentherapie im multimodalen Therapieansatz des Pankreaskarzinoms eine zentrale Saeule darstellt, wird die Rolle der Strahlentherapie in der Literatur kontrovers diskutiert. Der vorliegende Beitrag bietet eine Uebersicht moderner Bestrahlungsstrategien im interdisziplinaeren Konzept gemaess der Leitlinien der American Society of Clinical Oncology (ASCO) im Vergleich zu den

Volumetric MR-Guided High-Intensity Focused Ultrasound with Direct Skin Cooling for the Treatment of Symptomatic Uterine Fibroids : Proof-of-Concept Study

NARCIS (Netherlands)

Ikink, Marlijne E; van Breugel, Johanna M M; Schubert, Gerald; Nijenhuis, Robbert J; Bartels, LW; Moonen, Chrit T W; van den Bosch, Maurice A A J

2015-01-01

Objective. To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation with direct skin cooling (DISC) during treatment of uterine fibroids. Methods. In this proof-of-concept study, eight patients were

Traumatic injuries of the temporomandibular joint; Die traumatischen Kiefergelenkverletzungen

Energy Technology Data Exchange (ETDEWEB)

Puig, S.; Krestan, C.; Lomoschitz, F.; Robinson, S. [Vienna Univ. (Austria). Zentrales Inst. fuer Radiodiagnostik; Glaser, C. [Vienna Univ. (Austria). Klinik fuer Zahn-, Mund- und Kieferheilkunde; Staudenherz, A. [Vienna Univ. (Austria). Universitaetsklinik fuer Nuklearmedizin

2001-09-01

Injuries of the temporomandibular joint are mostly due to injuries or fractures of the mandibular condyle. Fractures of the skull base involving the temporomandibular joint are rare. Classification of fractures refers to their anatomical positions and the presence or absence of a luxation. Further, it is important whether the fracture is intra- or extra-capsular. The primary imaging method should be orthopantomography. As for therapy planning, especially surgery, also evaluation of soft tissue is necessary, computed tomography is the imaging method of choice. For diagnosis of complications or internal derangement of the temporomandibular joint, magnetic resonance imaging is to be recommended. (orig.) [German] Die Verletzungen des Kiefergelenks gehen zumeist mit einer Verletzung oder Fraktur des Kieferkoepfchens bzw. des Kiefergelenkfortsatzes einher. Frakturen der Schaedelbasis unter Beteiligung der Kiefergelenkpfanne sind selten. Unterschieden werden die Frakturen des Gelenkfortsatzes nach anatomischer Lokalisation und danach, ob eine Luxation vorhanden ist oder nicht. Weiter ist von Bedeutung, ob der Frakturspalt intraoder extrakapsulaer verlaeuft. Die primaere Bildgebung sollte mittels Orthopantomographie erfolgen. Da fuer eine weitere operative Behandlung auch die etwaige Verletzung der Weichteile von Bedeutung ist, bietet sich die Computertomographie als bildgebende diagnostische Methode an. Zur Abklaerung von Komplikationen bzw. des so genannten ''internal derangement'' ist die Magnetresonanztomographie zu empfehlen. (orig.)

Effluent treatment for nuclear thermal propulsion ground testing

Science.gov (United States)

Shipers, Larry R.

1993-01-01

The objectives are to define treatment functions, review concept options, discuss PIPET effluent treatment system (ETS), and outline future activities. The topics covered include the following: reactor exhaust; effluent treatment functions; effluent treatment categories; effluent treatment options; concept evaluation; PIPETS ETS envelope; PIPET effluent treatment concept; and future activities.

Experimentelle Untersuchungen zur sonographischen Frakturdiagnostik im Kinderalter

OpenAIRE

Meuser, Stefan Heinrich Peter

2010-01-01

Falsch diagnostiziert und nicht korrekt therapiert können Frakturen im Kindesalter zu Wachstumsstörungen und damit verbundenen lebenslangen Problemen führen. Nach einem Trauma ist die klinische Untersuchung und Bestimmung des Schmerzmaximums gerade bei Kindern oft sehr schwierig. So müssen häufig mehrere Röntgenaufnahmen getätigt werden, ehe eine Fraktur sicher diagnostiziert oder ausgeschlossen werden kann. Die hierbei auftretende ionisierende Strahlung geht jedoch besonder...

Concept - or no concept

DEFF Research Database (Denmark)

Thorsteinsson, Uffe

1999-01-01

Discussion about concept in industrial companies. A method for mapping of managerial concept in specific area is shown......Discussion about concept in industrial companies. A method for mapping of managerial concept in specific area is shown...

The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence?

NARCIS (Netherlands)

Kollen, B.J.; Lennon, S.; Lyons, B.; Wheatley-Smith, L.; Scheper, M.; Buurke, J.H.; Halfens, J.; Geurts, A.C.; Kwakkel, G.

2009-01-01

BACKGROUND AND PURPOSE: In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of

Concepts of formal concept analysis

Science.gov (United States)

Žáček, Martin; Homola, Dan; Miarka, Rostislav

2017-07-01

The aim of this article is apply of Formal Concept Analysis on concept of world. Formal concept analysis (FCA) as a methodology of data analysis, information management and knowledge representation has potential to be applied to a verity of linguistic problems. FCA is mathematical theory for concepts and concept hierarchies that reflects an understanding of concept. Formal concept analysis explicitly formalizes extension and intension of a concept, their mutual relationships. A distinguishing feature of FCA is an inherent integration of three components of conceptual processing of data and knowledge, namely, the discovery and reasoning with concepts in data, discovery and reasoning with dependencies in data, and visualization of data, concepts, and dependencies with folding/unfolding capabilities.

[New aspects of complex chronic tinnitus. I: Assessment of a multi-modality behavioral medicine treatment concept].

Science.gov (United States)

Goebel, G; Keeser, W; Fichter, M; Rief, W

1991-01-01

"Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

Female pattern hair loss: Current treatment concepts

Directory of Open Access Journals (Sweden)

Quan Q Dinh

2007-07-01

Full Text Available Quan Q Dinh, Rodney SinclairDepartment of Dermatology, St Vincent’s Hospital, Fitzroy, Victoria, AustraliaAbstract: Fewer than 45% of women go through life with a full head of hair. Female pattern hair loss is the commonest cause of hair loss in women and prevalence increases with advancing age. Affected women may experience psychological distress and impaired social functioning. In most cases the diagnosis can be made clinically and the condition treated medically. While many women using oral antiandrogens and topical minoxidil will regrow some hair, early diagnosis and initiation of treatment is desirable as these treatments are more effective at arresting progression of hair loss than stimulating regrowth. Adjunctive nonpharmacological treatment modalities such as counseling, cosmetic camouflage and hair transplantation are important measures for some patients. The histology of female pattern hair loss is identical to that of male androgenetic alopecia. While the clinical pattern of the hair loss differs between men, the response to oral antiandrogens suggests that female pattern hair loss is an androgen dependant condition, at least in the majority of cases. Female pattern hair loss is a chronic progressive condition. All treatments need to be continued to maintain the effect. An initial therapeutic response often takes 12 or even 24 months. Given this delay, monitoring for treatment effect through clinical photography or standardized clinical severity scales is helpful.Keywords: female pattern hair loss, androgenetic alopecia

Hepatic fibrosis: Concept to treatment.

Science.gov (United States)

Trautwein, Christian; Friedman, Scott L; Schuppan, Detlef; Pinzani, Massimo

2015-04-01

Understanding the molecular mechanisms underlying liver fibrogenesis is fundamentally relevant to developing new treatments that are independent of the underlying etiology. The increasing success of antiviral treatments in blocking or reversing the fibrogenic progression of chronic liver disease has unearthed vital information about the natural history of fibrosis regression, and has established important principles and targets for antifibrotic drugs. Although antifibrotic activity has been demonstrated for many compounds in vitro and in animal models, none has been thoroughly validated in the clinic or commercialized as a therapy for fibrosis. In addition, it is likely that combination therapies that affect two or more key pathogenic targets and/or pathways will be needed. To accelerate the preclinical development of these combination therapies, reliable single target validation is necessary, followed by the rational selection and systematic testing of combination approaches. Improved noninvasive tools for the assessment of fibrosis content, fibrogenesis and fibrolysis must accompany in vivo validation in experimental fibrosis models, and especially in clinical trials. The rapidly changing landscape of clinical trial design for liver disease is recognized by regulatory agencies in the United States (FDA) and Western Europe (EMA), who are working together with the broad range of stakeholders to standardize approaches to testing antifibrotic drugs in cohorts of patients with chronic liver diseases. Copyright © 2015. Published by Elsevier B.V.

[Opiate addiction in gravidity - consequences for the newborn. Results of an interdisciplinary treatment concept].

Science.gov (United States)

Rohrmeister, K; Bernert, G; Langer, M; Fischer, G; Weninger, M; Pollak, A

2001-01-01

To evaluate the outcome of infants of drug dependent mothers (IDM) after establishing an interdisciplinary attention concept at the University Hospital in Vienna. To compare the influence of different maintenance agents on neonatal morbidity. All newborns of opiate dependent mothers were prospectively included from III 1995 to IX 1999. The following data were collected: maintenance agent (methadone, slow release morphine, buprenorphine), infectious status, demographic data, congenital malformations, perinatal complications, as well as incidence and duration of the neonatal abstinence syndrome (NAS). Medical treatment with phenobarbital (1995 - 96) or morphine hydrochloride (MoHCl) (1997 - 99), respectively, was indicated when Finnegan score exceeded 10. 88 neonates (38 females/50 males) with a median gestational age of 39 weeks were included, 18 (20.5 %) were born prematurely. The median birthweight was 2905 g, 24 (27.3 %) infants were small for date (methadone group 76 %, in the morphine group 93 %, but in the buprenorphine group 19 % only (p methadone and morphine exposure (8.3 d versus 15 d and 16.5 d respectively). In neonates treated with phenobarbital duration of NAS was 17.6 d, whereas NAS in infants with MoHCl therapy lasted 12.8 d (p methadone and morphine exposure. Withdrawal time under morphin-hydrochloride therapy was reduced by one third compared to treatment with phenobarbital.

Development of combustion management concept for natural-aspirated small diesel engine; Shizen kyuki kogata diesel engine no nensho seigyo concept no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Wada, T; Kawano, T; Shoji, M; Kuniyosh, M; Yamashita, O; Nagao, A [Mazda Motor Corp., Tokyo (Japan); Yoshikawa, S [Zexel Corp., Tokyo (Japan)

1997-10-01

We have developed a combustion management concept for natural-aspirated small IDI diesel engines and achieved higher power, lower exhaust emissions and more comfort. The concept is related to improvements of intake volumetric efficiency, EGR effect, mixture formation caused by combustion chamber and spray characteristics, engine management system and after treatment device. This paper describes the concept and experimental results. 3 refs., 14 figs., 1 tab.

Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

International Nuclear Information System (INIS)

Rieken, Stefan; Gaiser, Timo; Mohr, Angela; Welzel, Thomas; Witt, Olaf; Kulozik, Andreas E; Wick, Wolfgang; Debus, Jürgen; Combs, Stephanie E

2010-01-01

Desmoplasia in medulloblastoma is often diagnosed in adult patients and was repeatedly associated with improved results. Today, all medulloblastoma patients receive intensive multimodal treatment including surgery, radiotherapy and chemotherapy. This study was set up to investigate treatment outcome and prognostic factors after radiation therapy in patients with desmoplastic medulloblastomas. Twenty patients treated for desmoplastic medulloblastoma in the Department of Radiation Oncology at the University of Heidelberg between 1984 and 2007 were included. Data were collected retrospectively. Tumor resection was performed in all patients. All patients underwent postsurgical radiotherapy (RT). Two patients underwent whole brain radiotherapy (WBRT), and 18 patients received craniospinal irradiation (CSI). In all patients, an additional boost was delivered to the posterior fossa. The median dose to the whole brain and the craniospinal axis was 35.2 Gray (Gy), and 54.4 Gy to the posterior fossa. Fourteen patients received chemotherapy, including seven who were treated with combined radiochemotherapy and twelve who received adjuvant chemotherapy. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. Median follow-up was 59 months. Overall (OS), local (LPFS) and distant progression-free survival (DPFS) was 80%, 71.2%, and 83.3% at 60 months. Patients who suffered from local or distant relapses had significantly worse outcome. Five patients died from recurrent medulloblastoma. Treatment-associated toxicity was acceptable. Multimodal approaches with surgical resection followed by chemoirradiation achieved high response rates with long OS in desmoplastic medulloblastoma patients. Staging parameters expected to predict for poor prognosis did not significantly influence outcome. However, success of any first line regimen had strong impact on disease control, and remission was achieved in no patient with relapsing disease. Multimodal concepts

How Do Parenting Concepts Vary within and between the Families?

Science.gov (United States)

Roskam, Isabelle; Meunier, Jean Christophe

2009-01-01

How do parenting concepts vary within and between the families? The present study regards parenting as a complex family process by considering three concepts of parenting: styles, differential treatment and coparenting consistency. A main question was addressed: whether and how these parenting concepts vary within the families towards siblings or…

A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

OpenAIRE

Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

2013-01-01

Background Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized cont...

La morfologia i els seus conceptes en l'ensenyament secundari: tractaments habituals | Morphology and its Concepts in Secondary Education: Common Treatments

Directory of Open Access Journals (Sweden)

Abelard Saragossà

2015-05-01

Full Text Available Resum Este article descriu les anomalies metodològiques més freqüents que apareixen en l’ensenyament secundari quan tracta els conceptes de la morfologia (o flexió, o accidents gramaticals. En la concepció històrica, es reduïx a sis nocions: gènere, nombre i cas (nom; temps i concordança (verb; comparació i concordança (adjectiu. Després d’exposar què tenen en comú les dos maneres d’expressar-los ({pensaré contra I will think}, {longer contra més llarg}, el treball mostra que els manuals actuals contenen dos idees de la morfologia, diferents i incompatibles entre elles: la tradicional i aquella en què el morfema (unitat significativa implica tota la lingüística excepte el fonema (unitat no significativa. Este article es complementa amb el de Sara Martínez Fraile, que oferix una alternativa. Abstract This article describes methodological anomalies that appear frequently in secondary school when the concepts of morphology (or inflection, or grammatical accidents are treated. Morphological concepts are six concepts in historical conception: gender, number and case (name; time and agreement (verb; comparison and agreement (adjective. After exposing what the two ways of expressing them have in common ({pensaré against I will think}, {longer against més llarg}, the present study shows that manuals contain two conceptions of morphology, which are different and incompatible: the traditional one and the one in which the morpheme (meaningful unit involves all language except the phoneme (unit without meaning. This article is complemented by Sara Martinez Fraile, which offers an alternative.

Introductory concepts

International Nuclear Information System (INIS)

Barnes, W.E.

1983-01-01

Physical theories are commonly classified as being either ''classical'' or ''modern''. The reasons for this distinction are both historical and substantive. Limited in the sophistication of their measuring instruments, early scientists proposed theories appropriate for the description of the simplest and most accessible physical phenomena, e.g., the trajectories of the planets. Because of the class of phenomena observed, certain beliefs came to underlie all classical theories with regard to the nature of time, space, matter, etc. For example, the idea was undisputed that an object has at all times both a definite position and velocity. Not until the interior of the atom and the nature of electromagnetic radiation were explored was it discovered that the concepts of classical physics are inadequate to deal with many phenomena. A reassessment of fundamental postulates led to the formulation of modern physics which, it is believed, successfully treats the behavior of all physical systems. To gain an understanding of the rudiments of modern physics, one proceeds as the early scientists did by first mastering the classical concepts that emerge from their intuitive picture of the world. Modifications of these concepts are subsequently introduced which allow a more accurate treatment of physical phenomena, particularly atomic and nuclear systems

Novel treatment concepts in Hodgkin lymphoma

NARCIS (Netherlands)

Glimelius, I.; Diepstra, A.

Treatment of classical Hodgkin's lymphoma (HL) has been a success story, with cure of localized disease with radiotherapy in the 1930s, cure of advanced stages with combination chemotherapy with/without radiotherapy in the mid-1960s and continuous improvements since then. Nonetheless, at present

Gamma knife radiosurgery for benign cavernous sinus tumors. Treatment concept and outcomes in 120 cases

International Nuclear Information System (INIS)

Hayashi, Motohiro; Chernov, Mikhail; Tamura, Noriko

2012-01-01

Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS TM ; Elekta Instruments AB, Stockholm, Sweden) and Perfexion TM (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications. (author)

The effect of an outdoor setting on the transfer of earth science concepts

Science.gov (United States)

Simmons, Jerry Marvin

The ability of students to transfer concepts learned in school to future learning and employment settings is critical to their academic and career success. Concept transfer can best be studied by defining it as a process rather than an isolated event. Preparation for future learning (PFL) is a process definition of transfer which recognizes the student's ability to draw from past experiences, make assumptions, and generate potential questions and strategies for problem resolution. The purpose of this study was to use the PFL definition of concept transfer to examine whether a knowledge-rich outdoor setting better prepares students for future learning of science concepts than the classroom setting alone does. The research hypothesis was that sixth-grade students experiencing a geology-rich outdoor setting would be better prepared to learn advanced earth science concepts than students experiencing classroom learning only. A quasi-experimental research design was used for this study on two non-equivalent, self-contained sixth-grade rural public school classes. After a pretest was given on prior geology knowledge, the outdoor treatment group was taken on a geology-rich field excursion which introduced them to the concepts of mineral formation and mining. The indoor treatment group received exposure to the same concepts in the classroom setting via color slides and identification of mineral specimens. Subsequently, both groups received direct instruction on advanced concepts about mineral formation and mining. They were then given a posttest, which presented the students with a problem-solving scenario and questions related to concepts covered in the direct instruction. A t-test done on pretest data revealed that the indoor treatment group had previously learned classroom geology material significantly better than the outdoor treatment group had. Therefore an analysis of covariance was performed on posttest data which showed that the outdoor treatment group was better

Diagnosis of occipital condyle fractures; Diagnostik von Frakturen der Okzipitalkondylen

Energy Technology Data Exchange (ETDEWEB)

Hefele-Roedel, B. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Vogl, T.J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Lochbuehler, H. [Dr. v. Haunersches Kinderspital, Kinderchirurgische Klinik, Univ. Muenchen (Germany); Lissner, J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany)

1995-01-01

Following the conventional X-ray diagnosis of the skull and upper cervical spine, CT proved to be the primary diagnostic method after a skull and brain injury: For all 4 cases we succeeded in detecting the occipital condyle fracture and in determing its size and location by reconstructions (coronal, sagittal, 3-D). In the case of complex occompanying injuries like soft tissue hematomas (cerebral, in the spinal cord, and the soft tissue of the neck) or for the detection of brain stem contusion, MRT had significant advantages. MRT can offer a higher image quality in soft tissue, especially in the spinal cord and the brain. (orig.) [Deutsch] Im Anschluss an die konventionelle Roentgendiagnostik des Schaedels und der Halswirbelsaeule, erwies sich die Computertomographie als primaer einzusetzendes diagnostisches Verfahren, nach erlittenem Schaedel-Hirn-Trauma. In allen Faellen gelang der exakte Frakturnachweis an den Okzipitalkondylen, die Bestimmung des Frakturausmasses und die genaue Frakturlokalisation in Rekonstruktionen (koronar, sagittal, 3-D). Bei komplexen Begleitverletzungen, wie Blutungen (zerebral, spinal und in den Halsweichteilen) oder zum Nachweis einer Hirnstammkontusion, erwies sich der Einsatz der MRT als vorteilhaft. Mit der MRT laesst sich ein deutlich hoeherer Weichteilkontrast, insbesondere spinal und zerebral, erzielen. (orig.)

Enhancing Elementary Pre-Service Teachers' Plant Processes Conceptions

Science.gov (United States)

Thompson, Stephen L.; Lotter, Christine; Fann, Xumei; Taylor, Laurie

2016-01-01

Researchers examined how an inquiry-based instructional treatment emphasizing interrelated plant processes influenced 210 elementary pre-service teachers' (PTs) conceptions of three plant processes, photosynthesis, cellular respiration, and transpiration, and the interrelated nature of these processes. The instructional treatment required PTs to…

Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment

Directory of Open Access Journals (Sweden)

Ilpo Huhtaniemi

2014-04-01

short- and long-term risks, is not yet available. In this review, we will summarize the current concepts and controversies in the pathogenesis, diagnosis and treatment of LOH.

Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment

Science.gov (United States)

Huhtaniemi, Ilpo

2014-01-01

- and long-term risks, is not yet available. In this review, we will summarize the current concepts and controversies in the pathogenesis, diagnosis and treatment of LOH. PMID:24407185

Reported concepts for the treatment modalities and pain management of temporomandibular disorders.

Science.gov (United States)

Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

2015-01-01

Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers. The most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied. The authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment

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Jennifer J. P. Collins

2017-05-01

Full Text Available Yearly more than 15 million babies are born premature (<37 weeks gestational age, accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD, one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age. Understanding how the alveoli develop, and repair, and regenerate after injury is critical for the development of therapies, as unfortunately there is still no cure for BPD. In this review, we aim to provide an overview of emerging new concepts in the understanding of perinatal lung development and injury from a molecular and cellular point of view and how this is paving the way for new therapeutic options to prevent or treat BPD, as well as a reflection on current treatment procedures.

Enhancing Elementary Pre-service Teachers' Plant Processes Conceptions

Science.gov (United States)

Thompson, Stephen L.; Lotter, Christine; Fann, Xumei; Taylor, Laurie

2016-06-01

Researchers examined how an inquiry-based instructional treatment emphasizing interrelated plant processes influenced 210 elementary pre-service teachers' (PTs) conceptions of three plant processes, photosynthesis, cellular respiration, and transpiration, and the interrelated nature of these processes. The instructional treatment required PTs to predict the fate of a healthy plant in a sealed terrarium (Plant-in-a-Jar), justify their predictions, observe the plant over a 5-week period, and complete guided inquiry activities centered on one of the targeted plant processes each week. Data sources included PTs' pre- and post-predictions with accompanying justifications, course artifacts such as weekly terrarium observations and science journal entries, and group models of the interrelated plant processes occurring within the sealed terraria. A subset of 33 volunteer PTs also completed interviews the week the Plant-in-a-Jar scenario was introduced and approximately 4 months after the instructional intervention ended. Pre- and post-predictions from all PTs as well as interview responses from the subgroup of PTs, were coded into categories based on key plant processes emphasized in the Next Generation Science Standards. Study findings revealed that PTs developed more accurate conceptions of plant processes and their interrelated nature as a result of the instructional intervention. Primary patterns of change in PTs' plant process conceptions included development of more accurate conceptions of how water is used by plants, more accurate conceptions of photosynthesis features, and more accurate conceptions of photosynthesis and cellular respiration as transformative processes.

Replication, randomization, and treatment design concepts for on-farm research

Science.gov (United States)

For most agronomists, randomization and replication are fundamental concepts that have a nearly sacred or spiritual status. They are an integral part of nearly all of our field-based activities. Some on-farm research falls into this category, simply because it is driven and designed by researchers w...

Disease concepts and treatment by tribal healers of an Amazonian forest culture.

Science.gov (United States)

Herndon, Christopher N; Uiterloo, Melvin; Uremaru, Amasina; Plotkin, Mark J; Emanuels-Smith, Gwendolyn; Jitan, Jeetendra

2009-10-12

The extensive medicinal plant knowledge of Amazonian tribal peoples is widely recognized in the scientific literature and celebrated in popular lore. Despite this broad interest, the ethnomedical systems and knowledge of disease which guide indigenous utilization of botanical diversity for healing remain poorly characterized and understood. No study, to our knowledge, has attempted to directly examine patterns of actual disease recognition and treatment by healers of an Amazonian indigenous culture. The establishment of traditional medicine clinics, operated and directed by elder tribal shamans in two remote Trio villages of the Suriname rainforest, presented a unique investigational opportunity. Quantitative analysis of clinic records from both villages permitted examination of diseases treated over a continuous period of four years. Cross-cultural comparative translations were articulated of recorded disease conditions through ethnographic interviews of elder Trio shamans and a comprehensive atlas of indigenous anatomical nomenclature was developed. 20,337 patient visits within the period 2000 to 2004 were analyzed. 75 disease conditions and 127 anatomical terms are presented. Trio concepts of disease and medical practices are broadly examined within the present and historical state of their culture. The findings of this investigation support the presence of a comprehensive and highly formalized ethnomedical institution within Trio culture with attendant health policy and conservation implications.

Molecular and cellular biology of cerebral arteriovenous malformations: a review of current concepts and future trends in treatment.

Science.gov (United States)

Rangel-Castilla, Leonardo; Russin, Jonathan J; Martinez-Del-Campo, Eduardo; Soriano-Baron, Hector; Spetzler, Robert F; Nakaji, Peter

2014-09-01

Arteriovenous malformations (AVMs) are classically described as congenital static lesions. However, in addition to rupturing, AVMs can undergo growth, remodeling, and regression. These phenomena are directly related to cellular, molecular, and physiological processes. Understanding these relationships is essential to direct future diagnostic and therapeutic strategies. The authors performed a search of the contemporary literature to review current information regarding the molecular and cellular biology of AVMs and how this biology will impact their potential future management. A PubMed search was performed using the key words "genetic," "molecular," "brain," "cerebral," "arteriovenous," "malformation," "rupture," "management," "embolization," and "radiosurgery." Only English-language papers were considered. The reference lists of all papers selected for full-text assessment were reviewed. Current concepts in genetic polymorphisms, growth factors, angiopoietins, apoptosis, endothelial cells, pathophysiology, clinical syndromes, medical treatment (including tetracycline and microRNA-18a), radiation therapy, endovascular embolization, and surgical treatment as they apply to AVMs are discussed. Understanding the complex cellular biology, physiology, hemodynamics, and flow-related phenomena of AVMs is critical for defining and predicting their behavior, developing novel drug treatments, and improving endovascular and surgical therapies.

CURRENT CONCEPTS IN ACL RECONSTRUCTION

Directory of Open Access Journals (Sweden)

Freddie H. Fu

2008-09-01

Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world

Shape of the self-concept clarity change during group psychotherapy predicts the outcome: An empirical validation of the theoretical model of the self-concept change

Directory of Open Access Journals (Sweden)

Rafał eStyła

2015-10-01

Full Text Available Background: Self-concept clarity describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of self-concept clarity change (especially stable increase and V shape observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable self-concept clarity increase is needed for the participants with a rather healthy personality structure, while self-concept clarity change characterized by a V shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M=5.8 was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale, Symptoms’ Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The Self-Concept Clarity Scale was also administered every two weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable self-concept clarity increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and V shape of self-concept clarity change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of self-concept clarity is a sign of a good treatment prognosis.

[Treatment of chronic bovine endometritis and factors for treatment success].

Science.gov (United States)

Feldmann, M; Tenhagen genannt Emming, S; Hoedemaker, M

2005-01-01

In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial treatment, n = 28). Before treatment, uterine swabs for bacteriologic examination and blood samples for determination of serum progesterone concentrations were collected. Two weeks following the first treatment, cows were reexamined. In case no clinical cure was diagnosed, treatment was repeated and control cows were treated for the first time with one of the three treatments mentioned above. The four treatment groups did not differ with respect to the clinical cure or reproductive performance. Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P conception rate and a lower pregnancy index were obtained when the treatment was performed following day 42 postpartum (P size had a negative effect on clinical cure over all groups (first treatment clinical cure: 68.2% (small uteri) vs 44.4% (large uteri); P 0.05). Isolation of Arcanobacterium (A.) pyogenes negatively influenced first treatment clinical cure over all treatment groups (79.0% vs 31.5%) and within treatment groups (P conception increased compared with the other treatment groups, when A. pyogenes was detected. Isolation of unspecific bacteria and the presence or absence of a corpus luteum only had minor effects over all and within the PG, AS and C group. Within the AB group, presence of luteal tissue was connected with a

Different conceptions of mental illness: consequences for the association with patients.

Science.gov (United States)

Helmchen, Hanfried

2013-01-01

Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e., an advanced bio-psycho-social conception about evidence-based characteristics on the social, psychological, and molecular-genetic level, require that all of these dimensions should be considered in order to personalize and thereby improve the care and treatment of the mentally ill.

Technical progress, the concept of individualized cancer treatment and the innovation of computer-assisted radiotherapy planning

International Nuclear Information System (INIS)

Merkle, K.; Tanneberger, S.; Matschke, S.

1985-01-01

After a first step of cancerogenesis, the further development of the tumor is an individual process. At the end of this process the tumor is formed as an individual in the individual. The individuality of cancer exists on the level of organs, tissues and cells and includes an individual tumor-host relationship. Today, optimized cancer treatment requires a most precise biological characterization possible of the tumor and of the tumor-host relationship, which will provide objective information about the individual character of every tumor. Routine analysis and strict therapeutic consideration of the clinical and biological individuality of human cancer can offer real chances for the improvement of cancer treatment. A routine acquisition of individual tumor characteristics will be possible only if methods and equipment are available for the registration of suitable parameters. In this context technical innovations have an essential influence on the realization of the concept of individualized cancer treatment. With the method of flow cytophotometry and other techniques examples are given in how far the ideas of individual cancer management can be realized by introduction of new technical solutions into medical research and clinical practice. Unfortunately there is still a lack of methodology in individualizing cancer treatment. The individualization of radiotherapy is connected to an extremely high degree of technical innovations. Particularly this refers to the topometrical description of the target volume in relation to the adjacent anatomical structures and the body contour as well as the fitting of isodoses to the shape and size of the target volume. As an example of innovation of a technical solution for individual radiotherapy planning the computer-assisted radiotherapy planning system DOPSY is described. (author)

Amelogenesis imperfecta: review of diagnostic findings and treatment concepts.

Science.gov (United States)

Sabandal, Martin M I; Schäfer, Edgar

2016-09-01

Mineralization defects like amelogenesis imperfecta are often of hereditary origin. This article reviews the diagnostic findings and summarizes the suggested treatment approaches. Currently, there are no defined therapy recommendations available for patients suffering from amelogenesis imperfecta. The mentioned therapies are more or less equal but no comprehensive therapy recommendation is evident. When treating patients suffering from amelogenesis imperfecta, a comprehensive therapy of almost every dental discipline has to be considered. The earlier the diagnosis of amelogenesis imperfecta is confirmed, the better the outcome is. Optimal treatment approaches consist of early diagnosis and treatment approach and frequent dental recall appointments to prevent progressive occlusal wear or early destruction by caries. Full-mouth prosthetic treatment seems to be the best treatment option.

Neurofeedback for Tinnitus Treatment - Review and Current Concepts.

Science.gov (United States)

Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

2017-01-01

An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

Novel concepts for CO2 capture

International Nuclear Information System (INIS)

Dijkstra, J.W.; Jansen, D.

2004-01-01

This paper describes the possibilities for power generation with CO 2 capture using envisaged key technologies: gas turbines, membranes and solid oxide fuel cells (SOFCs). First, the underlying programs in the Netherlands and at ECN are introduced. Then the key technologies are introduced, and concepts using these technologies are discussed. A literature overview of systems for power generation with fuel cells in combination with CO 2 capture is presented. Then a novel concept is introduced. This concept uses a water gas shift membrane reactor to convert the CO and H 2 in the SOFC anode off-gas to gain a CO 2 rich stream, which can be used for sequestration without elaborate treatment. Several implementation schemes of the technique are discussed such as atmospheric systems and hybrid SOFC-GT systems

Research designs for proof-of-concept chronic pain clinical trials

DEFF Research Database (Denmark)

Gewandter, Jennifer S; Dworkin, Robert H; Turk, Dennis C

2014-01-01

Proof-of-concept (POC) clinical trials play an important role in developing novel treatments and determining whether existing treatments may be efficacious in broader populations of patients. The goal of most POC trials is to determine whether a treatment is likely to be efficacious for a given i...

Different conceptions of mental illness: consequences for the association with patients

Directory of Open Access Journals (Sweden)

Hanfried eHelmchen

2013-05-01

Full Text Available Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e. the bio-psycho-social conception about specific interactions between the social environment and individual characteristics on both the psychological and molecular-genetic level, require that all of these dimensions should be considered in order to personalize and thereby improve the care and treatment of the mentally ill.

Establishing a library of resources to help people understand key concepts in assessing treatment claims-The "Critical thinking and Appraisal Resource Library" (CARL).

Science.gov (United States)

Castle, John C; Chalmers, Iain; Atkinson, Patricia; Badenoch, Douglas; Oxman, Andrew D; Austvoll-Dahlgren, Astrid; Nordheim, Lena; Krause, L Kendall; Schwartz, Lisa M; Woloshin, Steven; Burls, Amanda; Mosconi, Paola; Hoffmann, Tammy; Cusack, Leila; Albarqouni, Loai; Glasziou, Paul

2017-01-01

People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior. Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as 'intermediaries' of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups. CARL was populated with learning-resources identified from a variety of sources-two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by 'Key Concepts' needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org). We have created a database of resources called CARL

Concept and treatment of hydrocephalus in the Greco-Roman and early Arabic medicine.

Science.gov (United States)

Grunert, P; Charalampaki, P; Ayyad, A

2007-10-01

In the ancient medical literature hydrocephalus was not often described although its existence and symptomatology were well known. Most detailed descriptions of hydrocephalus including the surgical treatment are extant in the encyclopaedic works on medicine of the physicians Oreibasios and Aetios from Amida from the 4th and 6th centuries AD, respectively. Because of their broad scientific interests, this type of physicians, typical for the late Roman empire, were known as philosophy-physicians (iota alpha tau rho o sigma o phi iota sigma tau alpha iota). They defined hydrocephalus in contrast to our present understanding as a fluid collection excluding abscesses visible as a bulging tumour localised either outside or inside the skull of an infant. They classified the hydrocephalus similar as stated first by Galen in the 2nd century AD in four types corresponding to the assumed anatomic localisation of the fluid collection: 1st Type between the skin and the pericranium corresponding to the subgaleal haematoma or caput succedaneum of the newborn in our terminology, 2nd Type between the pericranium and the skull corresponding to the cephal haematoma after delivery, 3rd Type between skull and the meninges with increased head circumference, bone sutures being increasingly driven apart corresponding most likely to the hydrocephalus in our understanding, and 4th Type between the menings and the brain characterised by severe neurological deficit with lethal prognosis corresponding probably to all pathologies which were accompanied by an excessive increase of the intracranial pressure with a bulging fontanel. Due to the lack of autopsies in ancient times, the hydrocephalus was never linked to the pathology of the ventricles. All forms of hydrocephalus were believed to be caused by improper handling of the head by the midwife during delivery. Only the extracranial fluid collections, but not hydrocephalus in our sense, were considered to be suitable for surgical treatment

The Bobath concept in contemporary clinical practice.

Science.gov (United States)

Graham, Julie Vaughan; Eustace, Catherine; Brock, Kim; Swain, Elizabeth; Irwin-Carruthers, Sheena

2009-01-01

Future development in neurorehabilitation depends upon bringing together the endeavors of basic science and clinical practice. The Bobath concept is widely utilized in rehabilitation following stroke and other neurological conditions. This concept was first developed in the 1950s, based on the neuroscience knowledge of those times. The theoretical basis of the Bobath concept is redefined based on contemporary neuroscience and rehabilitation science. The framework utilized in the Bobath concept for the analysis of movement and movement dysfunction is described. This framework focuses on postural control for task performance, the ability to move selectively, the ability to produce coordinated sequences of movement and vary movement patterns to fit a task, and the role of sensory input in motor behaviour and learning. The article describes aspects of clinical practice that differentiate this approach from other models of practice. Contemporary practice in the Bobath concept utilizes a problem-solving approach to the individual's clinical presentation and personal goals. Treatment is focused toward remediation, where possible, and guiding the individual towards efficient movement strategies for task performance. The aim of this article is to provide a theoretical framework on which future research into the Bobath concept can be based.

Accident or maltreatment? Radiographic X-ray patterns in non-accidental trauma. The concept of sentinel injuries; Unfall oder Misshandlung? Radiologische Befunde beim nichtakzidentiellen Trauma. Das Konzept der ''sentinel injuries''

Energy Technology Data Exchange (ETDEWEB)

Hirsch, F.W.; Sorge, I.; Roth, C. [Uniklinikum Leipzig AoeR, Abteilung fuer Kinderradiologie, Leipzig (Germany); Gosemann, J.H. [Universitaetsklinikum Leipzig, Uniklinikum Leipzig AoeR, Klinik und Poliklinik fuer Kinderchirurgie, Leipzig (Germany)

2016-05-15

The focus of this review article is on child abuse and the radiographic pattern of X-ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary. The concept of sentinel injuries might be helpful for deciding in which cases a complete skeletal screening should be performed. In the age group up to 24 months old a complete skeletal status (with some exceptions) is recommended if one of the three sentinel injuries of rib fractures, intracranial bleeding and abdominal trauma is present. (orig.) [German] Die Kindesmisshandlung und ihre radiologischen Befundmuster sind Gegenstand dieser Uebersicht. Der Radiologe sollte in der Lage sein, typische Verletzungen als Misshandlungsfolge zu erkennen. In Einzelfaellen ist der Befund hochspezifisch fuer eine Misshandlung. Hierzu zaehlen z. B. metaphysaere Kantenabsprengungen an den langen Roehrenknochen bei bis 24 Monate alten Kindern. In anderen Faellen sind die Frakturen nicht spezifisch, aber hochsensitiv fuer das Vorliegen einer Misshandlung, z. B. bei Rippenfrakturen, die in ueber 50 % der Faelle mit einer Misshandlung assoziiert sein koennen. Die Misshandlung kann allerdings oft nur aus der Zusammenschau der unterschiedlichen Befunde, also nach Beurteilung des gesamten Skelettstatus, diagnostiziert werden. Fuer die Entscheidung, in welchen Faellen ein kompletter Skelettstatus angefertigt werden sollte, stellt sich das Konzept der ''sentinel injuries

Thoracic endometriosis syndrome: Current concept in ...

African Journals Online (AJOL)

Background: Thoracic endometriosis is a rare pathology. The diagnosis is often delayed or missed, however recently, there has been significant advances in the knowledge of this condition and hence, an improvement in the diagnosis and treatment. Objective: To review the current concepts in the pathophysiology and ...

Some concepts in condensed phase chemical kinetics

International Nuclear Information System (INIS)

Adelman, S.A.

1986-01-01

Some concepts in condensed phase chemical kinetics which have emerged from a recent rigorous statistical mechanical treatment of condensed phase chemical reaction dynamics (S.A. Adelman, Adv. Chem. Phys.53:61 (1983)) are discussed in simple physical terms

Nursing diagnosis “nausea” during chemotherapy: concept analysis

Directory of Open Access Journals (Sweden)

Aline Maria Bonini Moysés

2017-12-01

Full Text Available A study with the objective to analyze the concept nausea in chemotherapeutic treatment, to improve the nursing diagnosis “nausea”. We used the model proposed by Walker and Avant as a theoretical reference and, we conducted an integrative review in the databases PUBMED, EMBASE, CINAHL, and LILACS, with no time restriction. Thirty articles composed the sample, we identified 44 antecedents, being 25 related to the patient/biophysical, eight to the treatment/pharmacological factors and, 11 related to psychological factors. In the same sample, we identified 17 consequents, being the most frequent: “reduction of quality of life”, “chemotherapy can be cancelled, altered, dose reduced or interrupted treatment” and “decrease of nutrition/bad nutrition”. In the nausea definitions, the chemotherapeutic treatment is not cited as a cause. The precendents of this concept should be investigated in the clinical practice in an individualized way. The assessment of the consequents in this clientele can allow early interventions and decrease the undesirable nausea effects.

Cognitive Dissonance and Pediatric Procedural Pain Management: A Concept Clarification.

Science.gov (United States)

Bice, April A

2018-06-01

Pediatric nurses have often reported that pain management is a vital part of patient care. Evidence, however, suggests pediatric procedural pain treatments are often underused. Cognitive dissonance, the mental conflict leading to unpleasant thoughts and or feelings, may be related to this evidence-based gap found between what pediatric nurses claim about procedural pain management (that it is important) and what they actually do (underutilize pain treatments). The purpose of this manuscript is to clarify and further develop the concept of cognitive dissonance in terms of its relationship to nurses' mental struggles with underutilization of pediatric procedural pain treatments. A more relevant and extended definition of cognitive dissonance is presented. The concept of cognitive dissonance was examined using Rodgers' evolutionary concept analysis approach/framework. Analysis Methods: Through a six-step process of concept identification, setting and sample identification, data collection, data analysis, and future implication discussion, a more accurate and representative definition of cognitive dissonance is described. Databases used included CINAHL, Google Scholar, PsycINFO, ERIC, and PubMed. Seminal, recent, and relevant works were included in the review to adequately develop and clarify the concept. Procedural pain management breech among pediatric nurses is proposed to occur before the mental conflict produced. The unpleasant mental conflict created after the breech is followed by the nurse's determination to reduce mental conflict through attitude change followed by cognition change, which more closely reflects his or her behavior. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Dextromethorphan/quinidine pharmacotherapy in patients with treatment resistant depression: A proof of concept clinical trial.

Science.gov (United States)

Murrough, James W; Wade, Elizabeth; Sayed, Sehrish; Ahle, Gabriella; Kiraly, Drew D; Welch, Alison; Collins, Katherine A; Soleimani, Laili; Iosifescu, Dan V; Charney, Dennis S

2017-08-15

At least one-third of patients with major depressive disorder (MDD) have treatment-resistant depression (TRD), defined as lack of response to two or more adequate antidepressant trials. For these patients, novel antidepressant treatments are urgently needed. The current study is a phase IIa open label clinical trial examining the efficacy and tolerability of a combination of dextromethorphan (DM) and the CYP2D6 enzyme inhibitor quinidine (Q) in patients with TRD. Dextromethorphan acts as an antagonist at the glutamate N-methyl-d-aspartate (NMDA) receptor, in addition to other pharmacodynamics properties that include activity at sigma-1 receptors. Twenty patients with unipolar TRD who completed informed consent and met all eligibility criteria we enrolled in an open-label study of DM/Q up to 45/10mg by mouth administered every 12h over the course of a 10-week period, and constitute the intention to treat (ITT) sample. Six patients discontinued prior to study completion. There was no treatment-emergent suicidal ideation, psychotomimetic or dissociative symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) score was reduced from baseline to the 10-week primary outcome (mean change: -13.0±11.5, t 19 =5.0, p<0.001), as was QIDS-SR score (mean change: -5.9±6.6, t 19 =4.0, p<0.001). The response and remission rates in the ITT sample were 45% and 35%, respectively. Open-label, proof-of-concept design. Herein we report acceptable tolerability and preliminary efficacy of DM/Q up to 45/10mg administered every 12h in patients with TRD. Future larger placebo controlled randomized trials in this population are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Tissue perfusion as a key underlying concept of pressure ulcer development and treatment.

Science.gov (United States)

Wywialowski, E F

1999-03-01

The purpose of this article is to refine and advance the theory that tissue perfusion is the key concept in the development and delayed healing of pressure ulcers. The person likely to have (be at risk for) pressure ulcers is at greater risk for inadequate tissue perfusion generally and specifically at pressure points. Accordingly, the tissue perfusion theory of pressure ulcer development states that the factors that contribute to inadequate tissue perfusion should be used to predict (identify risk factors for) pressure ulcer development and delayed healing. Factors influencing a person's adequacy of tissue perfusion need to be assessed to identify risk for pressure ulcers. In addition, adequate tissue perfusion needs to be maintained to provide for healing of such wounds. Current beliefs about the causes and prevention of pressure ulcers are described. Physiologic components of the tissue perfusion theory are discussed: cellular exchange of nutrients and wastes, autoregulation of blood flow at the cellular level, and regulatory mechanisms that affect tissue perfusion when it is significantly compromised. The North American Nursing Diagnosis Association (NANDA) framework is used to classify or group examples of common pathophysiologic, treatment-related, situational, and maturational factors. Implications for research, practice, and education also are discussed.

Evolving concepts in the treatment of relapsing multiple sclerosis

DEFF Research Database (Denmark)

Comi, Giancarlo; Radaelli, Marta; Soelberg Sørensen, Per

2017-01-01

In the past 20 years the treatment scenario of multiple sclerosis has radically changed. The increasing availability of effective disease-modifying therapies has shifted the aim of therapeutic interventions from a reduction in relapses and disability accrual, to the absence of any sign of clinical...... or MRI activity. The choice for therapy is increasingly complex and should be driven by an appropriate knowledge of the mechanisms of action of the different drugs and of their risk-benefit profile. Because the relapsing phase of the disease is characterised by inflammation, treatment should be started...... as early as possible and aim to re-establish the normal complex interactions in the immune system. Before starting a treatment, neurologists should carefully consider the state of the disease, its prognostic factors and comorbidities, the patient's response to previous treatments, and whether the patient...

Different Conceptions of Mental Illness: Consequences for the Association with Patients†

OpenAIRE

Helmchen, Hanfried

2013-01-01

Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e. the bio-psycho-social conception about specific inter...

Concepts in local treatment of extensive paediatric burns

Science.gov (United States)

Ungureanu, M

2014-01-01

Abstract There is a wide variety of local therapeutical methods for extensive burns. This article aims to be a general overview of the most common methods used in the local treatment for extensive burns, both in our clinic and globally. Clinical examples are shown from our clinic; cases of the last 8 years. None of the less there is no such thing as the "perfect method of treatment" but a thin balance between the clinical experience of plastic surgeons, every case particularities and specified characteristics, meaning advantages, disadvantages and limited indications of local topics or methods of skin covering. PMID:25408723

Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors.

Science.gov (United States)

Kienle, Gunver S; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

2016-01-01

Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

Directory of Open Access Journals (Sweden)

Gunver S. Kienle

2016-01-01

Full Text Available Background. Mistletoe therapy (MT is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients’ general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients’ emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

Current concepts in the treatment of hereditary ataxias

Directory of Open Access Journals (Sweden)

Pedro Braga Neto

2016-03-01

Full Text Available ABSTRACT Hereditary ataxias (HA represents an extensive group of clinically and genetically heterogeneous neurodegenerative diseases, characterized by progressive ataxia combined with extra-cerebellar and multi-systemic involvements, including peripheral neuropathy, pyramidal signs, movement disorders, seizures, and cognitive dysfunction. There is no effective treatment for HA, and management remains supportive and symptomatic. In this review, we will focus on the symptomatic treatment of the main autosomal recessive ataxias, autosomal dominant ataxias, X-linked cerebellar ataxias and mitochondrial ataxias. We describe management for different clinical symptoms, mechanism-based approaches, rehabilitation therapy, disease modifying therapy, future clinical trials and perspectives, genetic counseling and preimplantation genetic diagnosis.

Space Mission Concept Development Using Concept Maturity Levels

Science.gov (United States)

Wessen, Randii R.; Borden, Chester; Ziemer, John; Kwok, Johnny

2013-01-01

Over the past five years, pre-project formulation experts at the Jet Propulsion Laboratory (JPL) has developed and implemented a method for measuring and communicating the maturity of space mission concepts. Mission concept development teams use this method, and associated tools, prior to concepts entering their Formulation Phases (Phase A/B). The organizing structure is Concept Maturity Level (CML), which is a classification system for characterizing the various levels of a concept's maturity. The key strength of CMLs is the ability to evolve mission concepts guided by an incremental set of assessment needs. The CML definitions have been expanded into a matrix form to identify the breadth and depth of analysis needed for a concept to reach a specific level of maturity. This matrix enables improved assessment and communication by addressing the fundamental dimensions (e.g., science objectives, mission design, technical risk, project organization, cost, export compliance, etc.) associated with mission concept evolution. JPL's collaborative engineering, dedicated concept development, and proposal teams all use these and other CML-appropriate design tools to advance their mission concept designs. This paper focuses on mission concept's early Pre-Phase A represented by CMLs 1- 4. The scope was limited due to the fact that CMLs 5 and 6 are already well defined based on the requirements documented in specific Announcement of Opportunities (AO) and Concept Study Report (CSR) guidelines, respectively, for competitive missions; and by NASA's Procedural Requirements NPR 7120.5E document for Projects in their Formulation Phase.

[M. Linehan dialectic behavioral psychotherapy. A new concept in the treatment of borderline personality disorders].

Science.gov (United States)

Bohus, M; Berger, M

1996-11-01

M. Linehan developed "dialectical behavioral therapy" specifically to treat chronically suicidal borderline patients. It rests on a biosocial model that assumes a disorder in the regulation of emotions and in tolerance of stress. The numerous dysfunctional patterns of behavior such as self-destructive behavior, inability to govern impulses or severe dissociative phenomena are regarded as attempts at problem-solving. This concept of therapy focuses on the continuing balance between the necessity of accepting maladaptive behavior patterns in both an intrapsychic and an interactional context while still working to change them. A comprehensive manual outlines the clearly structured therapy and integrates a wide choice of therapeutic strategies. Parallel to development of the therapy itself, a method also was developed for testing therapist adherence to the manual's guidelines, thus providing a basis for empirical evaluation. An initial controlled, randomized study demonstrated the significant superiority of this method to methods of unspecific psychotherapy at various levels. In the current endeavor to develop disorder-specific approaches to the treatment of personality disorders, "dialectical behavioral therapy" is a noteworthy model.

Effects of administration of gonadotropin-releasing hormone at artificial insemination on conception rates in dairy cows.

Science.gov (United States)

Shephard, R W; Morton, J M; Norman, S T

2014-01-10

A controlled trial investigating the effect on conception of administration of 250 μg of gonadotropin-releasing hormone (GnRH) at artificial insemination (AI) in dairy cows in seasonal or split calving herds was conducted. Time of detection of estrus, body condition, extent of estrous expression, treatment, breed, age and milk production from the most recent herd test of the current lactation was recorded. Cows were tested for pregnancy with fetal aging between 35 and 135 days after AI. Sixteen herds provided 2344 spring-calved cows and 3007 inseminations. Logistic regression adjusting for clustering at herd level was used to examine the effect of treatment for first (2344) and second (579) inseminations separately. For first AI, treatment significantly improved conception rate in cows with milk protein concentrations of 3.75% or greater and for cows with milk protein concentrations between 3.00% and 3.50% and less than 40 days calved; increased conception rate from 41.2% to 53.4%. Treatment reduced conception rates in cows with milk protein concentrations of 2.75% or less. Treating only cows identified as responding positively to treatment (11% of all study cows) was estimated to increase first service conception rate in herds from 48.1% to 49.4%. There was no significant effect of treatment on conception to second AI, nor any significant interactions. These findings indicate that GnRH at AI should be limited to the sub-group cows most likely to respond. The positive effect of GnRH at AI may be mediated through improved oocyte maturation and/or improved luteal function, rather than by reducing AI-to-ovulation intervals. Copyright © 2013 Elsevier B.V. All rights reserved.

[Concept analysis of medication adherence in patients with chronic disease].

Science.gov (United States)

Huang, Jen-Ying; Chen, Hsing-Mei

2014-06-01

Pharmacotherapy plays an important role in the management of chronic diseases. However, many patients with chronic disease do not adhere to their medication regimen. This results in worsening symptoms and frequent re-hospitalizations. As a result, healthcare providers may view these patients as bad. Medication adherence is a complex concept. Analyzing this concept may assist nurses to improve patient-centered care. This paper uses Walker & Avant's method to conduct a concept analysis of medication adherence. Results show the defining attributes of medication adherence as: (1) knowing and agreeing to the medication; (2) communicating and negotiating the regimen; and (3) active, continuous involvement in and appraisal of the treatment effect. Identified antecedents of medication adherence included the patient having: (1) a prescribed medication regimen; (2) cognitive and action abilities in her / his role as a patient; and (3) level of preparation for medication treatment. Identified consequences of medication adherence include: (1) improving symptom control; (2) decreasing re-hospitalizations and mortality; (3) reducing medical care costs; (4) restoring self-esteem; and (5) diminishing depression. It is hoped that this concept analysis provides a reference for nurses to achieve a better understanding of medication adherence and further improve nursing practice.

Neurofeedback for Tinnitus Treatment – Review and Current Concepts

Science.gov (United States)

Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

2017-01-01

An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically. PMID:29249959

Neurofeedback for Tinnitus Treatment – Review and Current Concepts

Directory of Open Access Journals (Sweden)

Dominik Güntensperger

2017-12-01

Full Text Available An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB, a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

Key Concept Mathematics and Management Science Models

Science.gov (United States)

Macbeth, Thomas G.; Dery, George C.

1973-01-01

The presentation of topics in calculus and matrix algebra to second semester freshmen along with a treatment of exponential and power functions would permit them to cope with a significant portion of the mathematical concepts that comprise the essence of several disciplines in a business school curriculum. (Author)

Neurofeedback for Tinnitus Treatment – Review and Current Concepts

OpenAIRE

Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

2017-01-01

An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily ...

Innatism, Concept Formation, Concept Mastery and Formal Education

Science.gov (United States)

Winch, Christopher

2015-01-01

This article will consider the claim that the possession of concepts is innate rather than learned. Innatism about concept learning is explained through consideration of the work of Fodor and Chomsky. First, an account of concept formation is developed. Second the argument against the claim that concepts are learned through the construction of a…

The concept of shalom as a constructive bereavement healing ...

African Journals Online (AJOL)

existence of African traditional healing and biomedical treatment, that is, plurality of health seeking practices. The approach ... The Hebrew concept of shalom, though distinctly salvific, is inclusive of holistic and personalistic healing aspects.

Progressive multifocal leukoencephalopathy: new concepts

Directory of Open Access Journals (Sweden)

Marco A. Lima

2013-09-01

Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

Quality Pain Management in Adult Hospitalized Patients: A Concept Evaluation.

Science.gov (United States)

Zoëga, Sigridur; Gunnarsdottir, Sigridur; Wilson, Margaret E; Gordon, Debra B

2016-01-01

To explore the concept of quality pain management (QPM) in adult hospitalized patients. Pain is common in hospitalized patients, and pain management remains suboptimal in some settings. A concept evaluation based on Morse et al.'s method. Of more than 5,000 articles found, data were restricted to 37 selected key articles published in peer-reviewed journals. Data were extracted from the selected articles and then synthesized according to the following: definition, characteristics, boundaries, preconditions, and outcomes. QPM relates to the Structure: organizationally supported evidence-based policies, competent staff, interprofessional and specialized care, and staff accountability; screening, assessment/reassessment and communication of pain and its treatment, patient/family education, individualized evidence-based treatment, embedded in safe, effective, patient-centered, timely, efficient, and equitable services; and reduced pain severity and functional interference, decreased prevalence/severity of adverse consequences from pain or pain treatment, and increase in patient satisfaction. QPM is a multifaceted concept that remains poorly defined in the literature. Studies should aim to develop valid, reliable, and operational measures of the pillars of QPM and to look at the relationship among these factors. Authors need to state how they define and what aspects of QPM they are measuring. © 2014 Wiley Periodicals, Inc.

Self-Concept Is a Concept Worth Considering

Science.gov (United States)

Shields, Nora

2009-01-01

There is a growing recognition of the importance of self-concept in the pediatric rehabilitation research literature. There also is confusion and inconsistency in the definitions of and the terminology used to describe self-concept. What is agreed is that self-concept is multidimensional, comprising a child's perception of their personal…

Planner concepts in IMRT planning

International Nuclear Information System (INIS)

Sahoo, Suvendu Kr.; Rath, A.K.; Patnaik, S.; Mishra, S.K.

2008-01-01

IMRT is the most sophisticated, innovative, three- dimensional conformal radiation treatment that delivers highly focused radiation with minimal impact to surrounding normal tissue. As it is a computer control technique, the planar should have adequate knowledge to execute the plan in proper way other wise it is very difficult to get the optimal plan. In this article we want to high light, planner should have the basic concepts before starting the IMRT planning

AMBIVALENCE OF THE ENTROPY CONCEPT IN THE HUMANITIES

Directory of Open Access Journals (Sweden)

Mr. Andrei V. Matyushko

2016-12-01

Full Text Available The paper deals with various views on the concept of entropy. The author gives examples of entropy actualization from different spheres of existence and comes to conclusion about the ambiguity of the treatment of this term in the Humanities.

Global response to HIV: treatment as prevention, or treatment for treatment?

NARCIS (Netherlands)

Sigaloff, Kim C. E.; Lange, Joep M. A.; Montaner, Julio

2014-01-01

The concept of "treatment as prevention" has emerged as a means to curb the global HIV epidemic. There is, however, still ongoing debate about the evidence on when to start antiretroviral therapy in resource-poor settings. Critics have brought forward multiple arguments against a "test and treat"

Point-of-care genetic testing for personalisation of antiplatelet treatment (RAPID GENE): a prospective, randomised, proof-of-concept trial.

Science.gov (United States)

Roberts, Jason D; Wells, George A; Le May, Michel R; Labinaz, Marino; Glover, Chris; Froeschl, Michael; Dick, Alexander; Marquis, Jean-Francois; O'Brien, Edward; Goncalves, Sandro; Druce, Irena; Stewart, Alexandre; Gollob, Michael H; So, Derek Y F

2012-05-05

Prospective assessment of pharmacogenetic strategies has been limited by an inability to undertake bedside genetic testing. The CYP2C19*2 allele is a common genetic variant associated with increased rates of major adverse events in individuals given clopidogrel after percutaneous coronary intervention (PCI). We used a novel point-of-care genetic test to identify carriers of the CYP2C19*2 allele and aimed to assess a pharmacogenetic approach to dual antiplatelet treatment after PCI. Between Aug 26, 2010, and July 7, 2011, 200 patients were enrolled into our prospective, randomised, proof-of-concept study. Patients undergoing PCI for acute coronary syndrome or stable angina were randomly assigned to rapid point-of-care genotyping or to standard treatment. Individuals in the rapid genotyping group were screened for the CYP2C19*2 allele. Carriers were given 10 mg prasugrel daily, and non-carriers and patients in the standard treatment group were given 75 mg clopidogrel daily. The primary endpoint was the proportion of CYP2C19*2 carriers with high on-treatment platelet reactivity (P2Y12 reactivity unit [PRU] value of more than 234) after 1 week of dual antiplatelet treatment, which is a marker associated with increased adverse cardiovascular events. Interventional cardiologists and data analysts were masked to genetic status and treatment. Patients were not masked to treatment allocation. All analyses were by intention to treat. This study is registered with ClinicalTrials.gov, NCT01184300. After randomisation, 187 patients completed follow-up (91 rapid genotyping group, 96 standard treatment). 23 individuals in each group carried at least one CYP2C19*2 allele. None of the 23 carriers in the rapid genotyping group had a PRU value of more than 234 at day 7, compared with seven (30%) given standard treatment (p=0·0092). The point-of-care genetic test had a sensitivity of 100% (95% CI 92·3-100) and a specificity of 99·3% (96·3-100). Point-of-care genetic testing after

Indian mental concepts on children and adolescents.

Science.gov (United States)

Sitholey, Prabhat; Agarwal, Vivek; Vrat, Satya

2013-01-01

Ancient Indian mental concepts of children and adolescents are very similar to the contemporary modern concepts. The ancient concepts were based on a very positive regard for the children's development, education and future independence, adult role and contribution to society. Children were wanted and considered precious. The children were categorized in to 4 different varnas based on their intelligence, abilities, merit and aptitude and educated accordingly, away from their home, at Gurukuls. They had universal right to education. Girls received attention equal to boys. The boys were expected to earn their livelihood, while the girls were expected to be homemakers. Graduation of the young person at the end of education and return to home marked the emancipation from adolescence. Children's physical and mental health and its disorders were given due attention. Aetiology and treatment of physical and mental disorders was in accordance with the overall scientific development of those times.

Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis.

Science.gov (United States)

Plakun, Eric

2012-06-01

Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.

Prosthodontic perspective to all-on-4® concept for dental implants.

Science.gov (United States)

Taruna, M; Chittaranjan, B; Sudheer, N; Tella, Suchita; Abusaad, Md

2014-10-01

The clinical success and longevity of endosteal dental implants as load bearing abutments are controlled largely by the mechanical setting in which they function. The treatment plan is responsible for the design, number and position of the implants. In biomechanically compromised environment such as poor quality bone, strain to the crestal bone can be reduced by increasing the anterioposterior spread of implants, placement of longer implants and maximizing the number of implants. The All-on-4(®) concept is one such treatment procedure which enlightens us for its use in the completely edentulous patients and which also leaves behind the routine treatment alternative of conventional dentures with successful outcome in the short term, long term and the retrospective studies that have been done in the past. The area of concern for any treatment alternative lies in the success of the prosthesis and its prosthodontic perspective involving the principles of occlusion. This article reviews the All-on-4(®) concept and its prosthodontic aspects.

Early fractionation methods and the origins of the NSD concept

International Nuclear Information System (INIS)

Thames, H.D. Jr.

1988-01-01

The concept of the time factor in radiotherapy originated in the controversy surrounding single-dose and fractionated treatments during the first 20 years of this century. The success of Coutard's fractionated treatments of larynx tumors was an important factor in the abandonment of single-dose treatments. There was considerable research afterwards into the influence of dose rate and overall time of treatment on the responses of normal tissues. Recovery was modeled in terms of the Schwarzschild law of photochemistry, as exemplified by the analysis of Strandqvist in log dose-log time coordinates. Different conventions were followed in defining the time for a single-dose treatment. Subsequently the concept arose that the slopes of isoeffect lines relating dose and treatment time for normal tissues and tumors were different and moreover that the effects of fraction number and overall time could be separated; these developments constituted the foundation of the Ellis NSD model. It had an important influence on clinical practice and was reasonably successful in predicting isoeffective regimens for acute effects. It failed to predict severe late effects after large dose fractions. The dissociation between acute and late effects with altered fractionation led to recognition of the importance of the ratio α/β in characterizing the fractionation sensitivity of tissues. (orig.) With 125 refs

Mengembangkan Self Concept Siswa Melalui Model Pembelajaran Concept Attainment

OpenAIRE

Sumartini, Tina Sri

2015-01-01

Dalam pembelajaran matematika, siswa masih kurang memiliki self concept yang positif. Salah satu model pembelajaran yang dapat diterapkan untuk mengembangkan self concept siswa adalah model concept attainment. Tujuan penelitian ini adalah untuk mengetahui perkembangan self concept siswa setelah mendapatkan model pembelajaran concept attainment. Penelitian ini berbentuk one shot case study. Populasi dalam penelitian ini adalah siswa di salah satu SMK di Kabupaten Garut. Pengambilan sampel d...

Current concepts in the assessment and treatment of hepatic encephalopathy.

LENUS (Irish Health Repository)

Cash, W J

2012-02-01

Hepatic encephalopathy (HE) is defined as a metabolically induced, potentially reversible, functional disturbance of the brain that may occur in acute or chronic liver disease. Standardized nomenclature has been proposed but a standardized approach to the treatment, particularly of persistent, episodic and recurrent encephalopathy associated with liver cirrhosis has not been proposed. This review focuses on the pathogenesis and treatment of HE in patients with cirrhosis. The pathogenesis and treatment of hepatic encephalopathy in fulminant hepatic failure is quite different and is reviewed elsewhere.

Treatment verification with megavoltage electronic portal imaging applied to the tomotherapy concept

International Nuclear Information System (INIS)

Hesse, B.-M.; Spies, L.; Groh, B.; Doll, J.; Haering, P.; Hoever, K. H.

1997-01-01

Purpose: A new treatment strategy called Tomotherapy, introduced by T. R. Mackie et al. in 1993, was designed to perform a dynamic conformal treatment technique in precision radiotherapy. This technique delivers sliced intensity-modulated radiation fields to achieve best tumor control while sparing neighbouring sensitive normal tissue and organs at risk. The beam continuously revolves around the patient similarly to a spiral-CT while the patient is moved through the bore of the gantry. As a first step towards the realization of such a concept with a linear accelerator (Siemens Mevatron Experimental) used in clinical routine, we focused on treatment setup and dose verification. In tomotherapy, an actual CT data set is needed for patient positioning and for the verification of the absorbed dose, also, the dose transmitted through the patient must be known. This makes possible both routine tomographic treatment setup verification and tomographic dose reconstruction of the actual delivered dose. Materials and Methods: All measurements were performed with a megavoltage electronic portal imaging device of Wellhoefer TM (BIS-710). The BIS-710 detector is based on a scintillation foil and contains a camera for 10-bit digital data output. The dimension of the detector plane is 512 x 512 pixels with a pixel size of 0.6 mm in each direction. The BIS-710 was developed especially for quantitative dose measuring, whereas most of the existing Portal Imaging Systems are used for image display only. To examine the properties of the BIS-710 concerning tomographical reconstruction with a therapeutic 6 MV X-ray beam, a tissue-equivalent Alderson head phantom was rotated stepwise across a stationary beam between the collimator and the detector plane. The influence of scattering can be estimated by comparing measurements which were taken with a homogeneous phantom which is invariant under rotation with a calculated exit dose distribution using a simple exponential law for the

Conceptions of Parents, Conceptions of Self, and Conceptions of God.

Science.gov (United States)

Buri, John R.; Mueller, Rebecca A.

Different theorists have suggested that an individual's view of God may be related to one's view of one's father, one's mother, or one's self. A study was conducted to examine the relationship of college students' conceptions of the wrathfulness-kindliness of God to their conceptions of their father's and mother's permissiveness, authoritarianism,…

THE EFFECT OF CONCEPT MAPPING ON CONCEPT LEARNING IN SCIENCE

OpenAIRE

岡, 直樹; 今永, 久美子

2012-01-01

An experiment was conducted to investigate the effects of concept map completion tasks on concept learning in the primary schoolchildren. The participants were to insert some of the suitable concepts (concept group) or link labeles (link label group) or both of them (concept/link label group) into the blanks to make up the map wholly. It was revealed that the results of the concept group and the concept/link label group were better than the link label group. These results were discussed in te...

Enhanced primary treatment of concentrated black water and kitchen residues within DESAR concept using two types of anaerobic digesters.

Science.gov (United States)

Kujawa-Roeleveld, K; Elmitwalli, T; Zeeman, G

2006-01-01

Anaerobic digestion of concentrated domestic wastewater streams--black or brown water, and solid fraction of kitchen waste is considered as a core technology in a source separation based sanitation concept (DESAR--decentralised sanitation and reuse). A simple anaerobic digester can be implemented for an enhanced primary treatment or, in some situations, as a main treatment. Two reactor configurations were extensively studied; accumulation system (AC) and UASB septic tank at 15, 20 and 25 degrees C. Due to long retention times in an AC reactor, far stabilisation of treated medium can be accomplished with methanisation up to 60%. The AC systems are the most suitable to apply when the volume of waste to be treated is minimal and when a direct reuse of a treated medium in agriculture is possible. Digested effluent contains both liquid and solids. In a UASB septic tank, efficient separation of solids and liquid is accomplished. The total COD removal was above 80% at 25 degrees C. The effluent contains COD and nutrients, mainly in a soluble form. The frequency of excess sludge removal is low and sludge is well stabilised due to a long accumulation time.

Mode of conception of triplets and high order multiple pregnancies.

LENUS (Irish Health Repository)

Basit, I

2012-03-01

A retrospective audit was performed of all high order multiple pregnancies (HOMPs) delivered in three maternity hospitals in Dublin between 1999 and 2008. The mode of conception for each pregnancy was established with a view to determining means of reducing their incidence. A total of 101 HOMPs occurred, 93 triplet, 7 quadruplet and 1 quintuplet. Information regarding the mode of conception was available for 78 (81%) pregnancies. Twenty eight (27.7%) were spontaneous, 34 (33.7%) followedlVF\\/ICSI\\/FET treatment (in-vitro fertilisation, intracytoplasmic sperm injection, frozen embryo transfer), 16 (15.8%) resulted from Clomiphene Citrate treatment and 6 (6%) followed ovulation induction with gonadotrophins. Triplet and HOMPs are a major cause of maternal, feta land neonatal morbidity. Many are iatrogenic, arising from fertility treatments including Clomiphene. Reducing the numbers of embryos transferred will address IVF\\/ICSI\\/FET-related multiple pregnancy rates and this is currently happening in Ireland. Clomiphene and gonadotrophins should only be prescribed when appropriate resources are available to monitor patients adequately.

Recent developments and current concepts in medulloblastoma.

Science.gov (United States)

Gerber, N U; Mynarek, M; von Hoff, K; Friedrich, C; Resch, A; Rutkowski, S

2014-04-01

Medulloblastoma is the most common malignant brain tumor of childhood. While prognosis has significantly improved in the last decades with multimodal therapy including surgery, radiotherapy, and chemotherapy, one third of patients still succumb to their disease. Further research is needed to find more efficient treatment strategies for prognostically unfavorable patient groups and to minimize long-term sequelae of tumor treatment. This review gives a summary of the current state of treatment concepts including an outlook on the near future. We describe recent advances in the understanding of molecular mechanisms, their potential impact on risk stratification in upcoming clinical trials, and perspectives for the clinical implementation of targeted therapies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Concepts in quantum field theory a practitioner's toolkit

CERN Document Server

Ilisie, Victor

2015-01-01

This book uses less strict yet still formal mathematical language to clarify a variety of concepts in Quantum Field Theory that remain somewhat “fuzzy” in many books designed for undergraduates and fresh graduates. The aim is not to replace formal books on Quantum Field Theory, but rather to offer a helpful complementary tool for beginners in the field. Features include a reader-friendly introduction to tensor calculus and the concept of manifolds; a simple and robust treatment for dimensional regularization; a consistent explanation of the renormalization procedure, step by step and in a transparent manner at all orders, using the QED Lagrangian; and extensive treatment of infrared as well as ultraviolet divergences. The most general (Lorentz invariant) form of Noether's theorem is presented and applied to a few simple yet relevant examples in Quantum Field Theory. These and further interesting topics are addressed in a way that will be accessible for the target readership. Some familiarity with basic no...

Concept mapping learning strategy to enhance students' mathematical connection ability

Science.gov (United States)

Hafiz, M.; Kadir, Fatra, Maifalinda

2017-05-01

The concept mapping learning strategy in teaching and learning mathematics has been investigated by numerous researchers. However, there are still less researchers who have scrutinized about the roles of map concept which is connected to the mathematical connection ability. Being well understood on map concept, it may help students to have ability to correlate one concept to other concept in order that the student can solve mathematical problems faced. The objective of this research was to describe the student's mathematical connection ability and to analyze the effect of using concept mapping learning strategy to the students' mathematical connection ability. This research was conducted at senior high school in Jakarta. The method used a quasi-experimental with randomized control group design with the total number was 72 students as the sample. Data obtained through using test in the post-test after giving the treatment. The results of the research are: 1) Students' mathematical connection ability has reached the good enough level category; 2) Students' mathematical connection ability who had taught with concept mapping learning strategy is higher than who had taught with conventional learning strategy. Based on the results above, it can be concluded that concept mapping learning strategycould enhance the students' mathematical connection ability, especially in trigonometry.

[Treatment goals in FACE philosophy].

Science.gov (United States)

Martin, Domingo; Maté, Amaia; Zabalegui, Paula; Valenzuela, Jaime

2017-03-01

The FACE philosophy is characterized by clearly defined treatment goals: facial esthetics, dental esthetics, periodontal health, functional occlusion, neuromuscular mechanism and joint function. The purpose is to establish ideal occlusion with good facial esthetics and an orthopedic stable joint position. The authors present all the concepts of FACE philosophy and illustrate them through one case report. Taking into account all the FACE philosophy concepts increases diagnostic ability and improves the quality and stability of treatment outcomes. The goal of this philosophy is to harmonize the facial profile, tooth alignment, periodontium, functional occlusion, neuromuscular mechanism and joint function. The evaluation and treatment approach to vertical problems are unique to the philosophy. © EDP Sciences, SFODF, 2017.

Amblyopia update: new treatments.

Science.gov (United States)

Vagge, Aldo; Nelson, Leonard B

2016-09-01

This review article is an update on the current treatments for amblyopia. In particular, the authors focus on the concepts of brain plasticity and their implications for novel treatment strategies for both children and adults affected by amblyopia. A variety of strategies has been developed to treat amblyopia in children and adults. New evidence on the pathogenesis of amblyopia has been obtained both in animal models and in clinical trials. Mainly, these studies have challenged the classical concept that amblyopia becomes untreatable after the 'end' of the sensitive or critical period of visual development, because of a lack of sufficient plasticity in the adult brain. New treatments for amblyopia in children and adults are desirable and should be encouraged. However, further studies should be completed before such therapies are widely accepted into clinical practice.

Treatment of Wound Healing Disorders of Radial Forearm Free Flap Donor Sites Using Cold Atmospheric Plasma: A Proof of Concept.

Science.gov (United States)

Hartwig, Stefan; Doll, Christian; Voss, Jan Oliver; Hertel, Moritz; Preissner, Saskia; Raguse, Jan Dirk

2017-02-01

The treatment of wound healing disturbances of the radial forearm free flap donor site after reconstructive surgery is typically long and burdensome and often requires additional surgery. Cold atmospheric plasma is a promising approach to overcome these impairments. The aim of this proof of concept study was to evaluate the clinical outcome of plasma irradiation in patients with wound healing disorders with exposed brachial tendons of the radial forearm. Four patients (mean age 64.2 years, range 44 to 80) who had undergone radial forearm free flap procedures and developed wound healing disturbance leading to exposed flexor tendons were included in the present prospective case series. In addition to routine wound care, all sites were irradiated with cold atmospheric plasma. The primary outcome variable was complete wound closure. In all patients, complete wound repair in terms of the absence of tendon exposure was observed within a mean treatment time of 10.1 weeks (range 4.9 to 16). No undesirable side effects were observed, and no inflammation or infection occurred. Cold atmospheric plasma could offer a reliable conservative treatment option for complicated wound healing disturbances. This was exemplarily shown in the case of radial forearm free flap donor site morbidity with exposed flexor tendons in the present study. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Short-term clinical outcomes of laser supported periodontal treatment concept using Er,Cr:YSGG (2780nm) and diode (940 nm): a pilot study

Science.gov (United States)

Odor, Alin A.; Violant, Deborah; Badea, Victoria; Gutknecht, Norbert

2016-03-01

Backgrounds: Er,Cr:YSGG (2780nm) and diode (940 nm) lasers can be used adjacent to the conventional periodontal treatment as minimally invasive non-surgical devices. Aim: To describe the short-term clinical outcomes by combining Er,Cr:YSGG (2780nm) and diode 940 nm lasers in non-surgical periodontal treatment. Materials and methods: A total of 10 patients with periodontal disease (mild, moderate, severe) - 233 teeth and 677 periodontal pockets ranging from 4 mm to 12 mm - were treated with Er,Cr:YSGG (2780nm) and diode (940 nm) lasers in adjunct to manual and piezoelectric scaling and root planning (SRP). Periodontal parameters such as mean probing depth (PD), mean clinical attachment level (CAL) and mean bleeding on probing (BOP) were evaluated at baseline and 6 months after the laser treatment using an electronic periodontal chart. Results: At baseline, the mean PD was 4.06 ± 1.06 mm, mean CAL was 4.56 ± 1.43 mm, and mean BOP was 43.8 ± 23.84 %. At 6 months after the laser supported periodontal treatments the mean PD was 2.6 ± 0.58 mm (p laser wavelengths in adjunct to SRP offers significant improvements of periodontal clinical parameters such as PD, CAL and BOP. Keywords: Laser supported periodontal treatment concept, Er,Cr:YSGG and diode 940nm lasers, Scaling and root planning, Minimally invasive non-surgical device

Nuclear data uncertainties: I, Basic concepts of probability

Energy Technology Data Exchange (ETDEWEB)

Smith, D.L.

1988-12-01

Some basic concepts of probability theory are presented from a nuclear-data perspective, in order to provide a foundation for thorough understanding of the role of uncertainties in nuclear data research. Topics included in this report are: events, event spaces, calculus of events, randomness, random variables, random-variable distributions, intuitive and axiomatic probability, calculus of probability, conditional probability and independence, probability distributions, binomial and multinomial probability, Poisson and interval probability, normal probability, the relationships existing between these probability laws, and Bayes' theorem. This treatment emphasizes the practical application of basic mathematical concepts to nuclear data research, and it includes numerous simple examples. 34 refs.

Nuclear data uncertainties: I, Basic concepts of probability

International Nuclear Information System (INIS)

Smith, D.L.

1988-12-01

Some basic concepts of probability theory are presented from a nuclear-data perspective, in order to provide a foundation for thorough understanding of the role of uncertainties in nuclear data research. Topics included in this report are: events, event spaces, calculus of events, randomness, random variables, random-variable distributions, intuitive and axiomatic probability, calculus of probability, conditional probability and independence, probability distributions, binomial and multinomial probability, Poisson and interval probability, normal probability, the relationships existing between these probability laws, and Bayes' theorem. This treatment emphasizes the practical application of basic mathematical concepts to nuclear data research, and it includes numerous simple examples. 34 refs

Evolving concepts of heredity and genetics in orthodontics.

Science.gov (United States)

Carlson, David S

2015-12-01

The field of genetics emerged from the study of heredity early in the 20th century. Since that time, genetics has progressed through a series of defined eras based on a number of major conceptual and technical advances. Orthodontics also progressed through a series of conceptual stages over the past 100 years based in part on the ongoing and often circular debate about the relative importance of heredity (nature) and the local environment (nurture) in the etiology and treatment of malocclusion and dentofacial deformities. During the past 20 years, significant advancements in understanding the genomic basis of craniofacial development and the gene variants associated with dentofacial deformities have resulted in a convergence of the principles and concepts in genetics and in orthodontics that will lead to significant advancement of orthodontic treatments. Fundamental concepts from genetics and applied translational research in orthodontics provide a foundation for a new emphasis on precision orthodontics, which will establish a modern genomic basis for major improvements in the treatment of malocclusion and dentofacial deformities as well as many other areas of concern to orthodontists through the assessment of gene variants on a patient-by-patient basis. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The SPoRT concept of bracing for idiopathic scoliosis.

Science.gov (United States)

Zaina, Fabio; Fusco, Claudia; Atanasio, Salvatore; Negrini, Stefano

2011-01-01

The SPoRT (acronym: Symmetrical, Patient-oriented, Rigid, Three-dimensional, active) concept of bracing is a new way to build braces based on our 20 years of experience and the biomechanical principles of scoliosis correction, inclusive of the Sibilla and Sforzesco braces. The concept always requires a custom brace, which is made according to the patient's individual requirements. New technologies such as CAD-CAM can be applied, and often for better results, without the customary use of prebuilt forms whose measurements are stored in databases. Once the initial draft brace is completed, a final test must be made on the patient to modify and adapt it, depending on his or her real interaction between the body and the brace. The results that are today available on the SPoRT concept relate to the Sforzesco brace and are necessarily short-term, because the first treated patients are now reaching the fourth-year follow-up examination and haven't yet completed their treatments. On the basis of the initial evaluations, we can state that the Sforzesco brace is more effective than the Lyon brace after 6 months of treatment and that the Sforzesco brace is equally effective as the Risser Plast brace.

Radionuclide containment in soil by phosphate treatment

International Nuclear Information System (INIS)

Lee, S.Y.; Francis, C.W.; Timpson, M.E.; Elless, M.P.

1995-01-01

Radionuclide transport from a contaminant source to groundwater and surface water is a common problem faced by most US Department of Energy (DOE) facilities. Containment of the radionuclide plume, including strontium-90 and uranium, is possible using phosphate treatment as a chemical stabilizer. Such a chemical process occurs in soils under natural environmental conditions. Therefore, the concept of phosphate amendment for radiostrontium and uranium immobilization is already a proven principle. In this presentation, results of bench-scale experiments and the concept of a field-scale demonstration are discussed. The phosphate treatment is possible at the source or near the advancing contaminant plume. Cleanup is still the ideal concept; however, containment through stabilization is a more practical and costeffective concept that should be examined by DOE Environmental Restoration programs

Concepts for treatment of micrometastases developed in murine systems

International Nuclear Information System (INIS)

Schabel, F.M. Jr.

1976-01-01

Current knowledge of tumor cell population growth kinetics indicates that the growth fraction (viable tumor cells undergoing active cell replication) is inversely related to population size. Tumor cells in micrometastases should, therefore, be more sensitive to anticancer drugs active against anabolizing cells than are tumor cells in the larger, grossly apparent primary tumor from which they were derived. This indicates the probability that micrometastases will be effectively responsive to more drugs than is the primary and clinically apparent tumor from which they came. Studies with at least four metastatic and uniformly fatal murine solid tumors (lung, breast, colon, and melanoma) have demonstrated significantly improved cure rates with drug treatment following surgical removal of the grossly apparent primary tumor than can be obtained with either surgery or drug treatment when used alone. Further, both disease staging and drug dosage have been shown to influence cure rates of combined-modality treatment. With several mouse tumors, a significantly smaller number of viable tumor cells can establish lethal tumors in the presence of radiation-inactivated tumor cells than in their absence. This suggests that small numbers of residual viable tumor cells in radiation-treated tumor sites may be a greater threat to clinical cure than smaller tumor cell populations remaining in situ after surgery

Volumetric MR-Guided High-Intensity Focused Ultrasound with Direct Skin Cooling for the Treatment of Symptomatic Uterine Fibroids: Proof-of-Concept Study

Directory of Open Access Journals (Sweden)

Marlijne E. Ikink

2015-01-01

Full Text Available Objective. To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU ablation with direct skin cooling (DISC during treatment of uterine fibroids. Methods. In this proof-of-concept study, eight patients were consecutively selected for clinical MR-HIFU ablation of uterine fibroids with the use of an additional DISC device to maintain a constant temperature (T≈20°C at the interface between the HIFU table top and the skin. Technical feasibility was verified by successful completion of MR-HIFU ablation. Contrast-enhanced T1-weighted MRI was used to measure the treatment effect (nonperfused volume (NPV ratio. Safety was evaluated by recording of adverse events (AEs within 30 days’ follow-up. Results. All MR-HIFU treatments were successfully completed in an outpatient setting. The median NPV ratio was 0.56 (IQR [0.27–0.72]. Immediately after treatment, two patients experienced coldness related discomfort which resolved at the same day. No serious (device-related AEs were reported. Specifically, no skin burns, cold injuries, or subcutaneous edema were observed. Conclusion. This study showed that it is safe and technically feasible to complete a volumetric MR-HIFU ablation with DISC. This technique may reduce the risk of thermal injury to the abdominal wall during MR-HIFU ablation of uterine fibroids. This trial is registered with NTR4189.

An overview of concept mapping in Dutch mental health care.

Science.gov (United States)

Nabitz, Udo; van Randeraad-van der Zee, Carlijn; Kok, Ineke; van Bon-Martens, Marja; Serverens, Peter

2017-02-01

About 25 years ago, concept mapping was introduced in the Netherlands and applied in different fields. A collection of concept mapping projects conducted in the Netherlands was identified, in part in the archive of the Netherlands Institute of Mental Health and Addiction (Trimbos Institute). Some of the 90 identified projects are internationally published. The 90 concept mapping projects reflect the changes in mental health care and can be grouped into 5-year periods and into five typologies. The studies range from conceptualizing the problems of the homeless to the specification of quality indicators for treatment programs for patients with cystic fibrosis. The number of concept mapping projects has varied over time. Growth has been considerable in the last 5 years compared to the previous 5 years. Three case studies are described in detail with 12 characteristics and graphical representations. Concept mapping aligns well with the typical Dutch approach of the "Poldermodel." A broad introduction of concept mapping in European countries in cooperation with other countries, such as the United States and Canada, would strengthen the empirical basis for applying this approach in health care policy, quality, and clinical work. Copyright © 2016. Published by Elsevier Ltd.

Concepts and Relations in Neurally Inspired In Situ Concept-Based Computing.

Science.gov (United States)

van der Velde, Frank

2016-01-01

In situ concept-based computing is based on the notion that conceptual representations in the human brain are "in situ." In this way, they are grounded in perception and action. Examples are neuronal assemblies, whose connection structures develop over time and are distributed over different brain areas. In situ concepts representations cannot be copied or duplicated because that will disrupt their connection structure, and thus the meaning of these concepts. Higher-level cognitive processes, as found in language and reasoning, can be performed with in situ concepts by embedding them in specialized neurally inspired "blackboards." The interactions between the in situ concepts and the blackboards form the basis for in situ concept computing architectures. In these architectures, memory (concepts) and processing are interwoven, in contrast with the separation between memory and processing found in Von Neumann architectures. Because the further development of Von Neumann computing (more, faster, yet power limited) is questionable, in situ concept computing might be an alternative for concept-based computing. In situ concept computing will be illustrated with a recently developed BABI reasoning task. Neurorobotics can play an important role in the development of in situ concept computing because of the development of in situ concept representations derived in scenarios as needed for reasoning tasks. Neurorobotics would also benefit from power limited and in situ concept computing.

Concept theory

DEFF Research Database (Denmark)

Hjørland, Birger

2009-01-01

  Concept theory is an extremely broad, interdisciplinary and complex field of research related to many deep fields with very long historical traditions without much consensus. However, information science and knowledge organization cannot avoid relating to theories of concepts. Knowledge...... organizing systems (e.g. classification systems, thesauri and ontologies) should be understood as systems basically organizing concepts and their semantic relations. The same is the case with information retrieval systems. Different theories of concepts have different implications for how to construe......, evaluate and use such systems. Based on "a post-Kuhnian view" of paradigms this paper put forward arguments that the best understanding and classification of theories of concepts is to view and classify them in accordance with epistemological theories (empiricism, rationalism, historicism and pragmatism...

[Treatment strategy and planning for pilon fractures].

Science.gov (United States)

Mittlmeier, Thomas; Wichelhaus, Alice

2017-08-01

Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms. The aim of the present analysis was to display the strategy variations for the treatment of pilon fractures taking into account the advantages and disadvantages of the corresponding treatment concepts. A staged procedure including primary closed reduction employing ligamentotaxis and fixation of the joints of the hindfoot via tibiocalcaneal metatarsal fixation offers a safe basis for consecutive imaging and the selection of specific approaches for definitive reconstruction. A simultaneous reconstruction and fixation of the fibula during the primary intervention are generally not recommended in order to avoid any limitations for subsequent reconstructive procedures. A time frame for definitive reconstruction covers a period of up to 3 weeks after trauma and allows a detailed planning considering the individual dynamics of the soft tissue situation and any logistic requirements. For the choice of the definitive treatment concept a wide range of procedures and implants are available. There are also valid concepts for primary treatment of defined fracture constellations while primary arthrodesis represents a solution in cases of major destruction of the joint surface. Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture.

Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 1: Biologics Overview, Ligament Injury, Tendinopathy.

Science.gov (United States)

LaPrade, Robert F; Geeslin, Andrew G; Murray, Iain R; Musahl, Volker; Zlotnicki, Jason P; Petrigliano, Frank; Mann, Barton J

2016-12-01

Biologic therapies, including stem cells, platelet-rich plasma, growth factors, and other biologically active adjuncts, have recently received increased attention in the basic science and clinical literature. At the 2015 AOSSM Biologics II Think Tank held in Colorado Springs, Colorado, a group of orthopaedic surgeons, basic scientists, veterinarians, and other investigators gathered to review the state of the science for biologics and barriers to implementation of biologics for the treatment of sports medicine injuries. This series of current concepts reviews reports the summary of the scientific presentations, roundtable discussions, and recommendations from this think tank. © 2016 The Author(s).

The applicability of the concept of treatment adherence in the context of the Brazilian mental health system.

Science.gov (United States)

Alvarez, Patricia Elizabeth Sanz de; Rosendo, Ernestina; Alchieri, João Carlos

2016-06-01

To present reflections on the type of research conducted on a treatment adherence among users of Public Mental Health System in Brazil and discuss the applicability of the concept of adherence to treatment in this context. Literature review in SciELO, LILACS, Cochrane Library and PubMed / MEDLINE using the Health Sciences Descriptors (DeCS) treatment, adhesion and "mental health" and the specific vocabulary of the Medical Subject Headings (MeSH) "patient compliance/psychologist" y "mental health". They were included for review the complete texts and theses published between 2007-2012 in Portuguese, English and Spanish. 127 articles were recovered, 32 specifically related to mental health. Eight were excluded for duplicates and after reading the remaining 24 articles were selected for this study 10 conducted in the field of Mental Health in Brazil. No investigations have been identified with focus on adherence to psychosocial treatment offered in public mental health. disregard of the mental health legislation and reinforce the asylum model of assistance. Presentar reflexiones sobre el tipo de investigaciones realizadas en Brasil sobre la adhesión al tratamiento de los usuarios del Sistema Público de Salud Mental y discutir la aplicabilidad del concepto de adhesión al tratamiento en dicho contexto. Revisión bibliográfica en las bases SciELO, LILACS, Biblioteca Cochrane y PubMed/MEDLINE utilizando los descriptores de Ciencias de la Salud (DeCS) adhesión, tratamiento y "salud mental" y el vocabulario específico de Medical Subject Headings (MeSH) "patient compliance/psychologist" y "mental health". Se incluyeron los textos completos y las tesis publicadas entre 2007-2012, en portugués, inglés y español. F1eron recuperados 127 artículos, 32 específicamente de la salud mental. Se excluyeron los 8 duplicados y de los 24 restantes fueron seleccionados para el presente trabajo los 10 realizados en Brasil. No se identificaron enfoques sobre la adhesión al

The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence?

Science.gov (United States)

Kollen, Boudewijn J; Lennon, Sheila; Lyons, Bernadette; Wheatley-Smith, Laura; Scheper, Mark; Buurke, Jaap H; Halfens, Jos; Geurts, Alexander C H; Kwakkel, Gert

2009-04-01

In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of randomized, controlled trials aimed to evaluate the available evidence for the effectiveness of the Bobath Concept in stroke rehabilitation. Method- A systematic literature search was conducted in the bibliographic databases MEDLINE and CENTRAL (March 2008) and by screening the references of selected publications (including reviews). Studies in which the effects of the Bobath Concept were investigated were classified into the following domains: sensorimotor control of upper and lower limb; sitting and standing, balance control, and dexterity; mobility; activities of daily living; health-related quality of life; and cost-effectiveness. Due to methodological heterogeneity within the selected studies, statistical pooling was not considered. Two independent researchers rated all retrieved literature according to the Physiotherapy Evidence Database (PEDro) scale from which a best evidence synthesis was derived to determine the strength of the evidence for both effectiveness of the Bobath Concept and for its superiority over other approaches. The search strategy initially identified 2263 studies. After selection based on predetermined criteria, finally, 16 studies involving 813 patients with stroke were included for further analysis. There was no evidence of superiority of Bobath on sensorimotor control of upper and lower limb, dexterity, mobility, activities of daily living, health-related quality of life, and cost-effectiveness. Only limited evidence was found for balance control in favor of Bobath. Because of the limited evidence available, no best evidence synthesis was applied for the health-related quality-of-life domain and cost-effectiveness. This systematic review confirms that overall the Bobath

Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept.

Science.gov (United States)

Perillo, Letizia; Esposito, Maria; Caprioglio, Alberto; Attanasio, Stefania; Santini, Annamaria Chiara; Carotenuto, Marco

2014-01-01

Dental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents. The study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects. Pearson's analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492-8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545-10.678) as risk factors for development of global self-concept score abnormalities. Our findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents.

The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective.

Science.gov (United States)

Lennon, S; Ashburn, A

2000-10-15

The Bobath concept, usually known as neuro-developmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these

The concept of caring: Perceptions of radiation therapists

International Nuclear Information System (INIS)

Bolderston, Amanda; Lewis, Donna; Chai, Martin J.

2010-01-01

Aims: This study explores radiation therapists' understanding and interpretations of the concept of caring within their profession. Background: Health professions' concepts of care have been explored in disciplines such as nursing and medicine. However, there has been little previous attempt to describe what caring means to radiation therapists. Methods: A qualitative phenomenological approach was used and 27 radiation therapists were interviewed in four focus groups. Discussions were transcribed and analysis was performed to identify themes from the data. Results: Three overarching themes emerged from the data: human connection established between radiation therapists and patients, technical care as the use of technology and procedures in treatment planning and delivery, and the therapist's unique identity as compared to other professions. Conclusions: The concept of care was seen by radiation therapists primarily as a supportive relationship with the patient but they were unable to agree if the technical aspects and procedures were considered a part of caring. Further research is needed to further examine the connection between technology and care.

Reduction of air pollution with new dehydration concepts

International Nuclear Information System (INIS)

Khoi, V.V.

1991-01-01

The conference paper deals with the new dehydration concepts being designed for preventing hydrate formation during the transport of gas for a group of fields being under development in the North Sea. The development comprises a central production platform consisting of a gas treatment system using triethylene and/or diethylene glycol in the process. 4 figs., 3 tabs

The concept of sexual narcissism

Directory of Open Access Journals (Sweden)

Silvana Gasar

2001-12-01

Full Text Available David Farley Hurlbert, a marriage and sex therapist in Belton, Texas, and Carol Apt, a therapist in private practice in Lexington, Kentucky, developed the concept of sexual narcissism after they studied the characteristics of nonalcoholic abusive males. Men and women who claim to be sex addicts or sexually compulsive are actually sexual narcissists, according to the abovementioned authors. Sexual narcissists lack the ability to experience intimacy. They are fixated on the sex act, but they cannot be intimate. He or she compensates for low self-esteem through high sexual esteem, and tries to build a positive self-image with one sexual encounter after another. They believe that sexual narcissism is more common in men. Treatment can be very difficult, because they never face the problem. It is important that the sexual narcissist is never identified as a patient - their fragile egos cannot handle being considered inadequate in any way. Group therapy does not work with them. A more constructive treatment plan includes gradual confrontation. Only long-term treatment will tell if such subjects can learn to become intimate.

Ultrasound and MRI of nerves for monitoring disease activity and treatment effects in chronic dysimmune neuropathies - Current concepts and future directions.

Science.gov (United States)

Décard, Bernhard F; Pham, Mirko; Grimm, Alexander

2018-01-01

New imaging modalities like high-resolution-ultrasound (HRUS) and MR-Neurography (MRN) are increasingly used for the evaluation of the peripheral nervous system. The increasing knowledge on morphological changes observed in different neuropathies has led to a better understanding of underlying pathophysiological processes. The diagnosis of acquired chronic dysimmune neuropathies (CDN) like chronic inflammatory demyelinating polyneuropathy (CIDP), Lewis-Sumner Syndrome (LSS) or multifocal motor neuropathy (MMN) can be challenging. The current diagnostic criteria and outcome parameters are mainly based on clinical and electrophysiological parameters. Especially in CDN cases with atypical presentation or during early disease stages, the diagnostic accuracy is low and standardized protocols for the evaluation of disease activity and treatment response are lacking. The establishment of combined diagnostic criteria for CDN including imaging modalities could help to improve the diagnostic accuracy, allow a better differentiation of subtypes and facilitate the follow-up of disease course. The appropriate selection of eligible patients and sensitive monitoring of treatment response is mandatory future in treatment trials. In this article, we briefly summarize the clinical presentations and pathophysiological concepts of different CDN like CIDP, LSS and MMN. Furthermore, this review focuses on the diagnostic value of HRUS/MRN and its potential role for the monitoring of disease activity. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Fast Adapting Ensemble: A New Algorithm for Mining Data Streams with Concept Drift

Science.gov (United States)

Ortíz Díaz, Agustín; Ramos-Jiménez, Gonzalo; Frías Blanco, Isvani; Caballero Mota, Yailé; Morales-Bueno, Rafael

2015-01-01

The treatment of large data streams in the presence of concept drifts is one of the main challenges in the field of data mining, particularly when the algorithms have to deal with concepts that disappear and then reappear. This paper presents a new algorithm, called Fast Adapting Ensemble (FAE), which adapts very quickly to both abrupt and gradual concept drifts, and has been specifically designed to deal with recurring concepts. FAE processes the learning examples in blocks of the same size, but it does not have to wait for the batch to be complete in order to adapt its base classification mechanism. FAE incorporates a drift detector to improve the handling of abrupt concept drifts and stores a set of inactive classifiers that represent old concepts, which are activated very quickly when these concepts reappear. We compare our new algorithm with various well-known learning algorithms, taking into account, common benchmark datasets. The experiments show promising results from the proposed algorithm (regarding accuracy and runtime), handling different types of concept drifts. PMID:25879051

[Mass casualty incidents - current concepts and developments].

Science.gov (United States)

Savinsky, Godo; Stuhr, Markus; Kappus, Stefan; Trümpler, Stefan; Wenderoth, Stephan; Wohlers, Jan-Hauke; Paschen, Hans-Richard; Kerner, Thoralf

2014-12-01

Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. Within the last 25 years throughout the whole country of Germany the role of a "chief emergency physician" has been implemented and in preparation for the FIFA World Cup 2006 mobile treatment units were set up. In 2007, special units of the "Medical Task Force" - funded by the german state - were introduced and have been established by now. They will be a permanent part of regional plannings for mass casualty incidents. This article highlights current concepts and developments in different parts of Germany. © Georg Thieme Verlag Stuttgart · New York.

Adolescence and polycystic ovary syndrome: current concepts on diagnosis and treatment.

Science.gov (United States)

Spritzer, P M; Motta, A B

2015-11-01

Adolescence is a time characterised by changes in reproductive hormones and menstrual patterns, which makes it difficult to diagnose polycystic ovary syndrome (PCOS) in this population. The diagnosis of PCOS has a great physical and psychosocial impact on the young person. Despite the importance of a diagnosis of PCOS at adolescence, data available are limited. This review focuses on analysing markers of PCOS diagnosis and possible treatments in adolescence. Although, during adolescence, diagnosis criteria of PCOS overlap with physiological changes including clinical manifestations of hyperandrogenism (acne and hirsutism), oligo/amenorrhoea, anovulation and ovarian microcysts, there is agreement that irregular menses and hyperandrogenaemia should be used to diagnose PCOS in this population. Moreover, considering that PCOS phenotype could change through the reproductive age and that adolescents display heterogeneous ovarian morphology, it has been proposed that diagnosis of PCOS should be confirmed after the age of 18. The first-line treatment for menstrual irregularity and hirsutism are oral contraceptive pills (OCPs) and for obesity and metabolic abnormalities are lifestyle changes. Insulin-sensitizer drugs, such as metformin, may be added to the treatment in the presence of metabolic alterations. Antiandrogen drugs may also be associated for treating moderate to severe hirsutism. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include lifestyle changes. Pharmacological treatments comprise OCPs, antiandrogens and metformin, used isolated or combined. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include

Theoretical concepts about "Intelligence" - practices and standards in democratic societies

Directory of Open Access Journals (Sweden)

Mr.Sc. Bahri Gashi

2013-06-01

Full Text Available My thesis consists of theoretical analysis on the need for recognition of academic concepts to shape and design research field intelligence community activity, careful analysis of the terms and concepts that are strongly linked to intelligence work methodology, theoretical aspects description given practice best to regulate this specific area in our academic studies, has made the study to take proper shape with bold shades of comparative empirical analysis. My study aims to summarize, to analyze existing approaches and break the "taboo theories," floats mysteriously present new knowledge, summed up in this multidisciplinary field study, now theories only considering the nature of scientific thought for recognition theoretical concepts and legal regulation best practice intelligence services in democratic societies. emocratic societies. Treatment of this complex matter such as "intelligent services submission principle" of democracy is very difficult. Is between the concept of democracy is to be open and transparent, and intelligent service logic in the concept is to be closed and secret. Generally in "strategic studies and Peace” security for the creation of "security system" argued by the authors Buzan and Herring. Concept Intelligent based on the theory: "The essence of intelligence is the adequate response to a stimulus." Is the essence of this analysis?

Knochen, Herz und Gefäße – „Bone-Vascular Axis“: Eine systematische Übersicht prospektiver Beobachtungsstudien // The Bone-Cardiovascular Axis: A Systematic Review of Prospective Studies

Directory of Open Access Journals (Sweden)

Tomaschitz A

2016-01-01

bone diseases the current evidence however indicates a potential benefit in screening for cardiovascular diseases and osteoporosis in respective risk groups. p bKurzfassung/b: Osteoporose und atherosklerotische Erkrankungen sind mit massiv erhöhter Morbidität, Mortalität und Gesundheitskosten verbunden. Mit der „bone-vascular axis“ entstand in den letzten Jahren ein intensiv beforschtes, klinisch hoch relevantes Gebiet. Mechanistische Studien identifizierten komplexe wechselseitige Beziehungen zwischen der vaskulären Physiologie, der Knochenneubildung und der Knochenmineralisation. Herz und Gefäße spielen eine relevante Rolle für die muskuloskelettale Funktion und umgekehrt beeinflusst das Knochengewebe u. a. über endo- und parakrine Signalwege das Herz-Kreislaufsystem. Epidemiologische Studien wiesen auch nach Berücksichtigung gemeinsamer Risikofaktoren auf unabhängige, wechselseitige Interaktionen zwischen Herz, Gefäßen und Knochengewebe hin.brIm Rahmen einer systematischen Literaturrecherche (Medline, Pubmed wurden insgesamt 49 prospektive Studien, die den Zusammenhang zwischen Osteoporose, Knochenmineraldichte und Auftreten von Frakturen mit atherosklerotischen Erkrankungen beschreiben, selektiert. Dabei konnten diese Untersuchungen mehrheitlich eine erhöhte kardiovaskuläre Morbidität und Mortalität bei Frauen und Männern mit verminderter Knochenmineraldichte an verschiedenen Lokalisationen sowie nach osteoporotischen Frakturen nachweisen. Umgekehrt konnten zahlreiche Studien ein erhöhtes Risiko für die Entstehung einer Osteoporose sowie von osteoporotischen Frakturen bei Patienten mit atherosklerotischen Erkrankungen nachweisen. Schließlich konnten konsistente Assoziationen zwischen Herzinsuffizienz (7 Studien, Schlaganfall (16 Studien, peripherer arterieller Verschlusskrankheit (3 Studien und Knochenmineraldichte sowie Frakturrisiko detektiert werden.brGrundsätzlich lassen Beobachtungsstudien keine Rückschlüsse auf die Kausalität der

Lateral Concepts

DEFF Research Database (Denmark)

Gad, Christopher; Bruun Jensen, casper

2016-01-01

This essay discusses the complex relation between the knowledges and practices of the researcher and his/her informants in terms of lateral concepts. The starting point is that it is not the prerogative of the (STS) scholar to conceptualize the world; all our “informants” do it too. This creates...... the possibility of enriching our own conceptual repertoires by letting them be inflected by the concepts of those we study. In a broad sense, the lateral means that there is a many-to-many relation between domains of knowledge and practice. However, each specific case of the lateral is necessarily immanent...... to a particular empirical setting and form of inquiry. In this sense lateral concepts are radically empirical since it locates concepts within the field. To clarify the meaning and stakes of lateral concepts, we first make a contrast between lateral anthropology and Latour’s notion of infra-reflexivity. We end...

Treatment of giant cell tumor of bone: Current concepts.

Science.gov (United States)

Puri, Ajay; Agarwal, Manish

2007-04-01

Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function.Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate.Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance.An accompanying treatment algorithm helps outline the management strategy in GCT.

Treatment of giant cell tumor of bone: Current concepts

Directory of Open Access Journals (Sweden)

Puri Ajay

2007-01-01

Full Text Available Giant cell tumor (GCT of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function. Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate. Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance. An accompanying treatment algorithm helps outline the management strategy in GCT.

Reported concepts for the treatment modalities and pain management of temporomandibular disorders

OpenAIRE

Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

2015-01-01

Background Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. Methods A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ ...

Current concepts of etiology and treatment of chondromalacia patellae.

Science.gov (United States)

Bentley, G; Dowd, G

1984-10-01

Chondromalacia patellae is a distinct clinical entity characterized by retropatellar pain that is associated with recognizable changes in the articular cartilage of the posterior surface of the patella. Several factors may be involved in the etiology, such as severe patella alta, trauma, and, in rare cases, abnormal patellar tracking. Clinical symptoms and signs are reliable in only 50% of cases, but measurable quadriceps wasting, palpable patellofemoral crepitus, and effusion are strongly suggestive. Diagnosis must be confirmed by arthroscopy or direct examination of the posterior surface of the patella. Radiologic measurements of patellofemoral relations are of limited value in diagnosis. The initial pathologic finding is usually surface cartilage breakdown. Radioisotope studies show cartilage cell replication which suggests a healing capacity in early cases following treatment that alters the load through the affected cartilage. There is no evidence of progression to patellofemoral osteoarthritis, which is probably a different entity. The treatment should be conservative where possible with isometric quadriceps exercises and simple anti-inflammatory drugs such as aspirin. Operative treatment is indicated for patients with persistent pain and macroscopic involvement of more than half a centimeter of the articular cartilage surface. The simplest effective procedure that avoids quadriceps dysfunction and fibrosis is a distal patellar tendon medial realignment with lateral release and medial reefing of the quadriceps expansion. Patellectomy is indicated in more extensive involvement of the patella of 2 or more centimeters in diameter, but this must be performed only when the patient has excellent quadriceps function before surgery and is motivated to exercise after surgery.

Defining the Bobath concept using the Delphi technique.

Science.gov (United States)

Raine, Sue

2006-03-01

The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept. A four-round Delphi study design was used. The sample included all members of the British Bobath Tutor's Association, who are considered experts in the field. Initial statements were identified from the literature, with respondents generating additional statements during the study. The level of agreement was determined using a five-point Likert scale. The respondents were then provided with feedback on group opinions and given an opportunity to re-rate each statement. The level of group consensus was set at 80%. Fifteen experts took part. The response rate was 85% in the first round, and 93% in each subsequent round. Ten statements from the literature were rated with a further 12 generated by the experts. Thirteen statements achieved consensus for agreement and seven for disagreement. The Delphi study was an effective research tool, maintaining anonymity of responses and exploring expert opinions on the Bobath concept. The experts stated that Bobath's work has been misunderstood if it is considered as the inhibition of spasticity and the facilitation of normal movement, as described in some literature. They agreed that the Bobath concept was developed by the Bobaths as a living concept, understanding that as therapists' knowledge base grows their view of treatment broadens.

The QWERTY/EE concept, Quantifying Recyclability and Eco-Efficiency for End-of-Life Treatment of Consumer Electronic Products

NARCIS (Netherlands)

Huisman, J.

2003-01-01

The QWERTY/EE concept addresses recyclability and eco-efficiency of take-back and recycling of consumer electronic products, a topic currently receiving large international attention. Through the environmental part of the concept an alternative for usual weight based recycling percentages is

A new perspective on concepts of asthma severity and control

NARCIS (Netherlands)

D.R. Taylor; E.D. Bateman (Eric); L.P. Boulet; H.A. Boushey; W.W. Busse; T.B. Casale (Thomas); P. Chanez; P.L. Enright (Paul); P.G. Gibson; J.C. de Jongste (Johan); H.A. Kerstjens; S.C. Lazarus; M.L. Levy (Mark); P. O'byrne; M.R. Partridge; I.D. Pavord; M.R. Sears; P.J. Sterk (Peter); S.W. Stoloff; S.J. Szefler; S.D. Sullivan (Sean); M.D. Thomas; S.E. Wenzel; H.K. Reddel

2008-01-01

textabstractConcepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European

A new perspective on concepts of asthma severity and control

NARCIS (Netherlands)

Taylor, D. R.; Bateman, E. D.; Boulet, L.-P.; Boushey, H. A.; Busse, W. W.; Casale, T. B.; Chanez, P.; Enright, P. L.; Gibson, P. G.; de Jongste, J. C.; Kerstjens, H. A. M.; Lazarus, S. C.; Levy, M. L.; O'Byrne, P. M.; Partridge, M. R.; Pavord, I. D.; Sears, M. R.; Sterk, P. J.; Stoloff, S. W.; Szefler, S. J.; Sullivan, S. D.; Thomas, M. D.; Wenzel, S. E.; Reddel, H. K.

2008-01-01

Concepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European Respiratory Society

A new perspective on concepts of asthma severity and control

NARCIS (Netherlands)

Taylor, D. R.; Bateman, E. D.; Boulet, L-P.; Boushey, H. A.; Busse, W. W.; Casale, T. B.; Chanez, P.; Enright, P. L.; Gibson, P. G.; de Jongste, J. C.; Kerstjens, H. A. M.; Lazarus, S. C.; Levy, M. L.; O'Byrne, P. M.; Partridge, M. R.; Pavord, I. D.; Sears, M. R.; Sterk, P. J.; Stoloff, S. W.; Szefler, S. J.; Sullivan, S. D.; Thomas, M. D.; Wenzel, S. E.; Reddel, H. K.

Concepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European Respiratory Society

Measurement and automatic control techniques at sewage treatment plants. Concepts, experience, trends.. Manuscripts and posters; Mess- und Regelungstechnik in abwassertechnischen Anlagen. Konzepte, Erfahrungen, Trends. Manuskripte und Poster-Praesentationen

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-31

This conference volume on measurement and automatic control techniques at sewage treatment plants deals with the following subjects: online analytics, measurement techniques and control techniques; use of model-assisted techniques; transparency and acceptance, plant management; process control concepts; optimization of operation. (SR) [Deutsch] Themen dieses Konferenzbandes ueber Mess- und Regelungstechnik in abwassertechnischen Anlagen sind: Online-Analytik, Mess- und Stelltechnik; Einsatz modellgestuetzter Verfahren; Transparenz und Akzeptanz, Betriebsmanagement; Leittechnische Konzepte; Betriebsoptimierung. (SR)

A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse.

Science.gov (United States)

Lindgren, Kristen P; Neighbors, Clayton; Gasser, Melissa L; Ramirez, Jason J; Cvencek, Dario

2017-05-01

This paper provides an overview of the self-concept as it relates to substance use. Self-concept has a long history in psychological theory and research; however, substance self-concept (e.g., viewing one's self as a drinker or smoker) is an understudied area of research with the potential to expand existing conceptualizations of substance use, addiction, and prevention and treatment efforts, and should receive greater research attention. First, we review and provide a theoretical framework of substance self-concept that draws from dual process models and distinguishes between implicit and explicit self-concept. Next, we summarize key findings related to substance use in the extant literature, focusing on alcohol and tobacco (smoking). Across both substances, there is converging evidence that substance self-concept is associated with substance use outcomes, including quantity and frequency of use and problems associated with use, and that change in substance self-concept is associated with recovery from substance misuse. Recommendations for the substance self-concept research agenda include routine assessment of substance self-concept, expanded use of implicit measures, investigation of moderators of substance self-concept, and targeting substance self-concept directly in prevention and intervention efforts. Ultimately, we suggest that substance self-concept is a promising, but understudied, construct. Greater research attention to substance self-concept could clarify its potential as an important risk factor for hazardous use and addiction as well as its utility as a prevention and treatment target.

Advanced High Voltage Power Device Concepts

CERN Document Server

Baliga, B Jayant

2012-01-01

Advanced High Voltage Power Device Concepts describes devices utilized in power transmission and distribution equipment, and for very high power motor control in electric trains and steel-mills. Since these devices must be capable of supporting more than 5000-volts in the blocking mode, this books covers operation of devices rated at 5,000-V, 10,000-V and 20,000-V. Advanced concepts (the MCT, the BRT, and the EST) that enable MOS-gated control of power thyristor structures are described and analyzed in detail. In addition, detailed analyses of the silicon IGBT, as well as the silicon carbide MOSFET and IGBT, are provided for comparison purposes. Throughout the book, analytical models are generated to give a better understanding of the physics of operation for all the structures. This book provides readers with: The first comprehensive treatment of high voltage (over 5000-volts) power devices suitable for the power distribution, traction, and motor-control markets;  Analytical formulations for all the device ...

Using Concept Mapping to Build Concept the Competence of School Principals

Directory of Open Access Journals (Sweden)

Mustamin Mustamin

2012-08-01

Full Text Available More and more the competence concept of school principals have an impact on two conditions, namely: (1 to develop the concept can complement and support each other; and (2 to develop the concept of possible contradict, giving rise to different interpretations. Therefore, this becomes the main issue researchers to identify the competence concept of school principals with adaptation of Jackson-Trochim method that is capable of illustrating the concept of competencies. Results of adaptation Jackson-Trochim method that school principals should have three types of competencies to lead the school effectively and efficiently. Kind of competencies are such as school leadership, instructional leadership, and operational leadership. Based on these results, the adaptationof Jackson-Trochim method to build the competence concept of school principals suggests this concept obtained may serve as a reference for school principals continue to build competencies in the future

Concept similarity and related categories in information retrieval using formal concept analysis

Science.gov (United States)

Eklund, P.; Ducrou, J.; Dau, F.

2012-11-01

The application of formal concept analysis to the problem of information retrieval has been shown useful but has lacked any real analysis of the idea of relevance ranking of search results. SearchSleuth is a program developed to experiment with the automated local analysis of Web search using formal concept analysis. SearchSleuth extends a standard search interface to include a conceptual neighbourhood centred on a formal concept derived from the initial query. This neighbourhood of the concept derived from the search terms is decorated with its upper and lower neighbours representing more general and special concepts, respectively. SearchSleuth is in many ways an archetype of search engines based on formal concept analysis with some novel features. In SearchSleuth, the notion of related categories - which are themselves formal concepts - is also introduced. This allows the retrieval focus to shift to a new formal concept called a sibling. This movement across the concept lattice needs to relate one formal concept to another in a principled way. This paper presents the issues concerning exploring, searching, and ordering the space of related categories. The focus is on understanding the use and meaning of proximity and semantic distance in the context of information retrieval using formal concept analysis.

The problem of automatic identification of concepts

International Nuclear Information System (INIS)

Andreewsky, Alexandre

1975-11-01

This paper deals with the problem of the automatic recognition of concepts and describes an important language tool, the ''linguistic filter'', which facilitates the construction of statistical algorithms. Certain special filters, of prepositions, conjunctions, negatives, logical implication, compound words, are presented. This is followed by a detailed description of a statistical algorithm allowing recognition of pronoun referents, and finally the problem of the automatic treatment of negatives in French is discussed [fr

The Double Contingency as a Key to Redifine the Concept of Social Order

Directory of Open Access Journals (Sweden)

Juan Pablo Gonnet

2017-10-01

Full Text Available The double contingency represents a key concept in Niklas Luhmann’s theory of social systems by giving rise to a new treatment of the problem of social order. From its consideration, it is possible to explain social order without blocking the contingency of both individual action and social structures. However, something that has remained out of discussion is precisely what concept of “order” is implied in the author's proposal. In principle, we identify a frequently assumed conception of order in social theory, which is related to the limitation (or conditioning of individual action/communication/selection. The aim of this paper is to demonstrate that the double contingency would also allow us to problematize and redefine this conception.

A novel biorefinery integration concept for lignocellulosic biomass

International Nuclear Information System (INIS)

Özdenkçi, Karhan; De Blasio, Cataldo; Muddassar, Hassan R.; Melin, Kristian; Oinas, Pekka; Koskinen, Jukka; Sarwar, Golam; Järvinen, Mika

2017-01-01

Highlights: • Wide review is provided on supply chain and biomass conversion processes. • The requirements for sustainable biorefinery are listed. • An enhanced version distributed-centralized network is proposed. • A novel hydrothermal process is proposed for biomass conversion. - Abstract: The concept of an integrated biorefinery has increasing importance regarding sustainability aspects. However, the typical concepts have techno-economic issues: limited replacement in co-processing with fossil sources and high investment costs in integration to a specific plant. These issues have directed the current investigations to supply-chain network systems. On the other hand, these studies have the scope of a specific product and/or a feedstock type. This paper proposes a novel biorefinery concept for lignocellulosic biomass: sectoral integration network and a new hydrothermal process for biomass conversion. The sectoral integration concept has the potential for sustainable production from biomass: pre-treatment at the biomass sites, regional distributed conversion of biomass from various sectors (e.g. black liquor, sawdust, straw) and centralized upgrading/separation of crude biofuels. On the other hand, the conversion processes compose the vital part of such a concept. The new conversion involves partial wet oxidation - or simultaneous dissolution with partial wet oxidation for solid biomass- followed by lignin recovery with acidification and a reactor that can perform either hydrothermal liquefaction or supercritical water gasification. The process can intake both liquid and solid biomass to produce lignin as biomaterial and syngas or bio-oil. The new concept can contribute social development of rural areas by utilizing waste as valuable raw material for the production of multiple products and reduce the net greenhouse gas emissions by replacing fossil-based production.

Theoretical concepts and practical applications of hypnosis in the treatment of children and adolescents with dental fear and anxiety.

Science.gov (United States)

Shaw, A J; Niven, N

1996-01-06

Dental fear and anxiety in children and adolescents is a common problem. Hypnosis has been shown to be useful in the treatment of these patients. This paper briefly reviews conventional management skills before considering the application of hypnosis. Following a definition of hypnosis, the concepts of relaxation, restricted awareness, blunting of critical faculties and the enhanced capacity to respond to suggestion are outlined. Consideration is given to the induction of hypnosis and its general application in an informal and formal manner. The application of more specific techniques, such as the use of hypnoanalgesia to reduce physical discomfort and the development of coping strategies to help children overcome their fears, are discussed. It has been widely shown that hypnosis is a useful adjunct in dentistry. However, it is unfortunate that hypnosis is not more widely used as it has the potential for making conventional dental management more acceptable and reducing the number of children requiring general anaesthesia.

Species concept and speciation

Directory of Open Access Journals (Sweden)

Amal Y. Aldhebiani

2018-03-01

Full Text Available Defining and recognizing a species has been a controversial issue for a long time. To determine the variation and the limitation between species, many concepts have been proposed. When a taxonomist study a particular taxa, he/she must adopted a species concept and provide a species limitation to define this taxa. In this paper some of species concepts are discussed starting from the typological species concepts to the phylogenetic concept. Positive and negative aspects of these concepts are represented in addition to their application. Keywords: Species concept, Species limitation, Species, Taxonomy, Classification

[The Concept and Treatment of Internet Addiction].

Science.gov (United States)

Elsalhy, Muhammad; Muramatsu, Taro; Higuchi, Susumu; Mimura, Masaru

2016-10-01

The Internet now plays a very important role in our lives. However, for some people, Internet use can lead to a state that appears to meet the DSM definition for a mental disorder. In this review, we briefly discuss definition, symptoms, risk factors, prevalence, comorbidities, and personality traits of people who are susceptible to becoming addicts. In the second section of the article, various types of Internet addiction are discussed, focusing mainly on Internet Gaming Disorder and social networking survices (SNS) addiction. Regarding Internet Gaming Disorder, we discuss various types of the newly emerged Massive Multiplayer Online Games (MMO), as well as theories about why people become addicted to them. We do the same for the SNS Addiction for sites like Facebook and LINE; again, different types, as well as theories about why some people become addicts to such sites are discussed. Finally, preventive measures are introduced, focusing on a number of commonly used treatment methods, perticulary cognitive behavioral therapy and family therapy.

Radiation treatment of brain tumors: Concepts and strategies

International Nuclear Information System (INIS)

Marks, J.E.

1989-01-01

Ionizing radiation has demonstrated clinical value for a multitude of CNS tumors. Application of the different physical modalities available has made it possible for the radiotherapist to concentrate the radiation in the region of the tumor with relative sparing of the surrounding normal tissues. Correlation of radiation dose with effect on cranial soft tissues, normal brain, and tumor has shown increasing effect with increasing dose. By using different physical modalities to alter the distribution of radiation dose, it is possible to increase the dose to the tumor and reduce the dose to the normal tissues. Alteration of the volume irradiated and the dose delivered to cranial soft tissues, normal brain, and tumor are strategies that have been effective in improving survival and decreasing complications. The quest for therapeutic gain using hyperbaric oxygen, neutrons, radiation sensitizers, chemotherapeutic agents, and BNCT has met with limited success. Both neoplastic and normal cells are affected simultaneously by all modalities of treatment, including ionizing radiation. Consequently, one is unable to totally depopulate a tumor without irreversibly damaging the normal tissues. In the case of radiation, it is the brain that limits delivery of curative doses, and in the case of chemical additives, it is other organ systems, such as bone marrow, liver, lung, kidneys, and peripheral nerves. Thus, the major obstacle in the treatment of malignant gliomas is our inability to preferentially affect the tumor with the modalities available. Until it is possible to directly target the neoplastic cell without affecting so many of the adjacent normal cells, the quest for therapeutic gain will go unrealized.72 references

CONGENITAL MALFORMATIONS: PRENATAL DIAGNOSTICS AND NOVEL CONCEPTION OF MEDICAL HELP TO NEWBORNS

Directory of Open Access Journals (Sweden)

Yu.F. Isakov

2007-01-01

Full Text Available Current views on basic prenatal diagnostics techniques, as ultrasound, maternal serum biochemical markers (alpha fetoprotein, human chorionic gonadotropin, and unconjugated estriol, and fetal biologic material (chorionic villus sampling, placenta, amniotic liquid, fetal blood, obtained with invasive techniques (chorion biopsy, amniocentesis, cordocentesis, its' efficacy and possible practical application are given in the article. These new conception announce to consolidate three branches providing maternal and children — welfare should consolidate maternal welfare outpatient clinics, maternal hospital and newborn surgery hospital — into one institute, thus allowing to success work of all stages, to avoid transportation and late surgical treatment, to reduce lethal outcomes following surgical treatment of congenital malformations. Primary results of implementation of this conception are presented in the article.Key words: prenatal diagnostics, newborns, congenital mal formations, prevention and prophylactics, diagnostics.

Sentinel node concept in breast cancer

International Nuclear Information System (INIS)

Kiricuta, I.C.

2000-01-01

could be spared from unnecessary irradiation. Conclusion: The sentinel node concept seems to revolutionize the treatment of early breast cancer. Biopsy of the sentinel node is a highly accurate, minimally invasive method of staging patients and can substantially reduce the morbidity and costs of treatment by avoiding unnecessary complete axillary lymph node dissection. The procedure may lead to a more justifiable approach to adjuvant therapy strategies with low complication rates. The identification of the individual lymphatic flow pattern would permit the irradiation of the individual locoregional lymphatic basin. (orig.) [de

Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment

International Nuclear Information System (INIS)

Bazeries, Paul; Paisant-Thouveny, Francine; Yahya, Sultan; Bouvier, Antoine; Nedelcu, Cosmina; Boussion, Francoise; Sentilhes, Loic; Willoteaux, Serge; Aubé, Christophe

2017-01-01

ObjectiveTo report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment.MethodsThis was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization.ResultsRPOC with MV occurred after abortion in 27 out of 31 patients (87%). The time elapsed between delivery/abortion and UAE ranged from 1 to 210 days (mean 55.7 ± 45 days). Primary clinical success was achieved in 23 women (74.2%) following a single embolization. In total, 27 out of 31 women (87%) had been exclusively managed by UAE with conservative success. Although procedural success was achieved in this number, six women had a further procedure to evacuate RPOC despite procedural success. Large uterine arteriovenous (AV) shunts associated with RPOC were observed in five cases (16.1%), among which two were successfully treated after a single UAE and one after two UAEs, while hysterectomy was performed in the last two cases despite two and three UAE procedures respectively. RPOC was histologically proven in ten cases (32.2%) including four out of five cases of uterine AV shunt.ConclusionRPOC with MV can present with large uterine AV shunt, particularly in case of late management. Uterine artery embolization is an effective and safe first-line treatment, and should be evaluated for this indication in larger prospective trials.

Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment

Energy Technology Data Exchange (ETDEWEB)

Bazeries, Paul, E-mail: paul.bazeries@chu-angers.fr; Paisant-Thouveny, Francine; Yahya, Sultan; Bouvier, Antoine; Nedelcu, Cosmina [Centre Hospitalier Universitaire d’Angers, Département d’Imagerie Diagnostique et interventionnelle (France); Boussion, Francoise; Sentilhes, Loic [Centre Hospitalier Universitaire d’Angers, Département de Gynécologie et Obstétrique (France); Willoteaux, Serge; Aubé, Christophe [Centre Hospitalier Universitaire d’Angers, Département d’Imagerie Diagnostique et interventionnelle (France)

2017-04-15

ObjectiveTo report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment.MethodsThis was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization.ResultsRPOC with MV occurred after abortion in 27 out of 31 patients (87%). The time elapsed between delivery/abortion and UAE ranged from 1 to 210 days (mean 55.7 ± 45 days). Primary clinical success was achieved in 23 women (74.2%) following a single embolization. In total, 27 out of 31 women (87%) had been exclusively managed by UAE with conservative success. Although procedural success was achieved in this number, six women had a further procedure to evacuate RPOC despite procedural success. Large uterine arteriovenous (AV) shunts associated with RPOC were observed in five cases (16.1%), among which two were successfully treated after a single UAE and one after two UAEs, while hysterectomy was performed in the last two cases despite two and three UAE procedures respectively. RPOC was histologically proven in ten cases (32.2%) including four out of five cases of uterine AV shunt.ConclusionRPOC with MV can present with large uterine AV shunt, particularly in case of late management. Uterine artery embolization is an effective and safe first-line treatment, and should be evaluated for this indication in larger prospective trials.

Hybridization of natural systems with advanced treatment processes for organic micropollutant removals: New concepts in multi-barrier treatment

KAUST Repository

Sudhakaran, Sairam

2013-07-01

In the past, emphasis has been on individual treatment processes comprising conventional treatment (coagulation, sedimentation, and filtration) followed by advanced treatment processes (adsorption, ion-exchange, oxidation, and membrane separation). With the depletion of water resources and high demand for power and chemical usage, efforts need to be made to judiciously use advanced treatment processes. There is a new interest in multiple barriers with synergies in which two coupled processes can function as a hybrid process. Within the context of this paper, the hybrid processes include a natural treatment process coupled with an advanced process. Pilot/full-scale studies have shown efficient removal of OMPs by these hybrid processes. With this hybridization, the usage of resources such as power and chemicals can be reduced. In this study, coupling/hybridization of aquifer recharge and recovery (ARR) with oxidation (O3), advanced oxidation process which involves ^{OH radicals (AOP), nanofiltration (NF), reverse osmosis (RO) and granular activated carbon (GAC) adsorption for OMP removal was studied. O3 or AOP as a pre-treatment and GAC, NF, RO, or UV/chlorination as a post-treatment to ARR was studied. NF can be replaced by RO for removal of OMPs since studies have shown similar performance of NF to RO for removal of many OMPs, thereby reducing costs and providing a more sustainable approach. © 2013 Elsevier Ltd.}

Self-concept structure and borderline personality disorder: evidence for negative compartmentalization.

Science.gov (United States)

Vater, Aline; Schröder-Abé, Michela; Weißgerber, Susan; Roepke, Stefan; Schütz, Astrid

2015-03-01

Borderline personality disorder (BPD) is characterized by an unstable and incongruent self-concept. However, there is a dearth of empirical studies investigating self-concept in BPD. In order to bridge this research gap, the purpose of this study was to apply an in-depth analysis of structural aspects of the self-concept in BPD. We examined the degree of compartmentalization, i.e., a tendency to organize knowledge about the self into discrete, extremely valenced (i.e., either positive or negative) categories (Showers, 1992). We hypothesized and found that BPD patients had the most compartmentalized self-concept structure and a higher proportion of negative self-attributes relative to both a non-clinical and a depressed control group. Moreover, BPD patients rated negative self-aspects as more important than positive ones relative to non-clinical controls. We cannot determine whether causal relationships exist between psychological symptoms and self-concept structure. Moreover, further comparisons to patients with other psychiatric disorders are necessary in order to further confirm the clinical specificity of our results. Our findings indicate that a negative compartmentalized self-concept is a specific feature of BPD. Implications for future research, psychological assessment, and psychotherapeutic treatment are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

[New concepts in hyperactive malarial splenomegaly].

Science.gov (United States)

Moraes, M F; Soares, M; Arroz, M J; Do Rosário, V E; Da Graça, J Pimenta; Abecasis, P

2003-01-01

Hyperreactive malarial splenomegaly is thought to represent an immunological dysfunction due to recurrent episodes of malaria. The authors present a case of hyperreactive malarial splenomegaly in a patient from São Tomé e Príncipe and discuss aspects of its differential diagnosis and treatment. A revision is made of recent concepts related to its pathogenesis and relationship with lymphoproliferative disorders. Malarial DNA was found in the absence of parasite forms in the peripheral blood. This may indicate that latent infection plays a role in its pathogenesis.

The influence of epilepsy on children's perception of self-concept.

Science.gov (United States)

Scatolini, Flora Lopes; Zanni, Karina Piccin; Pfeifer, Luzia Iara

2017-04-01

The diagnosis of epilepsy can lead to changes in the patient's perception due to factors such as learning and behavioral problems, lack of academic motivation, and low self-esteem. This study aimed to evaluate and compare the knowledge of self-concept in children with epilepsy and those with typical development and verify whether gender and age influence this perception. Eighty children of both sexes, aged between 8 and 14years, participated in this study. The children were divided into two groups: the epilepsy group, which consisted of 40 children diagnosed with epilepsy, and the control group, which consisted of 40 children with typical development and comparable to group 1 according to sex and age. The Piers-Harris Children's Self-Concept Scale, translated and adapted for the Brazilian population, was used as the evaluation instrument. In total, there were 23 boys and 17 girls in each group, with a mean age of 10.7years. There were significant differences in the overall score (p=0.000) and the subareas "behavior" (p=0.006), "intellectual and academic status" (p=0.001), and "popularity" (p=0.004). The group of children with epilepsy had a lower average score in self-concept. Children with epilepsy were observed to perceive themselves as clumsy, without many friends, with low academic performance and problems at school, and to experiencing feelings of unhappiness. These findings suggest that, in addition to the treatment of the clinical manifestations of epilepsy, it is extremely important to provide treatment focused on improving the self-concept of school-aged children with this condition. Copyright © 2016 Elsevier Inc. All rights reserved.

Definition of treatment geometry in radiation therapy

International Nuclear Information System (INIS)

Aaltonen, P.

1996-01-01

When accurate systems for quality assurance and treatment optimization are employed, a precise system for fixation and dosimetric and portal verification are as important as a continued and standardized code of practice for dosimetry and patient follow-up, including registration of tumour responses and acute and late normal tissue reactions. To improve the accuracy of existing dose response relations in order to improve future therapy the treatment geometry and dose delivery concepts have to be accurately defined and uniformly employed. A Nordic working group was set up in 1991 (by Nordic Association of Clinica Physics) to standardize the concepts and quantities used during the whole radiotherapy process in the Nordic countries. Now the group is finalizing its report ''Specification of Dose Delivery in Radiation Therapy''. The report emphasizes that the treatment geometry shall be consistent with the geometry used during the diagnostic work up. The patient fixation is of importance early in the diagnostic phase to ensure that the same reference points and patients position will be used both during the diagnostic work up, simulation and treatment execution. Reference Coordinate System of the patient is a concept based on defined anatomic reference points. This Patient Reference System is a local system which has validity for the tissues, organs and volumes defined during radiotherapy. The reference points of the Patient Reference System should in turn be used for beam set-up. The treatment geometry is then defined by using different concepts describing tissues which are mobile in the Patient Reference System, and finally, volumes which are fixed in this coordinate system. A Set-up Margin has to be considered for movements of the volumes defined in the Reference Coordinate System of the Patient in relation to the radiation beam. The Set-up Margin is dependent on the treatment technique and it is needed in the treatment planning procedure to ensure that the prescribed

Definition of treatment geometry in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Aaltonen, P [Finnish Centre for Radiation and Nuclear Safety (STUK), Helsinki (Finland)

1996-08-01

When accurate systems for quality assurance and treatment optimization are employed, a precise system for fixation and dosimetric and portal verification are as important as a continued and standardized code of practice for dosimetry and patient follow-up, including registration of tumour responses and acute and late normal tissue reactions. To improve the accuracy of existing dose response relations in order to improve future therapy the treatment geometry and dose delivery concepts have to be accurately defined and uniformly employed. A Nordic working group was set up in 1991 to standardize the concepts and quantities used during the whole radiotherapy process in the Nordic countries. Now the group is finalizing its report ``Specification of Dose Delivery in Radiation Therapy``. The report emphasizes that the treatment geometry shall be consistent with the geometry used during the diagnostic work up. The patient fixation is of importance early in the diagnostic phase to ensure that the same reference points and patients position will be used both during the diagnostic work up, simulation and treatment execution. Reference Coordinate System of the patient is a concept based on defined anatomic reference points. This Patient Reference System is a local system which has validity for the tissues, organs and volumes defined during radiotherapy. The reference points of the Patient Reference System should in turn be used for beam set-up. The treatment geometry is then defined by using different concepts describing tissues which are mobile in the Patient Reference System, and finally, volumes which are fixed in this coordinate system. A Set-up Margin has to be considered for movements of the volumes defined in the Reference Coordinate System of the Patient in relation to the radiation beam. The Set-up Margin is dependent on the treatment technique and it is needed in the treatment planning procedure to ensure that the prescribed dose to the Target Volume is delivered.

New reactor concepts

International Nuclear Information System (INIS)

Meskens, G.; Govaerts, P.; Baugnet, J.-M.; Delbrassine, A.

1998-11-01

The document gives a summary of new nuclear reactor concepts from a technological point of view. Belgium supports the development of the European Pressurized-Water Reactor, which is an evolutionary concept based on the European experience in Pressurized-Water Reactors. A reorientation of the Belgian choice for this evolutionary concept may be required in case that a decision is taken to burn plutonium, when the need for flexible nuclear power plants arises or when new reactor concepts can demonstrate proved benefits in terms of safety and cost

The Extended Enterprise concept

DEFF Research Database (Denmark)

Larsen, Lars Bjørn; Vesterager, Johan; Gobbi, Chiara

1999-01-01

This paper provides an overview of the work that has been done regarding the Extended Enterprise concept in the Common Concept team of Globeman 21 including references to results deliverables concerning the development of the Extended Enterprise concept. The first section presents the basic concept...... picture from Globeman21, which illustrates the Globeman21 way of realising the Extended Enterprise concept. The second section presents the Globeman21 EE concept in a life cycle perspective, which to a large extent is based on the thoughts and ideas behind GERAM (ISO/DIS 15704)....

Treatment of Sarcopenia with Bimagrumab: Results from a Phase II, Randomized, Controlled, Proof-of-Concept Study.

Science.gov (United States)

Rooks, Daniel; Praestgaard, Jens; Hariry, Sam; Laurent, Didier; Petricoul, Olivier; Perry, Robert G; Lach-Trifilieff, Estelle; Roubenoff, Ronenn

2017-09-01

To assess the effects of bimagrumab on skeletal muscle mass and function in older adults with sarcopenia and mobility limitations. A 24-week, randomized, double-blind, placebo-controlled, parallel-arm, proof-of-concept study. Five centers in the United States. Community-dwelling adults (N = 40) aged 65 and older with gait speed between 0.4 and 1.0 m/s over 4 m and an appendicular skeletal muscle index of 7.25 kg/m 2 or less for men and 5.67 kg/m 2 or less for women. Intravenous bimagrumab 30 mg/kg (n = 19) or placebo (n = 21). Change from baseline in thigh muscle volume (TMV), subcutaneous and intermuscular fat, appendicular and total lean body mass, grip strength, gait speed, and 6-minute walk distance (6MWD). Thirty-two (80%) participants completed the study. TMV increased by Week 2, was sustained throughout the treatment period, and remained above baseline at the end of study in bimagrumab-treated participants, whereas there was no change with placebo treatment (Week 2: 5.15 ± 2.19% vs -0.34 ± 2.59%, P < .001; Week 4: 6.12 ± 2.56% vs 0.16 ± 3.42%, P < .001; Week 8: 8.01 ± 3.70% vs 0.35 ± 3.32%, P < .001; Week 16: 7.72 ± 5.31% vs 0.42 ± 5.14%, P < .001; Week 24: 4.80 ± 5.81% vs -1.01 ± 4.43%, P = .002). Participants with slower walking speed at baseline receiving bimagrumab had clinically meaningful and statistically significantly greater improvements in gait speed (mean 0.15 m/s, P = .009) and 6MWD (mean 82 m, P = .022) than those receiving placebo at Week 16. Adverse events in the bimagrumab group included muscle-related symptoms, acne, and diarrhea, most of which were mild in severity and resolved by the end of study. Treatment with bimagrumab over 16 weeks increased muscle mass and strength in older adults with sarcopenia and improved mobility in those with slow walking speed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Current concepts of oral and maxillofacial rehabilitation and treatment in aviation.

Science.gov (United States)

Yuce, Esra; Koçer, Gulperi; Çini, Turan Atila

2016-01-01

Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

Quantitative Concept Analysis

NARCIS (Netherlands)

Pavlovic, Dusko; Domenach, Florent; Ignatov, Dmitry I.; Poelmans, Jonas

2012-01-01

Formal Concept Analysis (FCA) begins from a context, given as a binary relation between some objects and some attributes, and derives a lattice of concepts, where each concept is given as a set of objects and a set of attributes, such that the first set consists of all objects that satisfy all

[New concepts on the physiopathology, diagnosis, and treatment of achalasia].

Science.gov (United States)

Carmona-Sánchez, R; Valdovinos-Díaz, M A

1998-01-01

To review the most relevant publications on the pathophysiology, clinical manifestations, diagnosis and treatment of esophageal achalasia, and the clinical experience achieved at our institution in order to propose a practical strategy to facilitate the management of these patients. Manual and MEDLINE search of key articles published between January 1986 and July 1997 in addition to publications of our institute of thirty years. All kinds of publications with substantial clinical experience, new information or research protocols. Achalasia is an uncommon disorder of the myenteric plexus of the esophagus. Main symptoms are dysphagia, regurgitations and chest pain. The diagnosis is established by manometric criteria. Esophagogram, endoscopy and radionuclide esophageal emptying test help to differentiate other conditions and evaluate the response to treatment. Pharmacotherapy may provide relief to patients with mild symptoms and is useful for patients with high risk of complications. Dilations and myotomy are safe, effective and long lasting procedures. Botulinum toxin may be effective in selected cases. Predictive factors of response have been described for each therapy. A systematic approach to the management of patients with achalasia is necessary. Introduction of new therapies as botulinum toxin and minimal invasion surgery are changing the therapeutic decisions in this field. Drugs and BoTox are considered the first line of treatment for high risk patients and dilation and surgery for patients with no risk.

[Autonomy: to what extent is the concept relevant in psychiatry?].

Science.gov (United States)

de Wit, F A

2012-01-01

Autonomy is an important concept in psychiatry, but because it is a somewhat abstract and ambiguous notion, it is not applicable in its entirety in a psychiatric context. This becomes obvious in situations where patients are receiving long term care and treatment. To modify the concept of autonomy in such a way that it acquires an extra dimension that renders it applicable to daily psychiatric practice. The literature was reviewed in order to find articles that reveal the tensions that arise between autonomy and dependence in psychiatry and that reflect the human characteristics that are concealed behind the modern concepts of autonomy, freedom and respect for autonomy. Concepts such as person, identity, acknowledgement, dialogical ethics and life histories are used as an addition to the concepts of autonomy of Kant and Mill. A phenomenological and a context sensitive conception of autonomy is needed within the perspective of dialogical ethics. A dialogical perspective requires from psychiatric professionals a susceptibility for what the patient as a human being really has to say. On the basis of a dialogue where there is space and attention for life histories, backgrounds and the potentials of patients, a new perspective can be developed that is shared by the persons involved. In psychiatry, statements about real autonomy and genuine respect for autonomy are only truly meaningful within the context of doctors, nurses and patients. A hermeneutic approach to patients which involves dialogue creates new opportunities in the field of staff-patient relations.

High-rate wastewater treatment combining a moving bed biofilm reactor and enhanced particle separation.

Science.gov (United States)

Helness, H; Melin, E; Ulgenes, Y; Järvinen, P; Rasmussen, V; Odegaard, H

2005-01-01

Many cities around the world are looking for compact wastewater treatment alternatives since space for treatment plants is becoming scarce. In this paper development of a new compact, high-rate treatment concept with results from experiments in lab-scale and pilot-scale are presented. The idea behind the treatment concept is that coagulation/floc separation may be used to separate suspended and colloidal matter (resulting in > 70% organic matter removal in normal wastewater) while a high-rate biofilm process (based on Moving Bed biofilm reactors) may be used for removing low molecular weight, easily biodegradable, soluble organic matter. By using flotation for floc/biomass separation, the total residence time for a plant according to this concept will normally be treatment) and sufficient P-removal.

Pancreatic Cysts: Current Concepts of Pathogenesis, Diagnosis and Diagnostic and Treatment Approach

Directory of Open Access Journals (Sweden)

V.М. Ratchik

2014-09-01

Full Text Available The relevance of pancreatic cyst treatment is determined by the increase in the incidence of pancreatitis, a considerable number of complications and high mortality rate. In recent decades, there has been steady growth of destructive forms of pancreatitis, respectively the number of pancreatic cysts increases. Pancreatic cysts in 18–68 % of cases cause various complications (suppuration, perforation, bleeding, internal and external fistulas, malignant transformation that define high mortality — 9.2–53 %. The nature and extent of surgery depend on the etiology, the presence or absence of the cyst connection with ductal system, the presence of complications. Surgical treatment for pancreatic cysts remains the method of choice. Minimally invasive surgical procedures became widely used. High prevalence of cystic lesions of the pancreas, the difficulty of choosing the optimal method of treatment require the creation of a rational, convenient for clinical practice diagnostic and therapeutic algorithm. Dissatisfaction with the results of treatment and a large number of complications lead to the search for a new, so called gold standard for treatment of patients and determine the real place of minimally invasive and open surgical techniques.

Prospects of Source-Separation-Based Sanitation Concepts: A Model-Based Study

NARCIS (Netherlands)

Tervahauta, T.H.; Trang Hoang,; Hernández, L.; Zeeman, G.; Buisman, C.J.N.

2013-01-01

Separation of different domestic wastewater streams and targeted on-site treatment for resource recovery has been recognized as one of the most promising sanitation concepts to re-establish the balance in carbon, nutrient and water cycles. In this study a model was developed based on literature data

[Schizoaffective Disorder: Evolution and Current Status of the Concept].

Science.gov (United States)

Padhy, Susanta; Hedge, Aditya

2015-01-01

Schizoaffective disorder as a diagnostic entity is of particular present-day relevance; however, the concept of schizoaffective disorder, and its management and prognosis remain contentious. Descriptions of the disorder have varied over time. In this literature review, after tracking the evolution of the concept and nosology of schizoaffective disorder, research findings are summarized. This review takes a broad overview of the epidemiology, neurobiology, clinical presentation, diagnostic validity and stability, treatment, course, and outcome of schizoaffective disorder. Importance is given to the distinctness of schizoaffective disorder, and the overlap with schizophrenia and mood disorders, and problems associated with the construct are examined. Possible ways to treat the construct in the future in the best interest of patients, clinicians, and researchers are discussed.

Native Language Self-Concept and Reading Self-Concept: Same or Different?

Science.gov (United States)

Arens, A. Katrin; Yeung, Alexander Seeshing; Hasselhorn, Marcus

2014-01-01

In assessing verbal academic self-concept with preadolescents, researchers have used scales for students' self-concepts in reading and in their native language interchangeably. The authors conducted 3 studies with German students to test whether reading and German (i.e., native language) self-concepts can be treated as the same or different…

Research on Curriculum Plan and Learning Achievement for Aromatherapy with the Concept of the Chinese Five Elements

Science.gov (United States)

Hsu, Pei-Ching

2012-01-01

In Taiwan, people are getting more aware of beauty treatments and the concept of health care. This study hopes to bring all relevant concepts such as Aromatherapy, essential scented oils, medical foods, human meridians, Chinese five elements therapy, and beauty business management into the curriculum design, and seriously considered many factors…

Antenatal mood and fetal attachment after assisted conception.

Science.gov (United States)

Fisher, Jane R W; Hammarberg, Karin; Baker, Gordon H W

2008-05-01

Australian women conceiving with ART are at fourfold risk of admission to early parenting treatment programs compared with those conceiving spontaneously. This study aimed to identify prevalence and determinants of antenatal mood disturbance and other risks for early parenting difficulties after assisted conception. A prospective longitudinal investigation from conception to 18 months postpartum using telephone interviews and self-report questionnaires. Melbourne IVF and Royal Women's Hospital Reproductive Services, Victoria, Australia. A consecutive cohort of English-speaking women with ultrasound-confirmed ART-conceived pregnancies. Standardized psychometric measures of mood, quality of marital relationship, mother-to-fetus emotional attachment, and personality. None. Of the 288 women with confirmed pregnancies, 239 were contactable, and 183 (77%) were recruited, 95% of whom completed both early and late pregnancy assessments. Participants were socioeconomically advantaged, had very good pregnancy health, exceptional marital relationships, normal personality styles, and intense affectionate attachment to the fetus. Very few (<5%) had clinically significant mood disturbance in late pregnancy. There were low rates of antenatal mood disturbance and other risk factors for postpartum depression. Pregnancy and motherhood might be idealized after ART conception, and preparation for the realities of infant care might then be insufficient.

Emerging Concepts and Methodologies in Cancer Biomarker Discovery.

Science.gov (United States)

Lu, Meixia; Zhang, Jinxiang; Zhang, Lanjing

2017-01-01

Cancer biomarker discovery is a critical part of cancer prevention and treatment. Despite the decades of effort, only a small number of cancer biomarkers have been identified for and validated in clinical settings. Conceptual and methodological breakthroughs may help accelerate the discovery of additional cancer biomarkers, particularly their use for diagnostics. In this review, we have attempted to review the emerging concepts in cancer biomarker discovery, including real-world evidence, open access data, and data paucity in rare or uncommon cancers. We have also summarized the recent methodological progress in cancer biomarker discovery, such as high-throughput sequencing, liquid biopsy, big data, artificial intelligence (AI), and deep learning and neural networks. Much attention has been given to the methodological details and comparison of the methodologies. Notably, these concepts and methodologies interact with each other and will likely lead to synergistic effects when carefully combined. Newer, more innovative concepts and methodologies are emerging as the current emerging ones became mainstream and widely applied to the field. Some future challenges are also discussed. This review contributes to the development of future theoretical frameworks and technologies in cancer biomarker discovery and will contribute to the discovery of more useful cancer biomarkers.

Concept Mapping

Science.gov (United States)

Technology & Learning, 2005

2005-01-01

Concept maps are graphical ways of working with ideas and presenting information. They reveal patterns and relationships and help students to clarify their thinking, and to process, organize and prioritize. Displaying information visually--in concept maps, word webs, or diagrams--stimulates creativity. Being able to think logically teaches…

Management concepts.

Science.gov (United States)

Bittner, Rhonda

2006-01-01

Management concepts evolve through time. Health care managers can learn new concepts by evaluating classical management strategies, as well as modern-day strategies. Focusing on quality improvement and team building can help managers align the goals of their departments with the goals of the organization, consequently improving patient care.

Analyzing polysemous concepts from a clinical perspective: Application to auditing concept categorization in the UMLS

Science.gov (United States)

Mougin, Fleur; Bodenreider, Olivier; Burgun, Anita

2015-01-01

Objectives Polysemy is a frequent issue in biomedical terminologies. In the Unified Medical Language System (UMLS), polysemous terms are either represented as several independent concepts, or clustered into a single, multiply-categorized concept. The objective of this study is to analyze polysemous concepts in the UMLS through their categorization and hierarchical relations for auditing purposes. Methods We used the association of a concept with multiple Semantic Groups (SGs) as a surrogate for polysemy. We first extracted multi-SG (MSG) concepts from the UMLS Metathesaurus and characterized them in terms of the combinations of SGs with which they are associated. We then clustered MSG concepts in order to identify major types of polysemy. We also analyzed the inheritance of SGs in MSG concepts. Finally, we manually reviewed the categorization of the MSG concepts for auditing purposes. Results The 1208 MSG concepts in the Metathesaurus are associated with 30 distinct pairs of SGs. We created 75 semantically homogeneous clusters of MSG concepts, and 276 MSG concepts could not be clustered for lack of hierarchical relations. The clusters were characterized by the most frequent pairs of semantic types of their constituent MSG concepts. MSG concepts exhibit limited semantic compatibility with their parent and child concepts. A large majority of MSG concepts (92%) are adequately categorized. Examples of miscategorized concepts are presented. Conclusion This work is a systematic analysis and manual review of all concepts categorized by multiple SGs in the UMLS. The correctly-categorized MSG concepts do reflect polysemy in the UMLS Metathesaurus. The analysis of inheritance of SGs proved useful for auditing concept categorization in the UMLS. PMID:19303057

KALIMER design concept report

Energy Technology Data Exchange (ETDEWEB)

Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sub, Sim Yoon; Kim, Yeon Sik; Whan, Wim Myung; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon

1997-07-01

KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs.

KALIMER design concept report

International Nuclear Information System (INIS)

Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sim Yoon Sub; Kim, Yeon Sik; Wim Myung Whan; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon.

1997-07-01

KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs

Treatment of giant cell tumor of bone: Current concepts

OpenAIRE

Puri Ajay; Agarwal Manish

2007-01-01

Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function. Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone ...

Alternative concepts for spent fuel storage basin expansion at Morris Operation

International Nuclear Information System (INIS)

Graf, W.A. Jr.; King, C.E.; Miller, G.P.; Shadel, F.H.; Sloat, R.J.

1980-08-01

Alternative concepts for increasing basin capabilities for storage of spent fuel at the Morris Operation have been defined in a series of simplified flow diagrams and equipment schematics. Preliminary concepts have been outlined for (1) construction alternatives for an add-on basin, (2) high-density baskets for storage of fuel bundles or possible consolidated fuel rods in the existing or add-on basins, (3) modifications to the existing facility for increasing cask handling and fuel receiving capabilities and (4) accumulation, treatment and disposal of radwastes from storage operations. Preliminary capital and operating costs have been prepared and resource and schedule requirements for implementing the concepts have been estimated. The basin expansion alternatives would readily complement potential dry storage projects at the site in an integrated multi-stage program that could provide a total storage capacity of up to 7000 tonnes of spent fuel

Evolutionary space platform concept study. Volume 2, part B: Manned space platform concepts

Science.gov (United States)

1982-01-01

Logical, cost-effective steps in the evolution of manned space platforms are investigated and assessed. Tasks included the analysis of requirements for a manned space platform, identifying alternative concepts, performing system analysis and definition of the concepts, comparing the concepts and performing programmatic analysis for a reference concept.

Checkpoint inhibitors and radiation treatment in Hodgkin's lymphoma. New study concepts of the German Hodgkin Study Group

Energy Technology Data Exchange (ETDEWEB)

Baues, C.; Semrau, R.; Marnitz, S. [University of Cologne, Medical Faculty, Department of Radiooncology, Cologne (Germany); University of Cologne, German Hodgkin Study Group (GHSG), Cologne (Germany); Gaipl, U.S. [University Hospital Erlangen, Department of Radiooncology, Erlangen (Germany); Broeckelmann, P.J.; Engert, A. [University of Cologne, German Hodgkin Study Group (GHSG), Cologne (Germany); University of Cologne, Medical Faculty, Department of Internal Medicine I, Cologne (Germany); Rosenbrock, J. [University of Cologne, Medical Faculty, Department of Radiooncology, Cologne (Germany)

2017-02-15

Patients with classical Hodgkin's lymphoma (cHL) have a good prognosis even in advanced stages. However, combined chemo- and radiotherapy, as the standard of care, is also associated with treatment-related toxicities such as organ damage, secondary neoplasias, infertility, or fatigue and long-term fatigue. Many patients suffer from this burden although their cHL was cured. Therefore, the efficacy of immune checkpoint inhibitors like anti-PD1/PD-L1 antibodies in the treatment of solid cancers and also in HL offers new options. A remarkable and durable response rate with a favorable toxicity profile was observed in heavily pretreated cHL patients. Planning to perform prospective randomized clinical trials in the content of radio-immune treatment in patients with Hodgkin's lymphoma (HL), we transferred the results of preliminary clinical studies and basic research in clinical relevant study concepts. Based on these promising early phase trial data, the German Hodgkin Study Group (GHSG) will investigate innovative treatment regimens in upcoming phase II trials. The therapeutic efficacy and potential synergies of anti-PD1 antibodies in combination with chemo- or radiotherapy will be investigated in various settings of HL. (orig.) [German] Patienten mit einem klassischen Hodgkin-Lymphom (cHL) haben ueber alle Stadien hinweg eine gute Prognose. Allerdings treten unter der kombinierten Therapie mit Chemotherapie und Bestrahlung therapieabhaengige Toxizitaeten wie z. B. Organschaeden, Sekundaertumoren, Fatigue oder Langzeit-Fatigue auf. Viele Patienten leiden trotz einer Heilung an diesen Symptomen. Daher bietet die nachgewiesene Wirksamkeit der Anti-PD1/PD-L1-Antikoerper bei soliden Tumoren, aber auch beim HL neue Behandlungsoptionen. Bei intensiv vorbehandelten Patienten mit rezidiviertem cHL wurde bei guter Vertraeglichkeit eine hohe Ansprechrate mit z. T. langanhaltenden Remissionen beobachtet. Im Rahmen der Planung prospektiver randomisierter Studien im

Deep Borehole Disposal Concept: Development of Universal Canister Concept of Operations

Energy Technology Data Exchange (ETDEWEB)

Rigali, Mark J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Applied Systems Analysis and Research; Price, Laura L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Applied Systems Analysis and Research

2016-08-01

This report documents key elements of the conceptual design for deep borehole disposal of radioactive waste to support the development of a universal canister concept of operations. A universal canister is a canister that is designed to be able to store, transport, and dispose of radioactive waste without the canister having to be reopened to treat or repackage the waste. This report focuses on the conceptual design for disposal of radioactive waste contained in a universal canister in a deep borehole. The general deep borehole disposal concept consists of drilling a borehole into crystalline basement rock to a depth of about 5 km, emplacing WPs in the lower 2 km of the borehole, and sealing and plugging the upper 3 km. Research and development programs for deep borehole disposal have been ongoing for several years in the United States and the United Kingdom; these studies have shown that deep borehole disposal of radioactive waste could be safe, cost effective, and technically feasible. The design concepts described in this report are workable solutions based on expert judgment, and are intended to guide follow-on design activities. Both preclosure and postclosure safety were considered in the development of the reference design concept. The requirements and assumptions that form the basis for the deep borehole disposal concept include WP performance requirements, radiological protection requirements, surface handling and transport requirements, and emplacement requirements. The key features of the reference disposal concept include borehole drilling and construction concepts, WP designs, and waste handling and emplacement concepts. These features are supported by engineering analyses.

Role of membrane technology to achieve ALARA concept in reprocessing plant: utilization of low pressure reverse osmosis for treatment of delay tank solutions

International Nuclear Information System (INIS)

Pabby, Anil K.; Sonawane, J.V.; Rathore, N.S.; Gupta, S.K.; Roy, S.C.; Venugopalan, A.K.; Chagrani, R.D.; Dey, P.K.; Prabhakar, S.; Tiwari, P.K.

2004-01-01

Reverse osmosis is a well-developed technology. The systems have been used in industrial settings for many years with applications to separation, concentration of product streams and waste water treatment. The technology has been used for removal of the radionuclides from low-level liquid wastes, such as waste streams at nuclear power plants. Because reverse osmosis rejects nearly all contaminants from a solution the high purity product water may be recycled within the power plant, or is usually of such low activity that it is suitable for discharge to the environment. This technology will help in achieving ALARA concept which will be beneficial for the environment. In the present study, the removal of alpha and beta activities from delay tank solution is planned

How to Create Evidence for the Integration of Local and Locoregional Treatments in Future Oncological Treatment Concepts?

OpenAIRE

Lordick, Florian; Ricke, Jens; Mohnike, Konrad; Hacker, Ulrich

2014-01-01

Summary Background While local treatment using more innovative technologies is increasingly applied in contemporary treatment of advanced cancer, its impact on outcomes is not well understood. Methods We reviewed the literature using PubMed and major oncology congress websites, and report here about the understanding of oligometastatic disease, about the role of primary tumor resection in metastatic disease, and about the value of cytoreduction and tumor ablation. Results The Achilless' heel ...

Kierkegaard's concepts: Hypocrisy

DEFF Research Database (Denmark)

Fauth Hansen, Thomas Martin

2014-01-01

Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development...... of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, literature and aesthetics, thereby making...... this volume an ideal reference work for students and scholars in a wide range of disciplines....

The use of concept maps to detect and correct concept errors (mistakes

Directory of Open Access Journals (Sweden)

Ladislada del Puy Molina Azcárate

2013-02-01

Full Text Available This work proposes to detect and correct concept errors (EECC to obtain Meaningful Learning (AS. The Conductive Model does not respond to the demand of meaningful learning that implies gathering thought, feeling and action to lead students up to both compromise and responsibility. In order to respond to the society competition about knowledge and information it is necessary to change the way of teaching and learning (from conductive model to constructive model. In this context it is important not only to learn meaningfully but also to create knowledge so as to developed dissertive, creative and critical thought, and the EECC are and obstacle to cope with this. This study tries to get ride of EECC in order to get meaningful learning. For this, it is essential to elaborate a Teaching Module (MI. This teaching Module implies the treatment of concept errors by a teacher able to change the dynamic of the group in the classroom. This M.I. was used among sixth grade primary school and first grade secondary school in some state assisted schools in the North of Argentina (Tucumán and Jujuy. After evaluation, the results showed great and positive changes among the experimental groups taking into account the attitude and the academic results. Meaningful Learning was shown through pupilʼs creativity, expressions and also their ability of putting this into practice into everyday life.

[Perthes disease--results of a containment-oriented therapy concept].

Science.gov (United States)

Rühmann, O; Lazović, D; Wirth, C J; Gossé, F; Franke, J

1997-01-01

In a retrospective study a treatment concept for Perthes' disease dependent on the containment was applied. 49 hips of 41 children (9 female, 32 male) were treated between 01. 01. 1990 and 31. 12. 1995. In our concept of treatment a varus femoral osteotomy was performed in 28 cases with not contained hips or less than 4/5 coverage of the femoral head (X-ray/MRI). The other 21 well contained hips with 4/5 coverage or more were treated conservatively with physiotherapy and in case of joint effusion and pain additionally with the use of crutches (partial weight bearing) and anti-inflammatory medication. The average age in the non-operative group at the time of first investigation was 4 years and 9 months (3 y./1 m. to 7 y./1 m.) and 6 years and 3 months (4 y/2 m. to 10 y/0 m.) at our last examination (mean follow up 17.7 months, range of 6 to 72 months). At the time of indication for a varus femoral osteotomy the patients had an average age 6 years and 1 month (3 y./6 m. to 10 y./2 m.), the mean age at the last postoperative examination was 7 years and 11 months (4 y./8 m. to 12 y./5 m.) with an average follow up of 21.5 months (6 to 77 months). For the conservatively treated children we achieved good results (still well contained hips with 4/5 coverage, no decrease of function, no increase of pain) in 85.7% (18 of 21 cases). In 85.7% (24 of 28 cases) we found good results (well contained hips, increase of coverage, no decrease of function, no increase of pain) in the operation group. The presented concept of therapy in Perthes' disease was practicable for all patients and included the possibility of decision for operative or non-operative treatment. In both groups we achieved good results in 85.7% of the cases.

Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change

Science.gov (United States)

Styła, Rafał

2015-01-01

Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001

Joint Concept Correlation and Feature-Concept Relevance Learning for Multilabel Classification.

Science.gov (United States)

Zhao, Xiaowei; Ma, Zhigang; Li, Zhi; Li, Zhihui

2018-02-01

In recent years, multilabel classification has attracted significant attention in multimedia annotation. However, most of the multilabel classification methods focus only on the inherent correlations existing among multiple labels and concepts and ignore the relevance between features and the target concepts. To obtain more robust multilabel classification results, we propose a new multilabel classification method aiming to capture the correlations among multiple concepts by leveraging hypergraph that is proved to be beneficial for relational learning. Moreover, we consider mining feature-concept relevance, which is often overlooked by many multilabel learning algorithms. To better show the feature-concept relevance, we impose a sparsity constraint on the proposed method. We compare the proposed method with several other multilabel classification methods and evaluate the classification performance by mean average precision on several data sets. The experimental results show that the proposed method outperforms the state-of-the-art methods.

Concept Elicitation Within Patient-Powered Research Networks: A Feasibility Study in Chronic Lymphocytic Leukemia.

Science.gov (United States)

McCarrier, Kelly P; Bull, Scott; Fleming, Sarah; Simacek, Kristina; Wicks, Paul; Cella, David; Pierson, Renee

2016-01-01

To explore the feasibility of using social media-based patient networks to gather qualitative data on patient-reported outcome (PRO) concepts relevant to chronic lymphocytic leukemia (CLL). Between August and November 2013, US-residing members of the PatientsLikeMe online CLL patient community completed open-ended web-based surveys designed to elicit descriptions of CLL symptoms, impacts, and treatment-related perceptions. Qualitative telephone follow-up interviews were conducted with a subsample of respondents. Survey responses and interview transcripts were coded for qualitative analysis using Atlas.ti. Fifty survey responses were included in the analyses. Participants were age 60.5 ± 6.9 years, 54% female, and 96% white. When surveyed, 20% were receiving current treatment, 16% were in remission, and 64% were treatment-naïve. Among respondents, 369 descriptions of CLL symptoms were coded. Fatigue-related symptoms were expressed most frequently, with 54% reporting "fatigue," "tiredness," or both in their responses. These concepts were followed by night sweats (38%), swollen lymph nodes (32%), and frequent infections (28%). Among impacts of CLL, worry and fear (66% of respondents), depressed feelings (52%), and work limitations (50%) were noted most frequently. Survey results identified constitutional symptoms of CLL included in existing PRO instruments and the literature. Although the findings suggest that qualitative data obtained through social media applications can be potentially useful in supporting concept identification for newly developed PRO instruments, they also indicate that online approaches alone may not be sufficient to achieve efficient and exhaustive concept elicitation. Further research is needed to identify whether the results can support content validity in the same way as established qualitative research methods. Copyright © 2016. Published by Elsevier Inc.

The technological conception

International Nuclear Information System (INIS)

Parrochia, D.

1998-01-01

The 'technological conception' examines how a project can be concretized or how it is possible to 'conceive', i.e. to produce operative ideas that can be directly use. The first part of this book, called 'concepts and methods', analyzes the logics of conceiving and its philosophy in the construction of its objects and in the management of its programs or projects. The second part is devoted to some exemplary technologies: roads, tunnels, bridges, dams, nuclear power plants, aerospace constructions, and analyzes different concrete logics of technological conception. Finally, the author shows how todays conception faces the risks and complexity increase of systems and considers the possibility of an entirely automated manufacturing shop in the future. (J.S.)

Conception rates to fixed-time artificial insemination of two oestrus synchronisation programmes in dairy heifers.

Science.gov (United States)

Sahu, S K; Parkinson, T J; Laven, R A

2015-05-01

To evaluate the conception rate to fixed-time artificial insemination (FTAI) of two oestrus synchronisation programmes in dairy heifers on eight farms over 2 years. The study was conducted in 2008 and 2010 on eight farms near Palmerston North, New Zealand. Nulliparous Friesian and Friesian×Jersey heifers (13-15 months of age) were randomly allocated to one of two oestrus synchronisation programmes. Group 1 (GPG+P4; n=330), received gonadotrophin-releasing hormone (GnRH) I/M on Day 0, a progesterone (P4)-releasing intravaginal device from Days 0-7, prostaglandin F2α (PGF) I/M on Day 7 and a second dose of GnRH at the time of FTAI on Day 9. The second group (P4+PGF; n=343) received a P4-releasing intravaginal device from Days 0-7, PGF on Day 6 and FTAI on Day 9. Pregnancy was diagnosed from Days 42-52 by transrectal ultrasonography. The overall conception rate was 52.4% and 54.8% for the GPG+P4 and P4+PGF groups, respectively. The odds of conception for the two treatments were not different (OR=0.90; 95% CI=0.67-1.23), nor was there any difference between groups in different years (p=0.58). Farm affected conception rate (p=0.002), but there was no interaction with treatment (p=0.92) . This study has shown that an alternative synchronisation programme can produce similar results in terms of conception rate to the GPG+P4 treatment, currently commonly used in heifers. More research is required to establish whether other modifications to the GPG+P4 programme can produce similar results at lower costs, and to identify and quantify farm factors which affect the economic benefit of heifer synchronisation. This study indicated that synchronising heifers with P4 and PGF resulted in conception rates equivalent to those resulting from a GPG+P4 treatment, but with reduced drug costs. However, because heifers in the GPG+P4 group received the second GnRH injection at the time of AI, they needed only three yardings as opposed to the four required for the heifers treated with P4

The concept of cluster

DEFF Research Database (Denmark)

Laursen, Lea Louise Holst; Møller, Jørgen

2013-01-01

villages in order to secure their future. This paper will address the concept of cluster-villages as a possible approach to strengthen the conditions of contemporary Danish villages. Cluster-villages is a concept that gather a number of villages in a network-structure where the villages both work together...... to forskellige positioner ser vi en ny mulighed for landsbyudvikling, som vi kalder Clustervillages. In order to investigate the potentials and possibilities of the cluster-village concept the paper will seek to unfold the concept strategically; looking into the benefits of such concept. Further, the paper seeks...

The Marketing Concept

OpenAIRE

G. Nazan Gunay

2001-01-01

Since the term "Market Orientation" is recognised as the critical factor in business success there has been an overwhelming increase in research issues linking market orientation with company performance. The term market orientation has been employed by scholars to indicate the implementation of the marketing concept. In order to understand market orientation, one believes that there is a need to recall what the marketing concept is. Therefore, this study reviews the "marketing concept" as a ...

A theoretical concept for a thermal-hydraulic 3D parallel channel core model

International Nuclear Information System (INIS)

Hoeld, A.

2004-01-01

A detailed description of the theoretical concept of the 3D thermal-hydraulic single- and two-phase flow phenomena is presented. The theoretical concept is based on important development lines such as separate treatment of the mass and energy from the momentum balance eqs. The other line is the establishment of a procedure for the calculation of the mass flow distributions into different parallel channels based on the fact that the sum of pressure decrease terms over a closed loop must stay, despite of un-symmetric perturbations, zero. The concept is realized in the experimental code HERO-X3D, concentrating in a first step on an artificial BWR or PWR core which may consist of a central channel, four quadrants, and a bypass channel. (authors)

Short dental implants: an emerging concept in implant treatment.

Science.gov (United States)

Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah

2014-06-01

Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.

[Innovative training for enhancing patient safety. Safety culture and integrated concepts].

Science.gov (United States)

Rall, M; Schaedle, B; Zieger, J; Naef, W; Weinlich, M

2002-11-01

Patient safety is determined by the performance safety of the medical team. Errors in medicine are amongst the leading causes of death of hospitalized patients. These numbers call for action. Backgrounds, methods and new forms of training are introduced in this article. Concepts from safety research are transformed to the field of emergency medical treatment. Strategies from realistic patient simulator training sessions and innovative training concepts are discussed. The reasons for the high numbers of errors in medicine are not due to a lack of medical knowledge, but due to human factors and organisational circumstances. A first step towards an improved patient safety is to accept this. We always need to be prepared that errors will occur. A next step would be to separate "error" from guilt (culture of blame) allowing for a real analysis of accidents and establishment of meaningful incident reporting systems. Concepts with a good success record from aviation like "crew resource management" (CRM) training have been adapted my medicine and are ready to use. These concepts require theoretical education as well as practical training. Innovative team training sessions using realistic patient simulator systems with video taping (for self reflexion) and interactive debriefing following the sessions are very promising. As the need to reduce error rates in medicine is very high and the reasons, methods and training concepts are known, we are urged to implement these new training concepts widely and consequently. To err is human - not to counteract it is not.

Research concepts use in the diagnosis and treatment of urinary incontinence

Directory of Open Access Journals (Sweden)

Gabriela Bidzińska

2017-12-01

Full Text Available Urinary incontinence is a significant social problem that affects both women and men regardless of age, ethnic or cultural differences. It is estimated that in Poland about 5 million people suffer from this disorder and it affects twice as many women than men. In addition, it has been shown that the frequency of disease and the severity of symptoms increases with age. Recent reports indicate that over 50% of all cases are stress urinary incontinence (WNM, which using appropriate diagnostic and therapeutic methods, is reversible and can be cured. The cause of stress urinary incontinence is the reduction of muscle tone of the crotch, pelvic floor, fascia and relaxation of connective tissue. Diagnosis of the lower urinary tract should be based on the interview, analysis of the micturition diary, physical and urodynamic examination. In recent years, imaging diagnostics, mainly including ultrasound, have also begun to be used. The cheapest and safest method for the patient is conservative treatment and the patient should be qualified for this form of therapy at the very beginning. Surgical treatment should be used when conservative treatment does not bring positive effects.

Students’ conceptions analysis on several electricity concepts

Science.gov (United States)

Saputro, D. E.; Sarwanto, S.; Sukarmin, S.; Ratnasari, D.

2018-05-01

This research is aimed to analyse students’ conceptions on several electricity concept. This is a descriptive research with the subjects of new students of Sebelas Maret University. The numbers of the subject were 279 students that consisted of several departments such as science education, physics education, chemistry education, biology education and mathematics education in the academic year of 2017/2018. The instrument used in this research was the multiple-choice test with arguments. Based on the result of the research and analysis, it can be concluded that most of the students still find misconceptions and do not understand electricity concept on sub-topics such as electric current characteristic in the series and parallel arrangement, the value of capacitor capacitance, the influence of the capacitor charge and discharge towards the loads, and the amount of capacitor series arrangement. For the future research, it is suggested to improve students’ conceptual understanding with appropriate learning method and assessment instrument because electricity is one of physics material that closely related with students’ daily life.

Alternative concepts for treatment and disposal of Hanford site high-level waste in tanks

International Nuclear Information System (INIS)

Claghorn, R.D.; Powell, W.J.

1994-12-01

Some innovative approaches have recently been proposed that may have significant schedule, cost, or environmental advantages which could improve the current HLW program strategy. Three general categories of alternative concepts are now under consideration: (1) process/product alternatives, (2) facility layout options, and (3) contracting strategies. This report compares the alternate approaches to the current program baseline to illustrate their potential significance and to identify the risks associated with each approach

Alternative concepts for treatment and disposal of Hanford site high-level waste in tanks

Energy Technology Data Exchange (ETDEWEB)

Claghorn, R.D.; Powell, W.J.

1994-12-01

Some innovative approaches have recently been proposed that may have significant schedule, cost, or environmental advantages which could improve the current HLW program strategy. Three general categories of alternative concepts are now under consideration: (1) process/product alternatives, (2) facility layout options, and (3) contracting strategies. This report compares the alternate approaches to the current program baseline to illustrate their potential significance and to identify the risks associated with each approach.

COMPARISON OF THE ACCOUNTING CONCEPT “FAIR VALUE” WITH OTHER ECONOMIC VALUE CONCEPTS

OpenAIRE

Justine Jaunzeme

2011-01-01

Fair value is a measurement base found both in International Financial Reporting Standards and in Latvian accounting legislation. For the fair value measurements to be meaningful for financial analysts, consultants and other financial statement users, it is important that the fair value concept be understood in relation to other economic value concepts. The purpose of this paper is to compare the fair value concept of financial accounting to other economic value concepts. The qualitative meth...

COMET concept

International Nuclear Information System (INIS)

Alsmeyer, H.; Tromm, W.

1995-01-01

Studies of the COMET core catcher concept developed for a future PWR have been continued. The concept is based on the spreading of a core melt on a sacrificial layer and its erosion, until a subsequent addition of water from below causes a fragmentation of the melt. A porous solidification of the melt would then admit a complete flooding within a short period. (orig.)

Travelling Concepts

DEFF Research Database (Denmark)

Simonsen, Karen-Margrethe

2013-01-01

Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012......Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012...

Esophageal Motility Disorders: Current Concepts of Pathogenesis and Treatment

Directory of Open Access Journals (Sweden)

Peter J Kahrilas

2000-01-01

Full Text Available Current concepts of esophageal motility disorders are summarized. Primary data sources were located via MEDLINE or cross-citation. No attempt was made to be comprehensive or inclusive of the literature because fewer than 10% of citations are discussed. Instead, emphasis was placed on new developments in diagnosis, therapeutics, and practice patterns. Controlled therapeutic trials and pathophysiological observations are emphasized. Achalasia is a rare disease of failed lower sphincter relaxation and aperistalsis. Diffuse esophageal spasm (DES, an equally rare disease, is defined by non-propagated esophageal contractions. Nonspecific motility disorders, including nutcracker esophagus and hypertensive lower esophageal sphincter, are identified only by manometry and are ten times as prevalent. Neuromuscular pathology is evident only with achalasia (myenteric plexus neurons destruction. Pharmacological therapies have limited efficacy with achalasia; more limited with DES; and none with the nonspecific motility disorders. More efficacious therapies for the nonspecific disorders are directed at associated reflux disease or psychiatric disorders. Pneumatic dilation is effective therapy for achalasia 72% of instances, but frequently requires repeat dilation and is complicated by a 3% perforation rate. Surgical myotomy is effective in 88% of achalasics; morbidity from thoracotomy has been the major limitation but this has been sharply reduced with a laparoscopic approach. In conclusion, although it has been suggested that esophageal motility disorders are distinct clinical entities, critical review of the literature supports this only in the case of achalasia, a disease of well defined pathophysiology, functional disturbance, and therapies. This clarity diminishes progressively for DES and non-specific esophageal motility disorders.

Memory for expectation-violating concepts

DEFF Research Database (Denmark)

Porubanova, Michaela; Shaw, Daniel; McKay, Ryan

2014-01-01

Previous research has shown that ideas which violate our expectations, such as schema-inconsistent concepts, enjoy privileged status in terms of memorability. In our study, memory for concepts that violate cultural (cultural schema-level) expectations (e.g., ‘‘illiterate teacher’’, ‘‘wooden bottle...... expectations and with intuitive concepts (e.g., ‘‘galloping pony’’, ‘‘drying orchid’’, or ‘‘convertible car’’), in both immediate recall, and delayed recognition tests. Importantly, concepts related to agents showed a memory advantage over concepts not pertaining to agents, but this was true only...... for expectation-violating concepts. Our results imply that intuitive, everyday concepts are equally attractive and memorable regardless of the presence or absence of agents. However, concepts that violate our expectations (cultural-schema or domain-level) are more memorable when pertaining to agents (humans...

Prospects of Source-Separation-Based Sanitation Concepts: A Model-Based Study

Directory of Open Access Journals (Sweden)

Cees Buisman

2013-07-01

Full Text Available Separation of different domestic wastewater streams and targeted on-site treatment for resource recovery has been recognized as one of the most promising sanitation concepts to re-establish the balance in carbon, nutrient and water cycles. In this study a model was developed based on literature data to compare energy and water balance, nutrient recovery, chemical use, effluent quality and land area requirement in four different sanitation concepts: (1 centralized; (2 centralized with source-separation of urine; (3 source-separation of black water, kitchen refuse and grey water; and (4 source-separation of urine, feces, kitchen refuse and grey water. The highest primary energy consumption of 914 MJ/capita(cap/year was attained within the centralized sanitation concept, and the lowest primary energy consumption of 437 MJ/cap/year was attained within source-separation of urine, feces, kitchen refuse and grey water. Grey water bio-flocculation and subsequent grey water sludge co-digestion decreased the primary energy consumption, but was not energetically favorable to couple with grey water effluent reuse. Source-separation of urine improved the energy balance, nutrient recovery and effluent quality, but required larger land area and higher chemical use in the centralized concept.

Early aggressive intraocular pressure lowering, target intraocular pressure, and a novel concept for glaucoma care.

Science.gov (United States)

Singh, Kuldev; Shrivastava, Anurag

2008-11-01

Early diagnosis of glaucomatous optic nerve damage offers the potential for early treatment which may prevent vision loss from this neurodegenerative disease. Even in patients who do not begin early treatment, early diagnosis allows for better monitoring of disease at a stage where the stakes are lower relative to later stages of the disease. For these reasons, early diagnosis of glaucomatous optic nerve disease is desirable and opens the door for appropriately aggressive therapy. The target intraocular pressure (IOP) concept is widely employed by glaucoma practitioners. Although there have been no randomized clinical trials or other high-quality studies showing the benefits of setting a target IOP versus not using this approach, there is ample evidence that lowering IOP slows glaucoma progression and, in general, lower is better, regardless of disease stage and baseline IOP level. We propose an alternative approach to managing glaucoma without the use of the target IOP concept and suggest that this market IOP concept should be compared with the target IOP approach in an appropriately powered comparative clinical trial.

Cardiovascular disease risk among breast cancer survivors: an evolutionary concept analysis

Directory of Open Access Journals (Sweden)

Vo JB

2017-02-01

Full Text Available Jacqueline B Vo,1 Timiya S Nolan,1 David E Vance,1 Patricia A Patrician,2 Karen Meneses1 1Office of Research and Scholarship, 2Department of Family, Community Health, and Systems, University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA Background: More than 3.5 million breast cancer survivors are living in the US, and the overall five-year survival rate is approaching 90%. With increased survival and cancer treatment-related cardiotoxicities, there has been a rise in cardiovascular diseases among breast cancer survivors. Yet, cardiovascular disease risk among breast cancer survivors has not been well conceptualized. The purpose of this article was to analyze and define the concept of cardiovascular disease risk among breast cancer survivors. Methods: The databases CINAHL, EMBASE, and PubMed were used to identify articles that explored cardiovascular disease risk among breast cancer survivors. The search yielded 357 articles, which were reviewed for eligibility. Thirty articles were selected based on the inclusion/exclusion criteria. The concept of cardiovascular disease risk among breast cancer survivors was analyzed using Rodgers’ evolutionary concept analysis method. Results: The analysis suggests that cardiovascular disease risk among breast cancer survivors consists of several attributes: cancer treatment (chemotherapy, targeted therapies, radiation therapy, and endocrine therapy, modifiable risk factors (obesity, physical inactivity, poor diet, and smoking, and nonmodifiable risk factors (age, family history, and race. The antecedent identified includes breast cancer diagnosis and the consequence identified includes the development of cardiovascular disease. Conclusion: Findings suggest the need for increased education and understanding of ­cardiovascular disease risk among health care providers and patients. Survivorship care plans can incorporate cardiovascular disease risk monitoring and screening. Future research

Knowledge, perceptions and clinical application of the shortened dental arch concept among Malaysian government dentists.

Science.gov (United States)

Kasim, Siti Kamilah Mohd; Razak, Ishak Abdul; Yusof, Zamros Yuzadi Mohd

2018-02-01

To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice. The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice. A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software. The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients 5 years of work experience perceived that the SDA concept enables simpler treatment planning (P concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs. © 2017 FDI World Dental Federation.

Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis

OpenAIRE

Hasanpour-Dehkordi, Ali

2016-01-01

Background: Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers? evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis,...

The compression dome concept: the restorative implications.

Science.gov (United States)

Milicich, Graeme

2017-01-01

Evidence now supports the concept that the enamel on a tooth acts like a compression dome, much like the dome of a cathedral. With an overlying enamel compression dome, the underlying dentin is protected from damaging tensile forces. Disruption of a compression system leads to significant shifts in load pathways. The clinical restorative implications are significant and far-reaching. Cutting the wrong areas of a tooth exposes the underlying dentin to tensile forces that exceed natural design parameters. These forces lead to crack propagation, causing flexural pain and eventual fracture and loss of tooth structure. Improved understanding of the microanatomy of tooth structure and where it is safe to cut teeth has led to a revolution in dentistry that is known by several names, including microdentistry, minimally invasive dentistry, biomimetic dentistry, and bioemulation dentistry. These treatment concepts have developed due to a coalescence of principles of tooth microanatomy, material science, adhesive dentistry, and reinforcing techniques that, when applied together, will allow dentists to repair a compromised compression dome so that it more closely replicates the structure of the healthy tooth.

A randomized, double-blind, placebo-controlled, proof-of-concept trial of creatine monohydrate as adjunctive treatment for bipolar depression.

Science.gov (United States)

Toniolo, Ricardo Alexandre; Silva, Michelle; Fernandes, Francy de Brito Ferreira; Amaral, José Antonio de Mello Siqueira; Dias, Rodrigo da Silva; Lafer, Beny

2018-02-01

Depressive episodes are a major cause of morbidity and dysfunction in individuals suffering from bipolar disorder. Currently available treatments for this condition have limited efficacy and new therapeutic options are needed. Extensive research in the pathophysiology of bipolar disorder points to the existence of mitochondrial and bioenergetic dysfunction. We hypothesized that creatine monohydrate, a nutraceutical that works as a mitochondrial modulator, would be effective as an adjunctive therapy for bipolar depression. We conducted a double-blind trial in which 35 patients with bipolar disorder type I or II in a depressive episode by DSM-IV criteria and in use of regular medication for the treatment of this phase of the disease were randomly allocated into two adjunctive treatment groups for 6 weeks: creatine monohydrate 6 g daily (N = 17) or placebo (N = 18). Primary efficacy was assessed by the change in the Montgomery-Åsberg Depression Rating Scale (MADRS). We did not find a statistically significant difference in the comparison between groups for the change in score on the MADRS after 6 weeks in an intention-to-treat (ITT) analysis (p = 0.560; Cohen's d = 0.231). However, we found significant superiority of creatine add-on vs. placebo when we considered the remission criterion of a MADRS score ≤ 12 at week 6 analyzing the outcome of the 35 randomized patients on ITT (52.9% remission in the creatine group vs. 11.1% remission in the placebo group) and of the 23 completers (66.7% remission in the creatine group vs. 18.2% remission in the placebo group) (p = 0.012; OR = 9.0 and p = 0.036; OR = 9.0, respectively). Two patients who received creatine switched to hypomania/mania early in the trial. No clinically relevant physical side-effects were reported or observed. This proof-of-concept study, aiming to restore brain bioenergetics using an adjunctive mitochondrial modulator, is not conclusive on the efficacy of creatine add-on for bipolar

Nanomedicine concepts in the general medical curriculum: initiating a discussion

Directory of Open Access Journals (Sweden)

Sweeney AE

2015-12-01

Full Text Available Aldrin E Sweeney Center for Teaching & Learning, Ross University School of Medicine, Roseau, Commonwealth of Dominica Abstract: Various applications of nanoscale science to the field of medicine have resulted in the ongoing development of the subfield of nanomedicine. Within the past several years, there has been a concurrent proliferation of academic journals, textbooks, and other professional literature addressing fundamental basic science research and seminal clinical developments in nanomedicine. Additionally, there is now broad consensus among medical researchers and practitioners that along with personalized medicine and regenerative medicine, nanomedicine is likely to revolutionize our definitions of what constitutes human disease and its treatment. In light of these developments, incorporation of key nanomedicine concepts into the general medical curriculum ought to be considered. Here, I offer for consideration five key nanomedicine concepts, along with suggestions regarding the manner in which they might be incorporated effectively into the general medical curriculum. Related curricular issues and implications for medical education also are presented. Keywords: medical education, basic science, teaching, learning, assessment, nanoscience curriculum, nanomedicine concepts

The concept of control of COPD in clinical practice

Directory of Open Access Journals (Sweden)

Soler-Cataluña JJ

2014-12-01

Full Text Available Juan José Soler-Cataluña,1,2 Bernardino Alcázar-Navarrete,3 Marc Miravitlles2,4 1Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain; 2CIBER de Enfermedades Respiratorias (CIBERES, 3Respiratory Department, Hospital de Alta Resolucion, Granada, Spain; 4Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Abstract: Treatment of chronic obstructive pulmonary disease (COPD requires a personalized approach according to the clinical characteristics of the patients, the level of severity, and the response to the different therapies. Furthermore, patients with the same level of severity measured by the degree of airflow obstruction or even with multidimensional indices may have very different symptoms and limitations for daily activities. The concept of control has been extensively developed in asthma but has not been defined in COPD. Here, we propose a definition of COPD control based on the concepts of impact and stability. Impact is a cross-sectional concept that can be measured by questionnaires such as the COPD Assessment Test or the Clinical COPD Questionnaire. Alternatively, impact can be assessed by the degree of dyspnea, the use of rescue medication, the level of physical activity, and sputum color. Stability is a longitudinal concept that requires the absence of exacerbations and deterioration in the aforementioned variables or in the COPD Assessment Test or Clinical COPD Questionnaire scores. Control is defined by low impact (adjusted for severity and stability. The concept of control in COPD can be useful in the decision making regarding an increase or decrease in medication in the stable state. Keywords: COPD, control, CAT, CCQ, exacerbations, prognosis

A further study on the concept of top-up dose of spinal cord on rats

International Nuclear Information System (INIS)

Feng Yan

1993-01-01

The concept of top-up dose has been used in the study on process of spinal cord repair in multiple radiation treatment in order to avoid cellular proliferation and animal loss. This study indicates that top up dose could be given 24 h or 6 weeks after completion of radiation treatment without significant difference of biological effects. It is suggested that the radiobiological effect could be reduced if 16 Gy of top-up dose is used in the multiple treatment instead of half of the number of treatment. A possible mechanism is discussed

Social phobia and self-concept: a correlational study with physical activity practice

Directory of Open Access Journals (Sweden)

Christi Noriko Sonoo

2008-12-01

Full Text Available The objective of this study was to analyze social phobia in teenagers aged 14 to 20 years and its possiblerelationship with regular practice of physical activity and their self-concept. This study enrolled 191 students from privateand public schools and the measurement instruments used were a test of social phobia, a test of self-concept and a physicalactivity questionnaire. The results indicate that students from private schools are shyer than students from public schools. Inrelation to self-concept, there were significant differences in security factor for boys and moral factor for girls. This indicatesthat boys are more stable, brave and secure, while girls are more influenced by moral and ethical rules. These resultsdemonstrate that no relationship was detected between social phobia and physical activity, but it was possible to observea relationship between social phobia and some of the self-concept factors, and a relationship between physical activityand some of the self-concept factors. It is therefore concluded that the negative influence of high levels of social phobia onthe receptivity and security factors of men and women suggests a need for further studies in the area, which could help inthe prevention and treatment of social phobia, which could worsen over the years and compromise these young people’sability to socialize.

Alternative waste management concept for medium and low level wastes by in-situ solidification

International Nuclear Information System (INIS)

Kraemer, R.

1982-01-01

Since 1976, a German R and D project has been carried out to find an alternative concept for the treatment and disposal of MLW and LLW arising mainly in the planned German reprocessing plant and other nuclear facilities (LWR, fuel fabrication, R and D establishments). The main feature of this concept is an in-situ solidification of preconditioned waste granules in large salt caverns located in the deep geological underground, thus avoiding such non-radioactive ballast as lost concrete shielding and container material. (orig./RW)

Maternal undernutrition during the pre- and post-conception periods in twin-bearing hairsheep ewes: effects on fetal and placental development at mid-gestation.

Science.gov (United States)

Macías-Cruz, Ulises; Vicente-Pérez, Ricardo; Mellado, Miguel; Correa-Calderón, Abelardo; Meza-Herrera, Cesar A; Avendaño-Reyes, Leonel

2017-10-01

To evaluate the effects of pre- and post-conception undernutrition (UN) on fetal and placental development at mid-gestation, 28 Katahdin × Pelibuey multiparous ewes were blocked by weight and assigned to the following four dietary treatments (n = 7 each): ewes fed 100% (control) or 60% of their nutritional requirements 30 days before mating (UNPre), 50 days after mating (UNPost) or during both periods (UNB). Four twin-bearing ewes were selected per treatment at day 50 post-conception and then slaughtered at day 75 of gestation to analyze their fetuses. Control fetuses were heavier (P ewes than UNB ewes, but not relative to ewes of other treatments. The number of placentomes per ewe and placental efficiency were unaffected by UN treatments. Compared to control, only UNB ewes exhibited variations (P ewes than placentas of control ewes (P ewes carrying twins is mainly altered when nutritional restriction occurs simultaneously before conception and during the first third of pregnancy.

Clinical decisions for anterior restorations: the concept of restorative volume.

Science.gov (United States)

Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

2012-12-01

The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

Treatment of thyroid disorders before conception and in early pregnancy: a systematic review.

Science.gov (United States)

Vissenberg, R; van den Boogaard, E; van Wely, M; van der Post, J A; Fliers, E; Bisschop, P H; Goddijn, M

2012-07-01

Thyroid disorders are associated with pregnancy complications. Universal screening is currently not recommended because of a lack of evidence on the effectiveness of treatment. Women with hyperthyroidism and hypothyroidism evidently require treatment but this is less clear for women with subclinical hypothyroidism and thyroid autoimmunity. Therefore, we conducted a systematic review to provide a comprehensive overview on the available treatment interventions. Relevant studies were identified by searching Medline, EMBASE and Cochrane Controlled Trials Register, published until December 2011. From a total of 7334 primary selected titles, 22 articles were included for the systematic review and 11 were appropriate for meta-analyses. Eight studies reported on hyperthyroidism. Propylthiouracil (PTU) and methimazole reduce the risk for preterm delivery [risk ratio (RR): 0.23, confidence interval (CI): 0.1-0.52], pre-eclampsia (RR: 0.23, CI: 0.06-0.89) and low birthweight (RR: 0.38, CI: 0.22-0.66). The nine studies that reported on clinical hypothyroidism showed that levothyroxine is effective in reducing the risk for miscarriage (RR: 0.19, CI: 0.08-0.39) and preterm delivery (RR: 0.41, CI: 0.24-0.68). For treatment of subclinical hypothyroidism, current evidence is insufficient. The five studies available on thyroid autoimmunity showed a not significant reduction in miscarriage (RR: 0.58, CI: 0.32-1.06), but significant reduction in preterm birth by treatment with levothyoxine (RR: 0.31, CI: 0.11-0.90). For hyperthyroidism, methimazole and PTU are effective in preventing pregnancy complications. For clinical hypothyroidism, treatment with levothyroxine is recommended. For subclinical hypothyroidism and thyroid autoimmunity, evidence is insufficient to recommend treatment with levothyroxine. The overall lack of evidence precludes a recommendation for universal screening and is only justified in a research setting.

The Use of Instructional Animations in a College Algebra Course: Can It Facilitate Learning of Concepts and Skill Development?

Science.gov (United States)

Serfaty de Markus, Alicia

2018-01-01

This quasi-treatment study, using a non-equivalent group design, explored how a set of animations related to various concepts in algebra impacted students' ability to learn as measured by changes in quiz and test scores. The concepts that were investigated were addition and subtraction of rational expressions, solving equations involving rational…

Badminton--Teaching Concepts.

Science.gov (United States)

Gibbs, Marilyn J.

1988-01-01

Teaching four basic badminton concepts along with the usual basic skill shots allows players to develop game strategy awareness as well as mechanical skills. These four basic concepts are: (1) ready position, (2) flight trajectory, (3) early shuttle contact, and (4) camouflage. (IAH)

Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?

Science.gov (United States)

Tendais, I; Figueiredo, B

2016-10-01

Does mode of conception [spontaneous/after infertility treatment (IT)], type of pregnancy (singleton/twin) and parent gender have an effect on anxiety and depression levels and trajectories during pregnancy and the post-partum period? Conception after IT was associated with a transitory increase in anxiety during the perinatal period for parents of singletons, while for IT parents of twins higher levels of psychopathological symptoms tended to persist during pregnancy and the post-partum period. Most previous studies have shown that successful IT is not associated with poor psychological well-being during pregnancy and the post-partum period, but there is also some evidence for heightened pregnancy-related anxiety, lower self-esteem and lower self-efficacy. Parents of twins experience increased postnatal anxiety and depression. This prospective longitudinal study assessed 267 couples (N = 534) at each trimester of pregnancy, after childbirth and at 3 months post-partum. The sample comprised 36 couples who had conceived after IT (19 twin pairs and 17 singletons) and 231 couples who had conceived spontaneously (SC; 28 twin pairs and 203 singletons). Couples were recruited at four public hospitals in Portugal, and self-report measures of anxiety and depression symptoms were administered. IT parents reported higher anxiety after childbirth than parents who SC, regardless of pregnancy type. IT parents of twins showed higher anxiety at mid-pregnancy, as well as higher anxiety and depression at 3 months post-partum than IT parents of singletons. Among IT mothers, those who had twins exhibited higher depression after childbirth than those who had singletons. Differences according to mode of conception, pregnancy type and parents gender over time were also noted. During pregnancy, IT parents of twins showed no significant change in depression scores, while the other groups depression scores statistically significantly decreased over time. From pregnancy to the post

Treatment of thyroid disorders before conception and in early pregnancy: a systematic review

NARCIS (Netherlands)

Vissenberg, R.; van den Boogaard, E.; van Wely, M.; van der Post, J. A.; Fliers, E.; Bisschop, P. H.; Goddijn, M.

2012-01-01

Thyroid disorders are associated with pregnancy complications. Universal screening is currently not recommended because of a lack of evidence on the effectiveness of treatment. Women with hyperthyroidism and hypothyroidism evidently require treatment but this is less clear for women with subclinical

The comparative effect of individually-generated vs. collaboratively-generated computer-based concept mapping on science concept learning

Science.gov (United States)

Kwon, So Young

Using a quasi-experimental design, the researcher investigated the comparative effects of individually-generated and collaboratively-generated computer-based concept mapping on middle school science concept learning. Qualitative data were analyzed to explain quantitative findings. One hundred sixty-one students (74 boys and 87 girls) in eight, seventh grade science classes at a middle school in Southeast Texas completed the entire study. Using prior science performance scores to assure equivalence of student achievement across groups, the researcher assigned the teacher's classes to one of the three experimental groups. The independent variable, group, consisted of three levels: 40 students in a control group, 59 students trained to individually generate concept maps on computers, and 62 students trained to collaboratively generate concept maps on computers. The dependent variables were science concept learning as demonstrated by comprehension test scores, and quality of concept maps created by students in experimental groups as demonstrated by rubric scores. Students in the experimental groups received concept mapping training and used their newly acquired concept mapping skills to individually or collaboratively construct computer-based concept maps during study time. The control group, the individually-generated concept mapping group, and the collaboratively-generated concept mapping group had equivalent learning experiences for 50 minutes during five days, excepting that students in a control group worked independently without concept mapping activities, students in the individual group worked individually to construct concept maps, and students in the collaborative group worked collaboratively to construct concept maps during their study time. Both collaboratively and individually generated computer-based concept mapping had a positive effect on seventh grade middle school science concept learning but neither strategy was more effective than the other. However

Emerging treatment of endometriosis

Directory of Open Access Journals (Sweden)

Aboubakr Elnashar

2015-06-01

Full Text Available Current treatment of endometriosis is mainly based on surgery and ovarian suppressive agents (oral contraceptives, progestins, GnRh agonist and androgenic agents. Hormonal treatments are often associated with unwanted effects, delayed conception and recurrence of disease and symptoms when stopped. For these reasons, new drugs that aim new targets are required to cause regression of the disease & symptoms without adverse hypo-estrogenic effects. This review aims to provide an update on the new drugs used for treatment of endometriosis. These include the levonorgestrel-releasing intrauterine device, GnRH antagonists, aromatase inhibitors, selective estrogen-receptor modulators, progesterone antagonist, selective progesterone receptor modulators, angiogenesis inhibitors, and immunomodulatory drugs.

Selecting concepts for a concept-based curriculum: application of a benchmark approach.

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Giddens, Jean Foret; Wright, Mary; Gray, Irene

2012-09-01

In response to a transformational movement in nursing education, faculty across the country are considering changes to curricula and approaches to teaching. As a result, an emerging trend in many nursing programs is the adoption of a concept-based curriculum. As part of the curriculum development process, the selection of concepts, competencies, and exemplars on which to build courses and base content is needed. This article presents a benchmark approach used to validate and finalize concept selection among educators developing a concept-based curriculum for a statewide nursing consortium. These findings are intended to inform other nurse educators who are currently involved with or are considering this curriculum approach. Copyright 2012, SLACK Incorporated.

Tissue engineering in the treatment of cartilage lesions

Directory of Open Access Journals (Sweden)

Jakob Naranđa

2013-11-01

Full Text Available Background: Articular cartilage lesions with the inherent limited healing potential are difficult to treat and thus remain a challenging problem for orthopaedic surgeons. Regenerative treatment techniques, such as autologous chondrocyte implantation (ACI, are promising as a treatment option to restore hyaline-like cartilage tissue in damaged articular surfaces, as opposed to the traditional reparative procedures (e.g. bone marrow stimulation – microfracture, which promote a fibrocartilage formation with lower tissue biomechanical properties and poorer clinical results. ACI technique has undergone several advances and is constantly improving. The new concept of cartilage tissue preservation uses tissue-engineering technologies, combining new biomaterials as a scaffold, application of growth factors, use of stem cells, and mechanical stimulation. The recent development of new generations of ACI uses a cartilage-like tissue in a 3-dimensional culture system that is based on the use of biodegradable material which serves as a temporary scaffold for the in vitro growth and subsequent implantation into the cartilage defect. For clinical practice, single stage procedures appear attractive to reduce cost and patient morbidity. Finally, modern concept of tissue engineering facilitates hyaline-like cartilage formation and a permanent treatment of cartilage lesions.Conclusion: The review focuses on innovations in the treatment of cartilage lesions and covers modern concepts of tissue engineering with the use of biomaterials, growth factors, stem cells and bioreactors, and presents options for clinical use.

Rational design of nanomaterials for water treatment

KAUST Repository

Li, Renyuan

2015-08-26

The ever-increasing human demand for safe and clean water is gradually pushing conventional water treatment technologies to their limits and it is now a popular perception that the solutions to the existing and future water challenges will highly hinge upon the further development of nanomaterial sciences. The concept of rational design emphasizes ‘design-for-purpose’ and it necessitates a scientifically clear problem definition to initiate the nanomaterial design. The field of rational design of nanomaterials for water treatment has experienced a significant growth in the past decade and is poised to make its contribution in creating advanced next-generation water treatment technologies in the years to come. Within the water treatment context, this review offers a comprehensive and in-depth overview of the latest progress of the rational design, synthesis and applications of nanomaterials in adsorption, chemical oxidation and reduction reactions, membrane-based separation, oil/water separation, and synergistic multifunctional all-in-one nanomaterials/nanodevices. Special attention is paid on chemical concepts of the nanomaterial designs throughout the review.

Radiation promotive concept

International Nuclear Information System (INIS)

Shebaita, M.K.

1975-01-01

The concept of radiation promotion was proposed in this study. The proposal of this concept was dependent upon stimulation in growth weight of survived chicks when fertile eggs were exposed to 60 Co gamma radiation. It was found that female chick (Promotive Sex) responded to this proposal concept rather than the male. Moreover, the dose level of 640 rads was found to be the Promotive Dose. It is important before applying ionizing radiation as a growth promotive to take into consideration whether you want increasing egg or meat production, as meat promotion in layers breed is bound to decrease egg production. (orig.) [de

[Modern concepts of etiology, pathogenesis and treatment approaches to endo-perio lesions].

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Grudianov, A I; Makeeva, M K; Piatgorskaia, N V

2013-01-01

A combination ofperiodontitis and pulp or periapical tissues inflammation in one tooth is known as endo-periodontal lesions. Such kind of lesion is serious problem of modern dentistry. It was found that pathogenic microflora of periodontal pocket and root canal of tooth with eno-perio lesion is almost the equal and consist of anaerobic microorganisms. Pathogenic effects have not only microorganisms but also their life products. Apical foramen, lateral and additional canals are physiological ways for pathogens migration. Inflammatory processes in these structures complicate each other. Lack of information among dentists about treatment possibilities of endo-perio lesions is a main reasons of extraction such kind of teeth. Simultaneous elimination of pathogens both from periodontal pocket and root canal is a key factor for effective treatment. Periodontal status is main factor for prognosis of tooth with endo-perio lesion, because of it treatment of endo-perio lesions should consist of two stages: infection elimination and regeneration of tooth-supported structures.

[Concept analysis "Competency-based education"].

Science.gov (United States)

Loosli, Clarence

2016-03-01

Competency-based education (CBE) stands out at global level as the best educational practice. Indeed, CBE is supposed to improve the quality of care provided by newly graduated nurses. Yet, there is a dearth of knowledge in nursing literature regarding CBE concept's definition. CBE is implemented differently in each entity even inside the same discipline in a single country. What accounts for CBE in nursing education ? to clarify CBE concept meaning according to literature review in order to propose a definition. Wilson concept analysis method framed our literature review through two databases: CINHAL and ERIC. following the 11 Wilson techniques analysis, we identified CBE concept as a multidimensional concept clustering three dimensions : learning, teaching and assessment. nurses educators are accountable for providing performants newly graduated professional to the society. Schools should struggle for the visibility and the transparency of means they are using to accomplish their educational activities. This first attempt to understand CBE concept opens a matter of debate concerning further development and clarification of the concept. This first description of CBE concept is a step toward its identification and assessment.

Current concepts in urinary tract infections.

Science.gov (United States)

Williams, D H; Schaeffer, A J

2004-03-01

Urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. This review highlights the current concepts and recent advances in our understanding and management of this condition. Specific topics include pathogenesis, host factors, antimicrobial resistance, recurrent UTIs in women, diagnosis, treatment of uncomplicated and complicated UTIs, prophylaxis, catheter associated bacteriuria, pregnancy, diabetes, UTIs in men, prostatitis, and the chronic pelvic pain syndrome. UTIs can be viewed as an interaction between specific bacterial virulence factors and the patient. A new model explaining the pathogenesis of recurrent UTIs has been presented. There is a need to reconsider traditional treatment recommendations in the face of local resistance patterns, as well as the need to make better use of drugs that are currently available. Prospects for prevention of recurrent UTI include natural compounds, bacterial interference and immunization. With regard to UTI risk in women, patients can be classified based on age, and functional and hormonal status. Appropriate treatment approaches must be based on this classification. In contrast to uncomplicated UTIs, management of most complicated infections depends on clinical experience and resources at individual institutions rather than on evidence based guidelines. Asymptomatic bacteriuria generally should not be treated except in high-risk catheterized patients and in pregnancy. UTIs in men generally require formal urologic evaluation. Our understanding of the etiologies, diagnostic strategies, and treatment options for prostatitis and the chronic pelvic pain syndrome in men continues to evolve.

Madness or sadness? Local concepts of mental illness in four conflict-affected African communities

NARCIS (Netherlands)

Ventevogel, P.; Jordans, M.; Reis, R.; de Jong, J.

2013-01-01

Background Concepts of ‘what constitutes mental illness’, the presumed aetiology and preferred treatment options, vary considerably from one cultural context to another. Knowledge and understanding of these local conceptualisations is essential to inform public mental health programming and policy.

Semantic Representatives of the Concept

Directory of Open Access Journals (Sweden)

Elena N. Tsay

2013-01-01

Full Text Available In the article concept as one of the principle notions of cognitive linguistics is investigated. Considering concept as culture phenomenon, having language realization and ethnocultural peculiarities, the description of the concept “happiness” is presented. Lexical and semantic paradigm of the concept of happiness correlates with a great number of lexical and semantic variants. In the work semantic representatives of the concept of happiness, covering supreme spiritual values are revealed and semantic interpretation of their functioning in the Biblical discourse is given.

Calculation methods for advanced concept light water reactor lattices

International Nuclear Information System (INIS)

Carmona, S.

1986-01-01

In the last few years s several advanced concepts for fuel rod lattices have been studied. Improved fuel utilization is one of the major aims in the development of new fuel rod designs and lattice modifications. By these changes s better performance in fuel economics s fuel burnup and material endurance can be achieved in the frame of the well-known basic Light Water Reactor technology. Among the new concepts involved in these studies that have attracted serious attention are lattices consisting of arrays of annular rods duplex pellet rods or tight multicells. These new designs of fuel rods and lattices present several computational problems. The treatment of resonance shielded cross sections is a crucial point in the analyses of these advanced concepts . The purpose of this study was to assess adequate approximation methods for calculating as accurately as possible, resonance shielding for these new lattices. Although detailed and exact computational methods for the evaluation of the resonance shielding in these lattices are possible, they are quite inefficient when used in lattice codes. The computer time and memory required for this kind of computations are too large to be used in an acceptable routine manner. In order to over- come these limitations and to make the analyses possible with reasonable use of computer resources s approximation methods are necessary. Usual approximation methods, for the resonance energy regions used in routine lattice computer codes, can not adequately handle the evaluation of these new fuel rod lattices. The main contribution of the present work to advanced lattice concepts is the development of an equivalence principle for the calculation of resonance shielding in the annular fuel pellet zone of duplex pellets; the duplex pellet in this treatment consists of two fuel zones with the same absorber isotope in both regions. In the transition from a single duplex rod to an infinite array of this kind of fuel rods, the similarity of the

The concept of psychical trauma: a bridge in interdisciplinary space.

Science.gov (United States)

Tutté, Juan Carlos

2004-08-01

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post-Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post-traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non-declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue

Children's Self-Concepts as Related to Family Structure and Family Concept.

Science.gov (United States)

Parish, Joycelyn G.; Parish, Thomas S.

1983-01-01

Surveyed 426 children from intact, divorced, and reconstituted families, who responded to the Personal Attribute Inventory for Children to evaluate their families and themselves. Results showed a significant association between children's self-concepts and both their family structure and family concepts. (JAC)

2009 Melbourne metropolitan sewerage strategy: a portfolio of decentralised and on-site concept designs.

Science.gov (United States)

Brown, V; Jackson, D W; Khalifé, M

2010-01-01

The bulk and retail water companies of the greater Melbourne area are developing the 2009 Metropolitan Sewerage Strategy to provide sustainable sewerage services to 2060. The objective of the strategy is to establish long term principles and near term actions to produce a robust sewage management system for Melbourne. Melbourne's existing sewerage system is largely centralised and discharges to two major treatment plants. Several small satellite treatment plants service local urban areas generally more distant from the centralised system. Decentralised and on-site wastewater systems are options for future sewage management and could play a role in local recycling. A portfolio of 18 on-site and decentralised concept designs was developed, applicable to the full range of urban development types in Melbourne. The concepts can be used in evaluation of metropolitan system configurations as part of future integrated water cycle planning. The options included secondary and tertiary treatment systems incorporating re-use of water for non potable uses, urine separation, black and greywater separation and composting toilets. On-site and cluster treatment systems were analysed. Each option is described by its indicative capital and operating costs, energy use and water and nutrient balances. This paper summarises and compares the portfolio mix of decentralized and on-site options in Melbourne's context.

The effects of rational stage directed imagery on self-concept and reduction of psychological stress in adolescent delinquent females.

Science.gov (United States)

Reardon, J P; Tosi, D J

1977-10-01

This study examined the effect of four treatment conditions on self-concept and reduction of psychological stress in adolescent delinquent females. The treatments were Rational State Directed Imagery, a cognitive behavioral approach that utilized intensive muscle relaxation and vivid-emotive-imagery, a rational (cognitive) restructuring treatment, a placebo condition, and a no treatment control. Ss were assigned randomly to one of these treatment groups, which met 1 hour per week for 6 consecutive weeks, with in-vivo homework assignments also utilized. Statistically scale were noted for the RSDI group at the posttest and at a 2-month follow-up, which supports the therapeutic efficacy of this treatment. Support was found for the effectiveness of the rational (cognitive) restructuring approach immediately posttreatment; however these effects disappeared at the 2-month follow-up. The placebo and control groups showed no significant effects at either posttreatment or the follow-up. These results suggest that RSDI has potential for use as a short-term psychotherapeutic approach when self-concept modification is a primary goal.

A concept analysis of befriending.

Science.gov (United States)

Balaam, Marie-Clare

2015-01-01

To report an analysis of the concept of befriending. Befriending is an intervention used in a range of nursing, health and social care settings to provide support for individuals who are socially isolated or lack social support. However, in many cases befriending and its impact remains poorly understood and under researched. Concept analysis provides clarification of the concept and basis for further research and development. Concept analysis. AMED, Psyc Articles, Psych Info, Medline, MedlinePlus, Social Science Index and CINHAL databases were searched for literature published between 1993-2013 using the search term Befriending. Walker and Avant's method of concept analysis was chosen. This combined with insights from Risjord's work produced a theoretical concept analysis which focused on the concept in peer reviewed academic literature. There are currently several ways the mechanisms of befriending and its effects on individuals and communities are understood. It is possible however to identify key attributes which define the concept and differentiate it from related concepts, such as peer support and mentoring. Key attributes are that it is an organised intervention, involving the creation of an emotionally connected friend-like relationship, where there is a negotiation of power. This concept analysis has clarified current understandings and uses of befriending. It provides the basis for widening the focus of research into the effectiveness and impact of befriending on those who are befriended, those who befriend and the communities where befriending takes place. © 2014 John Wiley & Sons Ltd.

Current concepts regarding pharmacologic treatment of rheumatoid and osteoarthritis.

Science.gov (United States)

Wildy, K S; Wasko, M C

2001-05-01

Treating patients with osteoarthritis (OA) and rheumatoid arthritis (RA) remains challenging; however, new agents offer the chance for an improved quality of life. As an alternative to traditional nonsteroidal anti-inflammatories, cyclooxygenase-2 inhibitors provide pain relief for OA and RA patients with possible fewer side effects. Otherwise, OA patients may opt for topical agents, injections, or supplements. Rheumatoid arthritis research has led to an improved understanding of the inflammatory cascade and an appreciation of the early tissue destruction. A new treatment philosophy has thus emerged along with the development of new biologic agents; the latter, along with combination therapy and a new disease modifying antirheumatic drug, leflunomide, have greatly expanded the chances for disease control in RA patients.

Relating Complexity and Error Rates of Ontology Concepts. More Complex NCIt Concepts Have More Errors.

Science.gov (United States)

Min, Hua; Zheng, Ling; Perl, Yehoshua; Halper, Michael; De Coronado, Sherri; Ochs, Christopher

2017-05-18

Ontologies are knowledge structures that lend support to many health-information systems. A study is carried out to assess the quality of ontological concepts based on a measure of their complexity. The results show a relation between complexity of concepts and error rates of concepts. A measure of lateral complexity defined as the number of exhibited role types is used to distinguish between more complex and simpler concepts. Using a framework called an area taxonomy, a kind of abstraction network that summarizes the structural organization of an ontology, concepts are divided into two groups along these lines. Various concepts from each group are then subjected to a two-phase QA analysis to uncover and verify errors and inconsistencies in their modeling. A hierarchy of the National Cancer Institute thesaurus (NCIt) is used as our test-bed. A hypothesis pertaining to the expected error rates of the complex and simple concepts is tested. Our study was done on the NCIt's Biological Process hierarchy. Various errors, including missing roles, incorrect role targets, and incorrectly assigned roles, were discovered and verified in the two phases of our QA analysis. The overall findings confirmed our hypothesis by showing a statistically significant difference between the amounts of errors exhibited by more laterally complex concepts vis-à-vis simpler concepts. QA is an essential part of any ontology's maintenance regimen. In this paper, we reported on the results of a QA study targeting two groups of ontology concepts distinguished by their level of complexity, defined in terms of the number of exhibited role types. The study was carried out on a major component of an important ontology, the NCIt. The findings suggest that more complex concepts tend to have a higher error rate than simpler concepts. These findings can be utilized to guide ongoing efforts in ontology QA.

Treatment of tension-type headache: from old myths to modern concepts.

Science.gov (United States)

Barbanti, P; Egeo, G; Aurilia, C; Fofi, L

2014-05-01

Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is less simple and easy-to-treat than commonly thought. Antidepressants, despite their poor tolerability, are still the first-choice drugs for preventing TTH. The most widely studied non-pharmacological approach to TTH, cognitive-behavioral techniques, effectively relieve pain only in selected patients. The most frequently used and recommended treatments for acute TTH, NSAIDs and paracetamol have scarce efficacy as documented by their low therapeutic gain over placebo in the 2-h pain-free response. Their effectiveness may be increased by a more proper use and by the adjunction of caffeine, antiemetics, myorelaxants or tranquillizers but the risk of medication-overuse headache must be considered. Hence, the need for more effective and tailored treatments in TTH remains.

Assessment of fuel concepts

International Nuclear Information System (INIS)

Bailey, W.J.; Barner, J.O.

1978-01-01

The relative merits of various LWR UO 2 fuel concepts with the potential for improved power-ramping capability were qualitatively assessed. In the evaluation, it was determined that of the various concepts being considered, those that presently possess an adequately developed experience base include annular pellets, cladding coated with graphite on the inner surface, and packed-particle fuel. Therefore, these were selected for initial evaluation as part of the Fuel Performance Improvement Program. For this program, graphite-coated cladding is being used in conjunction with annular pellet fuel as one of the concepts with the anticipation of gaining the advantage of the combined improvements. The report discusses the following: the criteria used to evaluate the candidate fuel concepts; a comparison of the concepts selected for irradiation with the criteria, including a general description of their experience bases; and a general discussion of other candidate concepts, including identifying those which may be considered for out-of-reactor evaluation as part of this program, those for which the results of other programs will be monitored, and those which have been deleted from further consideration at this time

Concepts of scale

NARCIS (Netherlands)

Padt, F.J.G.; Arts, B.J.M.

2014-01-01

This chapter provides some clarity to the scale debate. It bridges a variety of approaches, definitions and jargons used in various disciplines in order to provide common ground for a concept of scale as a basis for scale-sensitive governance of the environment. The chapter introduces the concept of

Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis

Science.gov (United States)

Hasanpour-Dehkordi, Ali

2016-01-01

Background: Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers’ evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. Results: The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). Conclusion: The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams. PMID:27803559

Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis.

Science.gov (United States)

Hasanpour-Dehkordi, Ali

2016-01-01

Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. We used Rodgers' evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams.

Unifying the concept of consciousness across the disciplines: A concept-based, cross-cultural approach

Science.gov (United States)

Jones, Peter N.

The majority of studies concerning consciousness have examined and modeled the concept of consciousness in terms of particular lines of inquiry, a process that has circumscribed the general applicability of any results from such approaches. The purpose of this dissertation was to study consciousness from a concept-based, cross-cultural approach and to attempt to unify the concept across the cultures examined. The 4 cultures are the academic disciplines of philosophy, physics, psychology, and anthropology. Consciousness was examined in terms of how the concept is framed and where the major limitations in each line of inquiry occur. The rationale for examining consciousness as a concept across 4 cultures was to determine whether there was any common component in each line's framing that could be used to unify the concept. The study found that experience itself was the primary unifying factor in each field's framing and that experience was treated as a nonreducible property within each line of inquiry. By taking experience itself (but not subjective experience) as a fundamental property, each culture's concept of consciousness becomes tractable. As such, this dissertation argues that experience should be taken as a fundamental property of the concept. The significance of this analysis is that by taking experience as a fundamental property, it becomes possible to unify the concept across the 4 cultures. This unification is presented as a unity thesis, which is a theory arguing for unification of the concept based on the fundamental of experience. Following this theoretical examination, this paper discusses several key implications of the unity thesis, including implications of the unity thesis for the current status of altered states of consciousness and for the so-called hard and easy problems associated with the concept (at least within Occidental ontology). It is argued that the so-called hard problem does not exist when experience is taken as a fundamental property

Current concepts for chronochemotherapy of cancer.

Science.gov (United States)

Laerum, O D; Smaaland, R; Abrahamsen, J F

1995-01-01

In this article, a survey on the concepts and scientific basis for applying chemotherapy against malignant tumors on a circadian schedule is given. The idea is to give the cytostatic drugs at times of the day when optimal effect on the tumor is achieved, but at the same time causing minimal toxic side effects. Following a brief description of the complexity of cancer tissue, some aspects of the present status of cancer chemotherapy in general are reviewed. Applications of chronobiology in cancer treatment are then surveyed together with possibilities to increase cytostatic doses and reduce side effects. When optimal tumor cell kill is achieved, the next step is to address the circadian aspects of normal organs, including the proliferative behavior of tissues with rapid cell renewal. Finally, the question of how regulatory mechanisms responsible for normal circadian rhythms can be interfered with is addressed. Cancer chronochemotherapy today combined with modern infusional technology is a promising field for improving cancer treatment in general and reducing side effects and is expected to make important progress in the near future.

[AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders].

Science.gov (United States)

Schlüter-Müller, Susanne

2017-07-01

AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in adolescence and emerging adulthood the diagnosis is often delayed. In most cases, specific treatment is only offered late in the course of the disorder and to relatively few individuals. Adolescent Identity Treatment (AIT) is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, a behavior-oriented homeplan and intensive family work is part of AIT.

Concept-Based Curricula: A National Study of Critical Concepts.

Science.gov (United States)

Brussow, Jennifer A; Roberts, Karin; Scaruto, Matthew; Sommer, Sheryl; Mills, Christine

2018-02-22

As nursing education struggles to address a rapidly changing health care system, overcrowded curricula, and an increased focus on clinical reasoning skills, many programs have adopted or transitioned to concept-based curricula (CBCs), which are structured around key concepts and exemplars. Despite CBC's promised benefits, the process of developing a CBC framework may pose a challenge to programs. To address this barrier, a national study was conducted to develop a representative list of concepts and exemplars. This initiative expands on prior work by suggesting a leveled approach to positioning exemplars within a curricular sequence.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Integrating multimedia instructional design principles with complex physiological concepts in reproductive science

Science.gov (United States)

Oki, Angela Christine

2011-12-01

This dissertation examines the effect of digital multimedia presentations as a method to teach complex concepts in reproductive physiology. The digital presentations developed for this research consisted of two-dimensional (2-D) and three-dimensional (3-D) animations, scriptmessaging and narration. The topics were "Mammalian Ovarian Follicular Dynamics", "The Physiology of the Menstrual Cycle", and "The Physiology of Parturition". In all four experiments, participants were randomly assigned to treatment groups and learning was measured with multiple-choice tests. Experiment 1 determined if type of animation impacted learning about the physiology of the menstrual cycle. The treatments were: 3-D and 2-D animation (n = 110), 2-D animation only (n = 109) and no animation (n = 108). All three presentations were 14 minutes. No treatment effects were found (p > 0.05), indicating that student performance was not influenced by animation type. In experiment 2, the influence of added narrative explanations about the physiology of parturition was determined. The delivery time for the two treatments was 14 minutes (n = 164) and 24 minutes (n = 157), respectively. There were no differences between treatment groups (p > 0.05), indicating that concise explanations were as effective as elaborate explanations. Experiment 3 determined the influence of a digital presentation on knowledge retention of follicular dynamics over the course of a semester. Treatments were: a digital presentation (n = 23) or a classroom lecture captured on video (n = 23). Students completed three tests during the semester. Students in the multimedia group outperformed students in the video lecture group on all three tests (p read a booklet (n = 57) or viewed a multimedia presentation (n = 65) about parturition. Content was identical in each group. Patients in the multimedia group outperformed patients in the booklet group (p < 0.05). This set of four experiments indicates that digital multimedia

Self-concept deficits in massively multiplayer online role-playing games addiction.

Science.gov (United States)

Leménager, Tagrid; Gwodz, Alexander; Richter, Anne; Reinhard, Iris; Kämmerer, Nina; Sell, Madlen; Mann, Karl

2013-01-01

Previous studies on Internet addiction point towards a particular constellation of personality traits and deficits in social competence of players addicted to massively multiplayer online role-playing games (MMORPGs), which are hypothesized to result from impairments in self-concept. The aim of this study was to examine differences in self-concept and degree of avatar identification in World of Warcraft addicted, non-addicted and naive (nonexperienced) participants. Participants (n = 45) completed interviews and self-report questionnaires on social, emotional and physical aspects of self-concept. Attributes of participants' 'actual self', 'ideal self' and their avatar were assessed using the Giessen test. The extent of avatar identification was examined by assessing differences between 'ideal self' and avatar evaluations. In contrast to nonaddicted and naive participants, addicted players showed a more negative body appraisal and lower self-esteem as well as lower permeability, social response, general mood and social potency on the Giessen test subscales. They further showed significantly lower discrepancies between 'ideal self' and avatar ratings on nearly all Giessen test subscales. The results point towards impairments in self-concept and a higher degree in avatar identification in addicted MMORPG players compared to the remaining participants. These results could have important implications for the treatment of addicted MMORPG players. Copyright © 2013 S. Karger AG, Basel.

Enhancing Motivation and Acquisition of Coordinate Concepts by Using Concept Trees.

Science.gov (United States)

Hirumi, Atsusi; Bowers, Dennis R.

1991-01-01

Examines the effects of providing undergraduate learners with graphic illustrations of coordinate concept relationships to supplement text-based instruction. Half of those reading a specific passage received a graphic concept tree. That group outperformed those who did not, reporting significantly higher amounts of attenuation, confidence, and…

Autologous transplantation of genetically modified iris pigment epithelial cells: A promising concept for the treatment of age-related macular degeneration and other disorders of the eye

Science.gov (United States)

Semkova, Irina; Kreppel, Florian; Welsandt, Gerhard; Luther, Thomas; Kozlowski, Jolanta; Janicki, Hanna; Kochanek, Stefan; Schraermeyer, Ulrich

2002-10-01

Age-related macular degeneration (ARMD) is the leading cause for visual impairment and blindness in the elder population. Laser photocoagulation, photodynamic therapy and excision of neovascular membranes have met with limited success. Submacular transplantation of autologous iris pigment epithelial (IPE) cells has been proposed to replace the damaged retinal pigment epithelium following surgical removal of the membranes. We tested our hypothesis that the subretinal transplantation of genetically modified autologous IPE cells expressing biological therapeutics might be a promising strategy for the treatment of ARMD and other retinal disorders. Pigment epithelium-derived factor (PEDF) has strong antiangiogenic and neuroprotective activities in the eye. Subretinal transplantation of PEDF expressing IPE cells inhibited pathological choroidal neovascularization in rat models of laser-induced rupture of Bruch's membrane and of oxygen induced ischemic retinopathy. PEDF expressing IPE transplants also increased the survival and preserved rhodopsin expression of photoreceptor cells in the RCS rat, a model of retinal degeneration. These findings suggest a promising concept for the treatment of ARMD and other retinal disorders.

Mozart ear: diagnosis, treatment, and literature review.

Science.gov (United States)

Yamashita, Ken; Yotsuyanagi, Takatoshi; Saito, Tamotsu; Isogai, Noritaka; Mori, Hiromasa; Itani, Yoshihito

2011-11-01

Mozart ear is a congenital auricular deformity, which is mainly characterized by a bulging appearance of the anterosuperior portion of the auricle, a convexly protruded cavum conchae, and a slit-like narrowing of the orifice of the external auditory meatus. It is said to be uncommon, and because no one has yet fully described neither the disease nor the treatment, the concept of Mozart ear has not been unified. This report describes a case of a 13-year-old girl presented with an unusual congenital deformity which showed the features of Mozart ear. It is an extremely rare deformity that only about 4 clinical cases have been reported in medical literature thereby a treatment method has not been fully discussed. For surgical correction of our cases, we excised deformed conchal cartilage, turned it over, regrafted, and maintained a cosmetically positive result. We also reviewed and described the origin, current concept, and treatment method of Mozart ear.

Clinical reasoning: concept analysis.

Science.gov (United States)

Simmons, Barbara

2010-05-01

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

Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

DEFF Research Database (Denmark)

von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

2016-01-01

Objective: While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome......-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results: In total, 1033 respondents answered the survey. The majority of treatment beliefs...... and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy...

Separations innovative concepts: Project summary

Energy Technology Data Exchange (ETDEWEB)

Lee, V.E. (ed.)

1988-05-01

This project summary includes the results of 10 innovations that were funded under the US Department's Innovative Concept Programs. The concepts address innovations that can substantially reduce the energy used in industrial separations. Each paper describes the proposed concept, and discusses the concept's potential energy savings, market applications, technical feasibility, prior work and state of the art, and future development needs.

Low-dose natural prostaglandin F2α (dinoprost) at timed insemination improves conception rate in dairy cattle.

Science.gov (United States)

Ambrose, Divakar J; Gobikrushanth, Mohanathas; Zuidhof, Sjoert; Kastelic, John P

2015-03-01

The primary objective was to determine if low doses of PGF2α (dinoprost) given intramuscularly (im) concurrent with timed artificial insemination (TAI) would improve conception rates in dairy cattle. A secondary objective was to determine if body condition score (BCS) and parity would influence conception rates, either independently or in interaction with PGF2α treatment. In experiment I, 307 lactating Holstein cows were randomly assigned to receive either 5-mg PGF2α im (PGF2α treated, n = 154) or 0-mg PGF2α (control, n = 153) at TAI (Day 0). Blood samples were obtained on Days -10, -3, 0, and 7 to determine plasma progesterone (P4) concentrations. Pregnancy was confirmed 30 to 32 days after insemination by transrectal ultrasonography. In experiment II, 451 cows were randomly assigned to receive either 10-mg PGF2α im (PGF2α treated, n = 226) or 0-mg PGF2α (control, n = 225) at TAI, and pregnancy was confirmed 45 to 50 days after TAI by palpation per rectum. Pregnancy data were analyzed by CATMOD (SAS). In experiment I, PGF2α treatment, BCS, and parity did not affect conception rate (35.7% vs. 37.0% for PGF2α treated vs. control; P > 0.05). However, in experiment II, conception rates were higher in cows given 10-mg PGF2α than those in control cows (45.8% vs. 36.0%; P conception rates. In summary, 5 mg of PGF2α given im concurrent with TAI failed to enhance conception rate in lactating dairy cows, whereas 10 mg of PGF2α significantly increased conception rate. Copyright © 2015 Elsevier Inc. All rights reserved.

The limits of parental responsibility regarding medical treatment decisions.

Science.gov (United States)

Woolley, Sarah L

2011-11-01

Parental responsibility (PR) was a concept introduced by the Children Act (CA) 1989 which aimed to replace the outdated notion of parental rights and duties which regarded children as parental possessions. Section 3(1) CA 1989 defines PR as 'all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child'. In exercising PR, individuals may make medical treatment decisions on children's behalf. Medical decision-making is one area of law where both children and the state can intercede and limit parental decision-making. Competent children can consent to treatment and the state can interfere if parental decisions are not seemingly in the child's 'best interests'. This article examines the concept, and limitations, of PR in relation to medical treatment decision-making.

Carbohydrate restricted diet in conjunction with metformin and liraglutide is an effective treatment in patients with deteriorated type 2 diabetes mellitus: Proof-of-concept study

Directory of Open Access Journals (Sweden)

Müller Jürgen E

2011-12-01

Full Text Available Abstract Background Type 2 diabetes mellitus is a chronic progressive disease. During the course of the disease intensive treatment is often necessary resulting in multiple interventions including administration of insulin. Although dietary intervention is highly recommended, the clinical results of the widely prescribed diets with low fat content and high carbohydrates are disappointing. In this proof-of-concept study, we tested the effect of dietary carbohydrate-restriction in conjunction with metformin and liraglutide on metabolic control in patients with type 2 diabetes. Methods Forty patients with type 2 diabetes already being treated with two oral anti-diabetic drugs or insulin treatment and who showed deterioration of their glucose metabolism (i.e. HbA1c >7.5, were treated. A carbohydrate-restricted diet and a combination of metformin and liraglutide were instituted, after stopping either insulin or oral anti-diabetic drugs (excluding metformin. After enrollment, the study patients were scheduled for follow-up visits at one, two, three and six months. Primary outcome was glycemic control, measured by HbA1c at six months. Secondary outcomes were body weight, lipid-profile and treatment satisfaction. Results Thirty-five (88% participants completed the study. Nearly all participating patients experienced a drop in HbA1c and body weight during the first three months, an effect which was maintained until the end of the study at six months. Seventy-one percent of the patients reached HbA1c values below 7.0%. The range of body weight at enrollment was extreme, reaching 165 kg as the highest initial value. The average weight loss after 6 months was 10%. Most patients were satisfied with this treatment. During the intervention no significant change of lipids was observed. Most patients who were on insulin could maintain the treatment without insulin with far better metabolic control. Conclusions Carbohydrate restriction in conjunction with

Empowerment: a Concept Analysis

OpenAIRE

Febriana, Dara

2011-01-01

This paper conceptually analyzed the concept of empowerment using the strategies of Walker & Avant (2005) the objective is to clarify the meaning of the concept and to clearly identify empowerment characteristic that will provide consistent definition for practice and future research. Empowerment is defined and examined using relevant resources of literatures and selected empirical referents that described empowerment as a complex and multidimensional concept. Within nursing context empowerme...

Efficiency of a new internal combustion engine concept with variable piston motion

Directory of Open Access Journals (Sweden)

Dorić Jovan Ž.

2014-01-01

Full Text Available This paper presents simulation of working process in a new IC engine concept. The main feature of this new IC engine concept is the realization of variable movement of the piston. With this unconventional piston movement it is easy to provide variable compression ratio, variable displacement and combustion during constant volume. These advantages over standard piston mechanism are achieved through synthesis of the two pairs of non-circular gears. Presented mechanism is designed to obtain a specific motion law which provides better fuel consumption of IC engines. For this paper Ricardo/WAVE software was used, which provides a fully integrated treatment of time-dependent fluid dynamics and thermodynamics by means of onedimensional formulation. The results obtained herein include the efficiency characteristic of this new heat engine concept. The results show that combustion during constant volume, variable compression ratio and variable displacement have significant impact on improvement of fuel consumption.

Introductory remote sensing principles and concepts principles and concepts

CERN Document Server

Gibson, Paul

2013-01-01

Introduction to Remote Sensing Principles and Concepts provides a comprehensive student introduction to both the theory and application of remote sensing. This textbook* introduces the field of remote sensing and traces its historical development and evolution* presents detailed explanations of core remote sensing principles and concepts providing the theory required for a clear understanding of remotely sensed images.* describes important remote sensing platforms - including Landsat, SPOT and NOAA * examines and illustrates many of the applications of remotely sensed images in various fields.

Common tester platform concept.

Energy Technology Data Exchange (ETDEWEB)

Hurst, Michael James

2008-05-01

This report summarizes the results of a case study on the doctrine of a common tester platform, a concept of a standardized platform that can be applicable across the broad spectrum of testing requirements throughout the various stages of a weapons program, as well as across the various weapons programs. The common tester concept strives to define an affordable, next-generation design that will meet testing requirements with the flexibility to grow and expand; supporting the initial development stages of a weapons program through to the final production and surveillance stages. This report discusses a concept investing key leveraging technologies and operational concepts combined with prototype tester-development experiences and practical lessons learned gleaned from past weapons programs.

Current concept of the treatment of biliary atresia.

Science.gov (United States)

Miyano, T; Fujimoto, T; Ohya, T; Shimomura, H

1993-01-01

Hepatic portoenterostomy (Kasai operation) for the patient with biliary atresia (BA) can restore the bile flow in approximately 80% of children operated on before 60 days of life [1]. However, in terms of long-term survival, according to a recent nationwide survey among the major pediatric centers in Japan, only 325 of 2013 patients had more than 10 years' survival, and only 157 patients (7.8%) remained jaundice-free with normal liver function [2]. About 20% of BA cases without jaundice are generally able to survive for long periods; and most of those patients have portal hypertension or abnormal liver function [3-5]. As the results of liver transplantation have improved, controversy has arisen over the optimal care of these children [4, 6, 7]. Some investigators have claimed that transplantation is the favored primary therapy for most patients with BA [8]. We are thus at a turning point concerning the primary therapy of BA, which makes it necessary to determine the exact indications for the Kasai portoenterostomy and the timing of liver transplantation. This paper describes our strategy for the optimal treatment of BA patients based on our 117 patients who have had various form of portoenterostomy.

Compulsivity in Anorexia Nervosa: a transdiagnostic concept

Directory of Open Access Journals (Sweden)

Lauren Rose Godier

2014-07-01

Full Text Available The compulsive nature of weight loss behaviours central to Anorexia Nervosa (AN, such as relentless self-starvation and over-exercise, has led to the suggestion of parallels between AN and other compulsive disorders such as Obsessive-Compulsive Disorder (OCD and addictions. There is a huge unmet need for effective treatments in AN, which has high rates of morbidity and the highest mortality rate of any psychiatric disorder, yet a grave paucity of effective treatments. Viewing compulsivity as a transdiagnostic concept, seen in various manifestations across disorders, may help delineate the mechanisms responsible for the persistence of AN, and aid treatment development. We explore models of compulsivity that suggest dysfunction in cortico-striatal circuitry underpins compulsive behaviour, and consider evidence of aberrances in this circuitry across disorders. Excessive habit formation is considered as a mechanism by which initially rewarding weight loss behaviour in AN may become compulsive over time, and the complex balance between positive and negative reinforcement in this process is considered. The physiological effects of starvation in promoting compulsivity, positive reinforcement and habit formation are also discussed. Further research in AN may benefit from a focus on processes potentially underlying the development of compulsivity, such as aberrant reward processing and habit formation. We discuss the implications of a transdiagnostic perspective on compulsivity, and how it may contribute to the development of novel treatments for AN.

The Role of Self-Efficacy in the Treatment of Substance Use Disorders

Science.gov (United States)

Kadden, Ronald M.; Litt, Mark D.

2011-01-01

Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. The present paper reviews the recent literature on self-efficacy in the substance abuse field. In numerous studies of substance abuse treatment, self-efficacy has emerged as an important predictor of outcome, or as a mediator of treatment effects. Despite these repeated positive findings, the self-efficacy concept has had little impact on the design of treatments. Since the concept was first introduced, there have been numerous suggestions regarding the means by which self-efficacy may be enhanced in clinical settings, but very little by way of empirical tests of those suggestions. This review concludes with a number of recommendations for further research to improve understanding of this potentially valuable concept and its interactions with other variables, and to develop effective strategies for enhancing self-efficacy. PMID:21849232

Clinical judgement within the South African clinical nursing environment: A concept analysis

Directory of Open Access Journals (Sweden)

Anna C. van Graan

2016-10-01

Full Text Available Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982—2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.

[The concept of mania in Greek medical and philosophical literature].

Science.gov (United States)

Corleto, L M

1992-01-01

Coverage of the concept of mania in late archaic Greek culture displays a clear difference between its use in medical and philosophical works. Medical literature uses the terms [Greek] and [Greek] to describe mania, with the condition seen largely associated with physical illness. Specific treatment for this attered psychic state is not advanced. The philosophical view sees mania as a divine folly and thus possessing positive as well as negative aspects. Plate identifies four types of mania and treatment is closely associated with the divinity seen as responsible for that particular type. The radical rationalism found in the medical literature is a counterpoint to moderation as shown by Plato with his interest on regulations of society.

Sewage sludge treatment, utilisation and disposal; Schlammbehandlung, -verwertung und -beseitigung

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

In view of recent events and the resulting emotional and political decisions, the issue of sewage sludge treatment and disposal in Germany. must be seen in a new light. First, a new concept for sewage sludge management must be developed as recent legislation interferes with the 'classic' strategy of utilisation in agriculture, dumping and combustion. Scientists and sewage plant owners must find new ways to implement the specifications of the Act on Recycling and Waste Management. This ATV-DVWK training course discusses subjects that may be helpful on the new path. Starting from current legislation, problems, decision criteria and cost of sewage sludge treatment are gone into. Dimensioning fundamentals for sewage treatment plants re presented, and new and established treatment methods, operational problems and pollution problems are discussed. Further subjects are recycling of useful materials from sewage sludge, co-treatment of organic materials in fermenters, and disposal concepts for small and medium-sized communities. (orig.)

Flourishing: An Evolutionary Concept Analysis.

Science.gov (United States)

Agenor, Christine; Conner, Norma; Aroian, Karen

2017-11-01

Mental health is an important measure of public health (WHO, 2004); however, nursing practice and research continues to prioritize mental illness, rather than well-being (Wand, 2011). Flourishing is a recent concept in the field of well-being. The term has been used sparingly in nursing practice and research, and conceptual clarification is needed to promote comprehensive understanding of the phenomenon. The purpose of this study is to critically analyze flourishing, assess the maturity of the concept, and provide recommendations for future research, education, and practice. The concept of flourishing was analyzed using the evolutionary approach to concept analysis (Rodgers, 2000). A search for articles on flourishing within the context of well-being was conducted through CINAHL, MEDLINE, and PsycINFO. A sample of 32 articles and 1 book was reviewed. Data were reviewed for concept attributes, antecedents, consequences, surrogate terms and related concepts. Four models of flourishing were identified with six overlapping attributes: meaning, positive relationships, engagement, competence, positive emotion, and self-esteem. Limited longitudinal and predictive studies have been conducted, but there is evidence for several antecedents and outcomes of flourishing. Research is ongoing primarily in psychology and sociology and is lacking in other disciplines. The concept of flourishing is immature; however, evidence is building for related concepts. A lack of consistent terminology regarding flourishing prevents knowledge development of flourishing as a distinct concept. Further multidisciplinary research is needed to establish standard operational and conceptual definitions and develop effective interventions.

Establishing a library of resources to help people understand key concepts in assessing treatment claims—The “Critical thinking and Appraisal Resource Library” (CARL)

Science.gov (United States)

Chalmers, Iain; Atkinson, Patricia; Badenoch, Douglas; Oxman, Andrew D.; Austvoll-Dahlgren, Astrid; Nordheim, Lena; Krause, L. Kendall; Schwartz, Lisa M.; Woloshin, Steven; Burls, Amanda; Mosconi, Paola; Hoffmann, Tammy; Cusack, Leila; Albarqouni, Loai; Glasziou, Paul

2017-01-01

Background People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior. Objectives Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as ‘intermediaries’ of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups. Methods CARL was populated with learning-resources identified from a variety of sources—two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by ‘Key Concepts’ needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org). Results We have

Outsourcing. The Concept

Directory of Open Access Journals (Sweden)

Victor-Adrian TROACĂ

2012-06-01

Full Text Available In the last two decades, an economic phenomenon took place, phenomenon characterized by the transfer of manufacturing activity from the developed countries to those in developing process. This practice can be considered as the response found by the large companies to the problem of production costs that were in a continuous rising, concomitant with the rising of living standards and remuneration.This paper aims to analyze the concept of outsourcing in terms of its evolution, but also in terms of incentives, ups and downs associated with the concept. On the other hand, this paper seeks to capture the fundamentals of this concept veracity and whether it could be implemented in the public service.

Nanomedicine concepts in the general medical curriculum: initiating a discussion.

Science.gov (United States)

Sweeney, Aldrin E

2015-01-01

Various applications of nanoscale science to the field of medicine have resulted in the ongoing development of the subfield of nanomedicine. Within the past several years, there has been a concurrent proliferation of academic journals, textbooks, and other professional literature addressing fundamental basic science research and seminal clinical developments in nanomedicine. Additionally, there is now broad consensus among medical researchers and practitioners that along with personalized medicine and regenerative medicine, nanomedicine is likely to revolutionize our definitions of what constitutes human disease and its treatment. In light of these developments, incorporation of key nanomedicine concepts into the general medical curriculum ought to be considered. Here, I offer for consideration five key nanomedicine concepts, along with suggestions regarding the manner in which they might be incorporated effectively into the general medical curriculum. Related curricular issues and implications for medical education also are presented.

PERFORMANCE - AN EVOLVING CONCEPT

OpenAIRE

Assist. Mirela-Oana Pintea Ph.D Student; Lect. Monica-Violeta Achim

2010-01-01

The concept of performance is a problematic concept and will remain so as long as the definition of company performance varies depending on the interests of users of information. On this consideration, no consensus was reached regarding the definition, methodology and performance models used. Defining this concept is realized in accordance with its objectives of users of information, while the methodology and models used are influenced by legal regulations and management policies. The approac...

Tooth supported overdenture: A concept overshadowed but not yet forgotten!

OpenAIRE

Rupandeep Kaur Samra; Shreenivas Vasant Bhide; Chhavi Goyal; Taranjit Kaur

2015-01-01

The concept of conventional tooth-retained overdentures is a simple and cost effective treatment than the implant overdentures. When few firm teeth are present in an otherwise compromised dentition, they can be retained and used as abutments for overdenture fabrication. This helps improve the retention and stability of the final prosthesis significantly. Bone is a dynamic tissue. The extraction of teeth results in the initiation of the bone resorption pattern. However, when tensile stress is ...

Some Contributions for a Pedagogical Treatment of Alternative Conceptions in Biology: An Example from Plant Nutrition.

Science.gov (United States)

Vaz, Adelaine Neto; And Others

This paper reports on a study that investigated the alternative conceptions of students in a biology and geology teacher education course regarding plant nutrition. Data were collected from first year and final year students using a questionnaire that had both multiple choice and descriptive items. Findings indicate common features related to the…

The prediction of failure situations using the CTOD concept based on the engineering treatment model (ETM)

International Nuclear Information System (INIS)

Schwalbe, K.H.

1985-01-01

Under the assumption of plane stress conditions, the CTOD concept is extended such that a full R-curve methodology arises consisting of an experimental procedure for the determination of the R-curve and of the driving force prediction. Predictions of initiation and maximum loads are in reasonable agreement with experimental results. (orig./HP)

Modeling concept drift

DEFF Research Database (Denmark)

Borchani, Hanen; Martinez, Ana Maria; Masegosa, Andrés R.

2015-01-01

An often used approach for detecting and adapting to concept drift when doing classification is to treat the data as i.i.d. and use changes in classification accuracy as an indication of concept drift. In this paper, we take a different perspective and propose a framework, based on probabilistic ...... data set from a Spanish bank....

Forensic investigation of medical treatment related deaths.

Science.gov (United States)

Ibrahim, Joseph E; Ranson, David L; O'Brien, Adam; Charles, Amanda; Young, Carmel

2009-04-01

Patients suffer preventable harm from their medical treatment. The traditional approaches to investigating medical treatment related deaths are the 'hospital mortality audit' and legal or coroners investigation. The aim is to describe how the patient safety movement in the late 1990s is changing traditional approaches to the investigation. The prevention of medical treatment related death involves an investigation as one of five major stages. These are Stage I Preparedness; Stage II Recognition and reporting; Stage III Investigation and analysis; Stage IV Findings and recommendations; and Stage V Response. The influence of the patient safety approach is considered at each stage with a particular focus on Stage I. It is at this stage that the concepts of clinical governance, culture and systems of care have a major influence on the nature of an investigation. The genesis of the modern forensic investigation into medical treatment related deaths in Victoria, Australia is described. The formation of the Clinical Liaison Service incorporates concepts from the patient safety approach with clinical staff to transform the traditional Coroner's investigation. Benefits of a modern forensic investigation include improving appropriateness of cases proceeding to investigation and a focus on prevention. Achieving a reduction in medical treatment related death requires substantial shifts towards an approach consistent with the patient safety.

The concept of stigma in mental illness as applied to Haitian Americans.

Science.gov (United States)

Dieujuste, Colette

2016-06-01

To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. The method used for this concept analysis was that of Walker and Avant. Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects. © 2016 International Council of Nurses.

Alternate day treatment and late effects: The concept of an effective dose per fraction

International Nuclear Information System (INIS)

Courdi, A.; Hery, M.; Gabillat, J.M.

1990-01-01

Although most institutions treat all fields each day, some radiotherapists continue to adopt an alternate day schedule. The resulting daily variations of the dose per fraction in laterally located targets have been analyzed using the linear-quadratic model. Patients with breast carcinoma treated with definitive radiotherapy in 1974-1975 with one field a day were studied. An effective dose per fraction was derived, with a value higher than the average dose per fraction received by the reference point. The greater the fluctuations between the doses per fraction on successive days, the higher the effective dose per fraction. The corresponding cell survival due to alternate treatment as compared to survival with daily treatment depends on the alpha/beta ratio. For a late effect with low alpha/beta ratio, an alternate treatment may lead to almost 10-fold increase in cell kill in these lateral targets such as those responsible for subcutaneous sclerosis as compared to daily treatment of all fields with the same total dose. Taking the average effective dose per fraction in our series, the increase in cell kill was 4-fold. Acute effects would suffer less damage due to alternate treatment because of a high alpha/beta ratio. Treatment on an alternate schedule should be restricted to palliative radiotherapy

Acceptability and preferences for safer conception HIV prevention strategies: a qualitative study.

Science.gov (United States)

Schwartz, Sheree R; West, Nora; Phofa, Rebecca; Yende, Nompumelelo; Sanne, Ian; Bassett, Jean; Van Rie, Annelies

2016-10-01

Safer conception strategies to reduce the HIV transmission risk include antiretroviral therapy for HIV-positive partners, pre-exposure prophylaxis for HIV-negative partners, condomless sex limited to fertile periods, and home-based self-insemination. Resistance to taking treatment or cultural concerns may limit uptake of strategies and intervention success. Understanding the acceptability and preferences between different approaches is important to optimise service delivery. Between February and July 2013, 42 adults (21 HIV-positive and 21 HIV-negative) receiving primary care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, participated in focus group discussions or in-depth interviews. Themes were analysed using a grounded theory approach. Acceptability of antiretroviral-based strategies varied. Concerns over side effects, antiretroviral treatment duration and beliefs that treatment is only for the sick were common barriers; however, desperation for a child was noted as a facilitator for uptake. HIV-negative men and HIV-positive women had favourable attitudes towards self-insemination, though paternity and safety concerns were raised. Self-insemination was generally preferred over pre-exposure prophylaxis by HIV-negative men, and antiretroviral-based strategies were preferred by couples with HIV-negative female partners, despite concerns raised about condomless sex while virally suppressed. Knowledge about the fertile window was low. A strong counselling component will be required for effective uptake and adherence to safer conception services. © The Author(s) 2016.

Advanced composites structural concepts and materials technologies for primary aircraft structures: Design/manufacturing concept assessment

Science.gov (United States)

Chu, Robert L.; Bayha, Tom D.; Davis, HU; Ingram, J. ED; Shukla, Jay G.

1992-01-01

Composite Wing and Fuselage Structural Design/Manufacturing Concepts have been developed and evaluated. Trade studies were performed to determine how well the concepts satisfy the program goals of 25 percent cost savings, 40 percent weight savings with aircraft resizing, and 50 percent part count reduction as compared to the aluminum Lockheed L-1011 baseline. The concepts developed using emerging technologies such as large scale resin transfer molding (RTM), automatic tow placed (ATP), braiding, out-of-autoclave and automated manufacturing processes for both thermoset and thermoplastic materials were evaluated for possible application in the design concepts. Trade studies were used to determine which concepts carry into the detailed design development subtask.

Development of numerical concepts

Directory of Open Access Journals (Sweden)

Sabine Peucker

2013-06-01

Full Text Available The development of numerical concepts is described from infancy to preschool age. Infants a few days old exhibit an early sensitivity for numerosities. In the course of development, nonverbal mental models allow for the exact representation of small quantities as well as changes in these quantities. Subitising, as the accurate recognition of small numerosities (without counting, plays an important role. It can be assumed that numerical concepts and procedures start with insights about small numerosities. Protoquantitative schemata comprise fundamental knowledge about quantities. One-to-one-correspondence connects elements and numbers, and, for this reason, both quantitative and numerical knowledge. If children understand that they can determine the numerosity of a collection of elements by enumerating the elements, they have acquired the concept of cardinality. Protoquantitative knowledge becomes quantitative if it can be applied to numerosities and sequential numbers. The concepts of cardinality and part-part-whole are key to numerical development. Developmentally appropriate learning and teaching should focus on cardinality and part-part-whole concepts.

Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concepts. Final report FY-96

Energy Technology Data Exchange (ETDEWEB)

Barrie, S.L.; Carpenter, G.S.; Crockett, A.B. [and others

1997-04-01

The Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concept Project was initiated for the expedited development of new or conceptual technologies in support of groundwater fate, transport, and remediation; buried waste characterization, retrieval, and treatment; waste minimization/pollution prevention; and spent fuel handling and storage. In Fiscal Year 1996, The Idaho National Engineering and Environmental Laboratory proposed 40 development projects and the Department of Energy funded 15. The projects proved the concepts of the various technologies, and all the technologies contribute to successful environmental management.

Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concepts. Final report FY-96

International Nuclear Information System (INIS)

Barrie, S.L.; Carpenter, G.S.; Crockett, A.B.

1997-04-01

The Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concept Project was initiated for the expedited development of new or conceptual technologies in support of groundwater fate, transport, and remediation; buried waste characterization, retrieval, and treatment; waste minimization/pollution prevention; and spent fuel handling and storage. In Fiscal Year 1996, The Idaho National Engineering and Environmental Laboratory proposed 40 development projects and the Department of Energy funded 15. The projects proved the concepts of the various technologies, and all the technologies contribute to successful environmental management

The "child size medicines" concept

DEFF Research Database (Denmark)

Nsabagasani, Xavier; Okeng, Jasper Ogwal; Mbonye, Anthony

2015-01-01

Background In 2007, the World Health Organization (WHO) launched the ‘make medicines child size’ (MMCS) campaign by urging countries to prioritize procurement of medicines with appropriate strengths for children’s age and weight and, in child-friendly formulations of rectal and flexible oral solid...... of policy provisions for the MMCS recommendations. Results For most medicines for the selected diseases, appropriate strength for children’s age and weight was addressed especially in the EMHSLU 2012. However, policy documents neither referred to ‘child size medicines’ concept nor provided for flexible oral...... health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect ‘child size’, child appropriate and evidence based...

Value-based medicine: concepts and application

Science.gov (United States)

Bae, Jong-Myon

2015-01-01

Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research. PMID:25773441

Value-based medicine: concepts and application.

Science.gov (United States)

Bae, Jong-Myon

2015-01-01

Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research.

Social anxiety and self-concept in children with epilepsy: a pilot intervention study.

Science.gov (United States)

Jones, Jana E; Blocher, Jacquelyn B; Jackson, Daren C; Sung, Connie; Fujikawa, Mayu

2014-10-01

The purpose of this study was to assess the impact of a cognitive behavioral therapy (CBT) anxiety intervention on social phobia, social skill development, and self-concept. Fifteen children with epilepsy and a primary anxiety disorder participated in a CBT intervention for 12 weeks plus a 3-month follow-up visit. Children were assessed at baseline, week 7, week 12, and 3 months post treatment to measure changes in social phobia using the Screen for Child Anxiety Related Emotional Disorders (SCARED). Self-concept was also assessed by using the Piers-Harris Children's Self-Concept Scale II (Piers-Harris 2). There was a significant reduction in symptoms of social phobia and improved self-concept at the end of the 12-week intervention and at the 3 month follow-up. Repeated measures ANOVA's of child ratings revealed significant change over time on the SCARED-Social Phobia/Social Anxiety subscale score (p=0.024). In terms of self-concept, significant change over time was detected on the Piers-Harris 2-Total score (p=0.015) and several subscale scores of Piers-Harris 2, including: Physical Appearance and Attributes (p=0.016), Freedom from Anxiety (p=0.005), and Popularity (p=0.003). This pilot investigation utilized an evidenced based CBT intervention to reduce symptoms of social phobia, which in turn provided a vehicle to address specific social skills improving self-concept in children with epilepsy. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Reusable platform concepts

International Nuclear Information System (INIS)

Gudmestad, O.T.; Sparby, B.K.; Stead, B.L.

1993-01-01

There is an increasing need to reduce costs of offshore production facilities in order to make development of offshore fields profitable. For small fields with short production time there is in particular a need to investigate ways to reduce costs. The idea of platform reuse is for such fields particularly attractive. This paper will review reusable platform concepts and will discuss their range of application. Particular emphasis will be placed on technical limitations. Traditional concepts as jackups and floating production facilities will be discussed by major attention will be given to newly developed ideas for reuse of steel jackets and concrete structures. It will be shown how the operator for several fields can obtain considerable savings by applying such reusable platform concepts

Concepts in catalysis

International Nuclear Information System (INIS)

Boudart, M.

1992-01-01

This paper reports on concept in catalysis which are very important in heterogeneous catalysis, even today, when in spite of surface science, the complexity of events at a real catalytic surface is still evading the understanding necessary for design. In this paper the authors will attempt to give an update on evolving concepts in heterogeneous catalysis. The topics include: counting active centers on metal surfaces; the notion of turnover frequency for a catalytic cycle; the concept of structure (in) sensitive reactions; the ensemble (geometric) vs. The ligand (electronic) effect following Sachtler's school; the idea of a rate determining step and of a most abundant reactive intermediate; the effect of surface non-uniformity on catalytic kinetics; what makes catalytic cycles turnover

The Concept of Respite Care.

Science.gov (United States)

Whitmore, Kim E

2017-07-01

The aim of this article is to analyze the concept of respite care in the context of caring for a child with special healthcare needs. Respite care has often been identified as an important resource for caregivers of children with special healthcare needs. It can help provide a break from the constant demands of caregiving. A concept analysis was conducted using an evolutionary approach. The data source for the concept analysis was a review of literature addressing respite care for caregivers of children with special healthcare needs. A review of the literature was conducted and a concept model was developed using an evolutionary approach. A theoretical definition of respite care is provided and the defining attributes, related concepts, antecedents, and consequences of respite care are shown in a diagram of the concept of respite care. The conceptual model provides a framework to help nurses better understand the concept of respite care in order to educate caregivers, provide appropriate referrals, serve as providers of respite care, and advocate for policy changes related to the provision of respite care services for caregivers of children with special healthcare needs. © 2016 Wiley Periodicals, Inc.

ETHICAL FASHION CONCEPT AND DESIGNERS

Directory of Open Access Journals (Sweden)

Pinar GOKLUBERK OZLU

2015-01-01

Full Text Available Some problems like rapidly developing industrialization, irregular population growth, environmental pollution and to feel the impact of global warming as seriously, has been giving significant damage to the earth. People has realized that, after polluting to clean is harder than polluting of the measures to be taken before. And again people showed the sensitivity to the environment through different reactions and sanctions, took measures and created the new concepts about the enviroment. "Ethical Fashion" concept was created by the conscious and responsible individuals in the last two decades. However, that are being implemented as a concept is noticeable. Textile and fashion industry cover "Ethical Fashion"; ecological product, working conditions, fair trade and sustainable product are all in that concept. "Ethical Fashion" appeared and developed especially in United Kingdom, the USA and the other European countries. Nowadays, we may see a lot of textile and fashion designers, fabric and clothing collections, fairs and some specific courses at the universities about "Ethical Fashion". In this research contains "Ethical Fashion" concept, it's development processes and fashion designers who is working for this concept at the present time, also the main target is in this research, semtinizing "Ethical Fashion" concept.

The application of the fair value concept in accounting

OpenAIRE

Venelin Georgiev

2011-01-01

In the article there are discussed the advantages and disadvantages of fair value as a measurement basis for a great number of accounting objects and above all for financial instruments. This is done on the basis of a study of the experience of Bulgarian and foreign experts. The concept of fair value has been laid down in the treatments of the International Accounting Standards, but it has given ground for sceptics to be doubtful about its merits. Some of those go to extreme evaluations of it...

The reinterpretation of standard deviation concept

OpenAIRE

Ye, Xiaoming

2017-01-01

Existing mathematical theory interprets the concept of standard deviation as the dispersion degree. Therefore, in measurement theory, both uncertainty concept and precision concept, which are expressed with standard deviation or times standard deviation, are also defined as the dispersion of measurement result, so that the concept logic is tangled. Through comparative analysis of the standard deviation concept and re-interpreting the measurement error evaluation principle, this paper points o...

Disentangling The Thick Concept Argument

DEFF Research Database (Denmark)

Blomberg, Olle

2007-01-01

Critics argue that non-cognitivism cannot adequately account for the existence and nature of some thick moral concepts. They use the existence of thick concepts as a lever in an argument against non-cognitivism, here called the Thick Concept Argument (TCA). While TCA is frequently invoked...

Supersonic Retropropulsion Flight Test Concepts

Science.gov (United States)

Post, Ethan A.; Dupzyk, Ian C.; Korzun, Ashley M.; Dyakonov, Artem A.; Tanimoto, Rebekah L.; Edquist, Karl T.

2011-01-01

NASA's Exploration Technology Development and Demonstration Program has proposed plans for a series of three sub-scale flight tests at Earth for supersonic retropropulsion, a candidate decelerator technology for future, high-mass Mars missions. The first flight test in this series is intended to be a proof-of-concept test, demonstrating successful initiation and operation of supersonic retropropulsion at conditions that replicate the relevant physics of the aerodynamic-propulsive interactions expected in flight. Five sub-scale flight test article concepts, each designed for launch on sounding rockets, have been developed in consideration of this proof-of-concept flight test. Commercial, off-the-shelf components are utilized as much as possible in each concept. The design merits of the concepts are compared along with their predicted performance for a baseline trajectory. The results of a packaging study and performance-based trade studies indicate that a sounding rocket is a viable launch platform for this proof-of-concept test of supersonic retropropulsion.

The long-term prognosis for live birth in couples initiating fertility treatments.

Science.gov (United States)

Malchau, S S; Henningsen, A A; Loft, A; Rasmussen, S; Forman, J; Nyboe Andersen, A; Pinborg, A

2017-07-01

What are the long-term chances of having a child for couples starting fertility treatments and how many conceive with ART, IUI and without treatment? Total 5-year live birthrates were strongly influenced by female age and ranged from 80% in women under 35-26% in women ≥40 years, overall, 14% of couples conceived naturally and one-third of couples starting treatments with intrauterine insemination delivered from that treatment. Few studies report success rates in fertility treatments across a couple's complete fertility treatment history, across clinics, evaluating live births after insemination, ART and natural conceptions. This register-based national cohort study from Denmark includes all women initiating fertility treatments in public and private clinics with homologous gametes in 2007-2010. Women were identified in the Danish ART Registry and were cross-linked with the Medical Birth Registry to identify live births. Subfertile couples were followed 2 years (N = 19 884), 3 years (N = 14 445) and 5 years (N = 5165), or until their first live birth. Cumulative live birthrates were estimated 2, 3 and 5 years from the first treatment cycle, in all women, including drop-outs. Birthrates were stratified by type of first treatment (ART/IUI), mode of conception (ART/IUI/natural conception) and female age. Within 5 years, in women aged years (N = 3553), 35-39 years (N = 1156) and ≥40 years (N = 451), a total of 64%, 49% and 16% had a live birth due to treatment, respectively. Additionally, in women aged years, 35-39 years and ≥40 years, 16%, 11% and 10% delivered after natural conception, yielding total 5-year birthrates of 80%, 60% and 26%. In women starting treatments with IUI (N = 3028), 35% delivered after IUI within 5 years, 24% delivered after shift to ART treatments and 17% delivered after natural conception. Within 5 years from starting treatments with ART (N = 2137), 53% delivered after ART, 11% delivered after natural conception and 0.6% delivered after

Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

Science.gov (United States)

Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

2017-08-01

Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with

Guiding periodontal pocket recolonization: a proof of concept.

Science.gov (United States)

Teughels, W; Newman, M G; Coucke, W; Haffajee, A D; Van Der Mei, H C; Haake, S Kinder; Schepers, E; Cassiman, J-J; Van Eldere, J; van Steenberghe, D; Quirynen, M

2007-11-01

The complexity of the periodontal microbiota resembles that of the gastro-intestinal tract, where infectious diseases are treatable via probiotics. In the oropharyngeal region, probiotic or replacement therapies have shown some benefit in the prevention of dental caries, otitis media, and pharyngitis, but their effectiveness in the treatment of periodontitis is unknown. Therefore, this study addressed the hypothesis that the application of selected beneficial bacteria, as an adjunct to scaling and root planing, would inhibit the periodontopathogen recolonization of periodontal pockets. Analysis of the data showed, in a beagle dog model, that when beneficial bacteria were applied in periodontal pockets adjunctively after root planing, subgingival recolonization of periodontopathogens was delayed and reduced, as was the degree of inflammation, at a clinically significant level. The study confirmed the hypothesis and provides a proof of concept for a guided pocket recolonization (GPR) approach in the treatment of periodontitis.

Design of Concept Libraries for C++

KAUST Repository

Sutton, Andrew

2012-01-01

We present a set of concepts (requirements on template arguments) for a large subset of the ISO C++ standard library. The goal of our work is twofold: to identify a minimal and useful set of concepts required to constrain the library\\'s generic algorithms and data structures and to gain insights into how best to support such concepts within C++. We start with the design of concepts rather than the design of supporting language features; the language design must be made to fit the concepts, rather than the other way around. A direct result of the experiment is the realization that to simply and elegantly support generic programming we need two kinds of abstractions: constraints are predicates on static properties of a type, and concepts are abstract specifications of an algorithm\\'s syntactic and semantic requirements. Constraints are necessary building blocks of concepts. Semantic properties are represented as axioms. We summarize our approach: concepts = constraints + axioms. This insight is leveraged to develop a library containing only 14 concepts that encompassing the functional, iterator, and algorithm components of the C++ Standard Library (the STL). The concepts are implemented as constraint classes and evaluated using Clang\\'s and GCC\\'s Standard Library test suites. © 2012 Springer-Verlag.

Can We Feel Physics Concepts?

Science.gov (United States)

Su, Yucheng

2010-01-01

There are many ways to improve students' understanding of physics concepts. This article focused on drawing students' attention with picture-embedded questions. Pictures give students a direct impression or feeling about the corresponding concepts, which really makes a difference. However, the effects are limited. Some physics concepts are…

A clinical trial to evaluate the effects of flumethrin or ivermectin treatment on hemoparasites, gastrointestinal parasites, conception and daily weight gain in a dairy farm in Japan.

Science.gov (United States)

Yamane, I; Arai, S; Nakamura, Y; Hisashi, M; Fukazawa, Y; Onuki, T

2000-02-01

A clinical trial was performed to compare the effects of flumethrin and ivermectin treatments of grazing heifers at one farm in central Japan. 64 heifers were randomly allocated into two groups. Flumethrin (1 mg/kg pour on) was applied approximately once every 3 weeks to heifers in one group and heifers in the second group were injected approximately once every month with ivermectin (200 microg/kg; id). Between groups, no significant differences were detected in the proportions of animals that showed parasitemia of Theileria sergenti and conception risks. Significantly lower average log-transformed nematode-egg counts and higher average daily weight gain were observed in the ivermectin-treated group. Animals with higher body weight at the start of grazing and lower log-transformed total nematode-egg and coccidia-oocyst counts had higher odds of conceiving. Animals with ivermectin treatment, lower body weight at the start of grazing and lower log-transformed coccidia-oocyst count had higher daily weight gain. Ivermectin may be more useful in this farm because of the higher productivity for cattle and lower cost for its usage.

Effluent treatment options for nuclear thermal propulsion system ground tests

International Nuclear Information System (INIS)

Shipers, L.R.; Brockmann, J.E.

1992-01-01

A variety of approaches for handling effluent from nuclear thermal propulsion system ground tests in an environmentally acceptable manner are discussed. The functional requirements of effluent treatment are defined and concept options are presented within the framework of these requirements. System concepts differ primarily in the choice of fission-product retention and waste handling concepts. The concept options considered range from closed cycle (venting the exhaust to a closed volume or recirculating the hydrogen in a closed loop) to open cycle (real time processing and venting of the effluent). This paper reviews the strengths and weaknesses of different methods to handle effluent from nuclear thermal propulsion system ground tests

Advanced concepts for acceleration

International Nuclear Information System (INIS)

Keefe, D.

1986-07-01

Selected examples of advanced accelerator concepts are reviewed. Such plasma accelerators as plasma beat wave accelerator, plasma wake field accelerator, and plasma grating accelerator are discussed particularly as examples of concepts for accelerating relativistic electrons or positrons. Also covered are the pulsed electron-beam, pulsed laser accelerator, inverse Cherenkov accelerator, inverse free-electron laser, switched radial-line accelerators, and two-beam accelerator. Advanced concepts for ion acceleration discussed include the electron ring accelerator, excitation of waves on intense electron beams, and two-wave combinations

Advanced fusion concepts program

International Nuclear Information System (INIS)

Dove, W.F.

1978-01-01

While the prospects for the eventual development of a tokamak-based fusion reactor appear promising at the present time, the Department of Energy maintains a vigorous program in alternate magnetic fusion concepts. Several of the concepts presently supported include the toroidal reversed field pinch, Tormac, Elmo Bumpy Torus, and various linear options. Recent technical accomplishments and program evaluations indicate that the possibility now exists for undertaking the next development stage, a proof-of-principle experiment, for a few of the most promising alternate concepts

Alternative fusion concepts

International Nuclear Information System (INIS)

Rostagni, G.

1981-01-01

The paper reports the discussions and statements made by the participants on the actual state and future of five different approaches on the fusion concept; they are the following: bumpy torus, reversed-field pinch, open-ended configurations, compact toroids and stellarators. Tables show for each concept parameters that represent the achieved results; data expected for future devices and extrapolations on reactor requirements are included

Concepts of Chinese Folk Happiness

Science.gov (United States)

Ip, Po Keung

2011-01-01

Discourses on Chinese folk happiness are often based on anecdotal narratives or qualitative analysis. Two traditional concepts of happiness popular in Chinese culture are introduced. The paper constructs a concept of Chinese folk happiness on basis of the findings of a scientific survey on the Taiwanese people regarding their concepts of…

Perceived parental efficacy: concept analysis.

Science.gov (United States)

Montigny, Francine; Lacharité, Carl

2005-02-01

This paper describes a concept analysis carried out to remove some of the ambiguity surrounding the conceptual meaning of perceived parental efficacy and to distinguish it from related concepts such as parental confidence and parental competence. Constructing parental efficacy is a crucial step for family members after the birth of their first child. For some authors, perceived parental efficacy is a motor for adequate parental practices. Confusion about the definition and measurement of this concept has hindered both psychology and nursing practice and research. Concept delineation and concept clarification are required in order to further the development of the concept of perceived parental efficacy. A literature search using a variety of online databases yielded 113 articles between the years 1980 and 2000. The final sample (n=60) consisted of 30 articles from two disciplines: nursing and psychology. A content analysis of the literature was done using Rodger's evolutionary concept analysis method. Content analysis of the literature yielded four contributors to perceived parental efficacy: positive enactive mastery experiences, vicarious experiences, verbal persuasion and an appropriate physiological and affective state. Perceived parental efficacy can thus be defined as 'beliefs or judgements a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child'. This conceptual analysis has allowed perceived parental efficacy to be distinguished from parental confidence and parental competence. Both nursing and psychology research, practice and education will benefit from a more precise and delineated concept.

Database Concepts in a Domain Ontology

Directory of Open Access Journals (Sweden)

Gorskis Henrihs

2017-12-01

Full Text Available There are multiple approaches for mapping from a domain ontology to a database in the task of ontology-based data access. For that purpose, external mapping documents are most commonly used. These documents describe how the data necessary for the description of ontology individuals and other values, are to be obtained from the database. The present paper investigates the use of special database concepts. These concepts are not separated from the domain ontology; they are mixed with domain concepts to form a combined application ontology. By creating natural relationships between database concepts and domain concepts, mapping can be implemented more easily and with a specific purpose. The paper also investigates how the use of such database concepts in addition to domain concepts impacts ontology building and data retrieval.

The conservation and development of Myanmar teak bearing forests: an new approach/concept

International Nuclear Information System (INIS)

Ker Kelvin Saw

2001-04-01

The paper describes that the growing stock and natural regeneration of teak and other valuable commercial species in Myanmar's forests are fast declining due to successional changes in forest types, repeated severe annual forest fires, fuel wood crisis, and over exploitation, thereby necessitating new research approaches and concepts in the treatment of our forests

SKOS Concepts and Natural Language Concepts: an Analysis of Latent Relationships in KOSs

OpenAIRE

Mastora, Anna; Peponakis, Manolis; Kapidakis, Sarantos

2017-01-01

The vehicle to represent Knowledge Organisation Systems (KOSs) in the environment of the Semantic Web and linked data is the Simple Knowledge Organisation System (SKOS). SKOS provides a way to assign a Uniform Resource Identifier (URI) to each concept, and this URI functions as a surrogate for the concept. This fact makes of main concern the need to clarify the URIs’ ontological meaning. The aim of this study is to investigate the relationship between the ontological substance of KOS concepts...

Effective Reading Comprehension in EFL Contexts: Individual and Collaborative Concept Mapping Strategies

Directory of Open Access Journals (Sweden)

Zahra Riahi

2017-02-01

Full Text Available The present study attempted to investigate the possible impacts of Individual Concept Mapping (ICM and Collaborative Concept Mapping (CCM strategies on Iranian EFL learners' reading comprehension. For this purpose, 90 pre-intermediate female language learners ranged between 12 to 17 years of age were selected to randomly assign into ICM, CCM and Control groups in this study. After taking Key English Test (KET, the ICM and CCM groups received EFL reading materials presented and practiced with ICM and CCM strategies, respectively, while the Control group received only conventional instructions to reading comprehension. After conducting the treatment, all participants took a Concept Mapping post-test constructed by the researchers. The hypothetical assumptions in this study were in favor of ICM and CCM strategies to improve the Iranian EFL learners’ reading comprehension. Statistics supported the outperformance of the ICM and CCM groups comparing to Control group who received convention PPP teaching techniques on Concept Mapping post-test. However, the superiority of neither strategies was statistically proved so that no meaningful difference between the reading comprehension of the ICM and CCM groups were detected. Therefore, the researchers failed to determine which strategy caused a better or higher impact. Some pedagogical implications and recommended topics for further research were provided to the motivated researchers.

Impact of organ shape variations on margin concepts for cervix cancer ART.

Science.gov (United States)

Seppenwoolde, Yvette; Stock, Markus; Buschmann, Martin; Georg, Dietmar; Bauer-Novotny, Kwei-Yuang; Pötter, Richard; Georg, Petra

2016-09-01

Target and organ movement motivate adaptive radiotherapy for cervix cancer patients. We investigated the dosimetric impact of margin concepts with different levels of complexity on both organ at risk (OAR) sparing and PTV coverage. Weekly CT and daily CBCT scans were delineated for 10 patients. The dosimetric impact of organ shape variations were evaluated for four (isotropic) margin concepts: two static PTVs (PTV 6mm and PTV 15mm ), a PTV based on ITV of the planning CT and CBCTs of the first treatment week (PTV ART ITV ) and an adaptive PTV based on a library approach (PTV ART Library ). Using static concepts, OAR doses increased with large margins, while smaller margins compromised target coverage. ART PTVs resulted in comparable target coverage and better sparing of bladder (V40Gy: 15% and 7% less), rectum (V40Gy: 18 and 6cc less) and bowel (V40Gy: 106 and 15cc less) compared to PTV 15mm . Target coverage evaluation showed that for elective fields a static 5mm margin sufficed. PTV ART Library achieved the best dosimetric results. However when weighing clinical benefit against workload, ITV margins based on repetitive movement evaluation during the first week also provide improvements over static margin concepts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Refinement of the concept of uncertainty.

Science.gov (United States)

Penrod, J

2001-04-01

To analyse the conceptual maturity of uncertainty; to develop an expanded theoretical definition of uncertainty; to advance the concept using methods of concept refinement; and to analyse congruency with the conceptualization of uncertainty presented in the theory of hope, enduring, and suffering. Uncertainty is of concern in nursing as people experience complex life events surrounding health. In an earlier nursing study that linked the concepts of hope, enduring, and suffering into a single theoretical scheme, a state best described as 'uncertainty' arose. This study was undertaken to explore how this conceptualization fit with the scientific literature on uncertainty and to refine the concept. Initially, a concept analysis using advanced methods described by Morse, Hupcey, Mitcham and colleagues was completed. The concept was determined to be partially mature. A theoretical definition was derived and techniques of concept refinement using the literature as data were applied. The refined concept was found to be congruent with the concept of uncertainty that had emerged in the model of hope, enduring and suffering. Further investigation is needed to explore the extent of probabilistic reasoning and the effects of confidence and control on feelings of uncertainty and certainty.

Adverse drug reaction and concepts of drug safety in Ayurveda: An overview

Science.gov (United States)

Ajanal, Manjunath; Nayak, Shradda; Prasad, Buduru Sreenivasa; Kadam, Avinash

2013-01-01

Drug safety is a very basic and fundamental concept in medical practice. ADRs play an important role in assessing patient safety in any system of medicine. Pharmacovigilance study is thus significant to understand treatment outcomes. Current raised issue with respect to complementary and alternative system medicine (CAM) like Ayurveda is increased in number of safety reports along with report misinterpretation; this generates the negative impact on system. Although, Ayurveda which is holistic system of medicine from India has elaborated the causes and methods of drug-induced consequences along with preventive measures the available data in classical texts is scattered. The compilation and analysis along with modern concept drug safety is need of the hour. Present literature review was conducted from various compendium of Ayurveda and electronic data base with search terms of ‘Vyapad’, ‘Viruddha’, ‘Ahita’, ‘herb–herb interaction’, ‘idiosyncrasy’, ‘Prakritiviruddha’ etc. The reported information was analysed for the possible correlation on concept of ADR and Pharmacovigilance of current science. Overall review demonstrated that drug interaction, iatrogenic, over dose, administration of unsuitable drugs, reprehensive drug administration with respect to disease, complication from five procedural therapies (Panchakarma) and reprehensible preparation of mineral drug are nearer to the modern causes of ADR. Thus, concept of drug safety and ADR is not new to the Ayurveda. The concept “Drug which is not appropriate to be used as medicine”(Abheshaja) of Ayurveda sounds similar as that of modern pharmacovigilance. PMID:24563588

Between the cross and the sword: the crisis of the gene concept

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Charbel Niño El-Hani

2007-03-01

Full Text Available Challenges to the gene concept have shown the difficulty of preserving the classical molecular concept, according to which a gene is a stretch of DNA encoding a functional product (polypeptide or RNA. The main difficulties are related to the overlaying of the Mendelian idea of the gene as a ‘unit’: the interpretation of genes as structural and/or functional units in the genome is challenged by evidence showing the complexity and diversity of genomic organization. This paper discusses the difficulties faced by the classical molecular concept and addresses alternatives to it. Among the alternatives, it considers distinctions between different gene concepts, such as that between the ‘molecular’ and the ‘evolutionary’ gene, or between ‘gene-P’ (the gene as determinant of phenotypic differences and ‘gene-D’ (the gene as developmental resource. It also addresses the process molecular gene concept, according to which genes are understood as the whole molecular process underlying the capacity to express a particular product, rather than as entities in ‘bare’ DNA; a treatment of genes as sets of domains (exons, introns, promoters, enhancers, etc. in DNA; and a systemic understanding of genes as combinations of nucleic acid sequences corresponding to a product specified or demarcated by the cellular system. In all these cases, possible contributions to the advancement of our understanding of the architecture and dynamics of the genetic material are emphasized.

Concept Analysis: Music Therapy.

Science.gov (United States)

Murrock, Carolyn J; Bekhet, Abir K

2016-01-01

Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant's concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007-2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant's concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed.

The Concept of Philosophical Education

Science.gov (United States)

Boyum, Steinar

2010-01-01

Strangely, the concept of philosophical education is not much in use, at least not as a "philosophical" concept. In this essay, Steinar Boyum attempts to outline such a philosophical concept of philosophical education. Boyum uses Plato's Allegory of the Cave, Rene Descartes's life of doubt, and Immanuel Kant's criticism of metaphysics as paradigms…

Drawings as Representations of Children's Conceptions

Science.gov (United States)

Ehrlen, Karin

2009-01-01

Drawings are often used to obtain an idea of children's conceptions. Doing so takes for granted an unambiguous relation between conceptions and their representations in drawings. This study was undertaken to gain knowledge of the relation between children's conceptions and their representation of these conceptions in drawings. A theory of…

Family Relationships and Adolescent Self-Concept.

Science.gov (United States)

Massey, Catherine J.

Previous research relating the quality of the relationship with the mother, father, and sibling to adolescent self-concept only investigated social and general self-concept and not various social and cognitive dimensions of self-concept. This study investigated family relationships and their link to the several domains of self-concept.…

Cancer Stem Cells in Primary Liver Cancers: Pathological Concepts and Imaging Findings

Energy Technology Data Exchange (ETDEWEB)

Joo, Ijin [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Haeryoung [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lee, Jeong Min [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

2015-11-01

There is accumulating evidence that cancer stem cells (CSCs) play an integral role in the initiation of hepatocarcinogenesis and the maintaining of tumor growth. Liver CSCs derived from hepatic stem/progenitor cells have the potential to differentiate into either hepatocytes or cholangiocytes. Primary liver cancers originating from CSCs constitute a heterogeneous histopathologic spectrum, including hepatocellular carcinoma, combined hepatocellular-cholangiocarcinoma, and intrahepatic cholangiocarcinoma with various radiologic manifestations. In this article, we reviewed the recent concepts of CSCs in the development of primary liver cancers, focusing on their pathological and radiological findings. Awareness of the pathological concepts and imaging findings of primary liver cancers with features of CSCs is critical for accurate diagnosis, prediction of outcome, and appropriate treatment options for patients.

Cancer Stem Cells in Primary Liver Cancers: Pathological Concepts and Imaging Findings

International Nuclear Information System (INIS)

Joo, Ijin; Kim, Haeryoung; Lee, Jeong Min

2015-01-01

There is accumulating evidence that cancer stem cells (CSCs) play an integral role in the initiation of hepatocarcinogenesis and the maintaining of tumor growth. Liver CSCs derived from hepatic stem/progenitor cells have the potential to differentiate into either hepatocytes or cholangiocytes. Primary liver cancers originating from CSCs constitute a heterogeneous histopathologic spectrum, including hepatocellular carcinoma, combined hepatocellular-cholangiocarcinoma, and intrahepatic cholangiocarcinoma with various radiologic manifestations. In this article, we reviewed the recent concepts of CSCs in the development of primary liver cancers, focusing on their pathological and radiological findings. Awareness of the pathological concepts and imaging findings of primary liver cancers with features of CSCs is critical for accurate diagnosis, prediction of outcome, and appropriate treatment options for patients

Principles and criteria for creation of a concept for national radwaste repository

International Nuclear Information System (INIS)

Milanov, M.; Strezov, A.; Kojuharov, D.

1993-01-01

General principles and criteria based on the international experience and requirements as well as on specific Bulgarian conditions are used in the creation of the Concept for Radwaste Repository Construction as a first stage of the Bulgarian nuclear programme. The Concept contains about 70 projects of common or more specific character. The Bulgarian territory is categorized and several prospective areas are selected as a final result of the analysis performed. A model for development of a National System for Radwaste Management is considered. The formation of a working group appointed by governmental authorities as a solution of the existing highly complex situation connected with the treatment and storage of radwaste in the country is proposed. 1 fig., 14 refs. (author)

Fundamentals in Biostatistics for Research in Pediatric Dentistry: Part I - Basic Concepts.

Science.gov (United States)

Garrocho-Rangel, J A; Ruiz-Rodríguez, M S; Pozos-Guillén, A J

The purpose of this report was to provide the reader with some basic concepts in order to better understand the significance and reliability of the results of any article on Pediatric Dentistry. Currently, Pediatric Dentists need the best evidence available in the literature on which to base their diagnoses and treatment decisions for the children's oral care. Basic understanding of Biostatistics plays an important role during the entire Evidence-Based Dentistry (EBD) process. This report describes Biostatistics fundamentals in order to introduce the basic concepts used in statistics, such as summary measures, estimation, hypothesis testing, effect size, level of significance, p value, confidence intervals, etc., which are available to Pediatric Dentists interested in reading or designing original clinical or epidemiological studies.

Fundamental concepts of mathematics

CERN Document Server

Goodstein, R L

Fundamental Concepts of Mathematics, 2nd Edition provides an account of some basic concepts in modern mathematics. The book is primarily intended for mathematics teachers and lay people who wants to improve their skills in mathematics. Among the concepts and problems presented in the book include the determination of which integral polynomials have integral solutions; sentence logic and informal set theory; and why four colors is enough to color a map. Unlike in the first edition, the second edition provides detailed solutions to exercises contained in the text. Mathematics teachers and people

The current theoretical assumptions of the Bobath concept as determined by the members of BBTA.

Science.gov (United States)

Raine, Sue

2007-01-01

The Bobath concept is a problem-solving approach to the assessment and treatment of individuals following a lesion of the central nervous system that offers therapists a framework for their clinical practice. The aim of this study was to facilitate a group of experts in determining the current theoretical assumptions underpinning the Bobath concept.A four-round Delphi study was used. The expert sample included all 15 members of the British Bobath Tutors Association. Initial statements were identified from the literature with respondents generating additional statements. Level of agreement was determined by using a five-point Likert scale. Level of consensus was set at 80%. Eighty-five statements were rated from the literature along with 115 generated by the group. Ninety-three statements were identified as representing the theoretical underpinning of the Bobath concept. The Bobath experts agreed that therapists need to be aware of the principles of motor learning such as active participation, opportunities for practice and meaningful goals. They emphasized that therapy is an interactive process between individual, therapist, and the environment and aims to promote efficiency of movement to the individual's maximum potential rather than normal movement. Treatment was identified by the experts as having "change of functional outcome" at its center.

Long-term outcome of a multidisciplinary concept of spinal dural arteriovenous fistulae treatment

International Nuclear Information System (INIS)

Sherif, Camillo; Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert; Gibson, Daniel; Richling, Bernd

2008-01-01

The optimal treatment of spinal dural arteriovenous fistulae (SDAVF) remains controversial and long-term follow-up data, especially data from multidisciplinary treatment, are rarely available. Thus, long-term outcomes following a multidisciplinary approach to the treatment of SDAVF were investigated. The investigation included 26 patients with SDAVF treated at the authors' department over a 15-year period including a follow-up of more than 2 years. The treatment strategy when occlusion of the draining vein could be achieved was to embolize the fistula with Histoacryl, with surgery reserved for those patients unsuitable for embolization. Posttreatment angiography followed by MRI was performed in all patients. Clinical follow-up was performed using the gait and micturition Aminoff-Logue scale scores and the modified Rankin scale score. Embolization was performed in 19 patients (73.1%), and direct surgery in 7 patients (26.9%). Follow-up angiography (at a mean of 21.7 months) showed occlusion of the SDAVF in 24 patients (92.3%). Of the 19 embolized patients, 2 (10.5%) developed recurrence secondary to insufficient occlusion of the SDAVF draining vein, and one of these two patients underwent re-embolization and one re-operation. No negative effects of SDAVF recurrence on the final clinical outcome were identified in either patient. MRI after angiography (at a mean of 91.5 months) demonstrated occlusion of all SDAVFs. After a mean clinical follow-up of 103.4 months there was a statistically significant improvement in both the modified Rankin scale score and the Aminoff-Logue gait scale score (P < 0.05). The present multidisciplinary study showed for the first time that embolization leads to stable neuroradiological results and favourable clinical outcomes even for very long follow-up times of more than 100 months. Microsurgery remains the treatment of choice when safe embolization of the draining vein cannot be achieved. (orig.)

Stem cell-based treatments against stroke: observations from human proof-of-concept studies and considerations regarding clinical applicability

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Thorsten Roland Doeppner

2014-10-01

Full Text Available Ischemic stroke remains a heavy burden for industrialized countries. The only causal therapy is the recanalization of occluded vessels via thrombolysis, which due to a narrow time window still can be offered only to a minority of patients. Since the majority of patients continues to exhibit neurological deficits even following successful thrombolysis, restorative therapies are urgently needed that promote brain remodeling and repair once stroke injury has occurred. Due to their unique properties of action, stem cell-based strategies gained increasing interest during recent years. Using various stroke models in both rodents and primates, the transplantation of stem cells, namely of bone marrow derived mesenchymal stem cells (MSCs or neural progenitor cells (NPCs, has been shown to promote neurological recovery most likely via indirect bystander actions. In view of promising observations, clinical proof-of-concept studies are currently under way, in which effects of stem and precursor cells are evaluated in human stroke patients. In this review we summarize already published studies, which due to the broad experience in other medical contexts mostly employed bone marrow-derived MSCs by means of intravenous transplantation. With the overall number of clinical trials limited in number, only a fraction of these studies used non-treated control groups, and only single studies were adequately blinded. Despite these limitations, first promising results justify the need for more elaborate clinical trials in order to make stem cell transplantation a success for stroke treatment in the future.

Qualitative treatment of three-nucleon properties

International Nuclear Information System (INIS)

Efimov, V.

1981-01-01

An attempt is made at consistent qualitative treatment of the three-nucleon system. The approach used is based on the physical concept of effective three-nucleon long-range interaction resulting from the existence of the deuteron and the virtual singlet deuteron. Within the framework of the approach, a qualitative treatment of the triton properties, nucleon-deuteron scattering, and triton-disintegration reactions is carried out. The following topics are dealt with: the Phillips line, the triton D-wave admixture, the doublet effective range of the n-d scattering, the triton virtual state, the anomaly of the n-d elastic cross section near the three-body threshold, and the partial cross sections of the inelastic n-d scattering and of the triton photo- and electrodisintegration. The discussion of these topics includes the evaluation of three-nucleon parameters and the qualitative interpretation of experimental data and calculation results; some predictions are also made. The results of our analysis lead to the conclusion that the concept of effective three-nucleon long-range interaction can indeed serve as grounds for consistent qualitative treatment of the three-nucleon phenomena. (orig.)

System for supporting conception in the field of surface treatments

International Nuclear Information System (INIS)

Evrard, J.M.; Gras, M.

1989-01-01

The application of the techniques issued from artificial intelligence for assisting the development of a computer technical memory on a representative subject, which is the surface treatments and coating in tribology, is illustrated. The development of the system is composed of several steps: data acquisition and formatting representation, data validation and software. Particular attention is given to the dialogue between the user and the system. The study shows that the development of the following points are indispensable: the possibility of following the user's reasoning and coming back to previous steps or exploring several parallel ways [fr

Spatial Modernist Architectural Artistic Concepts

Science.gov (United States)

Gudkova, T. V.; Gudkov, A. A.

2017-11-01

The development of a single spatial modernist conception had continued until the middle of the twentieth century. The first authors who proposed the new conceptual solutions of an architectural space that had the greatest impact on the further development of architecture were Le Corbusier, Frank Lloyd Wright, Mies van der Rohein. They embodied different approaches within the common modernist spatial concept using the language of morphological, symbolic and phenomenological descriptions of space. The concept was based on the simplification of functional links, integration of internal architectural space with the environment due to the vanishing of boundaries between them and expansion of their interrelation. Le Corbusier proposed a spatio-temporal concept based on the movement and tempo-rhythmics of the space “from inside to outside.” Frank Lloyd Wright proposed the concept of integral space where inner and outer spaces were the parts of a whole. Mies van der Rohein was the author of the universal space concept in which the idea of the “dissolution” of the inner space in the outer space was embodied.

MSFC Advanced Concepts Office and the Iterative Launch Vehicle Concept Method

Science.gov (United States)

Creech, Dennis

2011-01-01

This slide presentation reviews the work of the Advanced Concepts Office (ACO) at Marshall Space Flight Center (MSFC) with particular emphasis on the method used to model launch vehicles using INTegrated ROcket Sizing (INTROS), a modeling system that assists in establishing the launch concept design, and stage sizing, and facilitates the integration of exterior analytic efforts, vehicle architecture studies, and technology and system trades and parameter sensitivities.

Concept medium programme

DEFF Research Database (Denmark)

Bjerrum, Peter

2005-01-01

The present essay is an attempt to determine the architectural project of the 21st century in relation to a modern conception of space as the medium of architecture, and of sociality as its program......The present essay is an attempt to determine the architectural project of the 21st century in relation to a modern conception of space as the medium of architecture, and of sociality as its program...

Concept medium program

DEFF Research Database (Denmark)

Bjerrum, Peter

2003-01-01

The present essays is an attempt to dertermine the architecural project of the 21st century in realation to a modern conception of space as the medium of architecture, and of society as its program. This attempt adopts the internal point of view of an architect in describing a modern architectural...... project within the framework: concept - program, these notions being concieved as spatial representations primarily and immediately "given" to architecture....

Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases.

Science.gov (United States)

Mucci, Armida; Merlotti, Eleonora; Üçok, Alp; Aleman, André; Galderisi, Silvana

2017-08-01

Primary and persistent negative symptoms (PPNS) represent an unmet need in the care of people with schizophrenia. They have an unfavourable impact on real-life functioning and do not respond to available treatments. Underlying etiopathogenetic mechanisms of PPNS are still unknown. The presence of primary and enduring negative symptoms characterizes deficit schizophrenia (DS), proposed as a separate disease entity with respect to non-deficit schizophrenia (NDS). More recently, to reduce the heterogeneity of negative symptoms by using criteria easily applicable in the context of clinical trials, the concept of persistent negative symptoms (PNS) was developed. Both PNS and DS constructs include enduring negative symptoms (at least 6months for PNS and 12months for DS) that do not respond to available treatments. PNS exclude secondary negative symptoms based on a cross-sectional evaluation of severity thresholds on commonly used rating scales for positive symptoms, depression and extrapyramidal side effects; the DS diagnosis, instead, excludes all potential sources of secondary negative symptoms based on a clinical longitudinal assessment. In this paper we review the evolution of concepts and assessment modalities relevant to PPNS, data on prevalence of DS and PNS, as well as studies on clinical, neuropsychological, brain imaging electrophysiological and psychosocial functioning aspects of DS and PNS. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of ascorbic acid on the conception rate of Yankasa ewes after estrus synchronization

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B. O. Omontese

2017-09-01

Full Text Available The objective of this study was to evaluate the effects of ascorbic acid (AA on the conception rates in ewes following progestin treatments. Yankasa ewes (n = 64 were equally allocated into two groups. One group was treated with controlled internal drug-released (CIDR intravaginal devices, the other with 45 mg fluorogestone acetate (FGA intravaginal sponges. After withdrawal of pro­gestin, ewes that exhibited estrus were further allocated into four subgroups for the administration of AA during estrus expression: CIDR control (CDNN, n = 12, CIDR plus AA (CDAA, n = 11, FGA control (FGNN, n = 13, and FGA plus AA (FGAA, n = 12. Estrus detection and natural mating were carried out with sexually active rams. The proportion of ewes in estrus did not differ between subgroups. The interval from withdrawal of devices to onset of estrus was significantly (p < 0.05 shorter in the FGA than in the CIDR group (30.35 ± 2.72 and 48.56 ± 7.52 hours, respectively. The duration of induced estrus did not differ (p < 0.05 between treatments (FGA 37.22 ± 4.22 and CIDR 39.75 ± 2.51 hours. Conception rates were comparable between subgroups. We therefore concluded that the administration of AA at sponge withdrawal did not improve the conception rate in Yankasa ewes treated with progestins.

Is there still a place for the concept of 'therapeutic regression' in psychoanalysis?

Science.gov (United States)

Spurling, Laurence S

2008-06-01

The author uses his own failure to find a place for the idea of therapeutic regression in his clinical thinking or practice as the basis for an investigation into its meaning and usefulness. He makes a distinction between three ways the term 'regression' is used in psychoanalytic discourse: as a way of evoking a primitive level of experience; as a reminder in some clinical situations of the value of non-intervention on the part of the analyst; and as a description of a phase of an analytic treatment with some patients where the analyst needs to put aside normal analytic technique in order to foster a regression in the patient. It is this third meaning, which the author terms "therapeutic regression" that this paper examines, principally by means of an extended discussion of two clinical examples of a patient making a so-called therapeutic regression, one given by Winnicott and the other by Masud Khan. The author argues that in these examples the introduction of the concept of therapeutic regression obscures rather than clarifies the clinical process. He concludes that, as a substantial clinical concept, the idea of therapeutic regression has outlived its usefulness. However he also notes that many psychoanalytic writers continue to find a use for the more generic concept of regression, and that the very engagement with the more particular idea of therapeutic regression has value in provoking questions as to what is truly therapeutic in psychoanalytic treatment.

Eliminating the “concept” concept

OpenAIRE

Harnad, Stevan

2010-01-01

Machery suggests that the concept of “concept” is too heterogeneous to serve as a “natural kind” for scientific explanation, so cognitive science should do without concepts. I second the suggestion and propose substituting, in place of concepts, inborn and acquired sensorimotor category-detectors and category-names combined into propositions that define and describe further categories.

Advancing Uncertainty: Untangling and Discerning Related Concepts

Directory of Open Access Journals (Sweden)

Janice Penrod

2002-12-01

Full Text Available Methods of advancing concepts within the qualitative paradigm have been developed and articulated. In this section, I describe methodological perspectives of a project designed to advance the concept of uncertainty using multiple qualitative methods. Through a series of earlier studies, the concept of uncertainty arose repeatedly in varied contexts, working its way into prominence, and warranting further investigation. Processes of advanced concept analysis were used to initiate the formal investigation into the meaning of the concept. Through concept analysis, the concept was deconstructed to identify conceptual components and gaps in understanding. Using this skeletal framework of the concept identified through concept analysis, subsequent studies were carried out to add ‘flesh’ to the concept. First, a concept refinement using the literature as data was completed. Findings revealed that the current state of the concept of uncertainty failed to incorporate what was known of the lived experience. Therefore, using interview techniques as the primary data source, a phenomenological study of uncertainty among caregivers was conducted. Incorporating the findings of the phenomenology, the skeletal framework of the concept was further fleshed out using techniques of concept correction to produce a more mature conceptualization of uncertainty. In this section, I describe the flow of this qualitative project investigating the concept of uncertainty, with special emphasis on a particular threat to validity (called conceptual tunnel vision that was identified and addressed during the phases of concept correction. Though in this article I employ a study of uncertainty for illustration, limited substantive findings regarding uncertainty are presented to retain a clear focus on the methodological issues.

[Pathophysiological basis of portal hypertension and the new concept of acute kidney injury in patients with liver cirrhosis].

Science.gov (United States)

Wang, J B

2017-06-20

Recently, the International Club of Ascites (ICA) has developed a new expert consensus on the diagnosis and treatment of acute kidney injury (AKI) in patients with liver cirrhosis, which reflects the new concept of AKI management in patients with liver cirrhosis. This consensus emphasizes the increase in the absolute value of serum creatinine (SCr) and establishes a new staging system for AKI, which may help to evaluate disease progression and recovery. In addition, the new management concept also emphasizes that when AKI progresses to stage 2/3 or still progresses after comprehensive treatment, a diagnosis can be made and vasoconstrictors and albumin can be used as long as the patient meets the other diagnostic criteria for hepatorenal syndrome, regardless of SCr level.

The Concept of Extraordinary Crime in Indonesia Legal System: is The Concept An Effective Criminal Policy?

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Vidya Prahassacitta

2016-10-01

Full Text Available The concept of extraordinary crime was a common concept in Indonesia. Adopts from the concept of the most serious crime in Rome Statute and adjusted with the Indonesian legal system. Then it developed wider and introduced into terrorism, corruption, drug abuse offenses, and child sexual abuse in legislations and Constitutional Court verdicts. The implementation of this concept generated some consequences in drafting and formulating the legislation as part of penal policy. This leads to two legal problems; first, what was the categorization of the concept of extraordinary crime? and second, what were the consequences of the concept extraordinary crime in accordance with penal policy?. Normative law research with literature study method, This was a conducted as the response of both legal problems. Using secondary data from legislation, Constitutional Court verdicts, book and journal, this research concludes that; the concept of extraordinary crime parts of criminal policy does not have any standard for the categorization. Then, as consequences of the implementation of the concept of extraordinary crime in several penal efforts are formulating in legislations. The penalty effort is not limited to criminalization and sentencing aspects but wider and shall be in line with the strategy of crime eradication and welfare protection purposes. To reach the effectiveness of the criminal policy of the concept of extraordinary crime, the penalty effort shall be in line with criminal law principles and human right basic principles.

ITER concept definition. V.2

International Nuclear Information System (INIS)

1989-01-01

Volume II of the two volumes describing the concept definition of the International Thermonuclear Experimental Reactor deals with the ITER concept in technical depth, and covers all areas of design of the ITER tokamak. Included are an assessment of the current database for design, scoping studies, rationale for concepts selection, performance flexibility, the ITER concept, the operations and experimental/testing program, ITER parameters and design phase schedule, and research and development specific to ITER. This latter includes a definition of specific research and development tasks, a division of tasks among members, specific milestones, required results, and schedules. Figs and tabs

[Treatment strategies for mass casualty incidents and terrorist attacks in trauma and vascular surgery : Presentation of a treatment concept].

Science.gov (United States)

Friemert, B; Franke, A; Bieler, D; Achatz, A; Hinck, D; Engelhardt, M

2017-10-01

The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs. terrorist attack MCI= dynamic situation) and the different security positions (rescue services vs. police services). This article is concerned with question of which changes in the surgical treatment of patients are made necessary by these new challenges. In this case it is necessary that physicians are familiar with the different injury patterns, whereby priority must be given to gunshot and explosion (blast) injuries. Furthermore, altered strategic and tactical approaches (damage control surgery vs. tactical abbreviated surgical care) are necessary to ensure survival for as many victims of terrorist attacks as possible and also to achieve the best possible functional results. It is only possible to successfully counter these new challenges by changing the mindset in the treatment of terrorist MCI compared to MCI incidents. An essential component of this mindset is the acquisition of a maximum of flexibility. This article would like to make a contribution to this problem.

[Clinical reasoning in nursing, concept analysis].

Science.gov (United States)

Côté, Sarah; St-Cyr Tribble, Denise

2012-12-01

Nurses work in situations of complex care requiring great clinical reasoning abilities. In literature, clinical reasoning is often confused with other concepts and it has no consensual definition. To conduct a concept analysis of a nurse's clinical reasoning in order to clarify, define and distinguish it from the other concepts as well as to better understand clinical reasoning. Rodgers's method of concept analysis was used, after literature was retrieved with the use of clinical reasoning, concept analysis, nurse, intensive care and decision making as key-words. The use of cognition, cognitive strategies, a systematic approach of analysis and data interpretation, generating hypothesis and alternatives are attributes of clinical reasoning. The antecedents are experience, knowledge, memory, cues, intuition and data collection. The consequences are decision making, action, clues and problem resolution. This concept analysis helped to define clinical reasoning, to distinguish it from other concepts used synonymously and to guide future research.

The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial

DEFF Research Database (Denmark)

Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun Katrine

2012-01-01

Abstract Objective The aim of this study was to evaluate the effects of a group based multidisciplinary stress treatment program on reductions in symptom levels and the return to work (RTW) rate. Methods General practitioners referred 199 patients with persistent work related stress symptoms...... to the project. The inclusion criteria included being employed and being on sick leave. Using a randomized wait- list control design, the participants were randomized into three groups: the intervention group (IG, 70 participants) was treated using the Stress Therapy Concept of Kalmia, which consists...... to the WLCG . Further, the prevalence of depression declined significantly in the IG and the TAUCG compared to the WLCG. Regarding the RTW rate, 66% of the participants in the IG had returned to full time work after three months. This rate was significantly greater than the percentage in the TAUCG (36...

Cognitive Architecture of Common and Scientific Concepts

Science.gov (United States)

Tarábek, Paul

2010-07-01

The cognitive architecture of concept is a specific structure consisting of the concept core, concept periphery, the semantic frame as the meaning and the sense of the concept, and the relations among all components of this structure. The model of the cognitive architecture of scientific and common concepts is a conceptual meta-model built upon Vygotsky's concept theory, Fillmore's semantic frame, semantic triangle, on widespread ideas of the structuring of conceptual systems, and the Hestenes' Modeling Theory. The method of semantic mapping of concepts flowing from the model is designed.

Recommendations by NACP for accurate treatment geometry specification

International Nuclear Information System (INIS)

Aaltonen, P.

1995-01-01

An investigation among the Nordic radiotherapy centres in 1991 confirmed that inconsistent use of dose and volume concepts is jeopardizing the high standard of radiation therapy. A Nordic working group was set up by NACP to standardize the concepts and quantities used throughout the whole radiation process. Now the draft report 'Specification of Dose Delivery in Radiation Therapy' is discussed with the radiotherapy community. The recent ICRU 50 report is the first step towards a uniform terminology and procedure at all radiotherapy centres. The new NACP report will be an important and more detailed addition for level 2-3 radiotherapy clinics and it will be specially adopted to the situation at the Nordic centres as well as other well equipped centres. The aim has been to recommend the use of concepts based on recent scientific development in the field of radiation therapy which are needed for the development of daily clinical practice. The terms and concepts for treatment geometry have been chosen by separating the concepts of tissues and volumes inside a patient. The tissues can be fixed in the coordinate system of the patient by adding a margin around them. This margin accounts for the movements of the tissues of interest inside the patient. The outer boundary of this margin is then encompassing the Strict Target Volume or Organ at Risk Volume which are fixed in the patient coordinate system. The set-up uncertainties of the patient in relation to the beams are considered during treatment planning by adding set-up margins to the beams

Value-based medicine: concepts and application

Directory of Open Access Journals (Sweden)

Jong-Myon Bae

2015-03-01

Full Text Available Global healthcare in the 21st century is characterized by evidence-based medicine (EBM, patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research.

Grouping of HLW in partitioning for B/T (burning and/or transmutation) treatment with neutron reactors based on three criteria

International Nuclear Information System (INIS)

Kitamoto, Mulyanto; Kitamoto, Asashi

1995-01-01

A grouping concept of HLW in partitioning for B/T (burning and/or transmutation) treatment by fission reactor was developed in order to improve the disposal in waste management from the safety aspect. The selecting and grouping concept was proposed herein, such as Group MA1 (Np, Am, and unrecovered U and Pu), Group MA2 (Cm, and trace quantity of Cf, etc.), Group A (Tc and I), Group B (Cs and Sr) and Group R (the partitioned remains of HLW), judging from the three criteria for B/T treatment, based on (1) the concept of the potential risk estimated by the hazard index for long-term tendency based on ALI (2) the concept of the relative dose factor related to the adsorbed migration rate transferred through ground water, and (3) the concept of the decay acceleration factor, the burning and/or transmutation characteristics for recycle B/T treatment. (author)

German emergency management concept

International Nuclear Information System (INIS)

Burkart, K.

1993-01-01

The advantages and disadvantages of the margin and start-up value concepts (according to ICRP 40 and EU-ordinances) are explained, and it is demonstrated that the two concepts are combinable. The combined concept has the advantage of immediately providing, if required, intervention levels for the various measures to be taken, and of obliging those persons concerned with emergency protection to study and quantify, already at the planning stage, the influence of a range of accident conditions on the decision on measures. In this context, the use of computerized decision support systems which are currently being developed is indispensable. (orig./DG) [de

[Oligometastasized colorectal cancer-modern treatment strategies].

Science.gov (United States)

Binnebösel, M; Lambertz, A; Dejong, K; Neumann, U P

2018-06-05

The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.

Difficulties of learning probability concepts, the reasons why these concepts cannot be learned and suggestions for solution

Directory of Open Access Journals (Sweden)

Dilek Sezgin MEMNUN

2008-06-01

Full Text Available Probability holds the first place among the subjects that both teachers and students have difficulty in handling. Although probability has an important role in many professions and a great many decisions we make for our daily lives, the understanding of the probability concepts is not an easy ability to gain for many students. Most of the students develop perception about lots of probability concepts and they have difficulty finding a reason for probability events. Thus, in the present study, the difficulties faced while learning probability concepts and the reasons why these concepts cannot be learned well are investigated, these reasons are tried to be put forward, and some suggestions for solutions regarding these concepts are presented. In this study, cross-hatching model was used. National and international studies on the subject of probability are investigated, the reasons why these concepts cannot be learned were categorized in the light of findings obtained, and the reasons why these concepts cannot be learned and taught are tried to be discovered. The categorization was displayed with Ishikawa diagram. In the diagram, the reasons why these concepts cannot be learned were noted as six categories. These categories were age, the insufficiency of advanced information, the deficiency of argumentation ability, teacher, error in concept, and students’ negative attitudes.

The Concept of Extraordinary Crime in Indonesia Legal System: is the Concept an Effective Criminal Policy?

OpenAIRE

Prahassacitta, Vidya

2016-01-01

The concept of extraordinary crime was a common concept in Indonesia. Adopts from the concept of the most serious crime in Rome Statute and adjusted with the Indonesian legal system. Then it developed wider and introduced into terrorism, corruption, drug abuse offenses, and child sexual abuse in legislations and Constitutional Court verdicts. The implementation of this concept generated some consequences in drafting and formulating the legislation as part of penal policy. This leads to two le...

Self-concept of children with cerebral palsy measured using the population-specific myTREEHOUSE Self-Concept Assessment.

Science.gov (United States)

Cheong, Sau Kuan; Lang, Cathryne P; Johnston, Leanne M

2018-02-01

Self-concept is an individual's perception of him/herself. Research into the self-concept of children with cerebral palsy (CP) has been sparse due to the lack of a population-specific self-concept instrument. Using the new myTREEHOUSE Self-Concept Assessment, this study investigated the self-concept of children with CP in relation to age, gender, motor, communication and cognitive function. Children with CP aged 8-12 years (n = 50; 29 males; mean 10 years 2 months; GMFCS-E&R I = 36, II = 8, III = 5, IV = 1) completed myTREEHOUSE and a standardised intelligence measure. Most children reported positive self-concept from all three myTREEHOUSE Performance Perspectives and over half (60%) fell within the Low range for the Personal Concern Score. Self-concept was not associated with age, gender, motor function, or communication function. However, for cognitive function, associations were observed for Social Skills (Below Average > Average cognitive function; Cohen's d = 1.07) and Learning Skills (Above Average > Average cognitive function; Cohen's d = 0.95) domains when rated from a Personal Performance Perspective. As the first study of the self-concept of children with CP using a CP-specific assessment, this study offers important insights into what children with CP think about themselves. Generally, the self-concept of children with CP was sound. Future research on environmental facilitators and barriers to robust self-concept development is recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Retrospective Report on the 7-Years Clinical and 5-Years Radiographic Outcomes.

Science.gov (United States)

Lopes, Armando; Maló, Paulo; de Araújo Nobre, Miguel; Sánchez-Fernández, Elena; Gravito, Inês

2017-04-01

There is a necessity of studies documenting the long-term outcome of full-arch flapless rehabilitations. To evaluate the 7 years implant and prosthesis survival rate and 5-years marginal bone loss of full-arch fixed prosthetic rehabilitations supported by implants in immediate function with the All-on-4 ® treatment concept using a computer guided surgical protocol (NobelGuide ® , Nobel Biocare). This retrospective clinical study included 111 edentulous patients (n = 53 bruxers; n = 21 smokers; n = 59 systemically compromised), rehabilitated between February 2005 and November 2010 with 532 implants with the All-on-4 ® treatment concept using NobelGuide ® . Outcome measures were implant and prosthesis survival, marginal bone loss at 5-years and the incidence of mechanical and biological complications. Survival was calculated using life-table analysis. Inferential analysis was performed to compare the difference in marginal bone loss between axial and tilted implants. Sixteen patients were lost to follow-up. The implant cumulative survival rate was 94.5% at 7 years. Prosthetic survival was 97.8% (n = 3 prosthetic failures). The average (standard deviation) marginal bone loss at 5 years was 1.3 mm (1.06 mm) overall, 1.27 mm (1.02 mm) for tilted implants and 1.34 mm (1.1 mm) for axial implants (p < .001). Ninety-one patients experienced complications in the provisional prostheses (n = 47 patients who were bruxers; n = 25 patients with implant-supported rehabilitation as opposing dentition) ranging from prosthetic fracture (n = 66 patients) to abutment or prosthetic screw loosening (n = 74 patients). Thirty-three patients experienced complications in the definitive prostheses (all exclusive to patients who were bruxers or had implant-supported rehabilitations as opposing dentition) ranging from acrylic-resin prosthetic/crown fracture (n = 23 patients) to abutment or prosthetic screw loosening (n = 10 patients). Twenty

The concept of collaborative health.

Science.gov (United States)

Sandberg, Håkan

2010-11-01

Based on empirical research about teamwork in human service organizations in Sweden, the concept of collaborative health (CH) encapsulates the physical, psychological and social health resources the individual uses in teamwork; resources which at the same time are influenced by the teamwork. My argument built on empirical research leading up to identifying and defining the core concept in this article, is that teamwork affects team members' health and this in turn affects the teamwork and its outcome. In this paper collaborative health is viewed from a social constructionism perspective and discussed in relation to earlier concepts developed in social psychology and working life research, including psychosocial stress and burnout. The paper also introduces the concept of functional synergy, which in this context is defined as the simultaneous presence of sharp goal-orientation and synergy in teamwork. The need for a holistic team theory is emphasized as a tool in research on teamwork. Such a theory relies on identifying sound and illuminating constituent concepts. I suggest that collaborative health could be a useful concept for better understanding the complex collaborative and co-operative teamwork of human service organizations of today.

The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

Energy Technology Data Exchange (ETDEWEB)

Becker, C.D.; Poletti, P.A. [Diagnostic and Interventional Radiology, Geneva Univ. Hospital (Switzerland)

2005-11-15

The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

International Nuclear Information System (INIS)

Becker, C.D.; Poletti, P.A.

2005-01-01

The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

Reactor concepts for laser fusion

International Nuclear Information System (INIS)

Meier, W.R.; Maniscalco, J.A.

1977-07-01

Scoping studies were initiated to identify attractive reactor concepts for producing electric power with laser fusion. Several exploratory reactor concepts were developed and are being subjected to our criteria for comparing long-range sources of electrical energy: abundance, social costs, technical feasibility, and economic competitiveness. The exploratory concepts include: a liquid-lithium-cooled stainless steel manifold, a gas-cooled graphite manifold, and fluidized wall concepts, such as a liquid lithium ''waterfall'', and a ceramic-lithium pellet ''waterfall''. Two of the major reactor vessel problems affecting the technical feasibility of a laser fusion power plant are: the effects of high-energy neutrons and cyclical stresses on the blanket structure and the effects of x-rays and debris from the fusion microexplosion on the first-wall. The liquid lithium ''waterfall'' concept is presented here in more detail as an approach which effectively deals with these damaging effects

Risk Factors Influencing Conception Rate in Holstein Heifers before Artificial Insemination or Embryo Transfer

Directory of Open Access Journals (Sweden)

M. Yusuf

2016-12-01

Full Text Available The objective of this study was to show the risk factors affecting the conception rate in Holstein heifers after synchronization of estrus. A total of 275 Holstein heifers housed in a free barn were used for the experiment. The herd was visited regularly at four week intervals for synchronization of estrus using Heatsynch and CIDR-Heatsynch protocols. A group of four to 14 animals, depending on the availability, were referred to the experiment at each visit. Estrus induction rates in the two protocols were 93.9% and 94.9%, respectively. There was no difference in the conception rate between the two protocols. Conception rate after artificial insemination (AI or embryo transfer (ET were 46.3% and 51.4%, respectively. The risk factors affecting conception rate in heifers were daily weight gain (odds ratio [OR]= 4.673; P= 0.036 and body condition score (BCS (OR= 3.642; P= 0.018. Furthermore, estrus synchronization protocol (OR= 1.774; P= 0.083 and the absence of corpus luteum (CL at the initiation of treatment (OR= 0.512; P= 0.061 had a tendency to affect the conception rate, while age (OR= 0.715; P= 0.008 was a protective factor to conception rate.  In conclusion, positive daily weight gain before AI or ET, higher BCS, younger age, and the presence of CL at the initiation of estrus synchronization in dairy heifers increased the likelihood to conceive.

Sexual Self-concept and Its Relationship to Depression, Stress and Anxiety in Postmenopausal Women.

Science.gov (United States)

Heidari, Mohammad; Ghodusi, Mansureh; Rafiei, Hossein

2017-04-01

Women in menopause have the more mood swings than before menopause. At the same time seem to sexual self-concept and sexual aspects of self-knowledge has a great impact on their mental health. This study aimed to investigate the sexual self-concept and its relationship to depression, stress and anxiety in postmenopausal women's. In this descriptive correlation research, 300 of postmenopausal women referred to healthcare and medical treatment centers in Abadeh city were selected by convenience sampling method. The information in this study was collected by using questionnaires of multidimensional sexual self-concept and depression anxiety stress scale 21 (DASS-21). For data analysis, SPSS/17 software was used. The results showed the mean score positive sexual self-concept was 41.03 ± 8.66 and the average score of negative sexual self in women's was 110.32 ± 43.05. As well as scores of depression, stress, and anxiety, 35.67%, 32.33% and 37.67% respectively were in severe level. Positive and negative sexual self-concept scores with scores of stress, anxiety, and depression, of post-menopausal women in the confidence of 0.01, is significantly correlated ( P stress, anxiety, and depression in severe level and also a significant correlation between increased stress, anxiety and depression with negative and weak self-concept of women's, it is necessary to devote more careful attention to mental health issues of women's and have appropriate interventions.

[Self esteem : concept analysis.

Science.gov (United States)

Doré, Christina

2017-06-01

Self-esteem is an inner attitude at the base of the construction of personality and psychic balance in addition to be responsible of adaptive processes over the course of life. The concept of self-esteem is commonly used in several disciplines however, it seems that the consensus on its conceptualization and its operationalization is not yet reached. In this context, the concept analysis allows to address a phenomenon and to understand its use and its evolution from a unique disciplinary perspective. The aim of this article is therefore to analyze the concept of self esteem from a nursing perspective to identify : definitions of the term and related terms, attributes, model and limit cases proposed here within the community of mental health nurses, antecedents and consequents as well as the empirical references using the Walker and Avant method. The attributes identified allowing a deeper understanding of the concept are : the self-value, the self-acceptance, the self-efficacy, attitude towards oneself and finally, self-respect.

An examination of the development and meaning of goodwill and the possibility of achieving a synthesis between its legal and accounting concepts

OpenAIRE

Tregoning, Ian Hamilton

2017-01-01

This paper addresses the topic of goodwill and the possibility of achieving a synthesis between its legal and accounting concepts. The genesis for this topic was the assertion by the High Court in FCT v. Murry that the legal and accounting concepts of goodwill were different to the extent that a synthesis between the concepts could not be achieved. The approach taken involves an examination of the evolution, nature and treatment of goodwill in both the legal and accounting contexts. The ...

The complex patient: A concept clarification.

Science.gov (United States)

Manning, Eli; Gagnon, Marilou

2017-03-01

Over the last decade, the concept of the "complex patient" has not only been more widely used in multidisciplinary healthcare teams and across various healthcare disciplines, but it has also become more vacuous in meaning. The uptake of the concept of the "complex patient" spans across disciplines, such as medicine, nursing, and social work, with no consistent definition. We review the chronological evolution of this concept and its surrogate terms, namely "comorbidity," "multimorbidity," "polypathology," "dual diagnosis," and "multiple chronic conditions." Drawing on key principles of concept clarification, we highlight disciplinary usage in the literature published between 2005 and 2015 in health sciences, attending to overlaps and revealing nuances of the complex patient concept. Finally, we discuss the implications of this concept for practice, research, and theory. © 2017 John Wiley & Sons Australia, Ltd.

Improving biogas yields using an innovative pretreatment concept for conversion of the fiber fraction of manure

DEFF Research Database (Denmark)

Biswas, Rajib; Uellendahl, Hinrich; Ahring, Birgitte Kiær

A new concept to enable economically feasible operation of manure based biogas plants was tested in lab-scale. Wet explosion (WEx) was implemented as treatment of the residual manure fibers separated after the anaerobic digestion process for enhancing the biogas production before reintroducing...

Social Accountable Medical Education: A concept analysis.

Science.gov (United States)

Abdolmaleki, Mohammadreza; Yazdani, Shahram; Momeni, Sedigheh; Momtazmanesh, Nader

2017-07-01

Considering the pervasiveness of social accountable medical education concept around the world and the growing trend of literature in this regard as well as various interpretations made about this concept, we found it necessary to analyze the concept of social accountable medical education. In this study, the modified version of McKenna's approach to concept analysis was used to determine the concept, explain structures and substructures and determine the border concepts neighboring and against social accountability in medical education. By studying the selected sources,the components of the concept were obtained to identify it and express an analytic definition of social accountability in medical education system. Then, a model case with all attributes of the given concept and the contrary and related concepts were mentioned to determine the boundary between the main concept and auxiliary ones. According to the results of this study in the field of social accountability, the detailed and transparent analytical definition of social accountable medical education can be used in future studies as well as the function and evaluation of medical education system.

Targeting Endothelial Adhesion Molecule Transcription for Treatment of Inflammatory Disease: A Proof-of-Concept Study

Directory of Open Access Journals (Sweden)

Liam M. Ashander

2016-01-01

Full Text Available Targeting the endothelial adhesion molecules that control leukocyte trafficking into a tissue has been explored as a biological therapy for inflammatory diseases. However, these molecules also participate in leukocyte migration for immune surveillance, and inhibiting the physiological level of an adhesion molecule might promote infection or malignancy. We explored the concept of targeting endothelial adhesion molecule transcription during inflammation in a human system. Intercellular adhesion molecule 1 (ICAM-1 mediates leukocyte migration across the retinal endothelium in noninfectious posterior uveitis. We observed an increase in the transcription factor, nuclear factor of kappa light polypeptide gene enhancer in B-cells 1 (NF-κB1, in parallel with ICAM-1, in human retinal endothelial cells treated with tumor necrosis factor-alpha (TNF-α, and identified putative binding sites for NF-κB1 within the ICAM-1 regulatory region. We targeted induced NF-κB1 expression in endothelial cells with small interfering (siRNA. Knockdown of NF-κB1 significantly decreased cell surface expression of ICAM-1 protein induced by TNF-α but did not reduce constitutive ICAM-1 expression. Consistently, NF-κB1 knockdown significantly reduced leukocyte binding to cell monolayers in the presence of TNF-α but did not impact baseline binding. Findings of this proof-of-concept study indicate that induced transcription of endothelial adhesion molecules might be targeted therapeutically for inflammatory disease in humans.

Zero energy Tunnel-concept

NARCIS (Netherlands)

Dzhusupova, R.

2012-01-01

Creating a zero energy environment is a hot topic. The developments in this field are based on the concept of the "Trias Energetica": reducing energy consumption, using renewable energy sources, and efficiently using fossil fuels. A zero energy concept can also be applied to road tunnels to improve

Suicide Lethality: A Concept Analysis.

Science.gov (United States)

DeBastiani, Summer; De Santis, Joseph P

2018-02-01

Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.

Non-extraction treatment of a Class III skeletal case.

Science.gov (United States)

Gonzalez, Bulmario

2009-01-01

Adult Class III Skeletal treatment options have generally included some form of surgery (Maxillary advancement in midface deficient cases and/or Mandibular set-back). This article discusses non-surgical treatment of an adult patient using the combined concepts of mandibular molar distalization enhanced with TADs and non-extraction camouflage dental correction through maxillary incisor protraction and mandibular incisor lingualization.

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: Current concepts' review

NARCIS (Netherlands)

T. Schepers (Tim); P. Patka (Peter)

2009-01-01

textabstractIntroduction: A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the different

Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts' review

NARCIS (Netherlands)

Schepers, T.; Patka, P.

2009-01-01

A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the different percutaneous distractional

Time Concepts for Elementary School Children.

Science.gov (United States)

Muir, Sharon Pray

1990-01-01

Points out that children have difficulty learning time concepts. Presents instructional activities for concepts associated with clocks, calendars, and chronology. Outlines Jerome Bruner's three different stages of representation for each concept: enactive, iconic, and symbolic. (DB)

Concept of grouping in partitioning of HLW for self-consistent fuel cycle

International Nuclear Information System (INIS)

Kitamoto, A.; Mulyanto

1993-01-01

A concept of grouping for partitioning of HLW has been developed in order to examine the possibility of a self-consistent fuel recycle. The concept of grouping of radionuclides is proposed herein, such as Group MA1 (MA below Cm), Group MA2 (Cm and higher MA), Group A ( 99 Tc and I), Group B (Cs and Sr) and Group R (the partitioned remain of HLW). Group B is difficult to be transmuted by neutron reaction, so a radiation application in an industrial scale should be developed in the future. Group A and Group MA1 can be burned by a thermal reactor, on the other hand Group MA2 should be burned by a fast reactor. P-T treatment can be optimized for the in-core and out-core system, respectively

Effect of Modeling Instruction on Concept Knowledge Among Ninth Grade Physics Students

Science.gov (United States)

Ditmore, Devin Alan

A basic knowledge of physics concepts is the gateway to success through high-paying careers in science, technology, engineering, and mathematics (STEM). Many students show little understanding of concepts following traditional physics instruction. As an alternative to current lecture-based approaches for high school physics instruction, Piaget's theory of cognitive development supports using real scientific experiences to lead learners from concrete to formal understanding of complex concepts. Modeling instruction (MI) is a pedagogy that guides learners through genuine scientific experiences. This project study analyzed the effects of MI on 9th grade physics students' gains on the test measuring mastery of physics concepts, Force Concept Inventory (FCI). A quasi-experimental design was used to compare the FCI scores of a traditional lecture-taught control group to a treatment group taught using MI. A t test t(-.201) = 180.26, p = .841 comparing the groups and an analysis of variance F(2,181) = 5.20 comparing female to male students indicated MI had no significant positive effect on students. A partial eta squared of the effect size showed that 5.4% of the variance in FCI gains was accounted for by gender, favoring female participants for both groups. The significant relationship between content and gender bears further inquiry. A lesson plan guide was designed to help teachers use computer simulation technology within the MI curriculum. The project promotes positive social change by exploring further ways to help adolescents experience success in physics at the beginning of high school, leading to future success in all STEM areas.

Health Habit: A Concept Analysis.

Science.gov (United States)

Opalinski, Andra S; Weglicki, Linda S; Gropper, Sareen S

2018-01-01

The aim of this article is to provide clarity of the concept of health habit. Using Walker and Avant's (1983; 2010) method for conducting a concept analysis, the authors identify the attributes and characteristics of health habit, its theoretical and practical application to nursing, and sample cases to further illustrate the concept. Empirical and conceptual literature was used to inform this concept analysis. Articles and one book from 1977 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing Health Literature (CINAHL), Science Direct, EBSCOhost and Web of Science. Offering a clear definition and conceptual model of health habit provide the foundation to identify/develop appropriate measures of the concept and guide further investigation of understanding the development and sustainability of healthy habits. Additional research is needed to test the conceptual relationships between health habits and outcome variables as they apply to different groups across the age continuum. © 2017 Wiley Periodicals, Inc.

The target volume concept at the recording of external beam radiotherapy

International Nuclear Information System (INIS)

Quast, U.; Glaeser, L.

1981-01-01

With the aim of complete, exact and reproducible manual recording and documentation of external beam radiotherapy a concept is proposed providing treatment planning and recording related to space and time for target volumes of different order corresponding to Ist, IInd or IIIrd part of treatment course, regarding all dose limiting organs at risk. The record consists of the dosage plan for medical treatment planning, the treatment plan for physical dose distribution planning and the treatment record of absorbed doses delivered as well as a checklist for patient and machine set-up, and labels for intended actions during treatment development. A clear arrangement of the record form in logical order was found, demanding exact specification of target(s) and beam(s) and their relation in space and time; asking for verbal and graphical description of target volumes, organs at risk, patient positioning, beam portals and dose reference points in terms of patients' anatomy; emphasizing the most important medical data by marked areas and leaving enough empty space for additional data, remarks or comments. During several years of clinical use these record forms proved to be suitable for all cases of external beam therapy, for complex situations of target volumes and treatment-scheduling, for all treatment techniques and radiation qualities and for all ways of physical treatment planning. They can be extended to automatic treatment verification, monitoring and recording as well as to the application of in-vivo-measurements of absorbed doses. (orig.) [de

Prevalence and risk factors of periodontal disease among pre-conception Chinese women.

Science.gov (United States)

Jiang, Hong; Su, Yi; Xiong, Xu; Harville, Emily; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

2016-12-01

Periodontal disease is one of the most common chronic infectious diseases. It has been reported that periodontal disease is associated with various adverse pregnancy outcomes including preterm birth, low birth weight, and gestational diabetes mellitus. Given the fact that the treatment for periodontal disease during pregnancy was ineffective in improving pregnancy outcomes by most of studies, the pre-conception period has been put forward as a more optimal time. However, very few studies have reported the prevalence of periodontal disease among pre-conception women. This study aimed to examine the prevalence and risk factors of periodontal disease among Chinese pre-conception women. A survey was conducted among pre-conception women at the Maternal and Child Health Hospital, Changzhou, China between January 2012 and December 2014. A total of 987 pre-conception women were recruited for a full-mouth dental examination after providing informed consent. A dental examination was carried out by probing six sites per tooth using a manual UNC-15 probe and a recording form. The overall rate of periodontal disease among participants was 73.9% (729/987) (95% confidence interval (CI): 71.0-76.6%). Among women with periodontal disease, 48.0% of cases were mild, 50.9% were moderate and 1.1% were severe. Self-reported bleeding during tooth brushing was the only significant predictive factor for overall periodontal disease (adjusted odds ratio (aOR): 3.71, 95% CI: 2.24, 6.15, P periodontal disease (aOR: 5.17, 95% CI: 3.05, 8.79, P periodontal disease was found in pre-conception Chinese women. Women who have bleeding during tooth brushing could be at increased risk of periodontal disease, and might require further oral health care.

Integrated anaerobic and aerobic treatment of sewage

NARCIS (Netherlands)

Wang, K.

1994-01-01

This thesis describes results of investigations dealing with sequential concept of anaerobic-aerobic treatment of municipal wastewater. The main purposes of the study were 1) to develop a proper anaerobic hydrolytic pretreatment unit, consisting of a Hydrolysis Upflow Sludge Bed (HUSB-)

A quality framework for addiction treatment programs

NARCIS (Netherlands)

Nabitz, Udo; van den Brink, Wim; Walburg, Jan

2005-01-01

AIM: To identify and specify the structure and the elements of a quality framework for addiction treatment programs. METHOD: Concept mapping strategy was applied. In brainstorm sessions, 70 statements were generated and rated by 90 representatives of three stakeholder groups. Using multivariate

Alternative Conceptions: Turning Adversity into Advantage

Science.gov (United States)

Ferreira, Annalize; Lemmer, Miriam; Gunstone, Richard

2017-08-01

While a vast body of research has identified difficulties in students' understanding about forces and acceleration and their related alternative conceptions, far less research suggests ways to use students' alternative conceptions to enhance conceptual understanding of a specific fundamental concept. This study focused on distinguishing between students' conceptual understanding of the Newtonian concept of gravitational acceleration being the same for all objects and students' alternative conception that heavy objects fall faster. A multiple choice questionnaire was distributed to first year physics students for three consecutive years at a university in South Africa. The results indicate that changing the direction of motion and the physics quantity asked in paired questions revealed practically significant inconsistencies in students' reasoning and conceptions. This research contributes to the body of knowledge in proposing how the alternative conception of mass-related gravitational acceleration can be used in instruction to enhance conceptual understanding of the force-mass-acceleration relationship. Understanding of this relationship not only promotes conceptual understanding of the basic Newtonian concepts of the laws of motion which forms the critical foundation on which more advanced physics courses are built, but also contributes towards students' perception of physics as a set of coherent ideas applicable in all contexts.

Cationic polyacrylamide enhancing cellulase treatment efficiency of hardwood kraft-based dissolving pulp.

Science.gov (United States)

Wang, Qiang; Liu, Shanshan; Yang, Guihua; Chen, Jiachuan; Ni, Yonghao

2015-05-01

Cellulase treatment for decreasing viscosity and increasing Fock reactivity of dissolving pulp is a promising approach to reduce the use of toxic chemicals, such as hypochlorite in the dissolving pulp manufacturing process in the industry. Improving the cellulase treatment efficiency during the process is of practical interest. In the present study, the concept of using cationic polyacrylamide (CPAM) to enhance the cellulase treatment efficiency was demonstrated. This was mainly attributed to the increased cellulase adsorption onto cellulose fibers based on the patching/bridging mechanism. Results showed that the cellulase adsorption was increased by about 20% with the addition of 250 ppm of CPAM under the same conditions as those of the control. It was found that the viscosity decrease and Fock reactivity increase for the cellulase treatment was enhanced from using CPAM. The CPAM-assisted cellulase treatment concept may provide a practical alternative to the present hypochlorite-based technology for viscosity control in the industry. Copyright © 2015 Elsevier Ltd. All rights reserved.